Search

Microstructure refinement down to d ∼ 0.1–1 μm is known to enhance processing properties of hard-to-deform materials and particularly can be used for facilitating superplastic forming or roll-forming. However refined microstructure can compromise service properties, particularly fatigue properties. In the present work, the fatigue behavior of the fine-grained Alloy 718 has been investigated. A number of fine-grained conditions with a grain size ∼0.1–1 μm were produced using multiple forging with a graduate decrease of the forging temperature. Part of the forged fine-grained conditions was also subjected to conventional solution annealing and ageing. In this case a small grain size was controlled by precipitates of the δ phase located on grain boundaries. Low cycle fatigue tests of the fine-grained conditions were carried out at room and elevated temperatures. The obtained properties are compared with those of the Alloy 718 in the coarse-grained conditions. The effect of the grain size on the fatigue strength of the fine-grained Alloy 718 is discussed in terms of the microstructure evolution and fracture mode.

Varicocele, closely linked to male fertility, requires urgent and focused research due to many unresolved questions. The absence of clear reference values distinguishing "normal" from "abnormal" semen parameters in the 6th World Health Organization (WHO) laboratory manual significantly complicates diagnosis and treatment. Additionally, the clinical relevance of total progressively motile sperm count (TMSC) remains unclear, leaving practitioners without critical guidance. The decision to perform varicocelectomy, particularly in cases of isolated teratozoospermia, is fraught with uncertainty. Furthermore, the best treatment strategy for those experiencing subfertility after varicocele surgery is still undetermined, adding another layer of complexity. These pressing issues, along with contentious debates surrounding isolated teratozoospermia treatment, highlight the need for large-scale multicenter randomized clinical trials. Such studies are essential to fully understand varicocele's impact on male fertility and to develop evidence-based management protocols., Competing Interests: The authors declare no conflict of interest., (©2024 The Author(s). Published by MRE Press.)

On the one hand, economies, particularly developing ones, need to grow. On the other hand, climate change is the most pressing issue globally, and nations should take the necessary measures. Such a complex task requires new theoretical and empirical models to capture this complexity and provide new insights. Our study uses a newly developed theoretical framework that involves renewable energy consumption (REC) and total factor productivity (TFP) alongside traditional factors of CO2 emissions. It provides policymakers with border information compared to traditional models, such as the Environmental Kuznets Curve (EKC), being limited to income and population. Advanced panel time series methods are also employed, addressing panel data issues while producing not only pooled but also country-specific results. 20 Renewable Energy Country Attractiveness Index (RECAI) nations are considered in this study. The results show that REC, TFP, and exports reduce CO2 emissions with elasticities of 0.3, 0.4, and 0.3, respectively. Oppositely, income and imports increase emissions with elasticities of 0.8 and 0.3. Additionally, we show that RECAI countries are commonly affected by global and regional factors. Moreover, we find that shocks can create permanent changes in the levels of the factors but only temporary changes in their growth rates. The main policy implication of the findings is that authorities should implement measures boosting TFP and REC. These factors are driven mainly by technological progress, innovation, and efficiency gains. Thus, they can simultaneously reduce emissions while promoting long-run green economic growth, which addresses the complexity mentioned above to some extent., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction and Hypothesis: Studies on non-obstetric urogenital fistulas (NOUGFs) provide limited information on predictive outcome factors. This study was aimed at specifying and analyzing the risk factors for long-term anatomical and functional results., Methods: A cross-sectional study of surgical repair for non-obstetric urogenital fistula was performed. From 2012 to 2020, a total of 479 patients with urogenital fistulas were treated in two tertiary centers. Patients with isolated ureteral fistulas and rectal injuries were excluded. For evaluation of the long-term results, patients with vesicovaginal and urethrovaginal fistulas with at least 12 months of follow-up were identified and contacted by phone and/or examined in the clinic. The anatomical outcome was assessed by resolution of symptoms and/or clinical examination. The Urinary Distress Inventory (UDI-6) was used for the functional outcomes., Results: Overall, 425 patients were studied (mean age was 49.8; BMI 27.5; mean fistula size 1.4 cm, mean follow-up was 12 months). Vesicovaginal fistula affected 73% of patients. Hysterectomy without radiation was the most common etiology (66.3%), followed by hysterectomy with subsequent radiation (16%) and pelvic radiotherapy (12.2%). The transvaginal approach was used in 54.4%, abdominal in 12.4%, transvesical in 22.4%, and a combined approach in 10.8%. The successful closure rate was 92.9% for primary cases, 71.6% for secondary cases, and 66.7% for radiation fistulas. A high risk for relapse was found for NOUGFs with ureteral involvement (RR 2.5; 95% CI 1.3-4.5; p = 0.003), radiation fistulas (RR 2.1; 95% CI 1.3-3.5, p = 0.003); and combined radiation and hysterectomy cases (RR 2.9; 95% CI 1.8-4.6; p = 0.0001). In multifactorial analysis, fistula size >3.0 cm, pelvic radiation, and previous vaginal surgeries were associated with a higher risk for failure or lower urinary symptoms., Conclusions: Factors for successful NOUGF closure are fistula size less than 3.0 cm, absence of pelvic radiation, and previous vaginal surgeries., (© 2022. The International Urogynecological Association.)

