Prospective randomized study to evaluate and compare the post-procedural sexual function in patients undergoing semi-rigid ureterorenoscopy for distal ureteric stones in three different operating room settings

Objective:To evaluate and compare the effect of semi-rigid ureterorenoscopy on post-procedural sexual function with three different operating room settings.Methods:In this prospective randomized study,consecutive sexually active patients with normal pre-operative sexual function undergoing uncomplicated semi-rigid ureterorenoscopy for distal ureteric stones were randomized into three groups,with three different operating room settings.Procedure-related anxiety and sexual function were assessed pre-operatively using Amsterdam Preoperative Anxiety and Information Scale and Brief Sexual Function Inventory(in males)and Female Sexual Function Index-6(in females),respectively.All the participants were stented following the procedure,and the stent was removed after 3 weeks.Post-procedural sexual function and general discomfort were assessed and compared between three groups at 1 week,3 weeks,and 12 weeks.The effect of surgery-related anxiety,preoperative sexual function,age,and general discomfort(including stent-related discomfort)on post-procedural sexual function were analyzed using multiple regression analysis.A p-value of less than 0.05 was considered statistically significant.Results:Totally,327 eligible patients were randomized into three groups.The group of patients who underwent the procedural with a screen separating the operating area from the patient vision,while the patient could watch the endoscopy through a separate monitor,had better post-procedural sexual function compared to those who had total vision of the operating area as well as to those whose eyes were blocked.This difference was statistically significant.This post-procedural reduction in sexual function could not be attributed to in situ stent alone.Conclusions:Our study showed that semi-rigid ureterorenoscopy can have significant negative effect on sexual function,which can be reduced with proper preoperative counseling and an ideal operating room settings.

末梢治理:中国式现代化进程中筑牢基层基础的实现路径

基层在国家治理结构中处于基础性地位。基于弥补科层化治理回应性不足以及破解治理“悬浮化”的需要,突出人民性和精细化的对基层的末梢治理应运而生。顺应属地管理和属性治理相融合的趋势,末梢治理把被动式治理转化为积极回应式治理。除了治理重心下沉和治理空间拓展之外,它还推动基层社会的安定有序且充满活力。通过构建“纵向到底与横向到边”融合共生的闭环式治理体系,它彰显制度优势以强化组织基础,注重治理为民以夯实社会基础,拓展治理空间以提升能力基础,重视数字赋能以稳固智治基础。依托组织协同、社会联动和民众参与的共同缔造机制,它积极调适治理结构、优化治理理念、调整治理策略并完善治理机制,增强敏捷治理和回应能力,进而更好地筑牢基层基础。

Ureteroscopy with Holmium: YAG Laser—A Initial Study in the Urology Department of the Pr Bocar Sidy Sall University Hospital of Kati

Introduction: Ureteroscopy is a minimally invasive endoscopic surgery which provides access to the ureter, pyelon and calyceal cavities via the urethra and the bladder. Laser ureteroscopy uses the laser as an energy source to treat the stone and eliminate it naturally. Minimally invasive endoscopic methods are struggling to become popular in sub-Saharan African countries, especially for the upper urinary tract. The objective of our work was to report the results of our first laser ureteroscopy experience in the department. Materials and Methods: This was a prospective and descriptive study running from December 1, 2023 to February 19, 2024. Included in our study was any case of upper urinary tract stone operated by Laser ureteroscopy. The characteristics of the lithiasis were determined by CT scan. Sterilization of urine was verified by carrying out a cytobacteriological examination of urine. Ureteral lithiasis was approached by semi-rigid ureteroscopy. Renal lithiasis was immediately addressed by flexible ureteroscopy. Ureteroscopy was coupled with a Holmium YAG laser. A double J ureteral catheter was placed after the operation. A 230 µm laser fiber was used in each case with a generator with a power of 35 watts (Storz Calculase III type). An access sheath was used in all cases of flexible ureteroscopy. The parameters studied were: sociodemographic characteristics, lithiasis (site, size, number, density, topography), type of anesthesia, duration of laser use, duration of intervention, postoperative outcomes. Data entry and analysis were carried out using the software (Word 2016 and SPSS). Result: We collected 30 cases of laser ureteroscopy. The average age was 37 years with extremes of 9 and 79 years. The male gender was more represented. The most common age group was 24-39 years old. Renal colic was the most frequent reason for admission, 12 patients (40%). On physical examination, lumbar tenderness was present in 47% (14 patients). ECBU was positive in 4 patients (13%). CT scan was performed in all our patients before the intervention. The average stone size was 12 mm and the largest was 23 mm. The majority of stones, i.e. 59% (18 patients), had a density greater than 1000 HU. The stone was unique in 19 patients (63%). The location of the stone was pyelic in 8 patients or 27%. An impact on the upper urinary tract was found in 16 of our patients or 53%. General anesthesia was used in 25 patients (83%). A digital flexible ureteroscopy was used in 24 patients and a semi-rigid ureteroscopy (URS) in 6 patients. Full-course fragmentation was the most used therapeutic method, 9 patients or 32%. The average duration of interventions was 61 minutes. Drainage by double J catheter at the end of the procedure was performed in all our patients. The length of hospitalization was 24 hours. Only one case of failure in the USSR was recorded, and one case of failure was in the semi-rigid URS. Conclusion: Laser ureteroscopy is an effective minimally invasive surgery in the management of lithiasis of the upper urinary tract. It significantly reduces the length of hospitalization. Mastery of this technique and the acquisition of the equipment necessary for its implementation is an undeniable asset in the management of renal and ureteral lithiasis.

