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To expand the applications of hybrid fiber composites in structural engineering applications, it is essential to study their fatigue behavior. The tensile and fatigue performance of unidirectional hybrid basalt/glass epoxy composites made with vacuum‐assisted resin infusion molding are investigated in this research. The sequencing influence on tensile properties was assessed using the two configurations of basalt/glass fiber epoxy hybrid fiber composites, namely GBBBG and BGBGB, having nearly equal volume fractions. According to the test results, hybrid fiber composites showed a positive hybrid effect on their tensile strength. Both hybrid layups showed higher tensile strengths (3.5% to 10.5%) than GFRPs and BFRPs. The GBBBG laminate has slightly higher fatigue resistance than BGBGB laminate under tension–tension (T–T) fatigue. Scanning electron microscopy (SEM) images verify the fatigue failure modes, which include fiber, matrix cracking, delamination, and debonding. The DMA analysis showed the lower adhesion efficiency of hybrid fiber composites, signifying lower damping properties. Highlights: The basalt/glass fiber hybrid fiber composites were fabricated using VARIM.The static and fatigue properties of basalt/glass fiber hybrid fiber composites were studied.The stiffness degradation and hysteresis were calculated for the composites tested.The DMA was performed, and Tg, storage modulus, and adhesion efficiency factor were calculated. [ABSTRACT FROM AUTHOR]

This work compares the tensile and fatigue behavior of unidirectional glass fiber/epoxy (GFRPs) and basalt fiber/epoxy (BFRPs) composites manufactured using vacuum-assisted resin infusion molding (VARIM). The tensile and fatigue tests are performed, and results show that both GFRPs and BFRPs have very similar tensile behavior, whereas BFRPs perform better than the GFRPs in terms of fatigue life and degradation of properties, showing about 75 MPa more fatigue limit. The S-N curve shows that BFRPs resist fatigue failure and stiffness degradation due to their better interfacial adhesion. Fractographic observations reveal fatigue failure mechanisms of both BFRPs and GFRPs. From the regression analysis performed, an S-N curve was fitted with a model available in the literature, and regression parameters were calculated. Dynamic mechanical analysis of both BFRPs and GFRPs was performed to evaluate parameters like glass transition temperature, storage modulus, and loss modulus. From the findings of this research, BFRPs may be recommended as a suitable alternative to GFRPs. Highlights • This article compares the tension-tension fatigue properties of unidirectional GFRPs and BFRPs. • From the research work, the authors found that BFRPs perform better than GFRPs under fatigue loading. • The stiffness degradation behavior of GFRPs and BFRPs are studied and compared. • Scanning electron micrographs of fractured samples are used to observe fatigue failure mechanisms. • Dynamic mechanical analysis (DMA) was performed to determine the storage modulus, loss modulus, glass transition temperature, and damping coefficient (tand) for both composites. [ABSTRACT FROM AUTHOR]

Visual question answering (VQA) is a challenging task in computer vision. Recently, there has been a growing interest in text‐based VQA tasks, emphasizing the important role of textual information for better understanding of images. Effectively utilizing text information within the image is crucial for achieving success in this task. However, existing approaches often overlook the contextual information and neglect to utilize the relationships between scene‐text tokens and image objects. They simply incorporate the scene‐text tokens mined from the image into the VQA model without considering these important factors. In this paper, the proposed model initially analyzes the image to extract text and identify scene objects. It then comprehends the question and mines relationships among the question, OCRed text, and scene objects, ultimately generating an answer through relational reasoning by conducting semantic and positional attention. Our decoder with attention map loss enables prediction of complex answers and handles dynamic vocabularies, reducing decoding space. It outperforms softmax‐based cross entropy loss in accuracy and efficiency by accommodating varying vocabulary sizes. We evaluated our model's performance on the TextVQA dataset and achieved an accuracy of 53.91% on the validation set and 53.98% on the test set. Moreover, on the ST‐VQA dataset, our model obtained ANLS scores of 0.699 on the validation set and 0.692 on the test set. [ABSTRACT FROM AUTHOR]

In Visual question answering (VQA), a natural language answer is generated for a given image and a question related to that image. There is a significant growth in the VQA task by applying an efficient attention mechanism. However, current VQA models use region features or object features that are not adequate to improve the accuracy of generated answers. To deal with this issue, we have used a Two‐way Co‐Attention Mechanism (TCAM), which is capable enough to fuse different visual features (region, object, and concept) from diverse perspectives. These diverse features lead to different sets of answers, and also, there is an inherent relationship between these visual features. We have developed a powerful attention mechanism that uses these two critical aspects by using both bottom‐up and top‐down TCAM to extract discriminative feature information. We have proposed a Collective Feature Integration Module (CFIM) to combine multimodal attention features and thus capture the valuable information from these visual features by employing a TCAM. Further, we have formulated a Vertical CFIM for fusing the features belonging to the same class and a Horizontal CFIM for combining the features belonging to different types, thus balancing the influence of top‐down and bottom‐up co‐attention. The experiments are conducted on two significant datasets, VQA 1.0 and VQA 2.0. On VQA 1.0, the overall accuracy of our proposed method is 71.23 on the test‐dev set and 71.94 on the test‐std set. On VQA 2.0, the overall accuracy of our proposed method is 75.89 on the test‐dev set and 76.32 on the test‐std set. The above overall accuracy clearly reflecting the superiority of our proposed TCAM based approach over the existing methods. [ABSTRACT FROM AUTHOR]

