Clitoral Pain and Dyspareunia after Female Genital Mutilation/Cutting: A Case Report

Background: Current evidence has focused on the complications of female genital mutilation/cutting (FGM/C) types 2 and 3, and there is a gap in the knowledge of the complications of FGM/C types 1 and 4, which are often considered milder forms of cutting. Case Presentation: A 23-year-old Somali woman with FGM/C was referred for chronic clitoral pain and superficial dyspareunia after several inconclusive gynecological examinations. Her clitoris was found to be entrapped under the scar of the cut clitoral hood. We surgically lysed the scar and reconstructed a prepuce. At the two-month follow-up, the patient reported no pain and physiologic sexual response. Conclusion: Clitoral pain and dyspareunia after FGM/C can be due to the incarceration of the clitoral glans. Treatment is surgical lysis of the scar.

Underlying Sociocultural Practices Influencing Prevalence of Female Genital Mutilation/Cutting in Kajiado County

Background: Female Genital Mutilation/Cutting (FGM/C) often has lifelong negative consequences for a woman’s physical and mental health but is still practiced in some parts of Kenya including Kajiado County. We aimed to estimate the current prevalence as well as the socio-cultural beliefs and power relations that are in favor of or against the practice in Kajiado, Kenya. Methods: A mixed method cross-sectional study was conducted in Kajiado County. The study targeted: women of reproductive age (15 to 49 years);community health volunteers (CHVs);opinion leaders;health care workers;officials from the ministries of Education, Health, Culture, Gender and Social Services;Community Health Assistants (CHAs);Traditional Birth Attendants (TBAs);teachers;morans and adolescent boys and girls aged 10 to 24 years. Data were collected both quantitatively through a household questionnaire and qualitatively through the focus group discussions and key informant interviews. Factors influencing Female Genital Mutilation/Cutting (FGM/C) were classified as either social, cultural beliefs or economic. Results: From the study, quantitative results revealed that the prevalence of FGM/C in Kajiado County was 91%, with most of them (96.7%) practicing type 2 (excision) circumcisions. From the interviews, girls undergo the cut as a rite of passage to womanhood and thus a prerequisite for marriage. It is also believed that girls who are uncircumcised cannot be helped by TBAs in delivery. It is believed that their blood is poisonous and can cause bad omen to whoever comes in contact with dirty blood. Additionally, it is believed that girls go through the cut to avoid conflict and natural phenomena;for instance, drought and outbreaks of diseases that kill many people. Finally, it is a practice that earns respect for the parents of the girls and incentives as dowry to the father of the girl. TBAs that perform FGM/C get paid in cash and kind. Conclusion: Female genital mutilation/cutting practice in Kajiado County is still high. Efforts to end the practice will need to have an integrated approach to include all the players. Suggested alternatives to the cut must, therefore, be inclusive so as to address the myths/beliefs, misconceptions, socio-cultural and economic factors in favor of the vice. The alternatives must be inclusive for the beneficiaries, supporters, and practitioners.

Examining the Types and Consequences of Female Genital Mutilation in Somalia: A Cross-Sectional Study on the Burden and Impact of Acute and Long-Term Complications