Numerical analysis of reflective cracking and fatigue lives of semi-rigid pavement structures using ABAQUS and FE-SAFE

In order to compare the impact of thickness of different layers on fatigue lives of different semi-rigid asphalt pavement structures, the mechanical results from finite element models in ABAQUS are incorporated with the fatigue results from fatigue models in FE-SAFE to calculate the mechanical response and fatigue lives of semi-rigid pavement structures under heavy traffic loads. Then the influences on fatigue lives caused by the changes in the thickness of layers in pavement structures are also evaluated. The numerical simulation results show that the aggregated base and the large stone porous mixture （LSPM） base have better anti-cracking performance than the conventional semi-rigid base. The appropriate thickness range for the aggregated layer in the aggregated base is 15 to 18 cm. The thickness of the LSPM layer in the LSPM base is recommended to be less than 15 cm.

Effects of interface slip and semi-rigid joint on elastic seismic response of steel-concrete composite frames

The stiffness matrix of semi-rigidly connected composite beams considering interface slip was established and the calculation method for elastic seismic response of composite frame was derived.The corresponding calculation programs were developed.Introducing the dimensionless quantities that were related to the connector shearing stiffness and the joint rotation stiffness,the influences of interface slip and semi-rigid joint on composite frame were transferred to quantitative parameter analysis,taking account of cross sectional properties,materials and linear stiffness of composite beam synthetically.Based on the calculation programs,free vibration frequencies and seismic responses of semi-rigid joint steel-concrete composite frame considering interface slip were calculated.The influences of interface slip and semi rigid joint on dynamic characteristics and seismic response were analyzed and the seismic design advices were presented.The results show that the interface slip decreases the free vibration frequencies and increase the seismic responses of composite frame.The semi-rigid joint reduces the free vibration frequencies and increases seismic responses of composite frame compared with rigid joint.With the increase of joint rotational stiffness,the elastic seismic responses of composite frame increase firstly and then decrease.The effects are related to the ratio of joint rotation stiffness to linear stiffness of composite beam.

Compressive strength and frost heave resistance of different types of semi-rigid base materials after freeze-thaw cycles

Freeze-thaw damage is the most common disease of semi-rigid bases in cold regions, which may greatly affect the dura- bility of roadways. In this study, the compressive strength and frost resistance of four different types of semi-rigid bases （lime-fly ash-stabilized sand, cement-stabilized sand, lime-fly ash-stabilized gravel, and cement-stabilized gravel） are assessed by varying the materials content. Based on freeze-thaw and compressive strength tests, this paper presents the performance of the different materials, each having different physical properties, and the optimal amounts of materials contents are proposed.

Use of a modified ureteral access sheath in semi-rigid ureteroscopy to treat large upper ureteral stones is associated with high stone free rates