Delayed gratification is an important focus of research, given its potential relationship to forms of behavior, such as savings, susceptibility to addiction, and pro-social behaviors. The COVID-19 pandemic may be one of the most consequential recent examples of this phenomenon, with people's willingness to delay gratification affecting their willingness to socially distance themselves. COVID-19 also provides a naturalistic context by which to evaluate the ecological validity of delayed gratification. This article outlines four large-scale online experiments (total N =12, 906) where we ask participants to perform Money Earlier or Later (MEL) decisions (e.g., $5 today vs. $10 tomorrow) and to also report stress measures and pandemic mitigation behaviors. We found that stress increases impulsivity and that less stressed and more patient individuals socially distanced more throughout the pandemic. These results help resolve longstanding theoretical debates in the MEL literature as well as provide policymakers with scientific evidence that can help inform response strategies in the future. [ABSTRACT FROM AUTHOR]

De-tubularised ileum is one of the most common segments used for augmentation cystoplasty. It is associated with complications such as metabolic disturbances, recurrent urinary tract infections, and stone formation. However, adenocarcinoma arising in an augmented bladder is a rare occurrence. We report a 37-year-old female, case of ileocystoplasty 25 years ago due to a thimble bladder (genitourinary tuberculosis) who presented with hematuria for one month. Cystoscopy showed bladder mass in the transposed ileal segments. The patient underwent transurethral resection of the bladder lesion, and the histopathology was suggestive of adenocarcinoma of the ileum. Subsequently, she underwent anterior pelvic exenteration and postoperative recovery was uneventful. The 6-month follow-up showed that the patient was asymptomatic without recurrence. In conclusion, even though adenocarcinoma in the ileal neobladder is rare, life-long with close follow-up with routine cytologic, radiologic, and cystoscopic evaluation for early cancer detection and treatment at an early stage is crucial. [ABSTRACT FROM AUTHOR]

Introduction: ureteral stents are used in managing various urological conditions. When these stents are left indwelling for a prolonged time, it results in complications like stent migration, fragmentation, and encrustation. The aim of this retrospective observational study is to analyse the incidence, risk factors, and morbidity associated with retained ureteral stents. Methods: the retained/forgotten ureteral stents were defined as the stents with an indwelling period of more than six months. The records of all such patients from January 2010 to January 2020 were retrospectively reviewed. The primary reason for the placement of a stent, total indwelling time, the reason for prolonged indwelling time, and part(s) of the stent encrusted were retrospectively reviewed. Single/multistage endourological procedures were used to make the patients remove the retained stents and stone free. The type, number of procedures, and total number of sessions needed were noted. Results: data of 114 patients was reviewed retrospectively. Most patients presented with abdominal pain (62 patients, 54.4%), and dysuria (41 patients, 35.1%). An average of 1.7 sessions (range 1-4) were needed to make the patients' stent and stone free. During these sessions, single/multiple procedures (endoscopic/open/combined) were performed. Nine patients (7.9%) had permanent loss of renal unit function and who needed a nephrectomy. Poor compliance (45.6%), unawareness (35.1%), and misconception that the stent would last a lifetime (12.3%), were the most common reasons for retained ureteral stents. The incidence rate of retained stents fell from 1.1% to 0.5% after the "three steps" prevention check method was in-cooperated to ensure timely follow-up of the patients. Conclusion: retained ureteral stents are a significant source of morbidity, which is avoidable by ensuring timely removal. Sincere efforts should be made to make patients aware of an indwelling foreign body. Prevention is the best strategy. [ABSTRACT FROM AUTHOR]

Cognitive fatigue and boredom are two phenomenological states that reflect overt task disengagement. In this article, we present a rational analysis of the temporal structure of controlled behavior, which provides a formal account of these phenomena. We suggest that in controlling behavior, the brain faces competing behavioral and computational imperatives, and must balance them by tracking their opportunity costs over time. We use this analysis to flesh out previous suggestions that feelings associated with subjective effort, like cognitive fatigue and boredom, are the phenomenological counterparts of these opportunity cost measures, instead of reflecting the depletion of resources as has often been assumed. Specifically, we propose that both fatigue and boredom reflect the competing value of particular options that require foregoing immediate reward but can improve future performance: Fatigue reflects the value of offline computation (internal to the organism) to improve future decisions, while boredom signals the value of exploration (external in the world). We demonstrate that these accounts provide a mechanistically explicit and parsimonious account for a wide array of findings related to cognitive control, integrating and reimagining them under a single, formally rigorous framework. [ABSTRACT FROM AUTHOR]

