50 research outputs found

    Laparoscopic Ist stage orchiopexy using antiadherent sheet for high abdominal testis

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    Abstract High undescended testes with short spermatic vessels are not treated with standard orchiopexy and are currently brought to scrotum prevalently after the section of spermatic vessels, according to the Fowler-Stephens procedure. The ischemic risk of that method is elevated and becomes unbearable in bilateral cases. In 2009 an original staged orchiopexy technique was proposed to elongate the whole cord with anti-adherent sheet preserving the spermatic vessels by which a normal scrotal position was successfully gained without any testis loss. Both stages were performed through inguinotomy. In the present article the successful procedure is updated with implementation of laparoscopy in the first stage in a case of extremely high bilateral 4a type abdominal testis. Laparoscopic access was confirmed as valuable both in terms of extended mobilization and coverage of the entire testis vascular supply. The method of progressive cord elongation by using an anti-adherent sheet avoids the excessive atrophy hazard deriving from the Fowler-Stephens procedure in bilateral high abdominal 4a type testes; based on our findings, the latter can benefit also of a laparoscopic approach in the first stage

    Left atrial strain in patients with β-thalassemia major: a cross-sectional CMR study

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    Objectives The aim of this cross-sectional study was to investigate the association of left atrial (LA) strain parameters with demographics, clinical data, cardiovascular magnetic resonance (CMR) fndings, and cardiac complications (heart failure and arrhythmias) in a cohort of patients with β-thalassemia major (β-TM). Materials and methods We considered 264 β-TM patients (133 females, 36.79 ± 11.95 years) consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia (E-MIOT) project. Moreover, we included 35 sex- and agematched healthy controls (14 females, mean age 37.36 ± 17.52 years). Reservoir, conduit, and booster LA functions were analysed by CMR feature tracking using dedicated software. Results Compared to the healthy control group, β-TM patients demonstrated lower LA reservoir strain and booster strains, as well as LA reservoir and booster strain rates. However, no diferences were found in LA conduit deformation parameters. In β-TM patients, ageing, sex, and left ventricle (LV) volume indexes were independent determinants of LA strain parameters. The number of segments with late gadolinium enhancement (LGE) signifcantly correlated with all LA strain parameters, with the exception of the LA conduit rate. Patients with cardiac complications exhibited signifcantly impaired strain parameters compared to patients without cardiac complications. Conclusion In patients with β-TM, LA strain parameters were impaired compared to control subjects, and they exhibited a signifcant correlation with the number of LV segments with LGE. Furthermore, patients with cardiac complications had impaired left atrial strain parameters. Clinical relevance statement In patients with β-thalassemia major, left atrial strain parameters were impaired compared to control subjects and emerged as a sensitive marker of cardiac complications, stronger than cardiac iron levels

    Redox status assessment in infertile patients with non‐obstructive azoospermia undergoing testicular sperm extraction: A prospective study

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    AbstractBackgroundOxidative stress (OS) is one of the most prevalent causes of sperm damage, through the toxic effects of endogenously generated hydrogen peroxide, superoxide anion, and hydroxyl radicals. Peripheral leukocytes represent a feasible model for studying the pathophysiology of OS‐mediated homeostasis, which can be responsible for cell dysfunction and cell injury.ObjectiveTo evaluate the redox status in patients with non‐obstructive azoospermia (NOA), establishing the potential role exerted by reactive oxygen species (ROS) in the genesis of testicular secretory injury.Material and methodsFrom May 2018 to March 2019, 39 patients were enrolled in this prospective single‐center cohort study and divided into two groups. Group 1 included 19 patients with NOA, and Group 2 included 20 normozoospermic men, partners of women with infertility tubal factor. All patients underwent serum blood tests. NOA underwent testicular sperm extraction (TeSE). ROS production (in lymphocytes, monocytes, and granulocytes) was assessed by fluorescence‐activated cell sorting (FACS) analysis. Plasma oxidative stress was evaluated by lipid peroxidation markers (MDA) and total antioxidant capacity (TAC) both assessed by fluorometric techniques.ResultsMean lymphocyte ROS production resulted 967.0 ± 224.5 vs 728.0 ± 98.0 (NOA vs Controls, P .05).ConclusionROS production can be directly related to disorders of spermatogenesis, leading to severe conditions of male infertility, including azoospermia