Objective:To examine differences in outcomes of semi-rigid ureteroscopy(URS)with or without a modified-ureteral-access-sheath(mUAS)to treat large upper ureteral stones.Methods:Patients with single,radio-opaque large upper ureteral stone(≥10 mm)treated using semi-rigid URS between August 2013 and October 2016 were retrospectively evaluated.The stone-free status was determined from Kidney-ureter-bladder(KUB)X-ray films taken on postoperative Day 1 and after 1 month.Results:Of 103 patients meeting inclusion criteria,43(41.75%)and 60(58.25%)were treated with semi-rigid URS with and without mUAS,respectively.The immediate stone-free rate(SFR)for the mUAS group was significantly higher than the non-mUAS group(40[93.0%]vs.46[76.7%];p=0.033).The SFR at 1 month was also high for patients treated using mUAS,but not statistically different from patients not treated with mUAS(41[95.3%]mUAS vs.51[85.0%]non-mUAS;p=0.115).Auxiliary procedure rates were significantly lower for mUAS patients compared to non-mUAS patients(2[4.7%]vs.14[23.3%];p=0.01).There were no significant differences in surgical duration and hospital stays,and the overall complication rates were statistically similar for mUAS patients compared to non-mUAS patients(1[2.3%]vs.3[5.0%];p=0.638).

Effects of temperature change on elastic behavior of steel beams with semi-rigid connections

Based on the nonlinear displacement-strain relationship,the virtual work principle method was used to establish the nonlinear equilibrium equations of steel beams with semi-rigid connections under vertical uniform loads and temperature change.Considering the non-uniform temperature distribution across the thickness of beams,the formulas for stresses and vertical displacements were presented.On the basis of a flowchart for analysis of the numerical example,the effect of temperature change on the elastic behavior of steel beams was investigated.It is found that the maximal stress is mainly influenced by axial temperature change,and the maximal vertical displacement is principally affected by temperature gradients.And the effect of temperature gradients on the maximal vertical displacement decreases with the increase of rotational stiffness of joints.Both the maximal stress and vertical displacement decrease with the increase of rotational stiffness of joints.It can be concluded that the effects of temperature changes and rotational stiffness of joints on the elastic behavior of steel beams are significant.However,the influence of rotational stiffness becomes smaller when the rotational stiffness is larger.

Design of the Composite Steel-Glass Beams with Semi-Rigid Polymer Adhesive Joint

New and high transparent structural element, steel-glass composite beam was developed in respect to fabrication, static-structural and architectural criteria and consists of steel flanges and glass web assembled together by semi-rigid polymer adhesive, which is the key element of whole composite system. These beams can be used mainly as members of high transparent roof or floor structure as well as stiffening fins for large area glass facades. This paper deals with experimental research performed at CTU （Czech Technical University） Prague, which started by adhesive selection and initial material tests by ISO527, continued via small-scale steel-glass connection tests and graduated by full-scale tests of hybrid beams with the span of 4 m. Generalized results of these experiments, analytical and numerical studies serve as device, how to accurately predict the behavior of the beam, describe the stress distribution along the cross section and safely and economically design such a kind of structure with semi-rigid shear connection, made by polymer adhesive.

Effects of Voluntary Apnea on Haemodynamic Responses during Groundwork Techniques of Judo

Context: Several studies were conducted on physiology of apnea in scuba diving. No survey has been reported in fighting sports. Objective: To evaluate cardiovascular variations misled by voluntary apnea during groundwork techniques of judo training. Methods: The temporal evolution of heart rate and modifications of the blood pressure have been investigated during cross sectional and experimental study. A total of 28 Congolese judoists took part in the study. The voluntary apnea was achieved by a judoist to try to carry out two kinds of groundwork (hon-gesagatame and kamishiho-gatame). According to the case, Student t test and analysis of variance were used for comparing data. Multivariate analysis was used to evaluate the effect of “type of groundwork technique × category of weight”. Results: Between 0 and 3 seconds, tachycardia has been observed during the static groundwork techniques and then bradycardia occurred to 3 - 9 seconds for the dynamic groundwork techniques : +6.8% of the rest frequency versus -9.4% for hon-gesa;+4.9% versus -13.7% for kami-shiho. Thereafter, it followed a fluctuation of heart rate of 9 - 15 seconds. Beyond, a stagnation was noted for hongesa, whereas a minimal increase (<5%) for kami-shiho. In relation to the systolic arterial pressure, a meaningful rise was recovered: +46.5% (hon-gesa) versus +50.1% (kami-shiho) in static exercise;+43.4% (hon-gesa) versus +43.3% (kami-shiho) in dynamic exercise. The report was similar for the diastolic arterial pressure: +31.5% (hon-gesa) versus 30.0% (kami-shiho) in static exercise;+20.3% (hon-gesa) versus +23.8% (kami-shiho) in dynamic exercise. Conclusion: The apnea consecutive to the hindrance of an exit groundwork technique to judo drags bradycardia increased while exercise realized static posture, and a rise of the arterial pressure.

