Complete Section Research Articles

Massage Therapy to Relieve Menopausal Symptoms: A Systematic Review

Objective: This study aims to analyze the duration, time, and results of massage therapy in reducing symptoms of menopause. Methods: A systematic review through maternity nursing articles to analyze the effects of massage therapy in reducing menopausal symptoms. The inclusion criteria in this study are 1) related articles about massage therapy. 2) Articles that contain interventions used in reducing menopausal symptoms. 3) Articles use English in writing. 4) Articles published after 2010. 5) Articles published have a complete section. Search articles using electronic databases namely Sciene Direct, Pubmed, PMC, Google Schoolar and Scopus. Articles that meet the inclusion criteria will be collected and analyzed systematically. Results: In a systematic review it is explained that massage therapy can reduce menopausal symptoms but in the location and duration of the intervention still need consideration from further researchers. Conclusion: Based on the results of the study, massage therapy carried out in the back area is recommended to reduce menopausal symptoms.

Palаeomagnetism of the Vendian traps of Volyn, southwestern margin of the East European platform. P. 1: palаeomagnetic directions and poles

In Earth’s geological evolution the Vendian is significant because: 1) it preceded the «Cambrian Evolutionary explosion» when the multicellular organisms became suddenly much more diverse; 2) it is associated with the global tectonic and palaeogeographic restructuring of supercontinents, a change in geomagnetic field generation and other global processes affecting different layers of the Earth. At the same time, recent publications indicate an extremely irregular behavior of the geomagnetic field in the Vendian, which significantly differs from the recent regime of the geomagnetic field generation. New information on the configuration and magnitude of the geomagnetic field is crucial for understanding the reasons that can cause different modes of geodynamo. The article describes the new results of palaeomagnetic studies of the Volyn traps — basalts and tuffs of the Volyn series with ages about 560—580 My. The determined palaeodirections and palaeopoles are in good agreement with the previously published data of other authors and substantially complement them. The ChRM-component of «low-titanium» basalts was isolated in high-temperature (>500 °C) and characterized as primary. The same samples were used for palaeointensity determinations which showed the extremely low values of the geomagnetic field — an order of magnitude lower than the present one. The ChRM-component of «high-titanium» basalts was yielded in the temperature range of 200—400 °C. No results were obtained from palaeointensity experiments, and the complex nature of remanent magnetization remains unclear. The new data are compared with the palaeo-magnetic data of the Vendian—Early Cambrian poles of the East European Platform determined by other authors. To test the hypothesis of an anomalous Ediacaran magnetic field characterized by a low dipole moment and a high inversion frequency, more data are necessary. These data can be obtained from the studies of a stratigraphically more complete section of the Volyn traps opened by boreholes. These results will be presented in the next part of the article.

An integrated remote sensing, aeromagnetic and field study of the Ablah shear zone (Asir Terrane, Saudi Arabia): Structural styles and implications for the tectonic evolution

• Surface and subsurface structural mapping was carried out for the Ablah shear zone. • Northerly striking thrust faults define the positive flower structure that impacts the shallow rocks in the zone. • Shallow thrusting ends at 1.5 to 2 km depth and is converted into single thrust shear. • Contraction tectonic regime initiated the shear zone and was later superposed by dextral-transpression regime. An integration of merged remote-sensing data having different spatial/spectral resolutions with aeromagnetic data and detailed field investigation is used to identify the composite Neoproterozoic rock complexes and define the structural architecture of the Ablah Shear Zone (ASZ). The SPOT and Landsat-8 data are processed as color composite images allowed the separation of different lithologic units and associated structures. Aeromagnetic data were analyzed using the Total Magnetic Intensity (TMI) and Reduced to the Pole (RTP) methods. The resulted anomalies show seven N-S opposite-dipping thrust faults that affect the shallow crustal rocks and coalesce together at about 1.5 to 2 km depth where the rock magnetic polarities inversed. This thin-skinned thrusting was initiated by a contractional tectonic regime in the E-W direction and superposed later by a transpresssion tectonic regime in the ENE-WSW direction. This study deals with the thin-skinned thrusting deformation in the ASZ that could be occurred during the deformation of the other shear zones that affect the internal part of the Asir tectonic terrane. Two controversial tectonic meanings describe the tectonic evolution of the ASZ, the first one is the thin-skinned thrusting tectonic that indicating shallow earth s crust deformation and the second one is the occurrence of some ophiolitic slices that indicating suturing tectonic deformation. The absent of the complete ophiolitic section encourages us regarding the ASZ as a structural shearing zone rather than a suture zone.

