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AIM: There is a lack of multidisciplinary studies examining the link between psychological factors and glycemic control in individuals with chronic illnesses. The aim of this study is to investigate the relationship between psychological factors such as resilience, perceived stress, emotional regulation, aggressiveness, and glycated hemoglobin (HbA1c) levels in patients with type 2 diabetes. Additionally, the study seeks to determine the predictive value of perceived stress and resilience on HbA1c levels and to explore the role of anger expression and emotion regulation strategies in glycemic control, comparing diabetic patients to healthy controls. MATERIALS AND METHODS: The study was conducted between November 2021 and November 2023 at the Clinic of Endocrinology and Metabolic Diseases at the St. George University Hospital, Bulgaria, and the Department of Science and Research at the Medical University of Plovdiv, Bulgaria. Of these 84 individuals were diagnosed with type 2 diabetes, divided into two groups of 42 individuals each, who had poor and fair glycated hemoglobin. The third group was a healthy control consisting of 42 individuals in the same age group who had no established chronic diseases. RESULTS: When comparing the study groups on HbA1c and individual psychological characteristics, there were statistically significant differences in resilience, perceived stress, emotion regulation suppression, and anger expression. When comparing the mean values of mental resilience with glycated hemoglobin levels, we find that there are statistically significantly higher mean values between the poor HbA1c control and the healthy group. From the regression analysis, we conclude that the psychological characteristics positively associated with perceived stress (ß=0.502; p<0.001) and inversely associated with mental resilience (ß=-0.359; p<0.001) are the most predictive. Less influential was the straight correlation with emotion regulation-expressive inhibition (ß=0.226; p<0.05), the positive correlation with anger (ß=0.170; p<0.001), and general aggressiveness (ß=0.151; p<0.05). CONCLUSION: From the present study, we note that glycated hemoglobin level is strongly influenced by two psychological predictors, namely subjective perception of stressful situations and resilience level.
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The most common histological variants of bladder cancer include urothelial, squamous, and adenocarcinoma. In high-grade, invasive urothelial carcinoma, divergent differentiation can be observed, including glandular, squamous, trophoblastic, and small-cell types. Urothelial sarcomatoid carcinoma is characteristic of advanced carcinomas and is considered a possible common end route for all epithelial carcinomas. Adenocarcinoma of the bladder refers exclusively to true glandular carcinomas. Hybrid tumors are extremely rare and consist of more than one tumor type within the total tumor mass. Penile metastases are extremely uncommon, and there are no reported cases of metastatic adenocarcinoma of the bladder in the literature.
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Urachal adenocarcinomas, constituting 10 % of bladder adenocarcinomas, pose a significant challenge with limited literature. A 43-year-old male presented with haematuria and abdominal pain, leading to surgical intervention for a 13 cm pelvic tumor. Histopathology identified an intestinal-type primary urachal adenocarcinoma, staged as IIIA, no recurrence on follow-up. Early detection is crucial for improved outcomes in these rare malignancies. While surgery remains the primary treatment, outcomes vary, emphasizing the need for research on standardized protocols. Enhanced awareness and interdisciplinary collaboration are vital for effective management. Comprehensive guidelines are essential for optimizing patient prognoses in urachal adenocarcinomas.
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Human echinococcosis is a parasitic disease caused by tapeworms of the genus Echinococcus. The two most important forms of the disease in humans are cystic echinococcosis (hydatidosis) and alveolar echinococcosis. Humans are infected through ingestion of parasite eggs in contaminated food, water, or soil, or through direct contact with animal hosts. Although most reported patients with Echinococcosis have cysts in their lungs and livers, more unusual cyst locations were also recorded. Evolution of cysts, irrespective of their localization is associated with many complications including life-threatening. We report unusual localization of parasitic cyst in urinary bladder, diagnostic and therapeutic problems.
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Janus kinase (JAK) inhibitors have heralded a paradigm shift in the management of immune-mediated diseases. While their efficacy is well-established, the safety concerns associated with these agents, particularly regarding thromboembolic events (TE), remain a focus of extensive research and clinical scrutiny. This comprehensive literature review embarks on an exploration of the multifaceted landscape of JAK inhibitors, providing insights into their safety profiles across diverse immune-mediated diseases. The introduction highlights the transformative influence of JAK inhibitors in the treatment of immune-mediated diseases. Historically, the therapeutic arsenal for these conditions included corticosteroids, disease-modifying antirheumatic drugs (DMARDs), and biologics. The advent of JAK inhibitors has revolutionized this landscape, although concerns about their safety persist. This review strives to comprehensively evaluate their safety, amalgamating knowledge from multiple studies and trials. The subsequent sections delve into the safety of specific JAK inhibitors in the context of rheumatoid arthritis, inflammatory bowel diseases, and dermatologic conditions and their associations with venous thromboembolism. The evolving understanding of TE risk, particularly the intricate relationship between these agents and immune-mediated diseases, is meticulously unravelled. The concluding remarks underscore the dynamic nature of TE risk assessment with regard to immune-mediated diseases involving JAK inhibitors. It underscores that risk assessment is multifactorial, influenced not only by the choice of JAK inhibitor but also by the nuances of the underlying immune-mediated disease and the unique patient characteristics. This review offers a holistic perspective on TE risks associated with JAK inhibitors and contributes to the ongoing dialogue regarding their safety in the realm of immune-mediated diseases.
