To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Lymph node yield is an important prognostic factor in head and neck squamous cell carcinoma. Variability in neck dissection sampling techniques has not been studied as a determinant of lymph node yield.
This retrospective study used lymph node yield and average nodes per level to compare level-by-level and en bloc neck dissection sampling methods, in primary head and neck squamous cell carcinoma cases operated between March 2017 and February 2020.
From 123 patients, 182 neck dissections were analysed, of which 133 were selective and the rest were comprehensive: 55 had level-by-level sampling and 127 had undergone en bloc dissection. The level-by-level method yielded more nodes in all neck dissections combined (20 vs 17; p = 0.097), but the difference was significant only for the subcohort of selective neck dissection (18.5 vs 15; p = 0.011). However, the gain in average nodes per level achieved by level-by-level sampling was significant in both groups (4.2 vs 3.33 and 4.4 vs 3, respectively; both p < 0.001).
Sampling of cervical lymph nodes level-by-level yields more nodes than the en bloc technique. Further studies could verify whether neck dissection sampling technique has any impact on survival rates.
To determine the incidence of nasolacrimal duct injury after functional endoscopic sinus surgery radiologically, using computed tomography.
Fifty patients of either sex who underwent functional endoscopic sinus surgery were evaluated for nasolacrimal duct injury by computed tomography. Computed tomography was conducted pre-operatively, and post-operatively at the end of four weeks, and nasolacrimal duct injury was analysed.
The prevalence of nasolacrimal duct injury dehiscence was 1.16 per cent, with a similar incidence of 1.16 per cent for nasolacrimal duct injury post-operatively. However, no cases of symptomatic nasolacrimal duct injury were recorded.
Computed tomography scan is an effective, non-invasive method to evaluate nasolacrimal duct injury following functional endoscopic sinus surgery, in accordance with evidence-based medicine.
The ENT run through pilot was introduced in 2018 to improve early recruitment to the specialty. This study aimed to understand what makes a successful interview applicant and the experience of the run through trainees during the specialty trainee one and specialty trainee two years.
A questionnaire survey was sent to all ENT run through trainees.
Twenty-three trainees responded. Of the successful candidates, 74 per cent held additional degrees prior to application. The median core surgical interview rank was 27 (range: 3–174). Trainees felt that being on the run through pilot had increased ENT trainer engagement.
The ENT run through posts are highly competitive, and holding an additional degree may improve applicant success. The pilot programme has been successful by increasing trainer engagement at this critical stage of training. These results will enable development of the pilot programme and provide valuable information for those applying to an ENT run through post.
Gravitational waves from coalescing neutron stars encode information about nuclear matter at extreme densities, inaccessible by laboratory experiments. The late inspiral is influenced by the presence of tides, which depend on the neutron star equation of state. Neutron star mergers are expected to often produce rapidly rotating remnant neutron stars that emit gravitational waves. These will provide clues to the extremely hot post-merger environment. This signature of nuclear matter in gravitational waves contains most information in the 2–4 kHz frequency band, which is outside of the most sensitive band of current detectors. We present the design concept and science case for a Neutron Star Extreme Matter Observatory (NEMO): a gravitational-wave interferometer optimised to study nuclear physics with merging neutron stars. The concept uses high-circulating laser power, quantum squeezing, and a detector topology specifically designed to achieve the high-frequency sensitivity necessary to probe nuclear matter using gravitational waves. Above 1 kHz, the proposed strain sensitivity is comparable to full third-generation detectors at a fraction of the cost. Such sensitivity changes expected event rates for detection of post-merger remnants from approximately one per few decades with two A+ detectors to a few per year and potentially allow for the first gravitational-wave observations of supernovae, isolated neutron stars, and other exotica.
