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Introduction: X-linked hypophosphatemia (XLH) is a rare, lifelong, progressive disease characterised by renal phosphate wasting and abnormal bone mineralisation. Symptoms begin in early childhood, with the development of rickets and related skeletal deformities and reduced growth, progressing to long-term complications, including pseudofractures and fractures, as well as pain, stiffness and fatigue. The present study was designed to explore the patient experience of pain, stiffness and fatigue and the psychosocial impact of XLH in detail.Methods: A cross-sectional qualitative study was conducted in the United Kingdom (18), Finland (6), France (4), Germany (1) and Luxembourg (1) with XLH patients aged 26 and over. Interview discussion guides were developed in consultation with clinical experts and patient associations. Data were analysed thematically.Results: Participants (N = 30) described pain, stiffness and fatigue as frequently experienced symptoms with a significant impact on physical functioning and activities of daily living (ADLs). Some also described the symptoms as impacting their mood/mental health, relationships, social life and leisure activities. Participants described how common symptoms could interact or aggravate other symptoms. Symptoms had often worsened over time, and for many, were associated with concern about the future. Most participants were worried or felt guilty about having children with XLH. The findings confirmed and extended the existing model of the burden of XLH.Conclusion: The present study is the first to provide an in-depth analysis of pain, stiffness and fatigue, their impact and the interrelatedness of these symptoms among adults with XLH. The study also described the psychosocial impact of XLH as a hereditary, lifelong progressive disease. [ABSTRACT FROM AUTHOR]

The confining stresses in a concrete column confined with fibre-reinforced polymer (FRP) are uniform across the section and isotropic only when the column is under concentric loading and circular in shape. If the column is under eccentric loading or non-circular in shape, the confining stresses in the column become non-uniform and anisotropic. However, without knowing the confining stresses, it is impossible to predict the structural behaviour of confined concrete columns. To overcome this difficulty, a new finite-element (FE) method was developed based on the most up-to-date lateral strain-axial strain and axial stress-strain constitutive models of concrete. This paper reports on using the method to analyse circular concrete columns confined by FRP under eccentric loading. It was found that, under eccentric loading, the confining stresses are generally smaller at larger eccentricity. Overall, good agreement between the theoretical results and published experimental data was achieved. In theory, the FE method can be applied to concrete columns of any shape and even those provided with lateral reinforcement, as will be elaborated upon in subsequent papers. [ABSTRACT FROM AUTHOR]

Engineering education in higher education is facing multiple and significant challenges due to the changing requirements for future professional engineers and the changing landscape of higher education. How to raise the standard and quality of engineering courses to meet the demands of the fast evolving industry and society, how to improve the employability of graduates by developing the mentality and competence of professional engineers, and how to improve the inclusiveness to maximise the benefits of widening participation and internationalisation of higher education are some key issues that need to be addressed. This paper presents an innovative system for engineering education, the CIVA (standing for Coursework-driven teaching and learning process, Integrated teaching approach, Verification and validation guided quality learning and professional development and Active support mechanism) system. The CIVA system aims to address the above mentioned key issues in engineering education and represents a new way to manage the teaching and learning process in order to achieve a high quality engineering education outcome that is characterised by high academic standard and quality, high inclusiveness and high employability. An example of implementation of the CIVA system for a structural vibration unit is provided for illustration. Furthermore, the CIVA system provides a framework in engineering education that is responsive and customisable to the requirements of both the learners and the employers. With further development, the CIVA system is promising to make a significant contribution to modernising engineering education. [ABSTRACT FROM AUTHOR]

Objectives:Most types of population-based cancer screening require repeat participation to be effective. This study investigated predictors of repeat participation in the NHS Bowel Cancer Screening Programme (BCSP).Methods:The BCSP in England offers biennial colorectal cancer screening using a guaiac fecal occult blood test (gFOBt) from age 60-74 years. This analysis included 62 081 individuals aged 60-64 years at the time of the first invitation (R1). The main outcome was repeat participation at their second (R2) or third (R3) invitation. Behavioural measures derived from screening records included late return of the gFOBt kit, compliance with follow-up investigations and previous screening participation. Other potential predictors of repeat participation included results of individual test kit analysis (normal, weak positive, strong positive, spoilt) and the definitive result of the gFOBt screening episode (normal or abnormal). Age, sex and socioeconomic deprivation were also recorded.Results:Overall repeat uptake was 86.6% in R2 and 88.6% in R3. Late return of the test kit was consistently associated with lower uptake (R2: 82.3% vs 88.6%, P<0.001; R3: 84.5% vs 90.5%, P<0.001). A definitive abnormal gFOBt result in the previous screening episode was a negative predictor of repeat uptake (R2: 61.4% vs 86.8%, P<0.001; R3: 65.7% vs 88.8%, P<0.001). Weak positive (R2: 76.9% vs 86.8%, P<0.001; R3: 81.7% vs 88.8%, P<0.05) and spoilt test kits (R2: 79.0% vs 86.6%, NS; R3: 84.2% vs 92.2%, P<0.05) were associated with lower repeat uptake, but were not consistently independent predictors in all invitation rounds or subgroups. Among those with a definitive abnormal gFOBt result, noncompliance with follow-up in a previous screening episode was also associated with lower repeat uptake (R2: 24.3% vs 67.1%, P<0.001; R3: 43.2% vs 69.9%, P<0.001).Conclusions:Behavioural markers and test results from previous screening episodes have been implicated in subsequent gFOBt uptake. [ABSTRACT FROM AUTHOR]

