Entropy and Network Centralities as Intelligent Tools for the Investigation of Terrorist Organizations.

In recent years, law enforcement authorities have increasingly used mathematical tools to support criminal investigations, such as those related to terrorism. In this work, two relevant questions are discussed: "How can the different roles of members of a terrorist organization be recognized?" and "are there early signs of impending terrorist acts?" These questions are addressed using the tools of entropy and network theory, more specifically centralities (degree, betweenness, clustering) and their entropies. These tools were applied to data (physical contacts) of four real terrorist networks from different countries. The different roles of the members are clearly recognized from the values of the selected centralities. An early sign of impending terrorist acts is the evolutionary pattern of the values of the entropies of the selected centralities. These results have been confirmed in all four terrorist networks. The conclusion is expected to be useful to law enforcement authorities to identify the roles of the members of terrorist organizations as the members with high centrality and to anticipate when a terrorist attack is imminent, by observing the evolution of the entropies of the centralities.

Competitive Conditions in Global Value Chain Networks: An Assessment Using Entropy and Network Analysis.

We investigated competitive conditions in global value chains (GVCs) for a period of fifteen years (2000-2014), focusing on sector structure, countries' dominance and diversification. For this purpose, we used data from the World Input-Output Database (WIOD) and examined GVCs as weighted directed networks, where countries are the nodes and value added flows are the edges. We compared the in-and out-weighted degree centralization of the sectoral GVC networks in order to detect the most centralized, on the import or export side, respectively (oligopsonies and oligopolies). Moreover, we examined the in- and out-weighted degree centrality and the in- and out-weight entropy in order to determine whether dominant countries are also diversified. The empirical results reveal that diversification (entropy) and dominance (degree) are not correlated. Dominant countries (rich) become more dominant (richer). Diversification is not conditioned by competitiveness.

Surgery for ureteral repair after gynaecological procedures: a single tertiary centre experience.

PURPOSE: This study evaluates the frequency of ureteral repair and its management in patients with a history of gynaecologic surgery. MATERIALS AND METHODS: After retrospective review of the medical records of all major gynaecologic operations performed over a six-year period (2004-2010), 17 cases of ureteral repair were identified. The indication and the type of gynaecological surgery, the anatomic site, the indication, the type of ureteral repair and the associated morbidity were analyzed. RESULTS: Ureteral repair was necessary in 17 (0.26 %) out of 6,422 patients who had undergone a gynaecological operation. The indication for surgery was fibroma in 6 cases (0.11 %) out of 5,481 and malignancy in 11 cases (1.17 %) out of 941. Ureteral damage was recognized intraoperatively in eight patients and postoperatively in nine with a mean delay of 13.1 days (range 1-29). Indications for ureteral repair were ligation (11.8 %), laceration (11.8 %), partial or total accidental transection (29.5 %), metastasectomy due to tumor infiltration (17.4 %) and fistula formation (29.5 %). Ureteral repair was accomplished by ureteroneocystostomy (70.6 %), ureteroureterostomy (5.9 %), insertion of a double-j stent (17.6 %) and Boari-Ockerblad flap (5.9 %). Febrile morbidity was the most common postoperative symptom (29.0 %), followed by wound infection (18 %) and ileus (1 %). One patient (5.9 %) developed hydronephrosis due to ureteric stenosis as a late complication. CONCLUSIONS: Although the need for ureteral repair is relatively infrequent during gynaecological operations, prompt recognition and treatment within accepted guidelines result in successful outcome.

Surgical repair of idiopathic scrotal elephantiasis.

Scrotal lymphedema (scrotal elephantiasis) is uncommon outside of filariasis endemic regions. We present a case of a 65-year-old with idiopathic lymphedema of the scrotum and functional impairment of the penis. The patient underwent surgical excision of the edematous subcutaneous tissues and plastic reconstruction of his penis and scrotum. Three years later, the patient showed no signs of local recurrence, had complete restoration of urinary and sexual function and was extremely satisfied with the result. Surgical management was an effective strategy in the management of scrotal lymphedema in this case.

Uterine prolapse after pelvic trauma: case report and literature review.

Up to date, the connection of pelvic trauma with genital prolapse is not widely recognized. These cases could be classified in a group where disruption of normal anatomy of the pelvis is apparent (i.e., pelvic fracture), and in a second group, where pelvis remains unaffected by the pelvic trauma (i.e., seat belt-related injuries). The aim of the report is to describe the management of a 39-year-old nulliparous patient presenting with stage III uterine prolapse after pelvic trauma; the patient had a history of Mitrofanoff's procedure for neurogenic bladder followed by closure of the bladder neck and permanent suprapubic urinary catheter for intractable incontinence. The prolapse was managed with a mesh anterior colporraphy combined with sacrospinous hysteropexy. At 3 months follow-up, she is well with no prolapse recurrence.

Treatment strategy for "non-responders" to tadalafil and vardenafil: a real-life study.