Background: In Africa, female genital mutilation (FGM) is a widespread and harmful practice, with Somalia having the highest incidence at 98%. This practice has severe and long-lasting physical and mental health consequences. The aim of the study was to evaluate the different types of FGM;immediate and long-term complications associated with the practice, and identify factors related to its prevalence. Method: In a one-year cross-sectional hospital-based study, data were collected from females aged 18 - 50 with a history of FGM. Face-to-face semi-structured questionnaires were used for data collection. Data analysis was performed using SPSS version 26, utilizing univariate and bivariate analyses to identify correlations between variables, which were presented in tables. Results: In a study involving 255 female participants, 65.5% were between 18 and 30 years old. The majority (82.7%) were married, while 47.1% were illiterate. FGM cases were more prevalent in rural areas (61.6%). Among the participants, 45.1% were employed. Type 3 FGM was the most common (44.3%), followed by Type 2 (32.2%) and Type 1 (23.9%). In terms of short-term complications experienced by circumcised women, the most common were bleeding, reported by 29.8% of participants, followed by infection (25.1%), and urinary retention (19.2%). Among the long-term complications observed, recurrent vaginal infections were the most prevalent, affecting 29.8% of the surveyed females. This was episiotomy during delivery (22.3%) and genital scarring (10.2%). Conclusion: The study reveals that Type 3 FGM is highly prevalent among the surveyed females, contributing to an increased risk of recurrent vaginal infections, prolonged second stage of labor, higher likelihood of episiotomy during delivery, and genital scarring. These findings emphasize the urgent need for effective preventive strategies and implementation from both international and local organizations to eliminate the harmful practice of FGM.

Instability mechanism of mining roadway passing through fault at different angles in kilometre-deep mine and control measures of roof cutting and NPR cables

The angle α between the fault strike and the axial direction of the roadway produces different damage characteristics. In this paper, the research methodology includes theoretical analyses, numerical simulations and field experiments in the context of the Daqiang coal mine located in Shenyang, China. The stability control countermeasure of "pre-splitting cutting roof + NPR anchor cable"(PSCR-NPR) is simultaneously proposed. According to the different deformation characteristics of the roadway, the faults are innovatively classified into three types, with α of type I being 0°-30°, α of type II being 30°-60°, and α of type III being 60°-90°. The full-cycle stress evolution paths during mining roadway traverses across different types of faults are investigated by numerical simulation. Different pinch angles α lead to high stress concentration areas at different locations in the surrounding rock. The non-uniform stress field formed in the shallow surrounding rock is an important reason for the instability of the roadway. The pre-cracked cut top shifted the high stress region to the deep rock mass and formed a low stress region in the shallow rock mass. The high prestressing NPR anchor cable transforms the non-uniform stress field of the shallow surrounding rock into a uniform stress field. PSCR-NPR is applied in the fault-through roadway of Daqiang mine. The low stress area of the surrounding rock was enlarged by 3-7 times, and the cumulative convergence was reduced by 45%-50%. It provides a reference for the stability control of the deep fault-through mining roadway.

Hole cleaning evaluation and installation spacing optimization of cuttings bed remover in extended-reach drilling

In extended-reach or long-horizontal drilling,cuttings usually deposit at the bottom of the annulus.Once cuttings accumulate to a certain thickness,complex problems such as excessive torque and drag,tubing buckling,and pipe stuck probably occur,which results in a lot of non-productive time and remedial operations.Cuttings bed remover can efficiently destroy deposited cuttings in time through hydraulic and mechanical stirring effects.This paper aims to build a method for hole cleaning evaluation and installation spacing optimization of cuttings bed remover to improve the wellbore cleaning effect.Firstly,a Computational Fluid Dynamics approach with Eulerian—Eulerian multiphase model was utilized to investigate the mechanism of cuttings transportation,and a new type of cuttings bed remover was designed.Next,an evaluation method of hole cleaning effect of remover was established.After that,the effects of several drilling parameters on hole cleaning including flow rate of drilling fluid,rotational speed of drillpipe,rate of penetration,wellbore size,rheological property of drilling fluid,and remover eccentricity on the performance of cuttings bed remover were investigated.The results demonstrate that the new type of remover with streamline blade performs better than conventional removers.The efficiency of hole cleaning is greatly improved by increasing the rotational speed of drillpipe,flow rate of drilling fluid,remover eccentricity,and 6 rpm Fann dial reading for drilling fluid.While higher rate of penetration and large wellbore size result in worse hole cleaning.These findings can serve as an important guide for the structure optimization design of cuttings bed remover and installation spacing of removers.