Existing reinforced concrete (RC) beams can be effectively strengthened by attaching steel plates to the side faces of the beams using anchor bolts. The performance of this type of beam, bolted side-plated (BSP) beams, is mainly controlled by the degree of partial interaction at the steel-concrete interface. In this study, a total of seven moderately reinforced BSP beams with different steel plate depths and various bolt spacings were tested. Their behaviours were compared to the available test results for lightly reinforced BSP beams obtained by other researchers. The results show that moderately reinforced RC beams are more effective in increasing the flexural strength and ductility capacity using deeper steel plates than the use of a greater number of anchor bolts. It was also found that the longitudinal and transverse slips were controlled by both the stiffness ratios of the steel plates to the RC beam and the force-slip response of the anchor bolts. [ABSTRACT FROM AUTHOR]

The three-dimensional (3D) free vibration of twisted cylinders with sectorial cross sec-tion or a radial crack through the height of the cylinder is studied by means of the Chebyshev-Ritz method. The analysis is based on the three-dimensional small strain lin-ear elasticity theory. A simple coordinate transformation is applied to map the twisted cy-lindrical domain into a norma! cylindrical domain. The product of a triplicate Chebyshev polynomial series along with properly defined boundary functions is selected as the ad-missible functions. An eigenvalue matrix equation can be conveniently derived through a minimization process by the Rayleigh-Ritz method. The boundary functions are devised in such a way that the geometric boundary conditions of the cylinder are automatically satisfied. The excellent property of Chebyshev polynomial series ensures robustness and rapid convergence of the numerical computations. The present study provides a full vibration spectrum for thick twisted cylinders with sectorial cross section, which could not be determined by ID or 2D models. Highly accurate results presented for the first time :are systematically produced, which can serve as a benchmark to calibrate other numerical solutions for twisted cylinders with sectorial cross section. The effects of height-to-radius ratio and twist angle on frequency parameters of cylinders with different subtended angles in the sectorial cross section are discussed in detail. [ABSTRACT FROM AUTHOR]

The integrated care pathway is used in end-of-life care to improve quality of care; the Liverpool Care Pathway (LCP) has been used in Europe and North America. Tuen Mun Hospital is a regional hospital in Hong Kong, China. The End-of-life Care Pathway (ECP) based on the concepts used in the Liverpool Care Pathway, was developed, with modification to suit the local condition. Criteria for entry onto the ECP were that the multidisciplinary team agreed the patient was dying, and was at least two of the following: bedbound; semi-comatose; only able to take sips of fluid; no longer able to take tablets. The ECP template replaced all other inpatient documents. The ECP was implemented in the palliative care unit for terminal cancer patients. An audit was performed to review the result. Fifty-one Chinese patients were included in the audit with mean age 64. The median duration of ECP use was 24 hours. All patients had current medication assessed and non-essential drugs were discontinued. The audit result suggested integrated care pathway in end-of-life care could be implemented successfully in an Oriental culture. The acceptance of using the ECP as a standard clinical practice takes time and education. Appropriate template design and supervision are the keys to success. [ABSTRACT FROM AUTHOR]

An integral formulation for 2D cracked infinite anisotropic magneto–electro–elastic media is presented. Based on the method proposed by Garcia-Sanchez et al. (Comput Struct 83: 804–820, 2005), the hypersingular kernels are analytically transformed into weakly singular and regular integrals with known analytical solution. Special quadratic discontinuous crack tip elements are employed to model the singular characteristics of the stresses, electric displacements and magnetic inductions. The extended stress intensity factors at the crack tips are calculated using the extended discontinuous displacements at crack tip elements based on one point extended displacement formulation. Some results for curved cracks in magneto–electro–elastic media are also presented. [ABSTRACT FROM AUTHOR]

