Rate of Leiomyosarcomas during Surgery for Uterine Fibroids: 8-Year Experience of a Single Center.

The aim of this study is to investigate the prevalence of occult malignant mesenchymal tumors in patients operated on for uterine fibroids in relation to the surgical approach and type of operation. A retrospective review of all patients that underwent surgery for uterine fibroids (January 2011-December 2018) at the 1st Department of Obstetrics & Gynecology at "Papageorgiou" Hospital. The surgical approach and clinicopathological characteristics were analyzed. A total of 803 patients were operated on: 603 (75.1%) with laparotomy, 187 (23.3%) laparoscopically, and 13 (1.6%) vaginally. Furthermore, 423 (52.7%) patients underwent hysterectomy and 380 (47.3%) myomectomies. Laparoscopy and myomectomy were offered to younger patients with fewer smaller uterine fibroids and were associated with statistically significant shorter hospitalization. The pathological reports revealed: 690 (86%) benign leiomyomas, 32 (4%) cellular leiomyomas, 29 (3.6%) degenerated leiomyomas, 22 (2.7%) adenomyomas, 18 (2.2%) atypical-bizarre leiomyomas, 1 (0.1%) STUMP, 5 (0.65%) endometrial stromal sarcomas, and 6 (0.75%) cases of leiomyosarcomas (LMS). All LMS were preoperatively characterized as suspicious and underwent abdominal hysterectomy. Morcellation was offered in two cases of atypical leiomyomas, with no morcellation-associated complication. Laparoscopy as a valuable surgical approach for young patients with fewer in number and smaller in size fibroids is associated with shorter hospitalization. The risk of unintended morcellation of LMS seems to be very low and can be reduced with careful preoperative work-up but not eliminated.

Mesoscopic Modeling and Experimental Validation of Thermal and Mechanical Properties of Polypropylene Nanocomposites Reinforced By Graphene-Based Fillers.

The development of nanocomposites relies on structure-property relations, which necessitate multiscale modeling approaches. This study presents a modeling framework that exploits mesoscopic models to predict the thermal and mechanical properties of nanocomposites starting from their molecular structure. In detail, mesoscopic models of polypropylene (PP)- and graphene-based nanofillers (graphene (Gr), graphene oxide (GO), and reduced graphene oxide (rGO)) are considered. The newly developed mesoscopic model for the PP/Gr nanocomposite provides mechanistic information on the thermal and mechanical properties at the filler-matrix interface, which can then be exploited to enhance the prediction accuracy of traditional continuum simulations by calibrating the thermal and mechanical properties of the filler-matrix interface. Once validated through a dedicated experimental campaign, this multiscale model demonstrates that with the modest addition of nanofillers (up to 2 wt %), the Young's modulus and thermal conductivity show up to 35 and 25% enhancement, respectively, whereas the Poisson's ratio slightly decreases. Among the different combinations tested, the PP/Gr nanocomposite shows the best mechanical properties, whereas PP/rGO demonstrates the best thermal conductivity. This validated mesoscopic model can contribute to the development of smart materials with enhanced mechanical and thermal properties based on polypropylene, especially for mechanical, energy storage, and sensing applications.

Plasma Ceramide Concentrations in Full-Term Pregnancies Complicated with Gestational Diabetes Mellitus: A Case-Control Study.

Ceramides, a sphingolipid group that acts as a messenger in cellular differentiation, proliferation, apoptosis and senescence, have been associated with cardiovascular disease and type 2 diabetes. The evidence for an association between ceramides and gestational diabetes mellitus (GDM) is scarce. This case-control study aimed to compare women with GDM with healthy, pregnant women in terms of plasma ceramide concentrations at the time of delivery. Ninety-two pregnant women were included in this case-control study, 29 in the GDM group and 63 in the control group. All women were admitted to a tertiary academic hospital for a full-term delivery. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was applied for the quantification of four molecular ceramides, namely Cer d18:1/16:0 (Cer16:0), Cer d18:1/18:0 (Cer18:0), Cer d18:1/24:0 (Cer24:0) and Cer d18:1/24:1 (Cer24:1) in plasma samples. The raw chromatographic data obtained from the LC-MS/MS analysis were processed using Analyst SCIEX (AB Sciex Pte. Ltd., USA). In a univariate statistical analysis, Cer24:0 concentration was significantly lower in the GDM group compared with the control group (p = 0.01). The present study demonstrated lower Cer24:0 concentrations in pregnancies complicated by GDM. Further prospective studies are required to enhance the results of this study.