Yield and Nutritive Values of Semi- and Non-Fall Dormant Alfalfa Cultivars under Late-Cutting Schedule in California’s Central Valley

California is one of the major alfalfa (Medicago sativa L) forage-producing states in the U.S, but its production area has decreased significantly in the last couple of decades. Selection of cultivars with high yield and nutritive value under late-cutting schedule strategy may help identify cultivars that growers can use to maximize yield while maintaining area for sustainable alfalfa production, but there is little information on this strategy. A field study was conducted to determine cumulative dry matter (DM) and nutritive values of 20 semi- and non-fall dormant (FD) ratings (FD 7 and FD 8 - 10, respectively) cultivars under 35-day cut in California’s Central Valley in 2020-2022. Seasonal cumulative DM yields ranged from 6.8 in 2020 to 37.0 Mg·ha−1 in 2021. Four FD 8 - 9 cultivars were the highest yielding with 3-yrs avg. DM greater than the lowest yielding lines by 46%. FD 7 cultivar “715RR” produced the highest crude protein (CP: 240 g·Kg−1) while FD 8 cultivar “HVX840RR” resulted in the highest neutral detergent fiber digestibility (NDFD: 484 g·Kg−1, 7% greater than the top yielding cultivars) but with DM yield intermediate. Yields and NDFD correlated positively but weakly indicating some semi- and non-FD cultivars performing similarly. These results suggest that selecting high yielding cultivars under 35-day cutting schedule strategy can be used as a tool to help growers to maximize yield while achieving good quality forages for sustainable alfalfa production in California’s Central Valley.

A Content Analysis Study Describing Information Regarding Female Genital Mutilation Present in US Medical Textbooks

This study examines the depth of information regarding Female Genital Mutilation (FGM)/Female Cutting (FC) present in US medical textbooks. According to Klein et al. (2018) [1], despite substantial attention regarding the effects of FGM, this practice is still ongoing all over the world. Healthcare providers are very important actors who need to understand FGM in order to provide care to girls and women subjected to it, but the small amount of existing work in this area shows a low level of knowledge and training about FGM/FC among U.S. physicians. The Center for Disease Control and Prevention (CDC) first published the estimated number of girls at risk of FGM/FC in the U.S. to be about 168,000 in 1997;that number had increased to 513,000 girls in the US by 2012 (according to Goldberg et al.) In this study, a small sample of medical textbooks were analyzed for the degree to which the textbooks include information regarding FGM/FC. The results of this study show that US medical textbooks do not include information regarding FGM/FC, suggesting that most medical providers don’t have knowledge and training about FGM/FC. The inadequate information on FGM/FC in medical textbooks reflects a culturally biased lack of recognition of the number of girls and women affected in the US. This maintains an ongoing pattern of silence that reinforces gender inequality. Considering the inadequate information covered in US medical textbooks on FGM/FC, and the concordant lack of provider training to provide advice and care to affected girls and women, incorrect and missed diagnoses may lead to harm to victims of FGM/FC. Providers would be better equipped to care for women and girls if their medical training included information regarding FGM/FC.

Unraveling engineering disturbance effects on deformation in red-bed mudstone railway cuttings:incorporating crack-facilitated moisture diffusion

Red-bed mudstone, prevalent in southwest China, poses a formidable challenge due to its hydrophilic clay minerals, resulting in expansion, deformation, and cracking upon exposure to moisture. This study addresses uplift deformation disasters in high-speed railways by employing a moisture diffusion-deformation-fracture coupling model based on the finite-discrete element method(FDEM). The model integrates the influence of cracks on moisture diffusion. The investigation into various excavation depths reveals a direct correlation between depth and the formation of tensile cracks at the bottom of the railway cutting. These cracks expedite moisture migration, significantly impacting the temporal and spatial evolution of the moisture field. Additionally, crack expansion dominates hygroscopic deformation, with the lateral coordinate of the crack zone determining peak vertical displacement. Furthermore, key factors influencing deformation in railway cuttings, including the swelling factor and initial moisture content at the bottom of the cutting, are explored. The number of tensile and shear cracks increases with greater excavation depth, particularly concerning shear cracks. Higher swelling factors and initial moisture contents result in an increased total number of cracks, predominantly shear cracks. Numerical calculations provide valuable insights, offering a scientific foundation and directional guidance for the precise prevention, control, prediction, and comprehensive treatment of mudstone-related issues in high-speed railways.