Background: Endoscopic removal of large sessile polyps is sometimes technically difficult and is associated with an increased risk of complications. Moreover, the incidence of invasive carcinoma within these polyps is not negligible. Laparoscopic colorectal resection has been recommended in the treatment of these large polyps. This study aimed to evaluate the outcomes of laparoscopic colorectal resection for polyps that were not suitable for colonoscopic removal.Methods: Forty-five patients (28 men and 17 women) who underwent laparoscopic colorectal resection with the preoperative diagnosis of colorectal polyps were analyzed. The reasons for surgical resection were large sessile polyps (n = 34), difficult position (n = 2), recurrence after transanal endoscopic microsurgery (n = 1), and the presence of intramucosal malignancy on histology after colonoscopic polypectomy (n = 8).Results: The mean age of the patients was 66.7 years (range, 33-89). Previous abdominal operation had been performed in 12 patients (26.7%). Two patients underwent subtotal colectomy because of multiple polyps (14 and 19, respectively). Synchronous resection of other organs was performed in two patients (a right salpingo-oophorectomy and a right adrenalectomy). Intraoperative complications occurred in two patients, and two patients (4.5%) required conversion because of perforation of the colon during dissection and dense adhesions, respectively. There was no postoperative mortality. Complications occurred in seven patients (15.6%), and they included postoperative ileus (n = 4), anastomotic leakage (n = 1), urinary retention (n = 1), and urinary tract infection (n = 1). Reoperation was required in one patient for anastomotic leakage. The median hospital stay was 6 days. The histopathology of colorectal polyps showed tubular (n = 12), tubulovillous (n = 13), and villous adenoma (n = 12); mixed adenomatous/hyperolastic polyps (n = 2); inflammatory polyp (n = 1); and colonic lipoma (n = 1). Four patients, who had previous polypectoray with intramucosal malignancy, had no residual pathology. The median size was 3.0 cm. Invasive carcinoma was found in 16 patients (35.6%). The median number of lymph node sampling was six, and two patients had lymph node metastases.Conclusions: Colonic polyps that were not amendable for colonoscopic removal were associated with a high incidence of malignant invasion. Laparoscopic colectomy offers safe and effective management of these polyps with the benefits of early postoperative recovery. [ABSTRACT FROM AUTHOR]

Our previous study revealed that the coefficient of variation of harmonic magnitude (HCV) of radial arterial pulse was significantly raised before the death of cancer patients. In this study, we recorded the caudate arterial pulse of 24 Sprague-Dawley rats that had a fatal dose of urethane injected into their abdomens. Twenty rats were dead within 3 hours after the injection and four survived. We defined the last 100 minutes of each rat's life as the dying process. During the dying process, we found that both the systolic blood pressure and diastolic blood pressure dropped steeply during the last 5 minutes. However, all HCVs, except HCV1, climbed steeply before the last 5 minutes. The HCV1 of the dying rats was significantly higher than that of rats that survived, starting from the first minute (P<0.01). The HCV2 of the dying rats was significantly higher than that of the survived rats starting from the 52nd minute (P<0.05). The HCV3 and HCV4 of the dying rats were significantly higher than those of the survived rats until the 70th minute and the 80th minute, respectively (P<0.05). Furthermore, HCV2–HCV4 proceeded with the dying process and increased gradually. We concluded that HCVs, which failed first in the high-frequency components and then in the low-frequency components, could provide physicians with earlier information to prevent the coming failure of circulatory system, and could reflect quantitatively pathological severity and predict patient outcome. The specific Fourier components in the pulse provide more physiological information than systolic and diastolic blood pressures. [ABSTRACT FROM AUTHOR]

Duckbill-shaped elastomer valves are often installed on wastewater effluent diffusers, stormwater outfalls, and industrial flow systems to prevent backflow and sediment/salt water intrusion. Unlike fixed diameter nozzles, the flow from a duckbill valve (DBV) depends both on the driving pressure and the size of the valve opening. A nonlinear large deformation finite element analysis of a prototype DBV is reported herein. The elastomer is modeled as a hyperelastic incompressible solid, and the flow inside the DBV, shaped like a converging nozzle, is treated as energy conserving. The deformed valve is computed iteratively from sequential standard large deformation analysis of the internal flow and pressure loading. The calculations show that the valve opening is lip shaped, and the maximum stress occurs around the two sides of the saddle of the DBV; maximum strains are on the order of 5%. In contrast to the traditional square-root head–discharge dependence, a linear pressure–discharge relation is predicted for a range of elastomer thickness; the jet velocity/valve opening area varies nonlinearly with discharge. The normalized predictions of valve discharge flow and opening area as a function of the driving pressure are in excellent agreement with experimental data. [ABSTRACT FROM AUTHOR]