Traumatic dislocation of testis (TDT) is an uncommon event. During trauma, the cremasteric reflex can forcefully retract the testis out of the scrotal sac saving the testis from the injury. However, associated injuries in the form of skin degloving, penile avulsion, and amputation can be present. Early surgical intervention to locate and deposit the displaced testis to the scrotal sac is essential. We present a case of a 33-year-old man with bilateral congenital cryptorchidism who suffered blunt trauma to his genitalia following a road traffic injury. On presentation, based on a well-developed scrotum, it looked like a case of TDT. However, good history along with detailed physical and radiological evaluation helped us reach the correct diagnosis. TDT must be suspected in a case of blunt trauma to the genitalia when the scrotal sac (well-developed) is empty. This case report highlights the importance of detailed clinical and radiological evaluation in such cases. [ABSTRACT FROM AUTHOR]

Micron-scale robots require systems that can morph into arbitrary target configurations controlled by external agents such as heat, light, electricity, and chemical environment. Achieving this behavior using conventional approaches is challenging because the available materials at these scales are not programmable like their macroscopic counterparts. To overcome this challenge, we propose a design strategy to make a robotic machine that is both programmable and compatible with colloidal-scale physics. Our strategy uses motors in the form of active colloidal particles that constantly propel forward. We sequence these motors end-to-end in a closed chain forming a two-dimensional loop that folds under its mechanical constraints. We encode the target loop shape and its motion by regulating six design parameters, each scale-invariant and achievable at the colloidal scale. We demonstrate the plausibility of our design strategy using centimeter-scale robots called kilobots. We use Brownian dynamics simulation to explore the large design space beyond that possible with kilobots, and present an analytical theory to aid the design process. Multiple loops can also be fused together to achieve several complex shapes and robotic behaviors, demonstrated by folding a letter shape "M," a dynamic gripper, and a dynamic pacman. The material-agnostic, scale-free, and programmable nature of our design enables building a variety of reconfigurable and autonomous robots at both colloidal scales and macroscales. [ABSTRACT FROM AUTHOR]

Do large datasets provide value to psychologists? Without a systematic methodology for working with such datasets, there is a valid concern that analyses will produce noise artifacts rather than true effects. In this paper, we offer a way to enable researchers to systematically build models and identify novel phenomena in large datasets. One traditional approach is to analyze the residuals of models--the biggest errors they make in predicting the data--to discover what might be missing from those models. However, once a dataset is sufficiently large, machine learning algorithms approximate the true underlying function better than the data, suggesting, instead, that the predictions of these data-driven models should be used to guide model building. We call this approach "Scientific Regret Minimization" (SRM), as it focuses on minimizing errors for cases that we know should have been predictable. We apply this exploratory method on a subset of the Moral Machine dataset, a public collection of roughly 40 million moral decisions. Using SRM, we find that incorporating a set of deontological principles that capture dimensions along which groups of agents can vary (e.g., sex and age) improves a computational model of human moral judgment. Furthermore, we are able to identify and independently validate three interesting moral phenomena: criminal dehumanization, age of responsibility, and asymmetric notions of responsibility. [ABSTRACT FROM AUTHOR]

Finding examples where experimental measurements have been repeated is a powerful strategy for assessing reproducibility of scientific data. Here, we collect quantitative data to assess how often synthesis of a newly reported material is repeated in the scientific literature. We present a simple power-law model for the frequency of repeat syntheses and assess the validity of this model using a specific class of materials, metal-organic frameworks (MOFs). Our data suggest that a power law describes the frequency of repeat synthesis of many MOFs but that a small number of "supermaterials" exist that have been replicated many times more than a power law would predict. Our results also hint that there are many repeat syntheses that have been performed but not reported in the literature, which suggests simple steps that could be taken to greatly increase the number of reports of replicate experiments in materials chemistry. [ABSTRACT FROM AUTHOR]

• Spreading dynamics of a sessile viscoelastic drop on a horizontal surface is studied. • Simplified Phan–Thien–Tanner model represents the rheology of the viscoelastic drop. • Theoretical results are validated with our experimental results. • Elastic nature of the viscoelastic fluids reduces the spreading rate of the drop. We study the spreading dynamics of a sessile viscoelastic drop on a horizontal surface, where a simplified Phan–Thien–Tanner (sPTT) model is considered to represent the rheology of viscoelastic drop. We have adopted a macroscopic approach to obtain the temporal evolution of the spreading drop, while to establish the efficacy of the theoretical model, we have validated the results obtained from the mathematical formulation with the experimental results for both the Newtonian (Si-oil) and viscoelastic (PDMS and aqueous solution of CMC and glycerin) drops. Following the framework of Seaver–Berg approximation, the spherical shape of the drop is assumed as a cylindrical disk here. We observe from this study that an increment in the elasticity of the fluid enhances the velocity gradient and increases the viscous dissipation in the drop volume, leading to a reduction in the spreading rate. [ABSTRACT FROM AUTHOR]