Statins' efficacy in non-alcoholic fatty liver disease: A systematic review and meta-analysis.

BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) is closely related with the metabolic syndrome and cardiovascular disease. Currently there is no approved medication for NAFLD. Although it has been suggested that statins can be safely used by patients with elevated liver enzymes, their effect on NAFLD has not been clearly defined. The aim of this study is to evaluate the effectiveness of statins on biochemical and histological parameters in patients with NAFLD. METHODS: We searched PubMed, Web of Science, and SCOPUS for clinical trials and observational studies concerning the effects of statins on the development and treatment of NAFLD, regardless of the type or dosage of statin, the duration of treatment or the methods used for the diagnosis of NAFLD (biopsy or imaging technique) up to November 2021. RESULTS: We identified 13 studies. Liver function tests and lipid profile were significantly improved. There was a significant decrease in steatosis grade (standardized mean difference, SMD -1.73, 95% CI -2.11 to -1.35; p < 0.00001; I2 = 98%) and in NAFLD activity score (NAS) (SMD -1.09 (95% CI -1.39 to -0.79; p < 0.00001; I2 = 93%)). CONCLUSIONS: Statins effectively decrease liver enzymes and beneficially affect liver histology in NAFLD patients.

Humanin and diabetes mellitus: A review of in vitro and in vivo studies.

Humanin (HN) is a 24-amino acid mitochondrial-derived polypeptide with cyto-protective and anti-apoptotic effects that regulates the mitochondrial functions under stress conditions. Accumulating evidence suggests the role of HN against age-related diseases, such as Alzheimer's disease. The decline in insulin action is a metabolic feature of aging and thus, type 2 diabetes mellitus is considered an age-related disease, as well. It has been suggested that HN increases insulin sensitivity, improves the survival of pancreatic beta cells, and delays the onset of diabetes, actions that could be deployed in the treatment of diabetes. The aim of this review is to present the in vitro and in vivo studies that examined the role of HN in insulin resistance and diabetes and to discuss its newly emerging role as a therapeutic option against those conditions.

3D Printing Processability of a Thermally Conductive Compound Based on Carbon Nanofiller-Modified Thermoplastic Polyamide 12.

A polyamide (PA) 12-based thermoplastic composite was modified with carbon nanotubes (CNTs), CNTs grafted onto chopped carbon fibers (CFs), and graphene nanoplatelets (GNPs) with CNTs to improve its thermal conductivity for application as a heat sink in electronic components. The carbon-based nanofillers were examined by SEM and Raman. The laser flash method was used to measure the thermal diffusivity in order to calculate the thermal conductivity. Electrical conductivity measurements were made using a Keithley 6517B electrometer in the 2-point mode. The composite structure was examined by SEM and micro-CT. PA12 with 15 wt% of GNPs and 1 wt% CNTs demonstrated the highest thermal conductivity, and its processability was investigated, utilizing sequential interdependence tests to evaluate the composite material behavior during fused filament fabrication (FFF) 3D printing processing. Through this assessment, selected printing parameters were investigated to determine the optimum parametric combination and processability window for the composite material, revealing that the selected composition meets the necessary criteria to be processable with FFF.

Formation and properties of iodine- and acetonitrile-functionalized two-dimensional Si materials: a Density Functional Theory study.

Topotactic transformations of suitable layered three-dimensional precursors are among the most robust methods to prepare two-dimensional (2D) materials based on silicon or germanium. Here we use Density Functional Theory calculations to probe the mechanisms underlying the formation of 2D-Si sheets functionalized with iodine atoms (SiI) or acetonitrile molecules [Si(MeCN)] starting from a layered CaSi2 precursor. We identify the sequence of exothermic surface reactions that enable the adsorption of, not only iodine atoms, but, surprisingly, also of solvent acetonitrile molecules on both sides of the top layer of a Si-terminated CaSi2 surface and its ensuing exfoliation as a standalone 2D sheet. In the acetonitrile case, the as-formed 2D material exhibits intriguing structural and electronic properties with an unusual quasi-one-dimensional substructure of silicon chains and a Dirac-like cone in the energy band diagram. The results elucidate the atomic-scale details of the established experimental technique of topotactic synthesis of functionalized silicene and identify new structural motifs for 2D materials.