    Combined digital and standard methods to optimize nitrogen (N) management and reduce N surplus in winter wheat (T. aestivum) production

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    Precision agriculture practices have the potential to support the transition towards more resource efficient and productive agriculture while at the same time reducing the negative impact on the environment. The process is supported by agronomical and environmental data that can be collected through a multitude of sensors, which allow monitoring crop growth in the field and nutrient availability from the soil in real-time and at high spatial and temporal resolution. Wheat is one of the three most cultivated crops globally, with about 750 Mt year−1 production and the most cultivated cereal crop in Europe and Switzerland. At the same time, the nitrogen use efficiency (NUE) in wheat cultivation (and other crops) is relatively low in Europe and globally, with values between 30% and 70%, whereas an optimal NUE should be about 80–90% to balance a low N surplus with a low risk of soil N depletion. Nitrogen (N) is often the most limiting nutrient for plant growth and accounts for most fertilizer applied in agriculture to promote high yield. The inaccurate use of N fertilizers globally and in Switzerland causes some of the major environmental and health problems related to agricultural crop production, namely the emission of greenhouse gas nitrous oxide (N2O) to the atmosphere and nitrate leaching (NO3 – ) into groundwater. Furthermore, the sources of N available to the plant during the season are affected by the natural spatial variability at field scale and the timely synchronization between N inputs from fertilization and crop N demand. The concept of observing, measuring, and responding to inter- and intra-field variability in crops during the season is known as site-specific N management. This thesis's objective was to develop and test a combination of digital and standard methods to provide decision-support for N fertilization in winter wheat production in Switzerland. The basic idea is that monitoring the agro-ecosystem's dynamic processes leads to a more automated quantification of the N balance, including the N supplied by the soil system. By precisely estimating the required, additional N input in relation to the expected N outputs, a better-informed N management would result in increased N use efficiency and reduced risk of N emission to the environment. This thesis's central hypothesis was that the implementation of site-specific N fertilization using variable rate (VR) technology would reduce average N application compared to the standard (ST) uniform application without affecting yield, thus increasing N use efficiency and reducing the risk of N surplus. The methods established were based on sensor data such as multi-spectral images and soil properties combined with standard plant and soil analysis. The experimental setup consisted of a multi-plot design with two treatments (VR and ST) and two controls (no fertilizer and additional fertilizer) in seven fields over three years (2018–2020) for a total of seven site-years (F1–F7) located in northeast Switzerland.ii Wheat was monitored throughout the season to support three split fertilizer applications. The combined imaging and ground truth plant data were used to validate the sensitivity of spectral vegetation indices, suitable for the sensor used, with biomass and N status traits. Grain yield was mainly in the expected range (6–7 t ha−1), and no significant difference between VR and ST was observed. In contrast, N fertilizer application was reduced in the VR treatments between 5 and 40%, depending on the field. In most site-years, N use efficiency was improved (13% on average) by redistributing and reducing the amount of N fertilizer applied. However, a better prediction of N mineralization in the soil and related N uptake by the plants was necessary to further optimize in season N fertilization. To better understand the relation between the components of the N balance and crop growth, part of the study concentrated on the ST treatment of six site-years (F2–F7). Two indicators were tested to link the weekly remote sensing-based monitoring of N uptake and nitrate-N dynamics in soil pore water measured with suction cups and an ion-selective electrode. The N balance was calculated and compared with the fertilization recommended by the adjusted N fertilization norm (ANFN) a good practice to determine N fertilizer requirement in Switzerland. The remotely estimated Nuptake (REN) allowed high temporal resolution N monitoring. The changes in nitrate-N in the soil solution (NSS) could be monitored weekly. The REN and NSS showed a distinct relationship for high- and low yielding fields. The timely integration of both was related to improved NUE and reduced N surplus. For Swiss wheat production, NUE can be increased and surpluses reduced with the ANFN method. A concept was developed to assess the economic and environmental performance of the two treatments VR and ST. The N balance was linked to the economic optima. This relation was used to calculate N fertilizer's price that would need to be charged to maximize revenues and minimize the risk of N surplus. On average, net revenues in VR were 4% (94 CHF ha−1) higher than in the ST treatment. The residual N was on average 32% (21 kg N ha–1 ) lower in VR compared to ST, due to a reduction in N inputs of 13% without significant yield differences. The economic optima ranged from 200 to 240 kg N ha–1 over the three years (2018–2020). The point where increasing N surplus occurs varied from 180 to 205 kg N ha–1 (2018–2020). The results imply that if N fertilizer's price increases by 20–40%, the gap between the economic optimum and the optimal N fertilization could be reduced. In conclusion, by monitoring and managing the variability observed in crop and soil, the established methods showed possible solutions to reduce N surplus in medium- to small-scale wheat production in Switzerland. Ultimately, the progress necessary to further improve wheat cultivation will rely on identifying genotypes and precision management practices better adapted to the changing environment. Sensor-based monitoring of agro-ecosystems can lead the way to these practices, aiming to maintain profitability, high yields, and quality, and reduce ecological impact by reducing emissions to the environment