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This study delves into the intricacies of ultraprecision machining, particularly in the context of machining optical freeform surfaces using Diamond Turning Machines (DTMs). It underscores the dynamic relationship between toolpath generation, hydrostatic bearing in DTMs, and the machining process. Central to this research is the innovative introduction of Metal Matrix Composites (MMCs) to replace the traditional materials used in designing linear bearings. This strategic substitution aims to dynamically enhance both the accuracy and the quality of the machined optical freeform surfaces. The study employs simulation-based analysis using ADAMS to investigate the interfacial cutting forces at the tooltip and workpiece surface and their impacts on the machining process. Through simulations of STS mode ultraprecision machining, the interfacial cutting forces and their relationship with changes in surface curvatures are examined. The results demonstrate that the use of MMC material leads to a significant reduction in toolpath pressure, highlighting the potential benefits of employing lightweight materials in improving the dynamic performance of the system. Additionally, the analysis of slideway joints reveals the direct influence of interfacial cutting forces on the linear slideways, emphasising the importance of understanding and controlling these forces for achieving higher-precision positioning and motion control. The comparative analysis between steel and MMC materials provides valuable insights into the effects of material properties on the system's dynamic performance. These findings contribute to the existing body of knowledge and suggest a potential shift towards more advanced precision forms, possibly extending to pico-engineering in future systems. Ultimately, this research establishes a new standard in the field, emphasising the importance of system dynamics and interfacial forces in the evolution of precision manufacturing technologies.
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This study focuses on the analysis of a linear hydrostatic bearing using harmonic frequency response and harmonic response simulations. The aim is to evaluate the feasibility of replacing the existing alloy steel material with a metal matrix composite (MMC) in terms of its performance and dynamic characteristics for both the base and carriage parts. The simulation results indicate that the MMC material exhibits higher resonant frequencies and improved damping capabilities compared to the structural steel material. The higher resonant frequencies observed in the MMC material are attributed to its stiffness and structural properties. These properties contribute to increased natural frequencies and improved vibration damping characteristics. This suggests that incorporating the MMC material in the bearing design could enhance motion control, improving the ability to precisely control and manipulate the movement of components or systems. In the context of ultraprecision machining applications, incorporating the MMC material in the hydrostatic bearing design can also lead to a more accurate and controlled motion, resulting in improved precision and finer machining outcomes. The displacement analysis confirms that both materials meet the specifications provided by the manufacturer, supporting the viability of using MMC as an alternative. However, further experimental validation and considerations of material feasibility, manufacturing factors, and cost-effectiveness are necessary before implementing the MMC material in practical applications. Overall, this research highlights the potential benefits of MMC in the design of linear hydrostatic bearings, paving the way for enhanced performance in ultraprecision machining processes.
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INTRODUCTION: Benign prostatic hyperplasia (BPH) is a histological diagnosis characterized by an increase in the number of epithelial and stromal cells in the transitional zone of the prostate gland. The clinical manifestation of BPH is associated with the appearance of so-called lower urinary tract symptoms (LUTS) which can also be a consequence of other conditions not related to the prostate. Covid-19, also known as severe acute respiratory syndrome coronavirus 2 was discovered as a disease in late 2019 in the city of Wuhan, China. MATERIALS AND METHODS: A case-control study was conducted between September 2021 and May 2022. Information was initially collected on 60 patients followed up and treated conservatively for BPH in two outpatient practices and recovered from Covid-19. After processing the received information, 27 patients were excluded from the study and 33 patients remained for observation The assessment of patients is carried out through an internationally validated questionnaire - international prostate symptom score (IPPS), prostate specific antigen, digital rectal examination (DRÐ), and ultrasound diagnostics of the prostate gland with consideration of its volume and the amount of residual urine. RESULTS: Our data show a strong correlation between the changes in LUTS in patients with BPH and Covid-19 infection. CONCLUSION: Although almost 3 years have passed since the beginning of this pandemic, there are still many unanswered questions surrounding this disease. We believe that with our experience we will enrich the information about the relationship between Covid-19 and LUTS, and the results obtained by us can serve as a basis for future large-scale and more in-depth studies on the subject.
Subject(s)
COVID-19 , Lower Urinary Tract Symptoms , Prostatic Hyperplasia , Male , Humans , Prostatic Hyperplasia/diagnosis , Case-Control Studies , COVID-19/complications , Prostate/pathology , Lower Urinary Tract Symptoms/diagnosisABSTRACT
This paper provides an overall view of the current research in micro-electrical discharge machining (micro-EDM or µEDM) and looks into the present understanding of the material removing mechanism and the common approach for electrode material selection and its limitations. Based on experimental data, the authors present an analysis of different materials' properties which have an influence on the electrodes' wear ratio and energy distribution during the spark. The experiments performed in micro-EDM conditions reveal that properties such as electron work function and electrical resistivity strongly correlate with the discharge energy ratio. The electrode wear ratio, on the other hand, is strongly influenced by the atomic bonding energy and was found to be related to the tensile modulus. The proposed correlation functions characterized the data with a high determination coefficient exceeding 99%.
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This editorial is for collating the Special Issue on micro-manufacturing and applications, based on stringently selected papers presented to the editorial board of this Special Issue [...].