Influence of lower limb dominance on mechanical asymmetries during high-speed treadmill running.

We determine whether mechanical asymmetries differ between dominant and non-dominant legs at fast treadmill speed. Stride temporal variables, derived from high-speed camera recordings, allowed to estimate leg and vertical stiffness through the sine-wave method in 31 uninjured males during treadmill running at 6.67 m.s-1. Lower limb dominance was determined by the triple-jump test. The asymmetry was expressed as dominant-non-dominant and indexed by the absolute asymmetry index (ASI). The lowest and highest mean ASI values were detected for contact time (1.69%) and flight time (5.66%), respectively; ASI values for spring-mass characteristics (2.6% ≤ leg and vertical stiffness, peak vertical force, change in vertical leg length and centre of mass vertical displacement ≤ 4.7%) were within this range. Inter-subject variability in ASI varied substantially among the seven analysed variables with larger and smaller range of variability in ASI found for flight time (0-16.56%) and contact time (0-3.47%), respectively. Because the magnitude of group mean ASI appears inconsistent among stride temporal and spring-mass characteristics, different biomechanical variables should not be used interchangeably to assess laterality effects at fast treadmill speed. The widespread ASI range also indicates that using a 'fixed cut-off' threshold is an arbitrary approach.

Shape Memory Composite Sandwich Structures with Self-Healing Properties.

In this study, Polyurea/Formaldehyde (PUF) microcapsules containing Dicyclopentadiene (DCPD) as a healing substance were fabricated in situ and mixed at relatively low concentrations (<2 wt%) with a thermosetting polyurethane (PU) foam used in turn as the core of a sandwich structure. The shape memory (SM) effect depended on the combination of the behavior of the PU foam core and the shape memory polymer composite (SMPC) laminate skins. SMPC laminates were manufactured by moulding commercial carbon fiber-reinforced (CFR) prepregs with a SM polymer interlayer. At first, PU foam samples, with and without microcapsules, were mechanically tested. After, PU foam was inserted into the SMPC sandwich structure. Damage tests were carried out by compression and bending to deform and break the PU foam cells, and then assess the structure self-healing (SH) and recovery capabilities. Both SM and SH responses were rapid and thermally activated (120 °C). The CFR-SMPC skins and the PU foam core enable the sandwich to exhibit excellent SM properties with a shape recovery ratio up to 99% (initial configuration recovery). Moreover, the integration of microcapsules (0.5 wt%) enables SH functionality with a structural restoration up to 98%. This simple process makes this sandwich structure ideal for different industrial applications.

Acute Effects of Whole-Body Vibration Warm-up on Leg and Vertical Stiffness During Running.

ABSTRACT: Paradisis, GP, Pappas, P, Dallas, G, Zacharogiannis, E, Rossi, J, and Lapole, T. Acute effects of whole-body vibration warm-up on leg and vertical stiffness during running. J Strength Cond Res 35(9): 2433-2438, 2021-Although whole-body vibration (WBV) has been suggested as a suitable and efficient alternative to the classic warm-up routines, it is still unknown how this may impact running mechanics. Therefore, the aim of this study was to investigate the effect of a WBV warm-up procedure on lower-limb stiffness and other spatiotemporal variables during running at submaximal speed. Twenty-two males performed 30-second running bouts at 4.44 m·s-1 on a treadmill before and after a WBV and control warm-up protocols. The WBV protocol (vibration frequency: 50 Hz, peak-to-peak displacement: 4 mm) consisted of 10 sets of 30-second dynamic squatting exercises with 30-second rest periods within sets. Leg and vertical stiffness values were calculated using the spring mass model. The results indicated significant increases only after the WBV protocol for leg stiffness (3.4%), maximal ground reaction force (1.9%), and flight time (4.7%). Consequently, the WBV warm-up protocol produced a change in running mechanics, suggesting a shift toward a more aerial pattern. The functional significance of such WBV-induced changes needs further investigation to clearly determine whether it may influence running economy and peak velocity.