Safety and efficacy of anterior intercostal artery perforator flaps in oncoplastic breast reconstruction.

Partial breast reconstruction based on the anterior intercostal artery perforators (AICAP) has been suggested to avoid the unsightly 'bird's beak' deformity for lower pole breast cancers. The aims of this study were to evaluate the initial clinical experience of AICAP flaps in terms of safety and efficacy in oncoplastic breast reconstruction. Between October 2013 and April 2020, AICAP flaps were offered to 30 patients with lower pole breast cancers. Hand-held Acoustic Doppler assessments were undertaken to confirm adequate perforators. Surgical results were evaluated in terms of safety and efficacy. Patients were invited to complete sections of the Breast-Q questionnaire at least 12 months postoperatively to assess patient satisfaction in terms of cosmetic outcome, physical and psychosocial wellbeing. Median operating theatre time for AICAP flap harvesting and positioning was 20 min (range 15-28 min). The median weight of resected breast specimens was 41 g (range 10-127 g). Total tumour size ranged from 7 to 35 mm (median 16 mm; three cases exhibited multifocal disease). Clear radial resection margins were achieved in 29 cases (96.7%). The median post-operative stay was two days (range 2-3 days). There were two postoperative complications comprising delayed wound healing/fat necrosis, which resolved with monitoring and inadine dressings. Based on the Breast-Q results, patients reported high levels of satisfaction with the physical appearance of their reconstructed breast, psychosocial and physical wellbeing. AICAP flaps appear to be safe in restoring breast contour after wide excision of lower pole breast cancers, with high levels of patient satisfaction reported postoperatively.

From initiation to termination: The evolution of the Ediacaran Volyn large igneous province (SW East European Craton) constrained by comparative geochemistry of proximal tuffs versus lavas and zircon geochronology

The Volyn Series, representing a large intra-plate igneous province, is the result of an Ediacaran lithospheric-scale extension related to the breakup of the Rodinia/Pannotia supercontinent. Due to its subsequent burial and thus limited subsurface access, the precise determination of the igneous activity’s initiation and termination, as well as the reconstruction of its geochemical evolution throughout time still remains a challenge. In its western part (the study area) abundantly cored deep boreholes provide an advantage in accessing rock samples. Among them Kaplonosy IG 1, representing the most complete section with the greatest thickness, preserves a record of initiation and termination of volcanic activity. Tuff samples, collected from the top the Volyn Series, were used for U-Pb zircon dating focussed on autocrysts but from the bottom also on antecrysts. The initiation of effusive activity was dated at 580 ± 10 Ma, and its termination at 547 ± 6 Ma. These volcanics have been affected by later alteration processes (hydrothermal and K- metasomatism), although trace element geochemical data hold information on the primary magmas. The data plot along a common geochemical trend, defined by the trace element contents of the lava samples. Detailed geochronological zonation of the vertical section (in this and previous studies) and its good geochemical coverage, allow for the reconstruction of the igneous system’s geochemical evolution through time. Three main phases were recognized. The initial phase, composed of picrite lavas and tuffs (c. 580–567 Ma), is characterised by extremely low concentrations of Zr and TiO2, but elevated Cr and Ni contents. The main phase (c. 567–551 Ma) is characterised by a large number and volume of subalkaline basalt to andesite flows and tuff beds. The eruptions in the terminal phase (c. 551–547 Ma) indicate a significant decrease in volume, longer hiatuses between eruptive episodes and an increase in the silicic components as well as in the most evolved compositions. The ages measured indicate that, during the break-up of Rodinia/Pannotia, the rifting and separation of Baltica from Amazonia occurred later than the separation of Laurentia from Baltica and from Amazonia.