Abstract An integral equation approach is presented to investigate the interaction between cracks and rigid-line inclusions embedded in an infinite isotropic elastic matrix subject to remote loading. The relevant fundamental solutions in the integral formulation are presented. Special tip elements are used to simulate the &ratic;r variation of the discontinuous displacements over the crack surfaces, and the axial and shear forces along the rigid-line inclusions. The stress intensity factors at the crack tips and at the ends of the rigid-line inclusions are computed and compared with available solutions. [ABSTRACT FROM AUTHOR]

Prentice (1986) proposed the case-cohort design and studied a pseudolikelihood estimator of regression parameters in Cox's model. We derive a class of estimating equations for case-cohort sampling, each depending on a different estimator of the population distribution, which lead naturally to simple estimators that improve on Prentice's pseudolikelihood estimator. We also discuss an equivalence between case-control and case-cohort sampling in terms of the estimation of regression parameters in Cox's model. [ABSTRACT FROM PUBLISHER]

Studies the electrical characteristics of polysilicon-gated ultrathin-oxide capacitors and field-effect transistors. Physical models and numerical techniques; Silicon oxide and silicon interface quantification effects; Finite inversion layer width and polysilicon depletion.

Normal computation and front intersection detection for boundary layer mesh generation are the most time-consuming parts in implementing a robust hybrid meshing tool for viscous flow simulations. This paper presents a generalized boundary layer meshing method with a fast collision detecting algorithm. The main works are as followings. Firstly, a novel continuous medial-surface representation method is proposed by splitting a constrained Delaunay triangulation (CDT) of boundary points in a linear complexity. Secondly, we enhance a Jump-and-Walk method for mesh intersection detecting by improving its robustness with a medial-surface wall introduced between marching fronts, which only relies on CDT and is simple to implement as no extra data structures are required. Finally, a concise domain partitioning and advancing method is used to significantly reduce the times of the normal computation and intersection detection operations at an extremely low price by sharing the CDT. The capability of the proposed algorithm is demonstrated by generating quality hybrid mesh for several models with complex configurations. The results show that it may be able considerably reduce the effort to implement a robust hybrid meshing program with a speed of about 4 times faster than a popular commercial software Pointwise for researchers. [ABSTRACT FROM AUTHOR]

Reinforced concrete (RC) beams strengthened with bolted steel plates on their side faces are known as bolted side-plated (BSP) beams. The performance of BSP beams is closely related to the longitudinal partial interaction caused by the longitudinal slip on the plate-RC interface. In this study, an analytical model for the longitudinal slip and partial interaction was developed, and formulas for the BSP beams under several simple loading conditions were developed. The superposition principle was also proven applicable to the analysis of longitudinal slip, thus can be used to analyse the BSP beams under complicated loading conditions. The results of a previous numerical study were extracted to validate the analytical model, and an example was then presented to illustrate the applicability of the theoretical approach. This study enhances the understanding of the behaviour of BSP beams, and provides an approach to consider the influence of longitudinal partial interaction in the BSP strengthening design. [ABSTRACT FROM AUTHOR]

This paper studies the free vibration of circular toroidal sectors with circular crosssections based on the three-dimensional small-strain, linear elasticity theory. A set of orthogonal coordinates, composing the polar coordinate (r, 0) with the origin on the cross-sectional centerline of the sector and the circumferential coordinate ~ with the origin at the curvature center of the centerline, is developed to describe the displacements, strains, and stresses in the sector~ Each of the displacement components is taken as a product offour functions: a set of Chebyshev polynomials in ~ and r coordinates, a set of trigonometric series in 0 coordinate, and a boundary function in terms of p. Frequency parameters and mode shapes have been obtained via a displacement-based extremum energy principle. The upper bound convergence of the first eight frequency parameters accurate up to five figures has been achieved. The present results agree with those from the finite element solutions. The effect of the ratio of curvature radius R to the cross-sectional radius a and the subtended angle cpo on the frequency parameters of the sectors are discussed in detail. The three-dimensional vibration mode shapes are also plotted. [ABSTRACT FROM AUTHOR]