In this paper, we present a model characterizing the interaction of a radiative shock (RS) with a solid material, as described in a recent paper (Koenig et al., Phys. Plasmas, 24, 082707 (2017)), the new model is then related to recent experiments performed on the GEKKO XII laser facility. The RS generated in a xenon gas cell propagates towards a solid obstacle that is ablated by radiation coming from the shock front and the radiative precursor, mimicking processes occurring in astrophysical phenomena. The model presented here calculates the dynamics of the obstacle expansion, which depends on several parameters, notably the geometry and the temperature of the shock. All parameters required for the model have been obtained from experiments. Good agreement between experimental data and the model is found when spherical geometry is taken into account. As a consequence, this model is a useful and easy tool to infer parameters from experimental data (such as the shock temperature), and also to design future experiments.
A new target design is presented to model high-energy radiative accretion shocks in polars. In this paper, we present the experimental results obtained on the GEKKO XII laser facility for the POLAR project. The experimental results are compared with 2D FCI2 simulations to characterize the dynamics and the structure of plasma flow before and after the collision. The good agreement between simulations and experimental data confirms the formation of a reverse shock where cooling losses start modifying the post-shock region. With the multi-material structure of the target, a hydrodynamic collimation is exhibited and a radiative structure coupled with the reverse shock is highlighted in both experimental data and simulations. The flexibility of the laser energy produced on GEKKO XII allowed us to produce high-velocity flows and study new and interesting radiation hydrodynamic regimes between those obtained on the LULI2000 and Orion laser facilities.
Background: The surgical risk factors and neuro-imaging characteristics associated with cerebellar mutism (CM) remain unclear and require further investigation. We aimed to examine surgical and MRI findings associated with CM in children following posterior fossa tumor resection. Methods: Using our data registry, we retrospectively collected data from pediatric patients who acquired CM and were matched based on age and pathology type with patients not acquiring CM after posterior fossa surgery. The strength of association between surgical and MRI variables and CM were examined using odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Results: A total of 22 patients were included. Medulloblastoma was the most common pathology among CM patients (91%). Tumor attachment to the floor of the fourth ventricle (OR, 6; 95% CI, 0.7-276), calcification/hemosiderin deposition (OR 7; 95% CI 0.9-315.5), and post-operative peri-ventricular ischemia on MRI (OR, 5; 95% CI, 0.5-236.5) were found to have the highest association with CM. Conclusions: Our results may suggest that tumor attachment to the floor of the fourth ventricle, pathological calcification, and post-operative ischemia are relatively more prevalent in patients with CM. Collectively, our work calls for a larger multi-institutional study of CM patients to further investigate the determinants and management of CM to potentially minimize its development and predict onset.
Harvesting solar energy, is only one of the incentives of incorporating photosynthetic proteins in electrochemical devices. Understanding the interface of photosynthetic protein complexes and organic\inorganic underlying electrodes can give rise to development of new generation of nano-bioelectronics for other applications such as sensing, as well. Previous approaches in fabricating photosynthetic bio-hybrid electrochemical solar cells were mainly based on metallic electrodes with protein complexes attached, either directly or through linker molecules. Due to the energy band structure in semiconductors, they potentially can be useful for selective charge transfer in an electrochemical device. In the current study, a two terminal sealed bio-hybrid solar cell device was fabricated comprising of hydrothermally grown ZnO nanowires on fluorine doped tin oxide (FTO) glass working electrode, a Pt counter electrode, and methyl viologen (MV) as a single diffusible redox mediator. The ZnO working electrode was initially characterized using scanning electron microscopy (XRD) and X-ray diffraction (XRD). A solution of dimeric Rhodobacter sphaeroides – light harvesting 1 (RC-LH1) core complexes and redox electrolyte was injected into the cavity between working and counter electrodes. Such structure resulted in ∼0.64 µA.cm-2 photocurrent density and ∼0.24 V open circuit potential difference in the dark and under illumination. Additionally, the device stability tests demonstrated that the current response of such devices remained unchanged after 33 hours storage in the dark.