Core-aware combining: Accelerating critical section execution on heterogeneous multi-core systems via combining synchronization

In heterogeneous multi-core systems, performance differences of the cores can affect lock synchronization, where the high-performance cores have to wait for slower cores to complete critical section execution. To better utilize the high-performance cores, we can offload critical section execution to high-performance cores. Since combining synchronization has the potential to transfer critical section execution to the combiner, this paper presents a core-aware combining approach for heterogeneous multi-core processors to accelerate critical section execution. In combining synchronization, one competing thread will become the combiner to help complete pending requests. It typically provides better performance than conventional locks on multi-core systems. To enable transferring critical section executions to a more efficient core, we implement the ideas of core efficiency-based selective lock ownership transfer and the dynamic helping quota in four combining implementations. On an aarch64 heterogeneous machine and an x86 asymmetric machine, we ran several micro-benchmarks and workloads to evaluate the performance of our core-aware implementations. The results show that core-aware combining implementations accelerate critical section execution and achieve better throughput than the original combining implementations.

Systematic study of fusion suppression for tightly bound projectiles at above-barrier energies

The present work aims to explore the effects of projectile breakup on fusion cross section at energies near the Coulomb barrier to well above it. The complete fusion cross section for the strongly bound non-$\ensuremath{\alpha}$-cluster projectile $^{14}\mathrm{N}$ in interaction with a $^{181}\mathrm{Ta}$ target was obtained by summing the experimentally measured channel-by-channel cross section data of evaporated residues. The obtained total fusion cross section was compared with the theoretical code ccfull and the results were found to be consistent with each other. Further, the experimental fusion function data on $^{181}\mathrm{Ta}$ target with $^{14}\mathrm{N}$ projectile were deduced and compared with those obtained for other strongly bound projectiles, viz., $^{12,13}\mathrm{C}$, $^{16}\mathrm{O}$, and $^{19}\mathrm{F}$, in order to get some systematics in fusion reactions. The analysis of experimental fusion functions was performed within the framework of a benchmark curve called the universal fusion function (UFF). A suppression of about 5--25% with respect to UFF was observed for the presently studied systems at energies above the Coulomb barrier, indicating that the suppression is essentially due to the prompt breakup of the projectiles and is a strong function of breakup threshold of projectiles. The magnitude of such suppression was found to be lower for $^{14}\mathrm{N}$ projectile as compared to other strongly bound projectiles. Moreover, an interesting exponential relation between the experimentally deduced suppression factor and the breakup threshold of the projectile was obtained.

Geochemical indications for the Paleocene-Eocene Thermal Maximum (PETM) and Eocene Thermal Maximum 2 (ETM-2) hyperthermals in terrestrial sediments of the Canadian Arctic

Abstract During the late Paleocene to early Eocene, clastic fluvial sediments and coals were deposited in northern high latitudes as part of the Margaret Formation at Stenkul Fiord (Ellesmere Island, Nunavut, Canada). Syn-sedimentary tectonic movements of the Eurekan deformation continuously affected these terrestrial sediments. Different volcanic ash layers occur, and unconformities subdivide the deposits into four sedimentary units. Rare vertebrate fossils indicate an early Eocene (Graybullian) age for the upper part of the Stenkul Fiord outcrop. Here, we present carbon isotope data of bulk coal, related organic-rich mud and siltstones, a plant leaf wax-derived alkane, and additional plant remains. These data provide a complete carbon isotope record of one stratigraphic section with defined unconformity positions and in relation to other Eurekan deformation features. A previously dated ash layer MA-1 provided a U-Pb zircon age of 53.7 Ma and is used as a stratigraphic tie point, together with a discrete negative carbon isotope excursion found above MA-1 in a closely sampled coal seam. The excursion is identified as the likely expression of the I-1 hyperthermal event. Based on our isotope data that reflect the early Eocene dynamics of the carbon cycle, this tie point, and previous paleontological constraints from vertebrate fossils, the locations of the Paleocene-Eocene Thermal Maximum (PETM) and Eocene Thermal Maximum 2 (ETM-2) hyperthermals and their extent along the complete section are herein identified. Within the intervals of the PETM and ETM-2 hyperthermal events, increasing amounts of clastic sediments reached the site toward the respective end of the event. This is interpreted as a response of the fluvial depositional system to an intensified hydrological system during the hyperthermal events. Our study establishes an enhanced stratigraphic framework allowing for the calculation of average sedimentation rates of different intervals and considerations on the completeness of the stratigraphic record. As one of the few high-latitude outcrops of early Eocene terrestrial sediments, the Stenkul Fiord location offers further possibilities to study the effects of extreme warming events in the Paleogene.