Precipitates Generation Mechanism and Surface Quality Improvement for Aluminum Alloy 6061 in Diamond Cutting

To improve the surface quality for aluminum alloy 6061(Al6061) in ultra-precision machining, we investigated the factors affecting the surface finish in single point diamond turning(SPDT)by studying influence of the precipitates generation of Al6061 on surface integrity and surface roughness.Based on the Johnson-Mehl-Avrami solid phase transformation kinetics equation, theoretical and experimental studies were conducted to build the relationship between the aging condition and the type, size and number of the precipitates for Al6061. Diamond cutting experiments were conducted to machine Al6061 samples under different aging conditions. The experimental results show that, the protruding on the chip surface is mainly Mg_(2)Si and the scratches on the machined surface mostly come from the iron-containing phase(α-, β-AlFeSi).Moreover, the generated Mg_(2)Si and α-, β-AlFeSi affect the surface integrity and the diamond turned surface roughness. Especially, the achieved surface roughness in SPDT is consistent with the variation of the number of AlFeSi and Mg_(2)Si with the medium size(more than 1 μm and less than 2 μm) in Al6061.

Assessing cutter-rock interaction during TBM tunnelling in granite:Large-scale standing rotary cutting tests and 3D DEM simulations

The widespread utilisation of tunnel boring machines(TBMs)in underground construction engineering requires a detailed investigation of the cutter-rock interaction.In this paper,we conduct a series of largescale standing rotary cutting tests on granite in conjunction with high-fidelity numerical simulations based on a particle-type discrete element method(DEM)to explore the effects of key cutting parameters on the TBM cutter performance and the distribution of cutter-rock contact stresses.The assessment results of cutter performance obtained from the cutting tests and numerical simulations reveal similar dependencies on the key cutting parameters.More specifically,the normal and rolling forces exhibit a positive correlation with penetration but are slightly influenced by the cutting radius.In contrast,the side force decreases as the cutting radius increases.Additionally,the side force shows a positive relationship with the penetration for smaller cutting radii but tends to become negative as the cutting radius increases.The cutter's relative effectiveness in rock breaking is significantly impacted by the penetration but shows little dependency on the cutting radius.Consequently,an optimal penetration is identified,leading to a low boreability index and specific energy.A combined Hertz-Weibull function is developed to fit the cutter-rock contact stress distribution obtained in DEM simulations,whereby an improved CSM(Colorado School of Mines)model is proposed by replacing the original monotonic cutting force distribution with this combined Hertz-Weibull model.The proposed model outperforms the original CSM model as demonstrated by a comparison of the estimated cutting forces with those from the tests/simulations.The findings from this work that advance our understanding of TBM cutter performance have important implications for improving the efficiency and reliability of TBM tunnelling in granite.

Ground response and failure mechanism of gob-side entry by roof cutting with hard main roof

This study is the result of long-term efforts of the authors’team to assess ground response of gob-side entry by roof cutting(GSERC)with hard main roof,aiming at scientific control for GSERC deformation.A comprehensive field measurement program was conducted to determine entry deformation,roof fracture zone,and anchor bolt(cable)loading.The results indicate that GSERC deformation presents asymmetric characteristics.The maximum convergence near roof cutting side is 458 mm during the primary use process and 1120 mm during the secondary reuse process.The entry deformation is closely associated with the primary development stage,primary use stage,and secondary reuse stage.The key block movement of roof cutting structure,a complex stress environment,and a mismatch in the supporting design scheme are the failure mechanism of GSERC.A controlling ideology for mining states,including regional and stage divisions,was proposed.Both dynamic and permanent support schemes have been implemented in the field.Engineering practice results indicate that the new support scheme can efficiently ensure long-term entry safety and could be a reliable approach for other engineering practices.

