ABSTRACT Objective: To clarify the association between smoking and stricture recurrence after urethroplasty. Materials and Methods: Pubmed, Web of Science, Embase, and Cochrane databases were searched with keywords: “urethroplasty,” “buccal mucosa graft urethroplasty,” “oral mucosa graft urethroplasty,” “excision and primary anastomosis urethroplasty,” “urethral stricture recurrence” until July 1, 2022. Inclusion and exclusion criteria were based on PICOS principles. The quality of included studies was assessed by Newcastle-Ottawa Scale (N.O.S.) system. Hazard ratio (H.R.), odds ratio (OR), and relative risk (RR) with 95% confidence interval (CI) were extracted or re-calculated from included studies. Meta-analysis was performed with Stata 15.0 based on univariate and multivariate data separately. Sensitivity analysis was performed to test the stability of the meta-analysis. I2 was calculated to evaluate heterogeneity. Publication biases were assessed by Egger's and Begg's tests. Funnel plots of univariate analysis and multivariate analysis were also offered. Results: Twenty one studies with 6791 patients were involved in this meta-analysis. The analysis results of the two stages were consistent. In the univariate meta-analysis stage, 18 studies with 5811 patients were pooled, and the result indicated that smoking might promote stricture recurrence (RR=1.32, P=0.001). Based on the adjusted estimate, 11 studies with 3176 patients were pooled in the multivariate meta-analysis stage, and the result indicated that smoking might promote stricture recurrence (RR=1.35, P=0.049). There was no significant heterogeneity in both the univariate and multivariate stages. Conclusion: Our study demonstrates that smoking may prompt stricture recurrence after the urethroplasty. Quitting smoking may be a good option for patients undergoing urethroplasty surgery.

ABSTRACT Introduction: The changes in muscle condition during jogging are studied according to their characteristics to formulate a correct fitness plan. With a medium effort intensity, studies on jogging have shown positive effects on mental de-stress and motor coordination. Objective: Study the effect of running training on muscle fatigue and body balance. Methods: A total of 60 sedentary freshmen from a university were selected, including 30 male and 30 female students. The volunteers were randomly divided into experimental and control groups. While the control performed routine sports activities according to the teaching plan during physical education class, the students in the experimental group performed a jogging training protocol. Data were collected before and after the intervention for comparison and statistical analysis. Results: The vestibular step test changed from 20.56 to 13.87, evidencing that jogging training significantly improved body balance ability in addition to providing body flexibility. Conclusion: Combined with curriculum standards and the level of physical training required, jogging can be integrated into physical education classes to promote student health. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMEN Introducción: Los cambios en el estado muscular durante el trote se estudian en función de sus características propias con el fin de formular un correcto plan de acondicionamiento físico. Con una intensidad de esfuerzo media, los estudios sobre el trote han demostrado efectos positivos sobre el desestresamiento mental y la coordinación motora. Objetivo: Estudiar el efecto del entrenamiento de carrera sobre la fatiga muscular y el equilibrio corporal. Métodos: Se seleccionó a un total de 60 estudiantes sedentarios de primer año de una universidad, de los cuales 30 eran hombres y 30 mujeres. Los voluntarios se dividieron aleatoriamente en grupo experimental y grupo de control. Mientras que el grupo de control realizó actividades deportivas rutinarias según el plan de enseñanza durante la clase de educación física, los estudiantes del grupo experimental llevaron a cabo un protocolo de entrenamiento de trote. Se recogieron datos antes y después de la intervención para su comparación y análisis estadístico. Resultados: La prueba de paso vestibular cambió de 20,56 a 13,87, lo que evidencia que el entrenamiento de trote mejoró significativamente la capacidad de equilibrio corporal además de proporcionar flexibilidad corporal. Conclusión: Combinado con las normas curriculares y el nivel de condición física exigido a los alumnos, el entrenamiento de trote puede integrarse en las clases de educación física para promover la salud de los estudiantes. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