The role and significance of Magnesium in modern day research-A review

Magnesium is one of the largely available elements in the earth's crust. It has a low structural density with high specific strength. This unique material property has forced an increase in the use of magnesium and its alloys in various applications pertaining to industrial sector, automobiles, aerospace and biomedical. Since magnesium is a highly reactive metal, it is prone to higher rate of corrosion as compared to its counterparts. Thus, it is essential to analyze the corrosion behavior of magnesium and its alloys in its applications. An appropriate process is to be followed in the design and development of magnesium alloys which overcome the limitations of magnesium and enhance the desired material properties in accordance to their applications. This review paper summarizes the importance of magnesium and its material properties. The influence of various alloying elements on the mechanical properties of magnesium is reviewed. The broad classification of Mg alloys and their behavioral trends are detailed. The corrosion behavior of magnesium and the influence of corrosion products on the material characteristics of magnesium, in aqueous medium, are discussed. The manufacturing techniques of magnesium alloys along with the secondary techniques are also covered. The various applications and the limitations of magnesium in these applications are covered. A complete section is dedicated towards detailing the recent trends of magnesium (Mg) alloys, i.e., the biodegradable nature and applications of Mg alloys. The influence of biocorrosion on Mg alloys and techniques to overcome it have been deliberated. This paper provides a thorough review on recent developments of magnesium with respect to engineering applications.

Experimental Study on the Bending Properties of Grouting Butt Joints Reinforced by Steel Plate Embedded in Bamboo Tube

The construction of grouting butt joints of bamboo tubes is simple and efficient. However, when the joint is bent, the low tensile strength of the mortar easily leads to cracking of the mortar prior to the failure of the bamboo tube. In this paper, a comparative test of the bending capacity was performed on grouting butt joints reinforced by nonperforated, fully perforated, and semiperforated steel plates embedded in bamboo tubes to obtain the load-displacement curves and ultimate bearing capacity of various specimens. The strengthening effect of CFRP pasted on bamboo tubes was also studied. The results show that the opening at the end of the steel plate is beneficial to resist the slip between the mortar and steel plate, while the complete section in the middle of the steel plate is conducive to making full use of the tensile strength of the steel plate. Therefore, it is best to insert the semiperforated steel plate with openings in the end and without openings in the middle into the mortar to enhance the bending properties of the grouting butt joint, which can make the failure mode of the joint change from brittle failure of mortar to ductile compression failure of bamboo tube. In addition, pasting CFRP sheets on the external wall of the bamboo tube helps to reduce the tensile stress of the mortar, while increasing the width of the steel plate can increase the bending moment of inertia of the mixture of the steel plate and mortar. These two complementary measures are very effective in delaying the cracking of the bamboo tube and improving the bending capacity of the joint.

Bile Duct Injury, Strasberg E3, Secondary to Open Cholecystectomy, Resolved by Minimal Invasion with Robotic Assistance. Multidisciplinary Management of Bile Duct Injuries

