UK guidance on the initial evaluation of an infant or an adolescent with a suspected disorder of sex development

It is paramount that any child or adolescent with a suspected disorder of sex development (DSD) is assessed by an experienced clinician with adequate knowledge about the range of conditions associated with DSD. If there is any doubt, the case should be discussed with the regional team. In most cases, particularly in the case of the newborn, the paediatric endocrinologist within the regional DSD team acts as the first point of contact. The underlying pathophysiology of DSD and the strengths and weaknesses of the tests that can be performed should be discussed with the parents and affected young person and tests undertaken in a timely fashion. This clinician should be part of a multidisciplinary team experienced in management of DSD and should ensure that the affected person and parents are as fully informed as possible and have access to specialist psychological support. Finally, in the field of rare conditions, it is imperative that the clinician shares the experience with others through national and international clinical and research collaboration. © 2011 Blackwell Publishing Ltd.

Influence Of Free Surface Curvature Of A Liquid Layer On The Critical Marangoni Convection

The Pearson instability was suggested to discuss the onset of Marangoni convection in a liquid layer of large Prandtl number under an applied temperature difference perpendicular to the free surface in the microgravity environment. In this case, the temperature distribution on the curved free surface is nonuniform, and the thermocapillary convection is induced and coupled with the Marangoni convection. In the present paper the effect of volume ratio of the liquid layer on the critical Marangoni convection and the corresponding spatial variation of the convection structure in zero-gravity condition were numerically investigated by two-dimensional model. (C) 2008 Elsevier Ltd. All rights reserved.

An In-Situ Observation On Initial Aggregation Process Of Colloidal Particles Near Three-Phase Contact Line Of Air, Water And Vertical Substrate

The self-assembling process near the three-phase contact line of air, water and vertical substrate is widely used to produce various kinds of nanostructured materials and devices. We perform an in-situ observation on the self-assembling process in the vicinity of the three phase contact line. Three kinds of aggregations, i.e. particle-particle aggregation, particle-chain aggregation and chain-chain aggregation, in the initial stage of vertical deposition process are revealed by our experiments. It is found that the particle particle aggregation and the particle-chain aggregation can be qualitatively explained by the theory of the capillary immersion force and mirror image force, while the chain-chain aggregation leaves an opening question for the further studies. The present study may provide more deep insight into the self-assembling process of colloidal particles.

Peeling Experiments Of Ductile Thin Films Along Ceramic Substrates - Critical Assessment Of Analytical Models

Two types of peeling experiments are performed in the present research. One is for the Al film/Al2O3 substrate system with an adhesive layer between the film and the substrate. The other one is for the Cu film/Al2O3 substrate system without adhesive layer between the film and the substrate, and the Cu films are electroplated onto the Al2O3 substrates. For the case with adhesive layer, two kinds of adhesives are selected, which are all the mixtures of epoxy and polyimide with mass ratios 1:1.5 and 1:1, respectively. The relationships between energy release rate, the film thickness and the adhesive layer thickness are measured during the steady-state peeling process. The effects of the adhesive layer on the energy release rate are analyzed. Using the experimental results, several analytical criteria for the steady-state peeling based on the bending model and on the two-dimensional finite element analysis model are critically assessed. Through assessment of analytical models, we find that the cohesive zone criterion based on the beam bend model is suitable for a weak interface strength case and it describes a macroscale fracture process zone case, while the two-dimensional finite element model is effective to both the strong interface and weak interface, and it describes a small-scale fracture process zone case. (C) 2007 Elsevier Ltd. All rights reserved.

On The Interaction Of Channeling/Segmentation Cracks Of Coating: Study On The Critical Spacing

Channeling/segmentation cracks may arise in the coating subjected to in-plane tensile stress. The interaction between these multiple cracks, say the effect of the spacing between two adjacent cracks oil the behaviors of channels themselves and the interface around the interface corners, attracts wide interest. However, if the spacing is greater than a specific magniture,, namely the Critical Spacing (CS), there should be no interaction between such channeling/segmentation cracks. In this study, file mechanism of the effect of the crack spacing oil the interfacial stress around the interface corner will be Interpreted firstly. Then the existence of the CS will be verified and the relationship between the CS and the so-called stress transfer length Ill coating will be established for plane strain condition. Finally, the dependence of the stress transfer length, simultaneously of the CS, on the sensitive parameters will be investigated with finite element method and expressed with a simple empirical formula. (C) 2007 Elsevier Ltd. All rights reserved.