• The white cane is the most common and widely used travel aid for the blind and its cost is not too much and many government hospitals provide for free to needy and poor people. • It's a great tool which helps blind people in detecting uneven surfaces, obstacles on ground, steps, holes and other hazard. • And which may lead to accidents. • The service animals (such as dogs, birds, miniature horses etc.) are good at dealing these types of situations but they are not easy to train and are very expensive. The white cane is the most common and widely used travel aid for the blind. Its cost is not too high and many government hospitals provide it for free to needy and poor people. It is a great tool that helps blind people detect uneven surfaces, obstacles on the ground, steps, holes, and other hazards. However, it has a major drawback in detecting obstacles that are beyond the range of the white cane, especially when the object is in motion. For example, when a blind person crosses the road, they may not be able to detect a car or person coming from either side (left and right), and it is not much help to the user when navigating through crowded places, which can lead to accidents. Service animals (such as dogs, birds, and miniature horses) are good at handling these types of situations, but they are not easy to train and are very expensive. This paper takes references from many papers and proposes a collision detection and prevention system made of integration of many technologies including image processing, cloud computing, machine learning, IoT and audio production devices, with better option for the blind people for navigating through roads and crowded places and using it along with white cane will make it more effective and will be able to cover some drawbacks of the device. [ABSTRACT FROM AUTHOR]

In contrast to the different approaches currently adopted for generating basic and side-split subcolumn distillation sequence for separating zeotropic multicomponent feed mixture, we present a unified graphical method applicable towards both basic and side-split subcolumn distillation sequence. For a given number of components in the feed mixture, we enforce constraints on a base graph to eliminate violations of conservation principles and to preclude distillation sequences that demand higher heat duty in all appraised practical scenarios. A compact set of algebraic constraints is transfixed using the graph counterpart for generating basic-only distillation configurations. These algebraic constraints utilize binary variables to quantify existence of submixture streams and this considerably reduces the number of variables in generating distillation sequences. We also suggest extension of the formulation to enable the exploration of thermally coupled configurations. [ABSTRACT FROM PUBLISHER]

A technoeconomic evaluation has been conducted by the US Department of Energy, for four conceptual photoelectrochemical (PEC) H2production systems namely, single-bed particle system, dual-bed particle system, PEC planar array system and PEC tracking solar concentrator system. The present work extends the analysis to capture solar energy in the vicinity of Indian oil refineries and generate H2at estimated costs of 42, 84, 281 and 85 in ₹/kg H2for the four systems, respectively. This includes the capital and operating costs involved if the PEC H2production plant is set up around these refineries. Employing PEC H2production systems obviate the CO2generated by conventional processes like steam reforming, and thereby earning carbon credits. Inclusion of such credits is found to increase the annual earnings of the four conceptual systems by 0.7–8% depending on the selling price of H2. The sensitivity analysis of various economic factors like payback time, H2price, carbon credit, efficiency of the system, etc., is performed which is useful in judging economics of the venture depending on the market variations in prices or rise in efficiency of the system or variable economic constraints of the investor. [ABSTRACT FROM PUBLISHER]

Purpose: The World Health Organisation has declared tuberculosis (TB) a global emergency and spinal tuberculosis is one of the most common forms. There is still controversy regarding optimum duration of treatment in osteoarticular tuberculosis due to the lack of well-defined criteria for the end point of treatment. Emergence of multi drug resistant tuberculosis, primarily due to use of poor drug regimens, further illustrates the need of newer and more effective diagnostic methods, particularly in developing countries. Methods: This prospective clinical study to evaluate the role of technetium (Tc)-ciprofloxacin scan as a tool to assess disease activity involved in 15 cases of TB spine with a mean age of 32.2 years (range 21-72). Following a clinico-radiological diagnosis, all patients were treated with standard anti tubercular treatment and a scan was done at zero, three and six months of treatment with tracer activity being recorded and compared in sequential scans along with a parallel evaluation of clinical and radiological profile at regular intervals. Results: Out of 15 cases, nine had an initially positive bone scan. Two patients (22%) converted to negative scans at three months, whereas the remaining seven (78%) turned negative at six months. The end of six months treatment was also accompanied by clinico-radiological resolution in all cases. Conclusion: In conclusion, technetium (Tc)-ciprofloxacin scan could be a promising tool for monitoring disease activity in selected cases of tuberculosis spine as an alternative for therapeutic drug monitoring; however, due to the small sample size, studies with a large number of patients might be of help in defining these cases in a better way. [ABSTRACT FROM AUTHOR]

In the evidence-based medicine era, objective treatment guidelines have been laid down for pulmonary tuberculosis, but the same is not true for osteoarticular tuberculosis. This has led to demands for standardising the treatment protocol and to a lack of consensus between doctors regarding the composition and duration of treatment. Twenty-five patients with extraspinal osteoarticular tuberculosis were evaluated prospectively. Following the diagnosis, patients were given standard directly observed treatment short course (DOTS) regimen and were monitored for disease activity at zero, three and six months with the help of technetium-99m-labelled ciprofloxacin ( Tc) scan. Tracer activity at the site was recorded and compared on sequential scans. Clinical and radiological profile of all the patients were also recorded at regular intervals and compared. All 25 cases had a positive Tc bone scan initially. Four patients (16%) converted to negative scans at three months, whereas the remaining 21 patients (84%) showed negative scans at six months. The end of six months therapy also coincided with resolution of clinical and radiological parameters in all cases. In conclusion, Tc scan is a promising tool for monitoring drug response in osteoarticular tuberculosis; however, due to the small sample size, studies with a large number of patients might be of help. [ABSTRACT FROM AUTHOR]

