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Three-dimensional printing is a revolutionary technology that is disrupting the status quo in surgery. It has been rapidly adopted by otolaryngology as a tool in surgical simulation for high-risk, low-frequency procedures. This systematic review comprehensively evaluates the contemporary usage of three-dimensional printed otolaryngology simulators.
A systematic review of the literature was performed with narrative synthesis.
Twenty-two articles were identified for inclusion, describing models that span a range of surgical tasks (temporal bone dissection, airway procedures, functional endoscopic sinus surgery and endoscopic ear surgery). Thirty-six per cent of articles assessed construct validity (objective measures); the other 64 per cent only assessed face and content validity (subjective measures). Most studies demonstrated positive feedback and high confidence in the models’ value as additions to the curriculum.
Whilst further studies supported with objective metrics are merited, the role of three-dimensional printed otolaryngology simulators is poised to expand in surgical training given the enthusiastic reception from trainees and experts alike.
The sense of bitter taste is critical for chickens to acquire and select feeds. It is important to understand the roles and mechanisms of bitter taste transduction in chickens. Denatonium is extensively used as a bitter taste receptor agonist to activate bitter taste receptors in recent studies. The objective of this study was to investigate the physiological effects and the potential molecular mechanisms of dietary exposure to a strong bitter taste receptor agonist on the jejunal epithelial cells of yellow-feathered chickens. A total of 240 yellow-feathered chickens were divided into four treatments receiving a normal diet (Control), a low-dose denatonium treatment (Control + 5 mg/kg denatonium), a middle-dose denatonium treatment (Control + 20 mg/kg denatonium) and a high-dose denatonium treatment (Control + 100 mg/kg denatonium) for 56 days, respectively. The results showed that dietary denatonium reduced (P < 0.05) the growth performance of chickens. High-dose denatonium damaged the morphology of the jejunal epithelium and decreased (P < 0.05) the activities of Ca2+-ATPase, sucrase and maltase after 56 days of exposure. Meanwhile, high-dose denatonium increased (P < 0.05) mRNA expressions of bitter taste receptors, which resulted in enhanced apoptosis in jejunal epithelial cells after 56 days of exposure. Furthermore, middle-dose and high-dose denatonium exhibited increased (P < 0.05) mRNA level of claudin 2 and decreased (P < 0.05) mRNA level of occludin after 28 days of exposure. Only high-dose denatonium decreased (P < 0.05) mRNA level of occludin after 56 days of exposure. In conclusion, denatonium manifested deleterious effects on the jejunum of chickens in a dose–effect manner via damaging the morphology of the jejunal epithelium, and inducing apoptosis associated with bitter taste receptors. Our data suggest that bitter-tasting feed additives may have side effects on the growth and development of intestines in chickens.
Advanced lightweight materials, including high-strength steels, aluminum, magnesium, plastics, and reinforced polymer composites, are increasingly used in industry. Combinations of mixed materials are becoming commonplace in the design of structures. Adhesives can be used to join a wide range and combinations of materials. However, joining of materials depends on their specific characteristics. The choice of adherend material is one particular and important parameter that influences adhesively bonded joint performance, and its effect should be taken into consideration in the design of adhesive joints. This article overviews experimental and modeling investigations on the influence of adherend properties on the strength of adhesively bonded joints.
Patient-reported outcomes and preferences rely on reports of the status of a patient’s health condition that comes directly from the patient, without interpretation or qualification by clinicians or investigators. Patient-reported outcomes and preferences have become an accepted approach in drug development. As part of this effort, we assessed the relative importance to patients with schizophrenia of trying a new antipsychotic that might improve symptoms in the context of common antipsychotic side effects, especially weight gain. Information from surveys such as this one can provide pilot guidance about what might be acceptable versus unacceptable trade-offs when considering new therapies for schizophrenia.
We prospectively administered a cross-sectional survey to 250 patients with clinical diagnoses of schizophrenia or schizoaffective disorder, aged ≥18 years, from five US outpatient community clinics, regarding the importance of efficacy and side effects on treatment decisions involving medications. Sixty-four percent (n=160) of the patients were male; mean age was 43 years (range: 18–72 years); mean weight was 91 kg (range: 49–182 kg); and mean body mass index was 30.3 kg/m2 (range: 15.3–63.3 kg/m2).
