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In the radial forearm phalloplasty multiple nerves are harvested to provide phallic sensation, resulting in iatrogenic nerve injuries. Despite this, nerve morbidity following this procedure has been minimally assessed. The purpose of this study was to assess donor site nerve morbidity following radial forearm phalloplasty.Patients who underwent gender-affirming phalloplasty at our institution between 2016-2020 using the radial forearm were included. Pain characteristics were assessed with a modified Mackinnon Pain questionnaire consisting of 33 items, including visual analog scales (VAS) for reporting of pain and impact on aspects of quality of life (QoL), as well as 20 descriptive pain adjectives and a 21-item questionnaire to capture overall pain experience.A total of 37 patients were included. 31 had minimal-mild pain (VAS scores 0-3), and 6 patients had moderate-severe pain (VAS scores 4-10). The mild pain group reported a mean 2.74 (0-7) pain descriptors and reported minimal impact on QoL metrics. The moderate-severe pain group reported mean 6.33 (2-15) pain descriptors and reported significant impacts on QoL metrics. Significant differences were observed with decreased QoL (p = 0.018), increased sadness (p = 0.009), increased frustration (p = 0.030), increased anger (p = 0.0496), and decreased hopefulness (p = 0.0496) in the moderate-severe pain group along with interference of pain with sleep (p = 0.002).In a cross-sectional analysis of 37 patients who underwent gender-affirming radial forearm phalloplasty, the majority (31) experienced a minimal degree of donor site nerve pain. Six patients suffered from more significant nerve pain that was associated with a decreased QoL. Treatment and prevention of this nerve pain represent important areas for future exploration.

Aim: Patients with Ehlers-Danlos Syndrome (EDS) are considered to have an increased risk for wound healing complications. Surgeons may therefore be hesitant to offer elective surgeries, including gender-affirming surgeries (GAS), to EDS patients. At our center, we frequently encountered patients presenting for GAS evaluation with the co-existing diagnosis of EDS. This study aims to establish the prevalence of EDS diagnosis in our GAS patients and compare their post-operative complications to patients without EDS diagnosis. Methods: This is a single-institution retrospective case-control study on all patients who underwent GAS from 2016-2020. Data include EDS diagnosis, demographics, operation, and complications (including minor wound healing issues). Results: Of 1363 patients presenting for GAS, 36 (2.6%) had EDS diagnoses and were matched with 108 control patients. Major complications requiring surgical intervention in the OR occurred in 6 patients (4.2%), (2.8% EDS vs. 5.4% controls; P = 0.63), while 8.3% of EDS and 14% of controls required minor interventions (P = 0.38). The rate of wound healing issues of any severity was 28% in EDS vs. 47% in control groups (P = 0.04). Conclusion: The prevalence of EDS diagnosis in our patient population is 132 times the highest reported prevalence in the general population. Wound healing issues and the need for additional post-operative interventions in the group with EDS diagnosis were not significantly different from the control group. Our findings suggest that patients with a diagnosis of EDS undergoing GAS have comparable outcomes to patients without EDS. Concerns for post-operative complications should not be a barrier to offering GAS to patients presenting with an EDS diagnosis.

A theoretical base of SPH method, including the governing equations, discussion of importance of the smoothing function length, contact formulation, boundary treatment and finally utilization in hydrocode simulations are presented. An application of SPH to a real case of large penetrations (crater creating) into the soil caused by falling mass in Dynamic Replacement Method is discussed. An influence of particles spacing on method accuracy is presented. An example calculated by LS-DYNA software is discussed. Chronological development of Smooth Particle Hydrodynamics is presented. Theoretical basics of SPH method stability and consistency in SPH formulation, artificial viscosity and boundary treatment are discussed. Time integration techniques with stability conditions, SPH+FEM coupling, constitutive equation and equation of state (EOS) are presented as well.

Bottom ash from EC Gdańsk and dredged material taken from the mouth of The Vistula were mixed to form an engineering material used for dike construction. Mixtures with different bottom ash content were tested in laboratory to determine its basic physical and mechanical properties. The optimum bottom ash-dredged material mixture, built in the corps of the test dike, contains 70% of ash. The optimum bottom ash content in the mixture was chosen taking into account high internal friction angle, good compaction and reduced filtration coefficient. The maximum dry density of the mixtures was measured in Proctor test for the mixtures formed in laboratory and on samples taken from the test dike. Minimum and maximum void ratio were also determined.

An analysis of using of anthropogenic materials, mainly ashes from Coal Combustion Products (CCP), for dike construction is shown. Perspectives of anthropogenic materials application in geotechnical engineering and their advantages in sense of the carbon dioxide reduction are discussed. According to regulations of Kioto Protocol 2005 and EU agreement “Energy Roadmap 2050” recycled materials have higher usage priority than natural ones. General remarks about constructions using soil-ash composites are given with discussion about their properties and laboratory investigation. Finally the full-scale experiment within the DREDGDIKES Project (www.dredgdikes.eu) is described, which is focused on the new technology with the usage of dredged and anthropogenic materials for construction of dikes.

W artykule przedstawiono sposób wyznaczania powierzchni płyniecia oraz powierzchni granicznej dla przykładowych równan konstytutywnych w ramach teorii hypoplastycznosci zaproponowanych przez Wu, Gudehus’a oraz Bauer’a. Pokazano jak wyznaczac i wykreslac obie powierzchnie dynamicznie dla dowolnych równan tej klasy. Przeanalizowano błedy obliczeniowe charakterystyczne dla uzytych formuł numerycznych. W pracy podano linki do komputerowych kodów zródłowych przygotowanych w komercyjnym systemie MATLAB, stosujacych instrukcje przedstawione w niniejszym artykule. Przedstawiono przykładowe dziedziny równan konstytutywnych narysowanych przy pomocy załaczonego programu komputerowego.

In this paper we present an inverse analysis method for material parameter identification applied to the hypoplastic constitutive model for soils. The proposed method is classified as a direct-approach one, since the discrepancy between the material responses, measured and calculated by means of the finite element method is directly minimized. In the presented work this minimization is made up of the modified Levenberg-Marquardt optimization method based on the so-called trust region approach. We provide a numerical example of parameter identification for a triaxial test performed on a sand material, supplemented by the analysis of the influence of the initial guesses of the parameters to be identified, as well as the errors in the measured control data on the identification process.

The structure of persistent and transient shear bands in granular materials by experimental modeling a quite idealized assembly of two-dimensional particles, Taylor-Schneebeli (T-S) material, is investigated. Flexible stress-controlled boundaries make possible biaxial compression test (samples 100 cm high and 30-100 cm wide), i.e. they avoid constraining the motion of particles within the shear bands. The displacement, volumetric strain, void ratio, rotation of the particles, rotation of their neighborhoods can be examined within the shear bands. The importance of particle's rotations inside shear bands can justify the micropolar description of granular materials. For measurement at the microstructure level a conventional digital video technique is used. New digital image processing (DIP) techniques are used for analysis at the microscopic level, giving localization, displacements and rotations of each T-S rods. Short description of a new plane strain experimental stand and an example of DIP analysis for a selected experimental test are presented. Some comments due to the mathematical model description of granular bodies is also given.