Intertrochanteric fracture is a common injury of increasing geriatric population. Dynamic hip screw (DHS) is one of the commonly used implants used for the internal fixation of intertrochanteric fractures. Use of standard plate by a minimally invasive technique is both possible and advantageous to patient outcome in these fractures by allowing a smaller incision, a shorter surgical time, decreased operative blood loss and less postoperative pain. All these factors in turn will reduce the duration of hospital stay and improve the healing and rehabilitation potential of the elderly patients. In this article, we describe a modification of standard technique for DHS fixation with a clinical follow-up of 40 consecutive cases, all having satisfactory outcome. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Dupatta (scarf) is a part of the traditional dress for females in the Indian subcontinent. Working near machinery, riding a motorcycle or cyclerickshaw, can result in entanglement of dupatta in moving parts of machinery and subsequent cervical spine injury. It is seen most commonly in rural areas, with farmyard equipment. Material and methods: A retrospective study was performed between January 2004 and January 2006, on all the patients presenting with cervical spine injury secondary to dupatta entanglement in machinery. They were assessed for mode, level of injury, neurological status, associated complications, radiological picture and clinical outcome. Results: There were 12 such cases of cervical spine injury. The most common cause of injury was a threshing machine. All cases except one had quadriplegia (ASIA grade A) with bladder and bowel involvement. There was loss of consciousness in nine patients. Three patients expired. There was no neurological recovery in any patient. Conclusion: Dupatta is a unique cause of cervical spine injury in females, especially in rural areas. Easy methods of prevention may be helpful in preventing such injuries. [Copyright &y& Elsevier]

Abstract: Background: Loss of dorsiflexion is a common problem in cases where an external fixator or Ilizarov assembly is applied. It results in functional impairment of the foot by affecting the swing phase of gait cycle. We devised a simple dynamic dorsiflexion assist splint for prevention, correction of equinus/cavus deformity and maintenance of normal dorsiflexion of foot. Methods: This prospective study used a rubber splint styled in the shape of a catapult, made of discarded car rubber tubes attached to the frame of fixator in 50 patients. Results: In 17 patients there was varying amount of loss of dorsiflexion at the time of application of splint while in 22 patients it was applied soon after the application of the fixator. In the rest of patients it was applied for cavus deformity. Out of 17 patients 10 had complete recovery of dorsiflexion. 22 patients in whom it was applied at the outset had normal range of movement at ankle. Correction was achieved in all 6 cases of cavus deformity and prevented its occurrence in the rest of 5 cases. Conclusion: Catapult splint is a low cost foot dorsiflexion assist splint. [Copyright &y& Elsevier]

Immobilization of lower limb following neurorrhaphy for sciatic nerve injuries poses a difficult clinical situation both for the surgeon and for the patient. In this article, we describe a new technique for maintenance of lower limb in desired position of extension at hip and flexion of knee without application of spica cast using an external fixator. In this method, a spanning external fixator across the knee and hip joint is applied in the desired position following neurorrhaphy, and both joints are sequentially brought back to normal position. Clinical follow-up of 2 cases is also presented with preservation of range of motion at hip and knee joint as well as good functional outcome of nerve repair. [ABSTRACT FROM AUTHOR]

Background: Persistent mullerian duct syndrome (PMDS) is a very rare form of internal male pseudohermaphroditism in individuals who are phenotypically males with 46 XY karyotypes harboring internal female reproductive organs which are Mullerian derivatives. It occurs as a defect in the genes coding for the Mullerian inhibiting substance (MIS) or the anti Mullerian hormone (AMH) receptor, ultimately leading to failure of regression of Mullerian ducts. Case Presentation: A 29-year-old male with PMDS presented with complaints of primary infertility. Diagnosis was made with the help of high index of suspicion, radiological imaging, and karyotyping. Our patient underwent exploratory laparotomy with hysterectomy and bilateral orchidopexy. Conclusion: The purpose of this study was increasing awareness regarding rare entities and surgeons should have high clinical suspicion of PMDS when patient with bilateral undescended testis comes for the evaluation of primary infertility. [ABSTRACT FROM AUTHOR]