The effect of four weeks of plyometric training on reactive strength index and leg stiffness is sport dependent.

BACKGROUND: Plyometric exercises are often used to develop lower limb strength and performance-related biomechanics such as leg stiffness. However, the effectiveness of plyometric training may depend on participants' own training and performance demands. The purpose of this study was to examine the effect of plyometric training on Reactive Strength Index (RSI) and leg stiffness (Kleg) on young athletes of different sports. METHODS: Forty eight female athletes (25 Taekwondo (TKD) and 23 rhythmic gymnastics (RG), mean±SD: age: 8.94±2.50 years; mass: 29.73±7.69 kg; height: 138.84±11.90 cm; training experience: 4.62±2.37 years) participated in this study. Participants were randomly assigned to experimental (PT, N.=24) and control (CG, N.=24) groups. The PT group followed a twice-weekly plyometric training program for 4 weeks. Plyometric drills lasted approximately 5-10 s, and at least 90 s rest was allowed after each set. To examine RSI, participants performed trials of five maximal CMJs. Submaximal hopping (20 hops) was performed in order to examine leg stiffness. RESULTS: Significant interaction effect was found for RSI and the post hoc analysis showed that RSI significantly increased by 35% (P=0.017) in RG athletes, whereas a significantly reduction by 28% (P=0.004) was revealed in TKD athletes. The interaction effect between time and group was statistically significant for Kleg (P<0.05) with Kleg significantly increasing by 31% (P=0.008) in TKD athletes, but remaining unchanged (P>0.05) in RG athletes. CONCLUSIONS: The results showed that the effect of a 4-week plyometric training program on RSI and leg stiffness is sport dependent. Further, the applied plyometric program was effective in reducing ground contact time and therefore increasing leg stiffness.

The effect of underweight on female and male reproduction.

Chronic energy deficiency can impair the hypothalamic-pituitary-gonadal (HPG) axis and lead to hypothalamic anovulation in underweight women. This review presents the syndromes related to underweight status that are associated with infertility, summarizes the underlying mechanisms, and reviews the available treatment options. Eating disorders, such as anorexia nervosa (AN), constitute the most common cause of infertility in underweight women, who, in addition, experience miscarriages, and sexual dysfunction. The relative energy deficiency in sports (RED-S; former terminology: athlete's triad) involves menstrual dysfunction due to low energy availability, which results in anovulation. Moreover, lipodystrophies, malnutrition, starvation, systematic illnesses (malignancies, endocrinopathies, infectious diseases, advanced chronic diseases, neurologic illnesses), and the utilization of drugs can cause excessive weight loss. They may result in fertility problems due to the loss of adipose tissue and the subsequent hormonal disturbances. Each of these conditions requires multidisciplinary management. Nutritional counseling should target the restoration of energy balance by increasing intake and reducing output. Medical treatment, recommended only for patients who did not respond to standard treatment, may include antipsychotics, antidepressants, or leptin administration. Finally, psychiatric treatment is considered an integral part of the standard treatment.

Sprint mechanical differences at maximal running speed: Effects of performance level.

As the effect of performance level on sprinting mechanics has not been fully studied, we examined mechanical differences at maximal running speed (MRS) over a straight-line 35 m sprint amongst sprinters of different performance levels. Fifty male track and field sprinters, divided in Slow, Medium and Fast groups (MRS: 7.67 ± 0.27 m∙s-1, 8.44 ± 0.22 m∙s-1, and 9.37 ± 0.41 m∙s-1, respectively) were tested. A high-speed camera (250 Hz) recorded a full stride in the sagittal plane at 30-35 m. MRS was higher (p < 0.05) in Fast vs. Medium (+11.0%) and Slow (+22.1%) as well as in Medium vs. Slow (+10.0%). Twelve, eight and seven out of 21 variables significantly distinguished Fast from Slow, Fast from Medium and Medium from Slow sprinters, respectively. Propulsive phase was significantly shorter in Fast vs. Medium (-17.5%) and Slow (-29.4%) as well as in Medium vs. Slow (-14.4%). Fast sprinters had significantly higher vertical and leg stiffness values than Medium (+44.1% and +18.1%, respectively) and Slow (+25.4% and +22.0%, respectively). MRS at 30-35 m increased with performance level during a 35-m sprint and was achieved through shorter contact time, longer step length, faster step rate, and higher vertical and leg stiffness.