RESUMO Introdução: As alterações da condição muscular na corrida moderada são estudadas segundo suas características próprias no intuito de formular um plano de aptidão física correta. Com uma intensidade de esforço média, estudos sobre a corrida vem demonstrando efeitos positivos sobre o desestresse mental e a coordenação motora. Objetivo: Estudar o efeito do treino de corrida moderada sobre a fadiga muscular e o equilíbrio corporal. Métodos: Um total de 60 calouros sedentários de uma universidade foram selecionados, incluindo 30 estudantes do sexo masculino e 30 do sexo feminino. Os voluntários foram divididos aleatoriamente em grupo experimental e grupo de controle. Enquanto o controle realizou atividades esportivas rotineiras, de acordo com o plano de ensino durante a aula de educação física, os alunos do grupo experimental realizaram um protocolo de treinamento de corrida. Os dados foram coletados antes e após a intervenção para comparação e análise estatística. Resultados: O teste de passo vestibular alterou-se de 20,56 para 13,87, evidenciando que o treinamento em corrida melhorou significativamente a capacidade de equilíbrio corporal além de propiciar a flexibilidade corporal. Conclusão: Combinado às normas curriculares e ao nível de aptidão física exigida dos estudantes, o treinamento em corrida moderada pode ser integrado às aulas de educação física para fomentar a saúde dos estudantes. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

Abstract Ti/Al/Mg/Al/Ti laminated composites were fabricated via hot-pressing at 350 °C, 400 °C and 450 °C successfully. The influences of interface morphology, diffusion zone, constraint effect on the mechanical properties were investigated. At Ti/Al interface, intermetallic compounds aren’t found. Whereas, they form at Al/Mg interface. With the increasing temperature, the bonding strength of Al/Mg interface doesn’t change linearly, and the maximum strength is obtained at 400 °C because of intermetallic compounds with appropriate thickness. With the increase of temperature, the hardness at both Ti/Al and Al/Mg interfaces increases owing to the solid solution and the intermetallic phases. Also, the ultimate tensile strength of LMCs increases with sacrificing the fracture elongation. The rule of mixture is used to predict the theoretical strength. It is found that the theoretical values are less than the measured, and the reasons may relate to interfaces in Ti/Al/Mg/Al/Ti laminated composites.

The aim of this study was to elucidate the concise effects of a traditional herb pair, Curcumae rhizoma-Sparganii rhizoma (CRSR), on uterine leiomyoma (UL) by analyzing transcriptional profiling. The UL rat model was made by intramuscular injection of progesterone and gavage administration of diethylstilbestrol. From 11 weeks of the establishment of the model, rats of the UL+CRSR group were gavaged daily with CRSR (6.67 g/kg). The serum concentrations of progesterone (P) and estradiol (E2) were determined by radioimmunoassay, the uterine index was measured by caliper measurement, and the pathological status was observed by hematoxylin and eosin stain. Gene expression profiling was checked by NimbleGen Rat Gene Expression Microarrays. The results indicated that the uterine mass of UL+CRSR rats was significantly shrunk and serum P and E2 levels significantly reduced compared to UL animals and nearly to the level of normal rats. Results of microarrays displayed the extensive inhibition of CRSR upon the expression of proliferation and deposition of extracellular matrix (ECM)-related genes, and significantly regulated a wide range of metabolism disorders. Furthermore, CRSR extensively regulated key pathways of the UL process, such as MAPK, PPAR, Notch, and TGF-β/Smad. Regulation of the crucial pathways for the UL process and ECM metabolism may be the underlying mechanisms of CRSR treatment. Further studies will provide clear clues for effectively treating UL with CRSR.

RESUMO Objetivo: A classificação da hérnia de disco lombar (LDH) da Michigan State University (MSU) é usada periodicamente por vários autores para classificar as hérnias discais. Pretendemos avaliar a confiabilidade deste sistema de classificação entre os residentes de ortopedia em nosso instituto. Métodos: Cinqüenta imagens de RM axial do corte T2 correspondendo ao nível de hérnia discal máxima de pacientes que foram diagnosticados com uma única LDH foram selecionadas e distribuídas para seis residentes ortopédicos. Todos os seis residentes deram uma classificação específica para cada imagem com base na classificação MSU; Além disso, três residentes deram notas em duas ocasiões diferentes. O grau de concordância entre os residentes foi analisado calculando-se a confiabilidade interobservador e intraobservador pela estatística Kappa. Resultados: Descobrimos que a confiabilidade interobservador entre seis residentes, calculando o Kappa de Fleiss, foi de 0,422; isso indica confiabilidade moderada. No entanto, a confiabilidade intra-observador de três residentes selecionados mostrou-se substancial (Kappa de Cohen = 0,750, 0,772 e 0,859 em três residentes, respectivamente). Variações na observação foram frequentes se houvesse hérnia discal ampla com estenose do canal vertebral. Conclusão: Nossos achados demonstram homogeneidade moderada das avaliações dadas pelos residentes; no entanto, teste-reteste provou que as classificações eram consistentes. Nível de Evidencia II, Estudos diagnósticos - investigação de um exame para diagnóstico.