    Characterisation of PHEMT intermodulation behaviour for highly linear MMIC power amplifier design

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    In this paper the intermodulation distortion (IMD) behaviour of a 0.25 power PHEMT is investigated under several device operating conditions. An extensive experimental device characterisation, together with numerical simulations using suitable non-linear transistor models is carried out. Experimental data were compared with different transistor models in order to understand the effect of the various cell parameters on the device IMD3 response. The data collected were applied in the design of a highly linear power amplifier family, covering different frequency ranges

    Predictor Variables for First Time Success on the National Physical Therapy Examination

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    The Federation of State Boards of Physical Therapy (FSBPT) administers the National Physical Therapy Examination (NPTE). A student who has graduated from an accredited physical therapy program must take and pass the examination to become a licensed physical therapist. The minimum score in order to be successful on the NPTE is a 600/800. Variables that predict first time success on the NPTE have been researched extensively to date. This literature review presents four studies aimed at identifying predictor variables for first time success on the NPTE

    Investigating two solutions to balance revenues and N surplus in Swiss winter wheat

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    CONTEXT Reducing N surplus from agriculture without compromising yield and quality requires economically and ecologically viable solutions. OBJECTIVE Based on field data, we investigated a technical and market-based solution to balance the economic and environmental performance of nitrogen (N) fertilizer application in winter wheat in Switzerland. METHODS The technical solution, i.e. variable rate (VR) technology, was compared to the standard uniform fertilizer application (ST) in terms of revenues and N balance over seven site-years between 2018 and 2020. The potential of a market-based solution to align revenues and N surplus was investigated based on the relationship between two indicators: the economic optimum (EO) of the revenues and the balanced N supply (BNS). The EO was estimated using a production function approach. The BNS was empirically defined as the point at which the N surplus estimated from total N input (N fertilizer + soil N supply) reaches a limit value of 30 kg N ha−1. RESULTS AND CONCLUSIONS On average, the revenues of VR were about 4% higher than in ST. The N surplus was, on average, 32% (21 kg N ha−1) lower in VR compared with ST due to a 13% reduction in N inputs with no significant differences in yield. Despite the differences across years and fields, VR appeared to be reducing N surplus without losses in revenues in 5 out of 7 site-years. The revenue curve reached an EO at total N input of 205, 249 and 246 kg N ha−1, in the years 2018, 2019, and 2020, respectively. The BNS was calculated at 220, 195, and 178 kg N ha−1 N inputs for the years 2018, 2019, and 2020, respectively. The results show that a price increase of up to 5.4 times the current fertilizer price through taxes would be necessary in order to reduce the N surplus to an environmentally friendly level. Such an increase would hardly be politically feasible. SIGNIFICANCE The reported data showed that VR technology appears as a viable solution for producing lower N surplus at comparable revenue levels, thereby making it an option for small- to medium-scale winter wheat production in Switzerland. The environmental benefit could encourage the financial support of technologies for precise N management, which are often too expensive for these systems. Future research should verify or extend the numeric values found in this study.ISSN:0308-521
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