This article examines the impact of carbon pricing on international competitiveness for Azerbaijan, utilizing different cointegration methods such as, ARDLBT, CCR, DOLS, and FMOLS to the data spanning from 2000 to 2019. The results of the various cointegration approaches are in line with each other. The estimation results revealed that domestic crude oil price as a proxy of carbon pricing has a positive and significant impact on the real effective exchange rate in Azerbaijan. This implies that a rise in domestic crude oil price raises the real effective exchange rate (appreciation of national currency). An increase in real effective exchange rate indicates a loss in international competitiveness. The study concludes that the Azerbaijani policymakers should implement carbon pricing measures (implicit) to decrease CO 2  emissions from energy heavy industries without harming the country's international competitiveness, as well as use more renewable energy in order to prevent higher pollution effects of fossil fuels., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Aim: Studies on non-obstetric urogenital fistula provide limited information on predictive factors. The aim of our study was to specify and to analyze the predictors for long-term anatomical and functional results in women with non-obstetric urogenital fistula., Materials and Methods: A cross-section study of surgical repair for non-obstetric urogenital fistula repairs was carried out. From 2012 to 2018, a total of 446 patients with urogenital fistulas were treated in two tertiary centers. Patients with vesicovaginal and urethrovaginal fistulas with at least 12 months of follow-up were identified and contacted by phone and/or examined in the clinic. Anatomical outcome was assessed by resolution of symptoms and/or results of clinical examination. Urinary distress inventory (UDI-6) was used for the measurement of functional outcomes. The nomogram is based on a multiple regression equation, the solution of which is performed using a computer. The nomogram is presented as a set of scales, each of which corresponds to a certain variable. The baseline parameter is assigned certain points, depending on its value, then the sum of all parameters is calculated. As a result, it is possible to determine the risk using a couple or three scales., Results: Overall, 169 patients were studied (mean age of 49.2, mean follow-up of 34 months). The most common cause of fistulas included hysterectomy (69.4%), followed by pelvic radiotherapy (18.9%). Only 64% of cases were primary fistula. Closure rate was 90.7% (98/108). Anatomical success depended on the surgical approach. For transvesical procedure, success rate was 89.4% (42/47), compared to 84% (89/106) and 87.5% (14/16), respectively for transvaginal and transabdominal success rate. According to Clavien-Dindo, complications were grade 1 (11.8%) and grade 2 (4.7%). As UDI-6 showed, the most common symptoms were frequency (62%), urgency (50%), incontinence (73%), pain (55%) and voiding symptoms (27%). Fistula size > 3.0 cm, pelvic radiation, and previous vaginal surgeries were associated with a higher risk of failure or more severe lower urinary tract symptoms. A high number of re-do cases and complex fistulas could be a limitation of this study. Factors for successful non-obstetric urogenital fistula closure were fistula size less than 3.0 cm, absence of pelvic radiation, and previous vaginal surgeries., Conclusion: According to our results, only fistula size > 3 cm, previous vaginal procedures and pelvis irradiation were unfavorable predictors for anatomic success of fistula repair. In addition, our results allow to determine the predictors for successful repair and risk of recurrence lower urinary tract symptoms postoperatively.