Cutting Propagation Technique of Pennisetum purpureum Schum

[Objectives]The paper was to study the cutting propagation technique of Pennisetum purpureum Schum and to provide a technical reference for establishing an efficient cutting propagation method.[Methods]Six treatments were set up using P.purpureum cv.Guiminyin and P.purpureum cv.Guimu-1 as test materials,including 1-node oblique insertion,1-node oblique insertion+rooting powder,1-node transverse burial,2-node oblique insertion,2-node oblique insertion+rooting powder and 2-node transverse burial.The following indices were observed and determined for P.purpureum cuttings:emergence rate,rooting rate,root number,longest root length,fresh root weight,plant height,number of tillers,number of leaves,and fresh stem and leaf weight.[Results]In the 2-node cutting+rooting powder treatment,Guiminyin and Guimu-1 exhibited the highest survival rate,root growth indices,and stem and leaf growth indices,with the emergence rates of 94.29%and 90.26%,respectively.The 2-node cutting treatment followed closely behind,while the 1-node cutting treatment had the lowest indices.Under the same treatment,Guimuyin exhibited higher mean values for plant height,number of leaves,fresh stem and leaf weight,longest root length,and fresh root weight compared to Guimu-1.However,it had lower mean number of tillers,and emergence rate and rooting rate of the 1-node cutting treatment compared to Guimu-1.[Conclusions]The P.purpureum cuttings thrived in the 2-node cutting+rooting powder treatment,and the overall cutting effect of Guiminyin was superior to that of Guimu-1.

Urological Complications of Female Genital Mutilation: A Case Report of 15 Patients

Objective background: This was a retrospective study of the clinical and therapeutic aspects of urological complications of female genital mutilation in the urology department of Bamako’s Gabriel Touré University Hospital. Methods: Our study took place from 2002 to 2017 in the urology department of the Gabriel Touré University Hospital in Bamako and concerned cases of complications of female genital mutilation. Our study included all girls or women presenting with urinary disorders related to complications of genital mutilation and received in urological consultation and surgical management. Results: The average age of our patients was 2.5 years, with extremes ranging from 3 months to 35 years. The oldest patient had presented with dystocia during both deliveries. Acute urine retention (n = 7) was the most frequent reason for consultation. Other signs included urinary incontinence, pollakiuria and burning. Physical examination revealed clitoridectomy and abrasion of the labia minora in 13 patients. Type III of the WHO classification of female genital mutilation was the most frequent and corresponded to infibulation.

Cutting-edge Technological Innovation Outcome Displayed at 2024 Beijing Science and Technology Week

The 2024 National Science and Technology Week and Beijing Science and Technology Week opened in Shougang Park in Shijingshan District from May 25 to June 1.Under the theme of“Carrying forward the spirit of scientists and inspiring societal innovation,”this event focused on the new-generation IT technology,medical health,energy and technology,modern agriculture and intelligent manufacturing industries.

On the Cutting Edge

From academia to cybersecurity,an insider's perspective on China's rise as a tech powerhouse Bertha Alvarado Banuet was born in Mexico City,capital of Mexico,and recalled that her first visit to China was a family trip when she was around 8 years old.Although she was just a child,this experience planted the initial seed of interest.