To quantify the impact that mild to moderate tonsillitis has on quality of life in children and compare it to that of severe tonsillitis.
In this prospective study, parents of children aged 0–16 years completed the Paediatric Throat Disorders Outcome Test, and quality of life scores in the tonsillitis groups were compared.
A hundred children were recruited: 58 had severe tonsillitis and were offered surgery, and 42 had mild to moderate tonsillitis and were managed conservatively. The mean outcome test scores in those children undergoing surgery were 36.7 for tonsillectomy patients and 36.9 for adenotonsillectomy patients, compared with a score of 31.5 for the mild to moderate tonsillitis patients (p = 0.019).
Children with mild to moderate disease had significantly better quality of life scores than those with severe disease. It is thought that those with mild to moderate disease have short-term improvements in general quality of life after surgery, which disappear in the medium term. This transient improvement needs to be balanced against the morbidity of the surgery and the cost burden to the National Health Service. The results of this study support the national drive towards limiting tonsillectomy to children with severe tonsillitis or obstructive sleep apnoea.
Chagas’ disease is a neglected tropical disease caused by Trypanosoma cruzi and constitutes a serious public health problem for Latin America. Its unsatisfactory chemotherapy stimulates the search for novel antiparasitic compounds. Amidines and related compounds exhibit well-known activity towards different microbes including T. cruzi. In this vein, our present aim was to evaluate the biological effect of 10 novel structurally related amidines in vitro against bloodstream and intracellular forms of the parasite as well as their potential toxicity on cardiac cell cultures. Our results show that although active against the extracellular forms, with some of them like DB2247 being 6-fold more effective than benznidazole and displaying very low toxicity (>96 μm), none presented superior trypanocidal effect against intracellular forms as compared with the reference drug. These results may be due to differences in susceptibility profiles related to distinct uptake/extrusion mechanisms and cellular targets between bloodstream and amastigote forms. The present study adds to the knowledge base for the future design of novel amidines that may provide promising activity against T. cruzi.
Dengue is regarded as the most important arboviral disease. Although sporadic cases have been reported, serotypes responsible for outbreaks have not been identified from central India over the last 20 years. We investigated two outbreaks of febrile illness, in August and November 2012, from Korea district (Chhattisgarh) and Narsinghpur district (Madhya Pradesh), respectively. Fever and entomological surveys were conducted in the affected regions. Molecular and serological tests were conducted on collected serum samples. Dengue-specific amplicons were sequenced and phylogenetic analyses were performed. In Korea and Narsinghpur districts 37·3% and 59% of cases were positive, respectively, for dengue infection, with adults being the worst affected. RT–PCR confirmed dengue virus serotype 1 genotype III as the aetiology. Ninety-six percent of infections were primary. This is the first time that dengue virus 1 outbreaks have been documented from central India. Introduction of the virus into the population and a conducive mosquitogenic environment favouring increased vector density caused the outbreak. Timely diagnosis and strengthening vector control measures are essential to avoid future outbreaks.
Identification of climate-smart nutrient management practices will overcome the ill effects of extreme climate variability on agricultural production under projected climate change scenarios. The rice–wheat cropping system is the major system used in India: using long-term yield data from Integrated Nutrient Management experiments on this system, the present study analysed trends in weather parameters and grain yield under different nutrient management practices. Twelve treatments with different combinations of inorganic (chemical fertilizer) and organic (farmyard manure (FYM), green manure (GM) and crop residue) sources of nutrients were compared with farmers’ conventional practices. A significant increasing trend was noticed for rainfall during the rice season at Kalyani and Navsari, of the order of 137·7 and 154·2 mm/decade, respectively. The highest increase in maximum temperature was seen at Palampur (1·62 °C/decade) followed by Ludhiana (1·14 °C/decade). At all the sites except Ludhiana and Kanpur, the yield of the rice–wheat system showed an increasing trend ranging from 0·08 t/ha/year in Jabalpur to 0·011 t/ha/year in Navsari, under the recommended dose of inorganic fertilizer application. A significant decreasing trend of 0·055 t/ha was found in Ludhiana. For most of the sites, a combination of half the recommended dose of inorganic fertilizer and either FYM or GM to provide the remainder of the N required was sufficient to maintain productivity. The top three climate-resilient integrated nutrient management practices were identified for all the study sites. Thus, the present study highlights the adaptive capacity of different integrated nutrient management practices to rainfall and temperature extremes under rice–wheat cropping system in distinctive agro-ecological zones of India.