ABSTRACT Objective: The Michigan State University (MSU) classification of lumbar disc herniation (LDH) is periodically used by various authors to classify disc herniation. We assessed the reliability of this classification system among orthopedic residents at our institute. Methods: Fifty T2 axial-cut magnetic resonance images (MRI) corresponding to the level of maximal disc herniation from patients diagnosed with a single LDH were selected and distributed to six orthopedic residents. All six residents gave a specific rating for each image based on the MSU classification; in addition, three residents gave ratings on two different occasions. The degree of agreement among residents was analyzed by calculating inter-observer and intra-observer reliability using the Kappa statistic. Results: The inter-observer reliability among the six residents calculated as the Fleiss’ Kappa was 0.422, which indicates moderate reliability. The intra-observer reliability of three selected residents calculated by Cohen's Kappa was 0.750, 0.772, and 0.859, which indicates substantial to almost perfect reliability. Variations in ratings were frequent in images portraying a broad-based disc herniation with spinal canal stenosis. Conclusion: Our findings demonstrate moderate homogeneity of ratings given by residents; however, test-retest results proved the ratings to be consistent. Level of Evidence II, Diagnostic studies - investigating a diagnostic examination.

OBJECTIVE: To determine the associations of liver lobe-based magnetic resonance diffusion-weighted imaging findings using multiple b values with the presence and Child-Pugh class of cirrhosis in patients with hepatitis B. METHODS: Seventy-four cirrhotic patients with hepatitis B and 25 healthy volunteers underwent diffusion-weighted imaging using b values of 0, 500, 800 and 1000 sec/mm2. The apparent diffusion coefficients of individual liver lobes for b(0,500), b(0,800) and b(0,1000) were derived from the signal intensity averaged across images obtained using b values of 0 and 500 sec/mm2, 0 and 800 sec/mm2, or 0 and 1000 sec/mm2, respectively, and were statistically analyzed to evaluate cirrhosis. RESULTS: The apparent diffusion coefficients for b(0,500), b(0,800) and b(0,1000) inversely correlated with the Child-Pugh class in the left lateral liver lobe, the left medial liver lobe, the right liver lobe and the caudate lobe (r=-0.35 to -0.60, all p<0.05), except for the apparent diffusion coefficient for b(0,1000) in the left medial liver lobe (r=-0.17, p>0.05). Among these parameters, the apparent diffusion coefficient for b(0,500) in the left lateral liver lobe best differentiated normal from cirrhotic liver, with an area under the receiver operating characteristic curve of 0.989. The apparent diffusion coefficient for b(0,800) in the right liver lobe best distinguished Child-Pugh class A from B-C and A-B from C, with areas under the receiver operating characteristic curve of 0.732 and 0.747, respectively. CONCLUSION: Liver lobe-based apparent diffusion coefficients for b(0,500) and b(0,800) appear to be associated with the presence and Child-Pugh class of liver cirrhosis.

In this study, we have proposed a three-dimensional (3D) model reconstruction system for breast tumors. The proposed system can establish an accurate 3D model of tumors, which will serve as a diagnostic reference for physicians and also address the shortcomings of the traditional breast needle localization method and other localization methods reported in previous studies. This developed system uses multispectral breast magnetic resonance images as input and detects the contour of the tumor in different sections using an active contour method - multispectral gradient vector flow snake (MGVFS) method. Thus, the system constructs a 3D model of only the tumor is contained in a breast surface model and excludes other tissues. Since the accuracy of the reconstructed 3D model depends on the accuracy of the tumor contour detection, for confirming the results obtained with the MGVFS method, we conducted experiments to evaluate its accuracy in contour detection, and compared the results with those traditional contour detection methods. Our results demonstrate that the MGVFS method has the highest accuracy in contour detection, with a correct contour detection rate as high as 99.79%.