We present the case of a 44-year-old male with a complex bile duct injury during an open cholecystectomy due to scheduled surgery, referred to our unit for definitive management. Material and methods A 44-year-old patient who was admitted to our unit referred from his health level, presenting with a noticeable disruption of the bile duct during open cholecystectomy, identified in the intraoperative period, and managed with cannulation of the hepatic duct with a feeding tube. On admission 7 days after the operation, referring to mild pain at the surgical wound site, with a feeding tube with frank biliary output of 400 cc daily. A study protocol is carried out for staging the lesion, reporting at the level of the contrasted computerized axial tomography, with a high lesion, of apparent presence at the immediate level of the confluence. Conditions of the patient are improved and their intervention is decided with a view to definitive derivation by means of minimal invasion assisted by robot. Which is performed 2 days after admission due to a patient with adequate evolution without an inflammatory response. Finding a cavity with no evidence of bile leakage, with the complete section at the level just below the confluence, with the cannulated hepatic duct, deciding to perform a Roux-en-Y hepatojejunum, with enlargement of the left hepatic duct, 0.5 cm , and the formation of the anastomosis with intracorporeal V-Lock, subsequent lavage of the cavity and placement of a drain.

Middle and Upper Miocene Deposits and Facies of Northern Ustyurt (Western Kazakhstan)

Abstract —We present data on the most complete Neogene sections and wells of northern Ustyurt and the Cis-Aral area. Miocene deposits in the northern chinks and the North Ustyurt depression are composed of sediments of the Tarkhanian, Chokrakian, Karaganian, Konkian, and Sarmatian regional stages of the Eastern Paratethys, which are overlapped by lower Pontian beds. The distribution of thickness and facies shows that the North Ustyurt depression remained the main synclinal structure of the region, along which the waters of all Miocene transgressions were spread. Sandy material was brought by the rivers from the north: A sandy lens of Chokrakian age is traced along the Shomishtykol Sor almost to the axial part of the depression. Transgressions were pulsating, and the lower and middle Sarmatian deposits were most widespread. These data are presented as a geological profile near Beineu Village and as schematic maps of facies for the middle Miocene regional stages.

Paleoenvironment of the Cerro Negro Formation (Aptian, Early Cretaceous) of Snow Island, Antarctic Peninsula.

A study of macro and microfacies, palynoflora and palynofacies of the non-marine Cerro Negro Formation at President Head Peninsula, Snow Island, northwest of the Antarctic Peninsula, was developed. Two assemblages were recognized: Palynofacies assemblage 1 (P1) at the base of the section with a dominance of fern spores and conifer pollen grains, and facies association consisting of a clastic layer, with the predominance of mudstones; and Palynofacies assemblage 2 (P2) at the top of the section, with remarkable abundance of AOM/Pseudoamorphous particles, associated with facies that includes tuffs. The complete section shows in some levels the presence of freshwater algae and translucent phytoclasts. The integrated data characterizes a fluvial-lacustrine environment, what is reinforced by the occurrence of freshwater algae (Botryococcus) in some levels of P1 and P2. We could verify an increase in volcanic activity towards the top of the section that apparently has played an important role in the collapse of the palynoflora. The occurrence of the spore species Muricingulisporis annulatus, Sotasporites elegans, S. triangularis, Foraminisporis wonthaggiensis, and F. asymmetricus in the Cerro Negro Formation allows the correlation with sections in South America and Australia, suggesting an Aptian age for these deposits.

Experimental investigation of the Ni-V-W ternary phase diagrams

Phase equilibria in the Ni-V-W ternary system have been experimentally investigated. The phases and their compositions of Ni-V-W alloys annealed at 900 and 1100 °C were studied via X-ray diffraction (XRD) and electron probe micro-analysis (EPMA) measurements. The isothermal section measured at 1100 °C showed a three-phase region of fcc + bcc + (σ). Two three-phase regions [fcc + bcc + (σ) and WNi4 + WNi + bcc] were detected in the samples annealed at 900 °C. No ternary compounds were detected in the present work. The solubility of V in the Ni-W binary compounds, i.e. WNi4, WNi, W2Ni, at 900 °C was found to be extremely small (maximum 1.12 at. % V). The solubilities of W in (σ) at 900 and 1100 °C were found to be 2.14 at. % and 3.17 at. %, respectively. The complete isothermal sections at 900 and 1100 °C of the Ni-V-W system were then constructed, which are needed for a thermodynamic optimization of the ternary system.