Predicting and understanding how people make decisions has been a long-standing goal in many fields, with quantitative models of human decision-making informing research in both the social sciences and engineering. We show how progress toward this goal can be accelerated by using large datasets to power machine-learning algorithms that are constrained to produce interpretable psychological theories. Conducting the largest experiment on risky choice to date and analyzing the results using gradient-based optimization of differentiable decision theories implemented through artificial neural networks, we were able to recapitulate historical discoveries, establish that there is room to improve on existing theories, and discover a new, more accurate model of human decision-making in a form that preserves the insights from centuries of research. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to assess the results of tunica vaginalis flap (TVF), dorsal preputial dartos flap (DPF), and spongioplasty alone as additional cover after neourethra formation in a Snodgrass repair for various types of hypospadias as per the selection criteria decided. Material and methods: This was a non-randomized experimental study of 97 patients with primary hypospadias treated via Snodgrass repair using various second layers (tunica vaginalis flap, dorsal preputial dartos flap, and spongiosum alone) as per the selection criteria in a single center by a single surgeon. The outcome of the procedure was assessed in terms of cosmesis, chordee correction, urinary stream, and uroflowmetry. Results: Of the 97 patients, we used dorsal preputial dartos flap in 42 (43.3%), tunica vaginalis in 38 (39.2%), and spongioplasty only in 17 (17.5%) for primary hypospadias. Urethrocutaneous fistula developed in four patients (three in DPF and one in the TVF groups). One patient each had skin necrosis, hematoma, and wound dehiscence in the DPF group. In the spongioplasty only group, one patient had meatal stenosis which was treated by meatoplasty after failing repeated periodic calibration. Conclusion: DPF should be preferably used for distal penile and TVF for mid and proximal penile hypospadias to ensure excellent result with minimum complications. Spongioplasty only as a second layer is sufficient to avoid the complications wherever it is thick and robust. [ABSTRACT FROM AUTHOR]

The UiO-6x family of metal-organic frameworks has been extensively studied for applications in chemical warfare agent (CWA) capture and destruction. An understanding of intrinsic transport phenomena, such as diffusion, is key to understanding experimental results and designing effective materials for CWA capture. However, the relatively large size of CWAs and their simulants makes diffusion in the small-pored pristine UiO-66 very slow and hence impractical to study directly with direct molecular simulations because of the time scales required. We used isopropanol (IPA) as a surrogate for CWAs to investigate the fundamental diffusion mechanisms of a polar molecule within pristine UiO-66. IPA can form hydrogen bonds with the μ 3 -OH groups bound to the metal oxide clusters in UiO-66, similar to some CWAs, and can be studied by direct molecular dynamics simulations. We report self, corrected, and transport diffusivities of IPA in pristine UiO-66 as a function of loading. Our calculations highlight the importance of the accurate modeling of the hydrogen bonding interactions on diffusivities, with about an order of magnitude decrease in diffusion coefficients when the hydrogen bonding between IPA and the μ 3 -OH groups is included. We found that a fraction of the IPA molecules have very low mobility during the course of a simulation, while a small fraction are highly mobile, exhibiting mean square displacements far greater than the ensemble average. [ABSTRACT FROM AUTHOR]

Sports competitions and recreational activities are practiced by infants, kids, and teenagers for their physical and mental health. Unfortunately, engaging in sports increases the chance of suffering trauma to the mouth's delicate and hard tissues, including lacerations to the lips, various injuries to the gingiva, tongue, or mucosa, chipped, luxated, or avulsed teeth, maxillary or mandibular fractures. The importance of the dentistry profession in connection to the prevention of dental and other orofacial sporting injuries has increased due to the popularity of contact sports and the encouraging of participation at a young age. Inculcating the prevention, management, and treatment of oral and face injuries, sports dentistry is the newest and most promising area of dentistry. Dentists should make it a point to tell parents about the orofacial damage caused by sports and about the different preventive measures that are available. They should also have solid clinical understanding of sports-related dentofacial injuries. In this article, we go over the different facets of sports-related injuries as well as the risk factors that go along with them. [ABSTRACT FROM AUTHOR]

Objective To evaluate the role of 2 different α-1 blockers and 1 phosphodiesterase-5 inhibitor as medical expulsive therapy for distal ureteric calculi. Materials and Methods Between January 2011 and December 2012, 285 patients presenting with distal ureteric stones of size 5-10 mm were on consent randomly assigned to 1 of 3 outpatient treatment arms: tamsulosin (group A), silodosin (group B), and tadalafil (group C). Therapy was given for a maximum of 4 weeks. Stone expulsion rate, time to stone expulsion, analgesic use, number of hospital visits for pain, follow-up, and endoscopic treatment and adverse effects of drugs were noted. All 3 groups were compared for normally distributed data by the analysis of variance, Bonferroni or Kruskal-Wallis test, and Mann-Whitney U test, as required. All the classified and categorical data were analyzed for all 3 groups by using the chi-square test. Results There was a statistically significant expulsion rate of 83.3% in group B compared with 64.4% and 66.7% in groups A and C, respectively, with lower time of stone expulsion ( P value = .006 and P value = .016, respectively). Statistically significant differences were noted in colicky episodes and analgesic requirement in group B than groups A and C. There was no serious adverse event. Conclusion Medical expulsive therapy for the distal ureteric stones using tamsulosin, silodosin, and tadalafil is safe, efficacious, and well tolerated. The result of this pilot study showed that silodosin increases ureteric stone expulsion quite significantly along with better control of pain with significantly lesser analgesic requirement. [ABSTRACT FROM AUTHOR]