Los hallazgos del comportamiento frágil de conexiones soldadas de acero después del temblor de Northridge de 1994, especialmente para marcos diseñados para resistir cargas laterales, ha traído la atención en los aspectos de seguridad y diseño de conexiones soldadas para estructuras localizadas en zonas sísmicas. En México, ingenieros de la práctica y diseñadores se están preguntando cuál será la efectividad sísmica de varias alternativas de conexiones utilizadas en estructuras de acero. Se deben tomar decisiones para equilibrar el nivel requerido de seguridad con los costos en que se incurre cuando se excede un estado límite. Las técnicas de confiabilidad estructural proveen del marco adecuado para incluir explícitamente las incertidumbres inherentes al proceso de diseño. Movimientos del terreno registrados en el temblor de la Ciudad de México de 1985 se escalan apropiadamente de acuerdo a la curva de riesgo sísmico de la zona de suelo blando de México, DF. La ocurrencia de temblores se modela de acuerdo a un proceso de Poisson y se toma como criterio de decisión el costo esperado en el ciclo de vida. El análisis paramétrico permite la identificación de variables dominantes y se identifican rangos en los que una opción, de las conexiones propuestas, es más recomendable que la otra. La formulación propuesta puede apoyar a diseñadores y constructores en el proceso de toma de decisiones acerca de la selección del tipo conveniente de conexión para zonas sísmicas como la Ciudad de México.

The findings about the fragile behavior of steel welded connections after the Northridge 1994 earthquake, specially for frames designed to withstand lateral force, has brought an amount of new attention to the design and safety issues of the welded connections for structures located on seismic zones. In México, practitioners and designers are facing the problem of the seismic effectiveness of the several kinds of connections as currently proposed for the design of steel structures. A decision must be made to balance the safety required with the costs incurred after exceeding the serviceability limit state. Structural reliability techniques provide the proper framework to include the inherent uncertainties into the design process. Registered motions after the 1985 Mexico City earthquake are properly scaled according to the seismic hazard curve for soft soil in Mexico City. Earthquake occurrence is modeled as a Poisson process and the expected life-cycle cost is taken as the decision criteria. Parametric analyses allow the identification of dominant variables and ranges where one option is more recommendable than the other one. The proposed formulation may support designers and builders on the analyses and justification process towards the selection of the convenient connection type for the seismic zones with soft soil in Mexico City.

Purpose: The percutaneous renal access (PRA) is the most critical step of percutaneous renal surgery (PRS). For the training of PRA in the lab, a novel non-biological bench model was developed and set for validation test. Materials and Methods: Experts in PRS (> 60 cases) and novices were included to perform fluoroscopy guided PRA on the model. Overall time, X-ray exposure time and puncture attempts were recorded to establish construct validity. After accomplishment, the experts rated the model using a standardized questionnaire for face and content validity based on a 5-point Likert scale, with 1 denoting very bad and 5 as excellent. Baseline and post-training data of novices were analyzed for skill acquisition. Results: 9 experts and 30 novices were finally included. The overall appraisal was 4 by the experts, and consensus of all experts was reached for the model as an excellent training tool. Significant difference between experts and novices was detected with the experts using less total time 183.11 ± 29.40 vs. 278.00 ± 50.30 seconds (P < 0.001), shorter X-ray exposure time 109.22 ± 19.93 vs. 183.13 ± 38.83 seconds (P < 0.001), and fewer attempts 1.28 ± 0.44 vs. 2.35 ± 0.65 (P < 0.001). After training, the novices demonstrated significant skill improvement in total and fluoroscopy time, and number of attempts (P < 0.001). Conclusions: Our non-biological model provides a new method for PRA training. The face, content and construct validity were demonstrated. This model allows contact with PRA skills and could be applied to the first step in the learning curve.

This study adopted 14 criteria for order-winners and qualifiers as the attributes for evaluation. The first stage used a simultaneous importance-performance analysis to analyse the competitive market situations of a corporation and its competitors. The second stage used the decision-making trial and evaluation laboratory method to analyse the attributes' causal relationships and levels of influence; then two methods of analysis were integrated to analyse and re-formulate the competitive strategies for the winning orders. As well as serving as a novel theory-based method to examine how manufacturers win orders, the proposals in this study can be applied to practical industry experiences.

OPSOMMING Veertien kriteria vir mededinging word vir attribuut evaluering voorgehou. Ten aanvang word gelyktydige vertonings gemeet ten opsigte van mededingers. Tweedens word 'n lukraakmetode aangewend by die evaluering van attribute se kousale verhoudings en invloedspeile vir mededingingspeile om sodoende bestellings te bekom. Die resulterende voorstelle kan in die praktyk toegepas word.