Surgical management of congenital uterine anomalies (including indications and surgical techniques).

The prevalence of congenital uterine anomalies (CUA) is reported to be 4.3-6.7% in the general population, 3.4%-8% in the infertile population, and 12.6-18.2% of those with recurrent miscarriages. They are the result of abnormal formation, differentiation, and fusion of the Müllerian or paramesonephric ducts during fetal life. To date, various classification systems have been proposed for the categorization of CUA, but the recently introduced ESHRE/ESGE classification seems to be a new, clear, and systematic categorization, which could be the basis for clinicians to rely on when they refer to CUA and their clinical impact either generally or concerning pregnancy outcomes. CUA are apparently related to an impaired reproductive outcome, while their exact clinical impact as well as the effectiveness of their treatment remain considered controversial. Surgery is indicated in women presenting with symptoms related to specific uterine anomalies, especially in those with fertility problems. In this review, indications, surgical techniques for the repair of CUA according to their classification, and fertility and pregnancy outcomes before and after surgery will be thoroughly reviewed.

Strain Engineering in Highly Wrinkled CVD Graphene/Epoxy Systems.

Chemical vapor deposition (CVD) is regarded as a promising fabrication method for the automated, large-scale, production of graphene and other two-dimensional materials. However, its full commercial exploitation is limited by the presence of structural imperfections such as folds, wrinkles, and even cracks that downgrade its physical and mechanical properties. For example, as shown here by means of Raman spectroscopy, the stress transfer from an epoxy matrix to CVD graphene is on average 30% of that of exfoliated monolayer graphene of over 10 µm in dimensions. However, in terms of electrical response, the situation is reversed; the resistance has been found here to decrease by the imposition of mechanical deformation possibly due to the opening up of the structure and the associated increase of electron mobility. This finding paves the way for employing CVD graphene/epoxy composites or coatings as conductive "networks" or bridges in cases for which the conductivity needs to be increased or at least retained when the system is under deformation. The tuning/control of such systems and their operative limitations are discussed here.

Acute Effects of Stretching on Leg and Vertical Stiffness During Treadmill Running.

Pappas, PT, Paradisis, GP, Exell, TA, Smirniotou, AS, Tsolakis, CK, and Arampatzis, A. Acute effects of stretching on leg and vertical stiffness during treadmill running. J Strength Cond Res 31(12): 3417-3424, 2017-The implementation of static (SS) and dynamic (DS) stretching during warm-up routines produces significant changes in biological and functional properties of the human musculoskeletal system. These properties could affect the leg and vertical stiffness characteristics that are considered important factors for the success of athletic activities. The aim of this study was to investigate the influence of SS and DS on selected kinematic variables, and leg and vertical stiffness during treadmill running. Fourteen men (age: 22.58 ± 1.05 years, height: 1.77 ± 0.05 m, body mass: 72.74 ± 10.04 kg) performed 30-second running bouts at 4.44 m·s, under 3 different stretching conditions (SS, DS, and no stretching). The total duration in each stretching condition was 6 minutes, and each of the 4 muscle groups was stretched for 40 seconds. Leg and vertical stiffness values were calculated using the "sine wave" method, with no significant differences in stiffness found between stretching conditions. After DS, vertical ground reaction force increased by 1.7% (p < 0.05), which resulted in significant (p < 0.05) increases in flight time (5.8%), step length (2.2%), and vertical displacement of the center of mass (4.5%) and a decrease in step rate (2.2%). Practical durations of SS and DS stretching did not influence leg or vertical stiffness during treadmill running. However, DS seems to result in a small increase in lower-limb force production which may influence running mechanics.

Reliability of Leg and Vertical Stiffness During High Speed Treadmill Running.