The conventional solar still is limited to a daily yield of approximately 2–3.5 kg/m2/day. To increase the yield, this study investigates experimentally the combined effects of latent and sensible energy storage together with magnetization. Paraffin and novel high-thermal conductivity nanomaterial (graphite plate) were used as latent and sensible heat storage materials, respectively. There was an overall increase of 62% and 235% in the daytime and night-time yield, respectively, giving a total yield of 5.5 kg/m2/day compared to 3.4 kg/m2/day for a conventional still. Enviro-economic parameters like emissions, CO 2 mitigation and carbon credit (CC) earned were also investigated. Energy matrices analysis and water quality checks were performed to estimate the energy-payback time, life cycle conversion efficiency (LCCE) and purity of desalinated water. The cost per liter of freshwater was found to be 3.7% cheaper than for a conventional still and 69% cheaper than bottled water in India. Over a 30 year period, 40.3 Tonnes of CO 2 will be mitigated contributing a CC and LCCE of $402 and 0.52, respectively. The proposed modified still is recommended as a substitute for conventional stills and stills with simple energy storage. [Display omitted] [ABSTRACT FROM AUTHOR]

Purpose: Video-assisted thoracoscopic surgery (VATS) has become an alternative tool for a variety of spinal conditions as this approach minimises much morbidity related to conventional thoracotomy. The purpose of this study was to determine the efficacy of VATS and its long-term results in patients with dorsal spinal tuberculosis. Materials and methods: This retrospective long-term follow-up study of VATS-assisted surgical treatment of dorsal spine tuberculosis included 30 patients with a mean age of 33.5 years (range 15-60). Patients with dorsal spine tuberculosis who were suitable surgical candidates for VATS underwent a three-portal thoracoscopy for decompression with/without fusion of the spine along with routine chemotherapy for tuberculosis (TB). Patients were assessed for blood loss, duration of surgery, postoperative incision pain, duration of hospital stay, neurological recovery, and progression of deformity. Patients were observed for a minimum of five years. Results: The mean duration of surgery was 158.8 min (range 90-220 min) with mean blood loss of 296.7 ml (range 200-450 ml). Complications were seen in ten patients. The mean follow-up was 80 months (range 60-90 months) with neurological improvement and return of ambulatory power in all patients at final follow-up. There was an average increase in kyphus angle by 7.5° at final follow-up and 95% of patients achieved an excellent or good subjective outcome. Conclusion: VATS-assisted surgical decompression can be a safe and effective technique for anterior debridement and fusion in tuberculosis of the dorsal spine to achieve neurological recovery with reduced morbidity, blood loss, and hospital stay compared to thoracotomy. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Improved Quality of Life After One Year With an Invasive Versus a Noninvasive Treatment Strategy in Claudicants: One-Year Results of the Invasive Revascularization or Not in Intermittent Claudication (IRONIC) Trial" by Joakim Nordanstig and colleagues that was published in the previous issue.

Purpose Pain is a comorbid and aggravating symptom that in many conditions can be perceived differently and should therefore be managed accordingly. Numerous factors, both social and cultural, are thought to influence the analgesic prescription. However, elucidation of such areas is limited. We therefore conducted a systematic literature review to test the hypothesis that variations in provider characteristics predict the prescription of pain medication. Methods A MEDLINE and Psyc INFO database search from 1960 to 2009 was conducted using the search terms of 'pain' or 'pain treatment' along with culture, ethnicity, race, minority, gender/sex, knowledge, attitudes, physician-patient relationship, stereotype, and physician practices. Twelve original research articles based on predefined inclusion criteria were identified and analyzed to test the hypothesis of provider characteristics influencing analgesics prescription. Results Of the 12 studies, 11 were cross-sectional in design, and 10 used a survey instrument or clinical vignettes to measure different pain management responses. A randomized sampling methodology was used in 5 of the studies. The majority of providers were male (64.9% in 8 studies), white (73.5% in 5 studies), internal medicine physicians (37.4% in 11 studies), and located in the United States (75% across all 12 studies). Ten studies identified at least one provider characteristic that influenced prescription practices; age, level of experience, as well as sex were listed most frequently as contributing factors. The interplay of the sex of the provider and patient characteristics were found to be important variables in pain management. Conclusions Our systematic review of existing literature highlights that provider's age, sex, experience, specialty, and the interplay between provider and patient characteristics are important variables in pain management. However, generalizations relating to these findings are limited by the heterogeneity of the studies and the paucity of literature in this field. [ABSTRACT FROM AUTHOR]