STATISTICAL MODELS FOR SEMI-RIGID NEMATIC POLYMERS

Semi-rigid liquid crystal polymer is a class of liquid crystal polymers different from long rigid rod liquid crystal polymer to which the well-known Onsager and Flory theories are applied. In this paper, three statistical models for the semi-rigid nematic polymer were addressed. They are the elastically jointed rod model, worm-like chain model, and non-homogeneous chain model. The nematic-isotropic transition temperature was examined. The pseudo-second transition temperature is expressed analytically. Comparisons with the experiments were made and the agreements were found.

Static behavior of semi-rigid thin-walled steel-concrete composite beam-to-column joints with bolted partial-depth flush end plate:experimental study

A new type of semi-rigid thin-walled steel-concrete composite beam-to-column joint has been proposed in this paper.Five semi-rigid composite beam-to-column joint specimens subjected to hogging moments under monotonic loading were tested to study the static behavior of this new type of joint.The main variable parameters for the five joint specimens were the longitudinal reinforcement ratio and the joint type.The experimental results designated that the magnitude of extension of the longitudinal reinforcement is the most important factor that influenced the moment-rotation characteristic of the new type of joint.The concrete slabs could resist 3.8%-19.1% of the total shear load applied to the cross-sections near the beam-to-column connection.The edge stiffened elements,such as the flange of the lipped I-section thin-walled steel beam,were capable of having considerable inelastic deformation capacity although they had comparatively large width-to-thickness ratios.The shear failure of the concrete cantilever edge strip must be taken into account in practical design because it has significant influence on the anchorage of the longitudinal reinforcement in the new type of external joints.

Progressive Collapse Analysis of Concrete-Filled Steel Tubular Frames with Semi-rigid Connections

A 9-story concrete-filled steel tubular frame model is used to analyze the response of joints due to sudden column loss. Three different models are developed and compared to study the efficiency and feasibility of simulation, which include substructure model, beam element model and solid element model. The comparison results show that the substructure model has a satisfying capability, calculation efficiency and accuracy to predict the concerned joints as well as the overall framework. Based on the substructure model and a kind of semi-rigid connection for concretefilled square hollow section steel column proposed in this paper, the nonlinear dynamic analyses are conducted by the alternate path method. It is found that the removal of the ground inner column brings high-level joint moments and comparatively low-level axial tension forces. The initial stiffness and transmitted ultimate moment of the semi-rigid connection are the main factors that influence the frame behavior, and their lower limit should be guaranteed to resist collapse. Reduced ultimate moment results in drastic displacement and axial force development, which may bring progressive collapse. The higher initial stiffness ensures that the structure has a stronger capacity to resist progressive collapse.

Infrapubic versus Penoscrotal Approaches for Implantation of Semi-Rigid Penile Prosthesis

Background: Modification of surgical techniques to minimize wound infections in penile implant surgery using malleable prosthesis which is easy to use, of very low risk of mechanical failure and is financially suitable to improve outcome and ensures less complications. The aim of the study is to compare infrapubic approach and Penoscrotal approach in penile semi-rigid prosthesis implantation surgery. Patients and methods: Fifty patients were randomly divided into two groups and each group underwent one approach. Results: No statically significant differences were found between both groups in terms of operative time. Corporeal cross over was the most common intraoperative complications, 3 cases in IP approach and 6 cases in PS but not statistically significant. Peyronie’s disease patients underwent penile implant through infrapubic approach in 3 cases and PS in 4 cases with one recorded complication of keloid formations with IP. Urethral false passage reported only in one case with PS approach without affecting the procedure. Only minor complications including superficial wound infection which was significantly more with PS, 6/25 (24%) and IP 1/25 (4%), p value = 0.041. Penile and scrotal edema was common with IP approach (92%) in comparison with PS approach (60%). The urethral catheter can be abandoned with IP to avoid the risk of catheterizations. No significant relation between diabetes and infections and no erosions were encountered. Conclusion: Through this research work, infrapubic approach is better than Penoscrotal approach even if it is not commonly used by surgeon.