OBJECTIVES: To develop and test step-wise treatment strategy for erectile dysfunction "non-responders" to tadalafil and vardenafil. MATERIAL AND METHODS: Two groups [tadalafil-treated (TG); vardenafil-treated (VG)] of 100 consecutive patients complaining of non-response to treatments were enrolled in three-phase study. Phase 1: inadequate use was identified and patients were rechallenged, after receiving detailed usage information. Phase 2: true non-responders were given new instructions based on drugs' pharmacologic profiles: TGs were dosed at least 2 h before intercourse; VGs were dosed only in fasted state. Remaining non-responders entered phase 3: continuous administration of 20 mg tadalafil every other day, or 20 mg vardenafil every day for 2 weeks. Efficacy was based on positive (yes) response to two questions: "Were your erections rigid, and did they last long enough to have successful intercourse?" and "Do you want to repeat your prescription?" RESULTS: Tadalafil group: Inappropriate use was recognized in 32 patients; 14 (43.75%) responded after adequate instruction. Phase 2: 32 of 86 (37.2%) had intercourse at least 2 h after dose intake. Phase 3: 6 of 86 (11.1%) responded to continuous administration. Overall salvage rate was 52 of 100 (52%). Vardenafil group: Inappropriate use was recognized in 38 patients; 12 (31.58%) responded after adequate instruction. Phase 2, 22 of 88 (25%) responded to dosing in a fasted state. Phase 3: 12 of 66 (18.2%) responded to daily dosing. Overall salvage rate was 46 of 100 (46%). CONCLUSIONS: Following proposed treatment strategy may maximize response rate to phosphodiesterase 5 inhibitors; appropriate usage instructions may play significant role in response rate.

Sildenafil failures may be due to inadequate patient instructions and follow-up: a study on 100 non-responders.

OBJECTIVE: The objective of this study was to identify factors that affect efficacy response rate to sildenafil in the clinical practice. MATERIAL AND METHOD: The study comprised 100 consecutive sildenafil non-responders. Mean patient age was 59+/-14.4 years and mean duration of ED 5.5+/-6.4 years. All patients underwent detailed medical and sexual history and completed the IIEF and a questionnaire regarding the previous use of sildenafil. When inadequate instructions were reported, information on the appropriate use of sildenafil was given and patients were asked to use at least 4 tablets at home. Pharmacologic efficacy was re-evaluated in a scheduled follow-up visit. RESULTS: Mean Erectile Function Domain (ED) of the IIEF score was 14+/-9.9. In 56 patients inappropriate use of sildenafil was recognized; 45 had never used the highest recommended dose (100 mg), 32 had taken the pill with a full stomach right after a meal, 22 had taken the pill just before the initiation of sexual activity and 12 were not aware that sexual stimulation was mandatory to achieve an erection. Furthermore, 8 patients had tried the 100mg dose, despite the presence of factors associated with sildenafil clearance reduction (renal insufficiency, cimetidine treatment). Only 34 patients reported that their physician had scheduled a follow-up visit. Following adequate dose titration and time adjustment, 31 patients responded to sildenafil; 10 patients used the 50 mg dose and 21 the 100 mg. Second and third-line treatment options were offered to the rest of the patients. CONCLUSIONS: ED patients may receive inadequate instructions with their prescriptions. Response rate to sildenafil may be maximized after receiving appropriate dose titration and instructions on administration. ED should be treated in the same way as other chronic conditions; follow-up is necessary to evaluate the appropriate application and pharmacologic efficacy of the proposed treatment.

Corporoplasty using tunica albuginea free grafts for penile curvature: surgical technique and long-term results.

PURPOSE: A Nesbit or plication procedure for correcting penile deformities is associated with penile shortening, especially in patients with excessive curvature and/or rotation. On the other hand, grafting procedures are associated with poor postoperative results due to graft shrinkage and veno-occlusive dysfunction. To minimize penile shortening and preserve potency we describe a new surgical technique combining the Nesbit procedure with tunica albuginea free grafting. Long-term functional results and patient satisfaction are reported. MATERIALS AND METHODS: We treated 17 potent patients with a mean age plus or minus standard deviation of 46.1 +/- 14.5 years, including 4 with congenital penile deviation and 13 with stabilized Peyronie's disease. Opposite the point of maximal curvature a typical Nesbit procedure was performed. The excised tunica albuginea segment consequently served as a free graft. A symmetrical incision was made at the opposite site and the preserved elliptical tunica albuginea graft was placed in the defect. Further elliptical excisions and grafting followed as needed to correct the deformity. RESULTS: At a mean followup of 39.5 +/- 13.7 months (range 18 to 62) all patients reported penile straightening and functional erection, while ultrasonography of the corpora cavernosa revealed no changes in graft ultrastructure. There was penile shortening in 8 patients (47%) but only 2 (11.7%) considered it significant. All patients with a minimum 2-year followup were positive in regard to recommending the operation to others or repeating it if necessary. CONCLUSIONS: The newly described technique may be considered as a treatment option in patients with excessive penile curvature since shortening of the penile shaft is eliminated by 50% compared with the result of the Nesbit procedure. Tunica albuginea seems to be an appropriate grafting material since it prevents postoperative corporeal veno-occlusive dysfunction.