We present multiwavelength study of a sample of radio loud early-type galaxies chosen from the B2 sample. We performed surface photometry in BVR broad band filters and Hα narrow band filter on CCD images of sample galaxies using IGO 2m telescope, Pune (INDIA), to get radial profiles of various photometric and geometrical parameters that describe elliptical isophotes fitted to the 2D light distribution of the galaxies. The analysis of radial profiles of quantities such as the (local) surface brightness, the ellipticity, and the deviations from elliptical isophotes parametrized by the Fourier coefficients are main focus of our study. We generated color maps, residual maps, and dust extinction maps, Hα emission maps of the galaxies to study the morphology of the dust and ionized gas content present in the galaxies. We carried out detailed analysis of the properties of the dust present in our sample galaxies. Additionaly, we investigated properties of the dust in the central ~10 arcsec region of our sample galaxies using optical images available from the HST (WFPC2) data archive. We estimated mass and temperature of the dust, molecular gas mass, in the sample galaxies using FIR fluxes of the galaxies obtained from IRAS.
We used spectroscopic data available from the SDSS (DR7) to get an estimate of the mass of the central super massive black-hole for B2 1257+28 (NGC 4874). We plotted rotation curve for coma cluster (Abell 1656), which indicates the presence of dark matter halo around the galaxy B2 1257+28.
The UBVRI photometric follow-up of SN 2011fu has been initiated a few days after the explosion, shows a rise followed by steep decay in all bands and shares properties very similar to that seen in case of SN 1993J, with a possible detection of the adiabatic cooling phase at very early epochs. The spectral modeling performed with SYNOW suggests that the early-phase line velocities for H and Fe ii features were ~ 16000 km s−1 and ~ 14000 km s−1, respectively. Studies of rare class of type IIb SNe are important to understand the evolution of the possible progenitors of core-collapse SNe in more details.
We report an interesting case of a right temporal pre-auricular arteriovenous fistula (cirsoid aneurysm) causing intractable tinnitus successfully managed by transarterial n-butyl cyanoacrylate glue embolisation.
A 52-year-old female presented with a one-year history of tinnitus and pulsatile swelling in the right pre-auricular region. A colour Doppler ultrasound test and magnetic resonance angiography revealed a high-flow scalp arteriovenous fistula with a feeder vessel from the distal superficial temporal artery, which drained into the corresponding, dilated, tortuous vein. The patient underwent diagnostic digital subtraction angiography. This was followed by transarterial embolisation of the fistula using a 50 per cent mixture of n-butyl cyanoacrylate glue and Lipiodol®, with manual distal venous occlusion. A successful outcome was achieved with instant relief of symptoms.
Cirsoid aneurysms of the facial region, an uncommon cause of tinnitus, can be effectively managed by endovascular embolisation. This treatment obviates the need for surgery, which is associated with an increased risk of complications such as scarring, deformity and bleeding.
Comparative studies have been carried out on the performance of the photovoltaic devices with dissimilar shapes of the InN nanostructures fabricated on p-Si (100). The devices fabricated with the nanodots show a superior performance compared to the devices fabricated with the nanorods. The discussions have been carried out on the superior junction property, larger effective junction area and inherent random pyramidal topographical texture of the cell fabricated with nanodots. Such single junction devices exhibit a promising fill factor and external quantum efficiency of 38% and 27%, respectively, under concentrated AM1.5 illumination.