Experimental Study Of Vortex-Induced Vibrations Of A Pipeline Near An Erodible Sandy Seabed

Based on similarity analyses, a series of experiments have been conducted with a newly established hydro-elastic facility to investigate the transverse vortex-induced vibrations (VIVs) of a submarine pipeline near an erodible sandy seabed under the influence of ocean currents. Typical characteristics of coupling processes between pipe vibration and soil scour in the currents have been summarized for Case 1: pipe is laid above seabed and Case 11: pipe is partially embedded in seabed on the basis of the experimental observations. Pipe vibration and the corresponding local scour are usually two coupled physical processes leading to an equilibrium state. The influence of initial gap-to-diameter ratio (e(0)/D) on the interaction between pipe vibration and local scour has been studied. Experimental results show that the critical values of V-r for the initiation of VIVs of the pipe near an erodible sand bed get bigger with decreasing initial gap-to-diameter ratio within the examined range of e(0)/D (-0.25 < e(0)/D < 0.75). The comparison of the pipe vibrations near an erodible soil with those near a rigid boundary and under wall-free conditions indicates that the vibration amplitudes of the pipe near an erodible sand bed are close to the curve fit under wall-free conditions; nevertheless, for the same stability parameter, the maximum amplitudes for the VIV coupled with local scour increase with the increase of initial gap-to-diameter ratio. (c) 2007 Elsevier Ltd. All rights reserved.

Search For Critical Slip Surface In Slope Stability Analysis By Spline-Based Ga Method

The stability of a soil slope is usually analyzed by limit equilibrium methods, in which the identification of the critical slip surface is of principal importance. In this study the spline curve in conjunction with a genetic algorithm is used to search the critical slip surface, and Spencer's method is employed to calculate the factor of safety. Three examples are presented to illustrate the reliability and efficiency of the method. Slip surfaces defined by a series of straight lines are compared with those defined by spline curves, and the results indicate that use of spline curves renders better results for a given number of slip surface nodal points comparing with the approximation using straight line segments.

Critical serrated flow features during nanoindentation in La-based bulk metallic glasses

La57.6Al17.5(Cu,Ni)(24.9) and La64Al14(Cu,Ni)(22) bulk metallic glasses (BMGs) were prepared by copper-mould casting method. Plastic deformation behavior of the two BMGs at various loading rates was studied by nanoindentation. The results showed that the La57.6Al17.5(Cu,Ni)(24.9) BMG with a glass transition temperature of 423 K exhibited prominent serrated flow at low loading rates, whereas less pronounced serrated flow at high rates during nanoindentation. In contrast, the La64Al14(Cu,Ni)(22) BMG with a glass transition temperature of 401 K exhibited prominent serrated flow at high loading rates. The different rate dependency of serrated flow in the two La-based BMGs is related to the different glass transition temperature, and consequently the degree of viscous flow during indentation at room temperature. A smoother flow occurs in the alloy with relatively lower glass transition temperature, due to the relaxation of stress concentration.

Analysis of critical excavation depth for a jointed rock slope using a face-to-face discrete element method

The critical excavation depth of a jointed rock slope is an important problem in rock engineering. This paper studies the critical excavation depth for two idealized jointed rock slopes by employing a face-to-face discrete element method (DEM). The DEM is based on the discontinuity analysis which can consider anisotropic and discontinuous deformations due to joints and their orientations. It uses four lump-points at each surface of rock blocks to describe their interactions. The relationship between the critical excavation depth D-s and the natural slope angle alpha, the joint inclination angle theta as well as the strength parameters of the joints c(r) ,phi(r) is analyzed, and the critical excavation depth obtained with this DEM and the limit equilibrium method (LEM) is compared. Furthermore, effects of joints on the failure modes are compared between DEM simulations and experimental observations. It is found that the DEM predicts a lower critical excavation depth than the LEM if the joint structures in the rock mass are not ignored.