This paper studies the three-dimensional (3-D) free vibration of uniform prisms with isosceles triangular cross-section, based on the exact, linear and small strain elasticity theory. The actual triangular prismatic domain is first mapped onto a basic cubic domain. Then the Ritz method is applied to derive the eigenfrequency equation from the energy functional of the prism. A set of triplicate Chebyshev polynomial series, multiplied by a boundary function chosen to, a priori, satisfy the geometric boundary conditions of the prism is developed as the admissible functions of each displacement component. The convergence and comparison study demonstrates the high accuracy and numerical robustness of the present method. The effect of length-thickness ratio and apex angle on eigenfrequencies of the prisms is studied in detail and the results are compared with those obtained from the classical one-dimensional theory and the 3-D finite element method. Sets of valuable data known for the first time are reported, which can serve as benchmark values in applying various approximate beam and rod theories. [ABSTRACT FROM AUTHOR]

Three-dimensional vibration solutions are presented for rectangular plates with mixed boundary conditions, based on the small strain linear elasticity theory. The analysis is focused on two kinds of rectangular plates, the boundaries of which are partially fixed while the others are free. One of those studied is a rectangular plate with partially fixed boundaries symmetrically arranged around four corners and the other one is a rectangular plate with partially fixed boundaries around one corner only. A global analysis approach is developed. The Ritz method is applied to derive the governing eigenvalue equation by minimizing the energy functional of the plate. The admissible functions for all displacement components are taken as a product of a characteristic boundary function and the triplicate Chebyshev polynomial series defined in the plate domain. The characteristic boundary functions are composed of a product of four components of which each corresponds to one edge of the plate. The R-function method is applied to construct the characteristic boundary function components for the edges with mixed boundary conditions. The convergence and comparison studies demonstrate the accuracy and correctness of the present method. The influence of the length of the fixed boundaries and the plate thickness on frequency parameters of square plates has been studied in detail. Some valuable results are given in the form of tables and figures, which can serve as the benchmark for the further research. [ABSTRACT FROM AUTHOR]

CTEN/TNS4 is an oncogene in colorectal cancer (CRC), which can induce cell motility although its mechanistic basis of activity and the clinical implications of Cten expression are unknown. As Cten is in complex with integrins at focal adhesions, we hypothesised that it may interact with integrin-linked kinase (ILK). Through forced expression and knockdown of Cten in HCT116 and SW620 (respectively, showing low and high Cten expression), we showed that Cten could regulate ILK. However, inhibition of ILK after forced expression of Cten abrogated the motility-inducing effects of Cten, thereby demonstrating that the Cten-ILK interaction was functionally relevant. Combined knockdown of Cten and ILK had no additive effects on cell motility compared with knockdown of each individually. In order to investigate the clinical implications of Cten expression, a series of 462 CRCs were evaluated by immunohistochemistry. High expression of Cten was associated with advanced Dukes' stage (P<0.001), poor prognosis (P<0.001) and distant metastasis (P=0.008). The role of Cten in metastasis was tested by (a) intrasplenic injection of CRC cells stably transfected with a Cten expression vector into nude mice and (b) testing a series of primary human CRCs and their metastases by immunohistochemistry. Compared with controls, mice injected with cells expressing Cten developed larger tumours in the spleen (P<0.05) and liver (P<0.05). In the human cases, compared with primary tumours, the metastatic deposits had a significantly higher frequency of nuclear localisation of Cten (P=0.002). We conclude that Cten expression is of prognostic significance in CRC, and we delineate a Cten-ILK pathway controlling cell motility and possibly promoting metastasis. [ABSTRACT FROM AUTHOR]

Deleted in liver cancer 1 (DLC1) is a RhoGTPase activation protein-containing tumor suppressor that associates with various types of cancer. Although DLC2 shares a similar domain structure with that of DLC1, the function of DLC2 is not well characterized. Here, we describe the expression and ablation of DLC2 in mice using a reporter-knockout approach. DLC2 is expressed in several tissues and in endothelial cells (ECs) of blood vessels. Although ECs and blood vessels show no histological abnormalities and mice appear overall healthy, DLC2-mutant mice display enhanced angiogenic responses induced by matrigel and by tumor cells. Silencing of DLC2 in human ECs has reduced cell attachment, increased migration, and tube formation. These changes are rescued by silencing of RhoA, suggesting that the process is RhoA pathway dependent. These results indicate that DLC2 is not required for mouse development and normal vessel formation, but may protect mouse from unwanted angiogenesis induced by, for example, tumor cells. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor referring to a case of sphenoid sinus mucocoele presenting with optic neuropathy and abducens palsy.