Study on Test Methods for Mechanical Properties of Semi-rigid Base Cores of In-service Pavements

Compressive strength and compressive resilience modulus are two important parameters to measure the mechanical properties of semi-rigid base.The test methods of semi-rigid base cores are different from those of the laboratory samples in terms of sample acquisition,sample selection and humidity requirements.Core-drilling location,size of core sample,smoothness and humidity conditions were analyzed.The test methods of compressive strength and compressive resilience modulus were proposed.The research results show that compressive strength of lime fly-ash stabilized gravels base has a tendency of increasing during a long period.The compressive resilience modulus increases significantly with compressive strength of semi-rigid base.The compressive resilience modulus generally is 3-4 times than the recommended range of asphalt pavement design specifications.The fluctuation range of compressive resilience modulus is obviously higher than the compressive strength.The compressive resilience modulus is more sensitive to the construction variability.The overall trend between the compressive resilience modulus and the back-calculation modulus is consistent.FWD(falling weight deflectometer)back-calculation modulus can reflect the stiffness and bearing capacity of asphalt pavement.

Semi-Rigid Registration of 3D Points

In this paper, we proposed a method for semi-rigid changed 3D point clouds registration. We first segment the point clouds into individual segments and then the alignment energy costs of each segment are calculated. The rough initial transformation is estimated by minimizing the energy cost using integer programming. The final registration results are obtained by rigid alignments of separated corresponded segments. Experimental result with simulated point clouds demonstrate that the concept of semi-rigid registration works well.

Analytical Model of Nonlinear Semi-rigid Frames Using Finite Element Method

Performance-based design for a constructional steel frame in nonlinear-plastic region requires an improvement in order to achieve a reliable structural analysis.The need to explicitly consider the nonlinear behaviour of structures makes the numerical modelling approach much more favourable than expensive and potentially dangerous experimental work.The parameters considered in the analysis are not limited to the linear change of geometry and material yielding,but also include the effect of large deformations,geometrical imperfections,load eccentricities,residual stresses,strain-unloading,and the nonlinear boundary conditions.Such analysis requires the use of accurate mathematical modelling and effective numerical procedures for solving equations of equilibrium.With that in mind,this paper presents the mathematical formulations and finite element procedures of nonlinear inelastic steel frame analysis with quasi-static semi-rigid connections.Verification and validation of the developed analytical procedures are conducted and good agreements are obtained.It is an approach that enables the structural behaviour of constructional steel frames to be traced throughout the entire range of loading until failure.It also provides information on the derivation of the structural analysis by using finite element method.

Semi-rigid腰椎后路动态钉棒固定系统治疗单节段腰椎不稳的疗效观察

目的探讨Semi-rigid腰椎后路动态钉棒固定系统治疗单节段腰椎不稳的临床疗效。方法对该院2009年6月—2011年1月间采用Semi-rigid腰椎后路动态钉棒固定系统手术治疗34例单节段腰椎不稳症病例进行回顾性分析。结果随访10～24个月,优31例(91.2%),良2例(5.9%),差1例(2.9%),优良率97.1%。结论 Semi-rigid腰椎后路动态钉棒固定系统可有效治疗单节段腰椎不稳,值得临床推广。

辽宁省大窑湾某建筑场地岩溶发育特征及工程地质条件评价

辽宁省大窑湾地区某建筑场地内基岩为可溶性中等～强的碳酸盐岩,岩体裂隙发育,在海水入侵、潜水与岩溶裂隙水等共同作用下,岩溶发育较强烈。本场地勘察揭露溶洞的见洞率70.27%。溶洞多发育于地表下20～30 m之间,其次为30～40 m。本文根据揭露溶洞的大小将溶洞分成大型溶洞(洞高≥4 m)、中偏大型溶洞(2 m≤洞高<4 m)、中型溶洞(0.5 m≤洞高<2 m)和小型溶洞(洞高<0.5m)等四类,分析表明本场地内溶洞以中型溶洞为主,其次为小型溶洞和中偏大型溶洞,岩溶的发育和分布对场地工程地质条件影响较大。本文围绕场地岩溶发育这一主要工程地质问题,从岩溶发育的地质背景、形成条件、分布特点等方面对场地内的岩溶发育特征进行了分析研究,认为本场地属于岩溶中等～强发育的复杂的岩溶红粘土地基,需采取CFG桩、振冲碎石桩复合地基或采用桩基等措施对地基进行处理,以保证工程安全。

地铁隧道开挖中地下管线的内力和变形分析

以Winkler弹性地基梁理论为基础,针对地铁开挖过程中地下管线的受力作用和变形作用进行分析,并在考虑地基扩散作用影响下构建地下管线挠度位移、转角、弯矩和剪力的表达式,定量分析地基扩散角与埋深对地下管线变形的影响.经理论分析证明:地下管线最大挠度出现在沉陷区域中间,沉陷区两端边缘处集中了最大弯矩和剪力,地基扩散角与管线的埋置深度均对管线最大挠度有重要影响.