Endoscopic radial incision and cutting method for adult congenital duodenal webs:A case report

BACKGROUND Congenital duodenal webs are rare in adults and can lead to various symptoms such as nausea,vomiting,and postprandial fullness.The treatment for this disease is mostly surgical.Endoscopic treatment techniques have been developed and attempted for this disease.Endoscopic radial incision and cutting(RIC)techniques are reportedly very effective in benign anastomotic stricture.This case report highlights the effectiveness and safety of endoscopic RIC as a minimally invasive treatment for adult congenital duodenal webs.CASE SUMMARY A 23-year-old female patient with indigestion was referred to a tertiary hospital.The patient complained of postprandial fullness in the epigastric region.Previous physical examinations or blood tests indicated no abnormalities.Computed tomography revealed an eccentric broad-based delayed-enhancing mass-like lesion in the second portion of the duodenum.Endoscopy showed an enlarged gastric cavity and a significantly dilated duodenal bulb;a very small hole was observed in the distal part of the second portion,and scope passage was not possible.Gastrografin upper gastrointestinal series was performed,revealing an intraduodenal barium contrast-filled sac with a curvilinear narrow radiolucent rim,a typical"windsock"sign.Endoscopic RIC was performed on the duodenal web.The patient recovered uneventfully.Follow-up endoscopy showed a patent duodenal lumen without any residual stenosis.The patient reported complete resolution of symptoms at the 18-month follow-up.CONCLUSION Endoscopic RIC may be an effective treatment for congenital duodenal webs in adults.

Application of Fuyang Paper Cutting Art in Cultural and Creative Design from the Perspective of Rural Revitalization

The application significance of Fuyang paper cutting art in cultural and creative design from the perspective of rural revitalization was discussed,and the implementation principles and specific practices of applying the elements and techniques of Fuyang traditional paper cutting art in cultural and creative products with local features were analyzed to provide reference for rural revitalization and development of cultural industry.

Design and Numerical Simulation of Dust Removal System for Sutomotive Iongitudinal Beam Plasma Cutting

To improve the poor efficiency of the dust removal system in the plasma cutting station of automotive longitudinal beams,and reduce the cutting surface quality degradation due to dust,a bottom-side suction dust removal system is designed,and the dust removal effect is optimized through the setting of the following dampers and diversion plates.The result of numerical simulation indicates that the particle collection rate can reach 99.44%,and the field test also proves the effectiveness of the dust removal system,which is of guiding significance for the transformation of other similar dust removal systems.

Research on the Resistance of Cutting Mechanism of Mining Longitudinal Roadheader

In order to accurately obtain the dynamic characteristics of the cutting mechanism of the mining longitudinal roadheader,combined with the working principle of the mining longitudinal roadheader,the theoretical analysis and derivation are carried out in detail.By using ADAMS to simulate,the resistance curve and torque curve of the cutting mechanism in different directions are obtained.The results show that ADAMS can effectively predict the excavation resistance and torque of the cutting mechanism of mining longitudinal roadheader,which has certain reference value for future optimization design.

ONECUT2高表达介导胃癌复发患者5-FU化疗耐药

目的:探究One cut结构域家族成员2(ONECUT2)是否可以作为对5-FU耐药的胃癌复发患者的治疗靶点。方法:利用癌症基因组图谱(TCGA)数据库分析ONECUT2基因在胃癌患者及胃癌复发患者的表达情况。利用基因集富集分析(GSEA)评估TCGA数据库中ONECUT2表达量与药物代谢相关生物学过程的相关性。利用CCK-8细胞毒性实验评估胃癌细胞敲低或过表达ONECUT2对5-FU的耐药情况。分析30例胃癌术后复发患者ONECUT2表达量与5-FU治疗效果的相关性。结果:TCGA数据库分析显示,在经受过化疗且复发的胃癌患者中,ONECUT2高表达的患者无病间隔期(disease-free interval,DFI)更短。GSEA分析结果表明,ONECUT2高表达与异生药物代谢通路呈正相关,这提示可能与胃癌患者的耐药相关。体外实验中,敲低ONECUT2降低胃癌细胞对5-FU的半数抑制浓度(IC_(50))值;反之,过表达ONECUT2增加细胞对5-FU的IC_(50)值。30例胃癌复发患者对5-FU的药物敏感性与ONECUT2表达量相关。结论:胃癌复发患者的ONECUT2表达量更高,ONECUT2高表达与胃癌复发患者的5-FU耐药相关,可能是潜在的治疗靶点。