Treatments for invasive carcinoma of the cervix: What are their impacts on the pelvic floor functions?

Aims: Describe the impact of surgery, radiotherapy and chemoradiation in the pelvic floor functions in cervical cancer patients. Materials and Methods: A prospective study with women submitted to radical hysterectomy (RH) (n = 20),exclusive radiotherapy (RT) (n= 20)or chemoradiation (CT/RT)(n = 20)for invasive cervical cancer. Urinary, intestinal and sexual function, as well as vaginal length and pelvic floor musclecontraction were evaluated. Comparisons between groups were performed by Kruskal-Wallis and Chi-square tests (p < 0.05). Results: The groups were similar in stress urinary incontinence incidence (p = 0.56), urinary urgency (p = 0.44),urge incontinence (p = 0.54),nocturia(p = 0.53), incomplete bowel emptying (p = 0.76),bowel urgency(p = 0.12)and soilage(p = 0.43). The CT/ RT group presented a higher urinary frequency(p < 0.001)and diarrhea(p = 0.025). Patients in the RH group were more sexually active(p = 0.01) and experienced less dyspareunia (p = 0.021). Vaginal length was shorter in RT group (5.5 ± 1.9 cm) and CT/ RT(.3 ± 1.5 cm) than in the RH group (7.4 ± 1.1 cm) (p < 0.001). Pelvic floor muscle contraction was similar (p = 0.302). Conclusions: RT and CT/RT treatment for cervical carcinoma are more associated to sexual and intestinal dysfunctions.

Engaging environments: Tacit knowledge sharing on the shop floor

Purpose: The purpose of this paper is to identify factors that facilitate tacit knowledge sharing in unstructured work environments, such as those found in automated production lines. Design/methodology/approach: The study is based on a qualitative approach, and it draws data from a four-month field study at a blown-molded glass factory. Data collection techniques included interviews, informal conversations and on-site observations, and data were interpreted using content analysis. Findings: The results indicated that sharing of tacit knowledge is facilitated by an engaging environment. An engaging environment is supported by shared language and knowledge, which are developed through intense communication and a strong sense of collegiality and a social climate that is dominated by openness and trust. Other factors that contribute to the creation of an engaging environment include managerial efforts to provide appropriate work conditions and to communicate company goals, and HRM practices such as the provision of formal training, on-the-job training and incentives. Practical implications: This paper clarifies the scope of managerial actions that impact knowledge creation and sharing among blue-collar workers. Originality/value: Despite the acknowledgement of the importance of blue-collar workers' knowledge, both the knowledge management and operations management literatures have devoted limited attention to it. Studies related to knowledge management in unstructured working environments are also not abundant. © Emerald Group Publishing Limited.

Pelvic floor muscle strength evaluation in different body positions in nulliparous healthy women and its correlation with sexual activity

Objective: The aim of this study was to assess pelvic floor muscle (PFM) strength in different body positions in nulliparous healthy women and its correlation with sexual activity.Materials and Methods: Fifty healthy nulliparous women with mean age of 23 years were prospectively studied. Subjective evaluation of PFM was assessed by transvaginal digital palpation (TDP) of anterior and posterior areas regarding the vaginal introitus. A perineometer with inflatable vaginal probe was used to assess the PFM strength in four different positions: supine with extended lower limbs (P1); bent-knee supine (P2); sitting (P3); standing (P4).Results: Physical activity, 3 times per week, was reported by 58% of volunteers. Sexual activity was observed in 80% of women and 82% of them presented orgasm. The average body mass index (BMI) was 21.76 kg/m(2), considered as normal according World Health Organization (WHO). We observed that 68% of volunteers were conscious about the PFM contraction. TDP showed concordance of 76% when anterior and posterior areas were compared (p = 0.00014). There was not correlation between PFM strength and orgasm in subjective evaluation. The PFM strength was significantly higher in standing position when compared with the other positions (p < 0.000). No statistical difference was observed between orgasm and PFM strength when objective evaluations were performed.Conclusions: There was concordance between anterior and posterior areas in 76% of cases when subjective PFM strength was assessed. In objective evaluation, higher PFM strength was observed when volunteers were standing. No statistical correlation was observed between PFM strength and orgasm in nulliparous healthy women.