Aim: To improve an early diagnosis of prostate cancer (PCa) by clarifying indications for prostate biopsy., Materials and Methods: A prospective analysis of 251 primary prostate biopsies performed in Republican Specialized Scientific and Practical Medical Center of Urology to patients with LUTS during the period from 2018 to 2019 was carried out. All patients were divided into two groups. The group 1 included 189 patients who underwent standard systematic prostate biopsy; the group 2 consisted of 62 patients, who had had baseline multiparametric magnetic resonance tomography (mp-MRI) of the prostate with risk evaluation using PI-RADS v2 score, followed by systematic biopsy in combination with targeted biopsy. The ultrasound-guided biopsy was done under local anesthesia using lidocaine gel and periprostatic nerve block with a 2% lidocaine solution. Systematic biopsy was performed with 10 to 12 cores using biopsy gun. In the second group, in addition to systematic biopsy, from 2 to 6 targeted cores from suspicious areas were taken., Results: In the group 1, PCa was diagnosed in 124 (65.6%) patients. In patients with a PSA level of less than 20 ng/ml, a total of 18 PCa were revealed (35.3%). A concordance between TRUS and DRE with the biopsy result was significantly less in patients with PSA level < 20 ng/ml (17.6%), than in patients with PSA level more than 20.1 ng/ml (61.6%; p<0.001). In the second group, PCa was diagnosed in 5 patients (17.9%) with PI-RADS v2 category 2 and 3 lesions, compared to 31 men (91.2%) with category 4 and 5 lesions. In patients with PSA level of less than 20 ng/ml, the proportion of positive biopsy results was 5.6% and 75.0%, respectively., Conclusions: In all patients with PSA level of less than 20 ng/ml, mp-MRI of the prostate should be performed prior to biopsy. In men with PI-RADS v2 category 4-5 lesions, systematic biopsy in combination with targeted biopsy is recommended, while in case of category 2-3 lesions and negative TRUS and DRE, it is more appropriate to follow-up patients, instead of performing biopsy.

This paper investigates the CO 2 emissions-economic growth relationship in Kazakhstan for the period 1992-2013. Johansen, ARDLBT, DOLS, FMOLS, and CCR cointegration methods are used for robustness purpose. We start with the cubic functional form to rule out any misleading results that can be caused by misspecification. Although the estimation results suggest "U"-shaped relationship, the turning point of income is out of the period. It means that the impact of economic growth on CO 2 is monotonically increasing in the long run indicating the Environmental Kuznets Curve (EKC) hypothesis does not hold for Kazakhstan. Moreover, we calculate that the income elasticity of CO 2 is about unity. The paper concludes that the Kazakhstani policymakers should focus on less energy-intensive sectors as well as using more renewable energy in order to avoid higher pollution effects of economic growth. They may also set new policy regulations for CO 2 reduction.

The study investigates the long-run impact of tourism development on ecological footprint by employing the time-varying coefficient cointegration approach (TVC), in addition to the conventional cointegration techniques in the case of Azerbaijan for the period of 1996-2014. Based on the TVC estimation results, the coefficient of tourism development, which is the income elasticity of environmental degradation, was found to be time invariant. The paper uses energy consumption, trade, urbanization, and institutional quality indicators as control explanatory variables. The estimation results revealed that trade and energy consumption have statistically significant and positive impact on ecological footprint, while the coefficients of the other explanatory variables were found to be insignificant. Both the conventional estimation methods and the TVC concluded that, for the relationship between ecological footprint and tourism development, the EKC hypothesis is not present in Azerbaijan. Policy implications for the resource-rich economies have been discussed.

In staghorn and multiple nephrolithiasis, method of choice for removing kidney stones is percutaneous nephrolithotripsy (PCNL). However, it may be accompanied by the leaving off of stones or fragments in pyelocaliceal system. The study was aimed to the evaluation of possibilities of the standard PCNL in terms of complete removal of staghorn and multiple kidney stones. Percutaneous nephrolithotripsy was made by a single access using standard method in 99 patients with staghorn and multiple kidney stones. The average age of the patients ranged from 9 to 61 (34.4±3.2) years. Staghorn stones were found in 80 (80.8%) patients, staghorn stones with multiple stones - in 19 (19.2%) patients. Stone size ranged from 18 to 94 (49.6±2.3) mm. The use of standard PCNL to remove staghorn and multiple kidney stones as monotherapy has allowed complete removing of the stones in 74 (74.7%) patients. The average length of stay of patients in hospital after surgery was 5.9±0.3 bed-days (2 to 31), medium time for removal of drains after surgery - 4.3±0.7 days. Intraoperative blood loss was observed in 11 (11.1%) patients, its volume ranged from 150 to 1130 (407.2±28.8) ml. In 8 (8.1%) cases, bleeding regarded as a complication, because it required replacement therapy. Postoperative complications were observed in 19 (19.2%) patients, of which 8 (8.1%) had bleeding, and 11 (11.1%) had exacerbation of urinary tract infection. Thus, the standard PCNL as monotherapy in staghorn and multiple nephrolithiasis serves as alternative method for removing stones. The results of treatment depend on the size and stereometric configuration of staghorn stones. The most common causes of residual stones are inaccessibility of calyx by endoscope and intraoperative bleeding.