Metal additive manufacturing using friction stir engineering: A review on microstructural evolution, tooling and design strategies

Solid state metal additive manufacturing (SS-MAM) techniques based on friction stir engineering (FSE) have gained significant attention since the last decade and act as a bridge for many existing MAM shortfalls. In this article, SS-MAM techniques based upon FSE especially additive friction stir (AFS) and friction stir additive manufacturing (FSAM) are discussed. There is meagre research with respect to tooling associated with these processes since they involve expertise in two fields i.e., AM and FSE. The current article bridges this gap with a detailed discussion on all relevant fundamentals of AFS and FSAM. The recent developments with respect to tooling design and parameters are discussed in-depth. Also, this article discusses metallurgy, microstructural aspects and mechanical properties of deposited layers via these techniques. A detailed timeline summarizing the development with respect to these techniques has been presented. A complete section is dedicated to utilization of these techniques for different applications. Recent developments and trends are also discussed in detail.

Distribution of Microfossils in the Vendian Deposits of the Orsha Depression of the East European Platform, Belarus

—The complete sections of the Lower and Upper Vendian of the East European Platform were opened in the boreholes of Belarus. This allows us to consider this region as a stratotype area. In order to update the paleontological characteristics of the Vendian, organic-walled microfossils from the Bogushevsk-1, Bogushevsk-2 (Liozno), and Lepel-1 reference boreholes drilled in the north of the Orsha Depression were studied. The transitive assemblage I with Leiosphaeridia minutissima–Leiosphaeridia tenuissima was recognized in the Lower Vendian Liozno Formation of the Volyn Series and the Upper Vendian Kotlin Formation. The Redkino microfossil assemblages were identified at three stratigraphic levels in the Nizy, Selyava, and Chernitsa formations: assemblage II with Morania zinkovi, assemblage III with Morania zinkovi–Tynnia precambrica, and assemblage IV with Morania zinkovi–Tynnia precambrica–Striatella coriacea, respectively. The Kotlin assemblage V with Vendotaenia antiqua–Primoflagella speciosa was distinguished in the upper part of the Kotlin Formation (Bogushevsk-1 borehole). On the basis of the taxonomic composition, assemblages III and IV are correlated with the first Redkino biota of the Starorusskaya Formation; assemblage V is correlated with the third Kotlin biota of the Vasileostrovskaya Formation of the northwestern part of Russia. Our data show a high biostratigraphic potential of organic-walled microfossils, which should be used to substantiate regional stratigraphic units of the Upper Vendian in the updated stratigraphic scheme of the East European Platform.

Late Eocene to early Oligocene calcareous nannofossil biostratigraphy of the Cerro Colorado Formation, Austral basin, Argentina

This paper documents calcareous nannofossil assemblages and the bioevents recorded in the Austral basin of Tierra del Fuego, Argentina. Fifty samples from the type section of the Cerro Colorado Formation were analyzed. Nannoflora is moderately preserved and indicates a late Eocene to early Oligocene age for sedimentary rocks of this formation. Biostratigraphic results are based on distribution patterns of calcareous nannofossils assemblages, permitting comparison with the Southern Ocean zonations and some correlations with standard schemes. Our biostratigraphic interpretation shows an almost complete stratigraphic section spanning from the Priabonian to Rupelian Stages and calcareous nannofossil Chiasmolithus oamaruensis to Blackites spinosus zones, or the low latitude zones of Martini NP18 to NP21. The oldest fossiliferous rocks from the type locality of the Cerro Colorado Formation contain Chiasmolithus oamaruensis indicating nannofossil Zone NP18. The Eocene/Oligocene boundary was placed between the last occurrence (LO) of Reticulofenestra oamaruensis and the increasing in abundance (IB) of Reticulofenestra daviesii. Samples taken from the top of the section belong to the Estancia María Cristina Beds have Cyclicargolithus abisectus. During the late middle to late Eocene a hiatus is suggested between the Cerro Colorado and Leticia formations evident by a 39 Ma detrital zircon age dating, and the first occurrence (FO) of Dictyococcitesbisectus. Furthermore, the presence of C. abisectus in the Estancia María Cristina Beds suggests an unconformity with the underlying Cerro Colorado Formation as previously inferred by stratigraphic relationships.