FROM FACTORY-FLOOR TO UNIVERSITY

The interaction between industry and university is often discussed. Industry participants feel they do not have enough time to spend with academics because of tight deadlines to achieve your goals. The other hand, professors and his students do not have availability and resources for responding quickly to industry activities. Both sides recognize the associated problems and feel the consequences of various forms. One way to reduce the distance between them is to provide industrial labs that resemble the factory floor at the university. Thus not only students may work on a real technological base, but also the industry's problems can be brought to the university laboratory. To ensure that relevant industrial problems will be studied, the industry needs help in the formulation of the problem being researched. The graduate program of Automation and Control Engineering from UNESP Sorocaba is aimed at training human resources with skills in automation and control activities related to the development of automatic control processes, integrating electronic commands, intelligent manufacturing and industrial robotics. In order to achieve its objectives, one of the pillars of the university consists of a wide range of modern equipments and software for industrial automation, which allows the circuit assembly from most primitive until configuration and programming of a complex system of integrated manufacturing. This paper describes industrial automation equipments and laboratory structure offered to students of Control and Automation Engineering graduate program at UNESP Sorocaba as alternative to close technologies and real problems on the job until academic world. The strategic is to do students understand theory and operations in robotic and industrial automation by means to manipulating real production systems locate at university

Análise da influência da concentração de feixeis de fibras de bambu em ensaios de piso

Bamboo has one of the highest growth rates among plants, however, its lignifications (which confers resistance) takes around a few years and, therefore, certain physical characteristics and mechanical, that depend on this process will only be acquired between the three to six years old. In addition, bamboo also has significant density variations in different parts of the stem, both in the radial direction as the axial. In particular the radial direction, where the density found in the inner and outer (near the bark) of a single stem can range on average from 0.5 to 0.9 g/cm3. Thus, the application of bamboo as a floor, there to examine whether both sides of the bamboo (internal and external), provide resistance properties required for that purpose. In this study sought to characterize and quantify the influence of the concentration of fiber bundles in the inner and outer sides of rules or bamboo strips of bamboo flooring through testing service. Analyses performed were based on ASTM D 2394- 83 for wooden floors and derivatives. This was necessary because of the absence of a specific prohibition of the use and testing of floors made of bamboo and its products. The data were analyzed by ball indentation test shooting, test for resistance to abrasion, indentation test for stress / load treadmill test and by indentation loads applied to small areas - test the jump. The results of the tests were extremely friendly bamboo, even this presents considerable differences between the resistances obtained from assay of the cover of the inner and outer face, being comparable with those of many commonly used to manufacture wood flooring. This comparison was made possible by information from technical trials of several floors made with wood

Reliability of pelvic floor muscle strength assessment in healthy continent women

Background: The aim of this study was to compare pelvic floor muscle (PFM) strength using transvaginal digital palpation in healthy continent women in different age groups, and to compare the inter- and intra-rater reliability of examiners performing anterior and posterior vaginal assessments.Methods: We prospectively studied 150 healthy multiparous women. They were distributed into four different groups, according to age range: G1 (n = 37), 30-40 years-old; G2 (n = 39), 41-50 years-old; G3 (n = 39), 51-60 years-old; and G4 (n = 35), older than 60 years-old. PFM strength was evaluated using transvaginal digital palpation in the anterior and posterior areas, by 3 different examiners, and graded using a 5-point Amaro's scale.Results: There was no statistical difference among the different age ranges, for each grade of PFM strength. There was good intra-rater concordance between anterior and posterior PFM assessment, being 64.7%, 63.3%, and 66.7% for examiners A, B, and C, respectively. The intra-rater concordance level was good for each examiner. However, the inter-rater reliability for two examiners varied from moderate to good.Conclusions: Age has no effect on PFM strength profiles, in multiparous continent women. There is good concordance between anterior and posterior vaginal PFM strength assessments, but only moderate to good inter-rater reliability of the measurements between two examiners.

Sequential healing of the elevated sinus floor after applying autologous bone grafting: an experimental study in minipigs

AimTo describe the sequential healing after elevation of the maxillary sinus mucosa applying the lateral access technique with the use of autogenous bone grafting without membrane to occlude the osteotomy access.Material and methodsImmediately after the elevation of the maxillary sinus Schneiderian membrane, applying the lateral access technique in 10 minipigs, autologous bone was harvested from the lateral aspect of the mandibular molar region and ground into particles with a bone mill. The space under the Schneiderian membrane was filled with this graft. No membranes were placed onto the access osteotomy. The healing was evaluated after 15, 30, 90 and 180days. Paraffin sections were prepared and analyzed histologically.ResultsAfter 15days of healing, the elevated area was mainly filled with provisional matrix, newly formed bone and some remnants of bone chips, and appeared reduced in volume compared with that at the time of surgery. After 30days of healing, further shrinkage of the height of the elevated space was found, with similar percentages of the different tissue components. After 90 and 180days, the area underneath the Schneiderian membrane appeared reduced in volume and condensed toward the base of the sinus. The bone tissues appeared to be more mature, both for the mineralized and the non-mineralized portions, while connective tissue occupied 20% of the space, most likely related to the lack of the use of a membrane occluding the access at the time of surgery.ConclusionsSuboptimal healing outcomes with respect to augmentation of the space under the sinus floor membrane were documented when autologous bone chips were used as a filler and no membrane was applied to cover the access.