In research, the accurate and reliable measurement of leg and vertical stiffness could contribute to valid interpretations. The current study aimed at determining the intraparticipant variability (ie, intraday and interday reliabilities) of leg and vertical stiffness, as well as related parameters, during high speed treadmill running, using the "sine-wave" method. Thirty-one males ran on a treadmill at 6.67 m∙s-1, and the contact and flight times were measured. To determine the intraday reliability, three 10-s running bouts with 10-min recovery were performed. In addition, to examine the interday reliability, three 10-s running bouts on 3 separate days with 48-h interbout intervals were performed. The reliability statistics included repeated-measure analysis of variance, average intertrial correlations, intraclass correlation coefficients (ICCs), Cronbach's α reliability coefficient, and the coefficient of variation (CV%). Both intraday and interday reliabilities were high for leg and vertical stiffness (ICC > 0.939 and CV < 4.3%), as well as related variables (ICC > 0.934 and CV < 3.9%). It was thus inferred that the measurements of leg and vertical stiffness, as well as the related parameters obtained using the "sine-wave" method during treadmill running at 6.67 m∙s-1, were highly reliable, both within and across days.

Mechanical Stability of Flexible Graphene-Based Displays.

The mechanical behavior of a prototype touch panel display, which consists of two layers of CVD graphene embedded into PET films, is investigated in tension and under contact-stress dynamic loading. In both cases, laser Raman spectroscopy was employed to assess the stress transfer efficiency of the embedded graphene layers. The tensile behavior was found to be governed by the "island-like" microstructure of the CVD graphene, and the stress transfer efficiency was dependent on the size of graphene "islands" but also on the yielding behavior of PET at relatively high strains. Finally, the fatigue tests, which simulate real operation conditions, showed that the maximum temperature gradient developed at the point of "finger" contact after 80 000 cycles does not exceed the glass transition temperature of the PET matrix. The effect of these results on future product development and the design of new graphene-based displays are discussed.

Leg and vertical stiffness (a)symmetry between dominant and non-dominant legs in young male runners.

Biomechanical findings show that running is asymmetric in many kinetic properties. Running stiffness is a vital kinetic property of yet unknown pattern of lateralization. The aim of this study was to examine the degree and variability of lower limb dominance specific asymmetry of running in terms of leg stiffness, vertical stiffness, contact time, flight time, maximal ground reaction force during contact, vertical displacement of the center of mass, and change in leg length. Leg and vertical stiffness was estimated by the sine-wave method in 22 young males during treadmill running at 4.44 m/s. Lower limb dominance was determined by the triple-jump test. Asymmetry was expressed as dominant - non-dominant, and indexed by the absolute asymmetry index. Significant asymmetry was found only in flight time (3.98%) and in maximal ground reaction force (1.75%). The absolute asymmetry index ranged from 1.8% to 6.4%, showed high variation between subjects (0-31.6%), and differentiated among the 7 analyzed variables. Leg and vertical stiffness in treadmill running of moderate pace (4.44 m/s) should be considered symmetric.

Reliabilities of leg and vertical stiffness during treadmill running.

The aim of this study was to determine the intra-participant variabilities (i.e. intra-day and inter-day reliabilities) in leg and vertical stiffness, as well as related kinematic parameters, during treadmill running using the sine-wave method. Twenty-two healthy men ran on a treadmill at 4.44 m/s, and the flight and contact times were measured with a high-speed video camera. Three 30-s running bouts with 2-min inter-bout rests were performed to examine the intra-day reliability, and single 30-s running bouts on three separate days with 24- to 48-h inter-bout intervals were performed to examine the inter-day reliability. The reliability statistics included repeated-measure analyses of variance, average inter-trial correlations, intra-class correlation coefficients (ICCs), Cronbach's α reliability coefficient, and the coefficient of variation. Both leg and vertical stiffness produced high ICCs within 0.972 and 0.982, respectively, and between 0.922 and 0.873 days, respectively. High values were also observed for all of the reliability coefficients. Similar results were found regarding contact time, flight time, step length, and step rate. It was concluded that the measurements of leg and vertical stiffness, as well as related kinematic parameters, obtained using the sine-wave method during treadmill running at 4.44 m/s, were highly reliable, both within and across days.