Purpose: Video-assisted thoracoscopic surgery (VATS) has become an alternative tool for a variety of spinal conditions as this approach minimises much morbidity related to conventional thoracotomy. The purpose of this study was to determine the efficacy of VATS and its long-term results in patients with dorsal spinal tuberculosis.Materials and Methods: This retrospective long-term follow-up study of VATS-assisted surgical treatment of dorsal spine tuberculosis included 30 patients with a mean age of 33.5 years (range 15-60). Patients with dorsal spine tuberculosis who were suitable surgical candidates for VATS underwent a three-portal thoracoscopy for decompression with/without fusion of the spine along with routine chemotherapy for tuberculosis (TB). Patients were assessed for blood loss, duration of surgery, postoperative incision pain, duration of hospital stay, neurological recovery, and progression of deformity. Patients were observed for a minimum of five years.Results: The mean duration of surgery was 158.8 min (range 90-220 min) with mean blood loss of 296.7 ml (range 200-450 ml). Complications were seen in ten patients. The mean follow-up was 80 months (range 60-90 months) with neurological improvement and return of ambulatory power in all patients at final follow-up. There was an average increase in kyphus angle by 7.5° at final follow-up and 95% of patients achieved an excellent or good subjective outcome.Conclusion: VATS-assisted surgical decompression can be a safe and effective technique for anterior debridement and fusion in tuberculosis of the dorsal spine to achieve neurological recovery with reduced morbidity, blood loss, and hospital stay compared to thoracotomy. [ABSTRACT FROM AUTHOR]

Purpose: The World Health Organisation has declared tuberculosis (TB) a global emergency and spinal tuberculosis is one of the most common forms. There is still controversy regarding optimum duration of treatment in osteoarticular tuberculosis due to the lack of well-defined criteria for the end point of treatment. Emergence of multi drug resistant tuberculosis, primarily due to use of poor drug regimens, further illustrates the need of newer and more effective diagnostic methods, particularly in developing countries.Methods: This prospective clinical study to evaluate the role of technetium ((99m)Tc)-ciprofloxacin scan as a tool to assess disease activity involved in 15 cases of TB spine with a mean age of 32.2 years (range 21-72). Following a clinico-radiological diagnosis, all patients were treated with standard anti tubercular treatment and a scan was done at zero, three and six months of treatment with tracer activity being recorded and compared in sequential scans along with a parallel evaluation of clinical and radiological profile at regular intervals.Results: Out of 15 cases, nine had an initially positive bone scan. Two patients (22%) converted to negative scans at three months, whereas the remaining seven (78%) turned negative at six months. The end of six months treatment was also accompanied by clinico-radiological resolution in all cases.Conclusion: In conclusion, technetium ((99m)Tc)-ciprofloxacin scan could be a promising tool for monitoring disease activity in selected cases of tuberculosis spine as an alternative for therapeutic drug monitoring; however, due to the small sample size, studies with a large number of patients might be of help in defining these cases in a better way. [ABSTRACT FROM AUTHOR]

In the evidence-based medicine era, objective treatment guidelines have been laid down for pulmonary tuberculosis, but the same is not true for osteoarticular tuberculosis. This has led to demands for standardising the treatment protocol and to a lack of consensus between doctors regarding the composition and duration of treatment. Twenty-five patients with extraspinal osteoarticular tuberculosis were evaluated prospectively. Following the diagnosis, patients were given standard directly observed treatment short course (DOTS) regimen and were monitored for disease activity at zero, three and six months with the help of technetium-99m-labelled ciprofloxacin ((99m)Tc) scan. Tracer activity at the site was recorded and compared on sequential scans. Clinical and radiological profile of all the patients were also recorded at regular intervals and compared. All 25 cases had a positive (99m)Tc bone scan initially. Four patients (16%) converted to negative scans at three months, whereas the remaining 21 patients (84%) showed negative scans at six months. The end of six months therapy also coincided with resolution of clinical and radiological parameters in all cases. In conclusion, (99m)Tc scan is a promising tool for monitoring drug response in osteoarticular tuberculosis; however, due to the small sample size, studies with a large number of patients might be of help. [ABSTRACT FROM AUTHOR]

Syphilis outbreaks in the United States have been reported since 2000 with highest rates in the South and many cases among HIV-infected individuals. We evaluated incident syphilis cases and concurrent gonorrhea and chlamydia screening at a southern HIV clinic. A retrospective cohort study included HIV-infected patients with at least one reactive plasma reagin (test for serum reagin antibodies to cardiolipin-cholesterol-lecithin antigen) and primary care visit from July 2004 to June 2007. Primary, secondary, and early latent syphilis cases were identified as incident syphilis and evaluation for gonorrhea and chlamydia within 1 month were described. Logistic regression was performed to determine factors associated with incident syphilis. Among 1544 patients, 40 incident syphilis cases were identified (5 primary, 29 secondary, and 6 early latent). The majority of patients were not virologically suppressed and only 25% had gonorrhea and chlamydia testing. In adjusted analyses, younger age (0.57 per 10 years, 95% confidence interval [CI] 0.41–0.80) and minority race (2.26, 95% CI 1.12–4.59) were associated with incident syphilis. Among 40 incident syphilis cases, only 1 in 4 were further tested for gonorrhea and chlamydia. These low rates are concerning as concurrent sexually transmitted infections (STIs) increase risk for HIV transmission. HIV care provider education with emphasis on STI testing in the setting of incident syphilis is key in prevention. [ABSTRACT FROM AUTHOR]