Compressed Air, Wooden Clappers, and Other Non-Traditional Methods for Dispersing European Starlings from an Urban Roost

During autumn 2003, several thousand European starlings (Sturnus vulgaris) began roosting on exposed I-beams in a newly constructed, decorative glass canopy that covered the passenger pick-up area at the terminal building for Cleveland Hopkins International Airport, Ohio. The use of lethal control or conventional dispersal techniques, such as pyrotechnics and fire hoses, were not feasible in the airport terminal area. The design and aesthetics of the structure precluded the use of netting and other exclusion materials. In January 2004, an attempt was made to disperse the birds using recorded predator and distress calls broadcast from speakers installed in the structure. This technique failed to disperse the birds. In February 2004, we developed a technique using compressed air to physically and audibly harass the birds. We used a trailer-mounted commercial air compressor producing 185 cubic feet per minute of air at 100 pounds per square inch pressure and a 20-foot long, 1-inch diameter PVC pipe attached to the outlet hose. One person slowly (< 5 mph) drove a pick-up truck through the airport terminal at dusk while the second person sat on a bench in the truck bed and directed the compressed air from the pipe into the canopy to harass starlings attempting to enter the roost site. After 5 consecutive nights of compressed-air harassment, virtually no starlings attempted to roost in the canopy. Once familiar with the physical effects of the compressed air, the birds dispersed at the sound of the air. Only occasional harassment at dusk was needed through the remainder of the winter to keep the canopy free of starlings. Similar harassment with the compressor was conducted successfully in autumn 2004 with the addition of a modified leaf blower, wooden clappers, and laser. In conclusion, we found compressed air to be a safe, unobtrusive, and effective method for dispersing starlings from an urban roost site. This technique would likely be applicable for other urban-roosting species such as crows, house sparrows, and blackbirds.

The density of metastatic lymph node as prognostic factor in squamous cell carcinoma of the tongue and floor of the mouth

The presence of metastatic lymph nodes is a relevant prognostic factor in oral cancer. Objective: This paper aims to assess metastatic lymph node density (pN+) in patients with tongue and floor-of-mouth squamous cell carcinoma (SCC) and the association of this parameter with disease-free survival (DFS). Materials and Methods: A group of 182 patients seen between 1985 and 2007 was included, 169 of which were males. Five were on stage I, 35 on stage II, 56 on stage III, and 85 on stage IV. Median values were considered in lymph node density assessment, and the Kaplan-Meier curve was used to evaluate DFS; survival differences within the group were elicited through the log-rank test. Results: An average 3.2 metastatic lymph nodes were excised from the patients in the group. Density ranged from 0.009 to 0.4, with a mean value of 0.09. Five-year DFS rates were of 44% and 28% for the groups with lymph node densities below and above the median respectively (p = 0.006). Two-year local/regional control was achieved for 71% and 49% for the patients below and above the median density respectively (p = 0.01). In terms of pN staging, local/regional control was achieved in 70% and 54% of pN1 and pN2 patients respectively, albeit without statistical significance (0.20%). Conclusion: Lymph node density may be used as a prognostic indicator for tongue and floor-ofmouth SCC.

Prognostic significance of the number of lymph nodes in elective neck dissection for tongue and mouth floor cancers

The presence of metastatic lymph nodes is a relevant aspect in the treatment of head and neck cancer, bringing about a 50% reduction in survival. Objective: To assess the number of lymph nodes removed in the neck dissection and their relationship with the prognosis. Methods: A retrospective study involving 143 patients with tongue and mouth floor epidermoid carcinoma, which histological exam showed no lymph node metastases. Among those, 119 were males and 24 females, with mean age of 54 years. As to the primary tumor site, 65 were in the tongue and 78 in the mouth floor. T stage distribution was of four T1, 84 T2, 36 T3 and 19 T4. We carried out 176 neck dissections, unilateral in 110 cases and bilateral in 33. Of these, 78 were radical and 98 selective. The patients were broken down into three groups, according to the 33 and 66 percentiles of the number of lymph nodes resected. Results: The mean number of resected lymph nodes was 27; 24 in selective dissections and 31 in the complete ones. We did not have statistically significant differences when associated to the T and N stages. Conclusions: The larger number of lymph nodes dissected in the neck dissection identifies the group of better prognoses among pN0 cases.