An Automated Approach to Improve the Quantification of Pericytes and Microglia in Whole Mouse Brain Sections.

Whole slide scanning technology has enabled the generation of high-resolution images from complete tissue sections. However, commonly used analysis software is often unable to handle the large data files produced. Here, we present a method using the open-source software QuPath to detect, classify and quantify fluorescently-labeled cells (microglia and pericytes) in whole coronal brain tissue sections. Whole-brain sections from both male and female NG2DsRed x CX3CR1+/GFP mice were analyzed. Small regions of interest were selected and manual counts were compared with counts generated from an automated approach, across a range of detection parameters. The optimal parameters for detecting cells and classifying them as microglia or pericytes in each brain region were determined and applied to annotations corresponding to the entire somatosensory and motor cortices, hippocampus, thalamus, and hypothalamus in each section. 3.74% of all detected cells were classified as pericytes; however, this proportion was significantly higher in the thalamus (6.20%) than in other regions. In contrast, microglia (4.51% of total cells) were more abundant in the cortex (5.54%). No differences were detected between male and female mice. In conclusion, QuPath offers a user-friendly solution to whole-slide image analysis which could lead to important new discoveries in both health and disease.

Incidence of New-Onset Obstructive Sleep Apnea After Posterior Flap Pharyngoplasty in Children.

Obstructive sleep apnea (OSA) is a well-recognized complication of velopharyngeal insufficiency (VPI) surgery, but studies assessing OSA by means of a respiratory polygraphy (PG) are scarce. The aim of the study was to evaluate the incidence of new-onset OSA after posterior flap pharyngoplasty (PFP). The postoperative PG of children with VPI who had a normal preoperative PG were analyzed. Eighteen patients (mean age, 9.8 ± 4.8 years; Pierre Robin sequence [n = 5], isolated cleft palate [n = 7], 22q11 deletion [n = 3], and 3 other diagnoses) were included in the study. Mean delay between surgery and the postoperative PG was 11.5 ± 13.5 months. Two patients (11%) developed severe OSA after PFP. One patient with 22q11 deletion developed overt OSA symptoms immediately after surgery with an apnea-hypopnea index (AHI) of 39 events per hour, requiring continuous positive airway pressure (CPAP) therapy. Obstructive sleep apnea improved spontaneously after 10 months, with an AHI of 2 events/h after CPAP weaning. The second patient had a cleft palate associated with a fetal alcohol syndrome and developed OSA symptoms after surgery with an AHI of 18 events/h requiring CPAP therapy. He could be weaned from CPAP 6 months later after a complete section of the pharyngeal flap with an AHI of 6 events/h during spontaneous breathing. New-onset OSA after PFP in children with VPI who had a normal preoperative PG was uncommon (11%) in the present cohort.

Analysis on the Construction Timing and Stability of Double-layer’s initial supports of Soft Rock Tunnel Based on Convergence-Confinement Method

Many tunnels face large soft rock deformation problems in Southeast China. Double-layer’s initial support could effectively solve the problem of large deformation in soft rock tunnels, which can flexibly control the timing and ensure support stability. Combined with the Yuntunbao Tunnel of Chengdu-Lanzhou Railway, the timing and stability of the double-layer’s initial support in soft rock tunnel were studied based on the convergence-confinement method. The ground reaction curve was calculated under different models, and the longitudinal deformation profile was evaluated using numerical simulation. Empirical equations helped to compute the support characteristic curve. The convergence-confinement curve was drawn to discuss the second layer’s initial support timing according to the results mentioned above. After the verification of field data, the effectiveness of numerical simulation was initially verified. The results show that: 1. The ground reaction curve obtained by the H-B model is closer to the engineering reality than the curve obtained by the M-C model. 2. Compared with the bench method, the complete section method is unfavorable to the support, and the support safety factor is lower. 3. The first layer’s initial support should be implemented immediately after excavation, and the second layer’s initial support should be executed when the first layer reaches 70% of its limit deformation.