Use of a titanium device in lateral sinus floor elevation: an experimental study in monkeys

Aim: To evaluate the effect of a space-maintaining device fixed to the lateral wall of the maxillary sinus after the elevation of the sinus mucosa on bone filling of the sinus cavity. Material and methods: Immediately after the elevation of the maxillary sinus Schneiderian membrane accomplished through lateral antrostomy in four monkeys, a titanium device was affixed to the lateral sinus wall protruding into the sinus cavity to maintain the mucosa elevated without the use of grafting material. The healing of the tissue around the implants was evaluated after 3 and 6 months. Ground sections were prepared and analyzed histologically. Results: The void under the elevated sinus membrane, originally filled with the blood clot, was reduced after 3 as well as after 6 months of healing of about 56% and 40.5%, respectively. In seven out of eight cases, the devices had perforated the sinus mucosa. The formation of mineralized bone and bone marrow amounted to about 42% and 69% after 3 and 6 months, respectively. The connective tissue represented about 53% and 23% of the newly formed tissue after 3 and 6 months, respectively. Conclusions: New bone formation was found below the devices. However, shrinkage of the newly formed tissue was observed both after 3 and 6 months of healing. Hence, the space-maintaining function of the devices used in the present study has to be questioned.

Comparison of active and passive forces of the pelvic floor muscles in women with and without stress urinary incontinence

Background: The reduction of the pelvic floor muscles (PFM) strength is a major cause of stress urinary incontinence (SUI). Objective: To compare active and passive forces, and vaginal cavity aperture in continent and stress urinary incontinent women. Method: The study included a total of thirty-two women, sixteen continent women (group 1 - G1) and sixteen women with SUI (group 2 - G2). To evaluate PFM passive and active forces in anteroposterior (sagittal plane) and left-right directions (frontal plane) a stainless steel specular dynamometer was used. Results: The anteroposterior active strength for the continent women (mean +/- standard deviation) (0.3 +/- 0.2 N) was greater compared to the values found in the evaluation of incontinent women (0.1 +/- 0.1 N). The left-right active strength (G1=0.43 +/- 0.1 N; G2=0.40 +/- 0.1 N), the passive force (G1=1.1 +/- 0.2 N; G2=1.1 +/- 0.3 N) and the vaginal cavity aperture (G1=21 +/- 3 mm; G2=24 +/- 4 mm) did not differ between groups 1 and 2. Conclusion: The function evaluation of PFM showed that women with SUI had a lower anteroposterior active strength compared to continent women.

Composite connections in slim-floor system: An experimental study

This paper reports the results of full-scale tests in beam-to-column connections for composite slim floor systems, including tests on Bare Steel connection and composite connection. The tested system consists of a concrete-filled composite column and a composite floor where an asymmetric steel beam is connected to a composite column by shear steel plates. Tests results previously obtained on partially encased composite beams were used to define the position of the headed studs in the slim floor system. Based on the obtained results of connections, the composite and Bare Steel connection behaved as semi-rigid and nominally pinned respectively. The tests results also indicated a significant contribution of the slim floor to the moment capacity of the connection. (C) 2011 Elsevier Ltd. All rights reserved.

Is the Sexual Satisfaction of Postmenopausal Women Enhanced by Physical Exercise and Pelvic Floor Muscle Training?

Introduction. Physical exercise including pelvic floor muscle (PFM) training seems to improve the sexual function of women with urinary incontinence. This effect in postmenopausal women who are continent has not yet been determined. Aim. The aim of this study was to assess the effect of a 3-month physical exercise protocol (PEP) on the sexual function and mood of postmenopausal women. Methods. Thirty-two sedentary, continent, sexually active women who had undergone menopause no more than 5 years earlier and who had follicle stimulating hormone levels of at least 40 mIU/mL were enrolled into this longitudinal study. All women had the ability to contract their PFMs, as assessed by vaginal bimanual palpation. Muscle strength was graded according to the Oxford Modified Grading Scale (OMGS). A PEP was performed under the guidance of a physiotherapist (M. M. F.) twice weekly for 3 months and at home three times per week. All women completed the Sexual Quotient-Female Version (SQ-F) and the Hospital Anxiety and Depression Scale (HADS) before and after the PEP. Main Outcome Measures. SQ-F to assess sexual function, HASDS to assess mood, and OMGS to grade pelvic floor muscle strength. Results. Thirty-two women (24 married women, eight women in consensual unions) completed the PEP. Following the PEP, there was a significant increase in OMGS score (2.59 +/- 1.24 vs. 3.40 +/- 1.32, P < 0.0001) and a significant decrease in the number of women suffering from anxiety (P < 0.01), but there was no effect on sexual function. Conclusion. Implementation of our PEP seemed to reduce anxiety and improve pelvic floor muscular strength in sedentary and continent postmenopausal women. However, our PEP did not improve sexual function. Uncontrolled variables, such as participation in a long-term relationship and menopause status, may have affected our results. We suggest that a randomized controlled trial be performed to confirm our results. Lara LAS, Montenegro ML, Franco MM, Abreu DCC, Rosa e Silva ACJS, Ferreira CHJ. Is the sexual satisfaction of postmenopausal women enhanced by physical exercise and pelvic floor muscle training? J Sex Med 2012; 9: 218-223.