Patients rated both efficacy and side effects as important attributes of medication for schizophrenia treatment, with 88.5% identifying the ability to think more clearly as an important property of their medication. Patients identified efficacy and side effects as important drivers to take their prescribed medicine (endorsed as very or most important by 94.3% and 84.0% of patients, respectively). Patients identified weight gain, physical restlessness and somnolence as significant side effects of current treatments for schizophrenia (very/most important by 61.5%, 60.4%, and 58.9%, respectively). When asked about willingness to change antipsychotics, anticipated weight gain had a strong negative influence on willingness to try a new antipsychotic, with 44.9% of patients declining to try a medication that would lead to a weight gain of 3–5 kg, and 70.8% of patients declining for an anticipated weight gain of 5–9kg.
Patients living with schizophrenia or schizoaffective disorder are influenced by many factors when considering whether to take their prescribed medication, including efficacy and side effects. It is important for clinicians to assess patient-specific concerns and develop a comprehensive treatment plan to maximize adherence to prescribed therapies.
Funding Acknowledgements: This study was funded by Alkermes, Inc.
Laser interaction with an ultra-thin pre-structured target is investigated with the help of both two-dimensional and three-dimensional particle-in-cell simulations. With the existence of a periodic structure on the target surface, the laser seems to penetrate through the target at its fundamental frequency even if the plasma density of the target is much higher than the laser’s relativistically critical density. The particle-in-cell simulations show that the transmitted laser energy behind the pre-structured target is increased by about two orders of magnitude compared to that behind the flat target. Theoretical analyses show that the transmitted energy behind the pre-structured target is actually re-emitted by electron ‘islands’ formed by the surface plasma waves on the target surfaces. In other words, the radiation with the fundamental frequency is actually ‘surface emission’ on the target rear surface. Besides the intensity of the component with the fundamental frequency, the intensity of the high-order harmonics behind the pre-structured target is also much enhanced compared to that behind the flat target. The enhancement of the high-order harmonics is also related to the surface plasma waves generated on the target surfaces.
To report a novel management strategy for mixed hearing loss in advanced otosclerosis.
A 50-year-old male was referred to St Thomas’ Hearing Implant Centre with otosclerosis; he was no longer able to wear conventional hearing aids because of recurrent otitis externa. The patient underwent short process incus vibroplasty (using the Med-El Vibrant Soundbridge device), followed at a suitable interval (six weeks) by stapes surgery. The main outcome measures were: pure tone audiometry, functional gain and monosyllabic word recognition scores.
Post-operative pure tone audiometry showed a reduction of the mean air–bone gap from 55 dB HL to 20 dB HL. The residual mixed hearing loss was rehabilitated with the Vibrant Soundbridge, with an average device gain of 32 dB. The monosyllabic word recognition scores in quiet at 65 dB improved from 37 to 100 per cent when using the Vibrant Soundbridge at six months after switch-on of the device.
Stapedotomy in conjunction with incus short process vibroplasty (i.e. inner-ear vibroplasty) is a safe and promising procedure for managing advanced otosclerosis with mixed hearing loss in selected patients.
The coronal field typically reorganizes itself to attain a force-free field configuration. We have evaluated the power law index of the energy distribution f(E) = f0E−α by using a model of relaxation incorporating different profile functions of winding number distribution f(w) based on braided topologies. We study the radio signatures that occur in the solar corona using the radio data obtained from the Gauribidanur Radio Observatory (IIA) and extract the power law index by using the Statistic-sensitive nonlinear iterative peak clipping (SNIP) algorithm. We see that the power law index obtained from the model is in good agreement with the calculated value from the radio data observation.
The properties of the acoustic modes are sensitive to magnetic activity. The unprecedented long-term Kepler photometry, thus, allows stellar magnetic cycles to be studied through asteroseismology. We search for signatures of magnetic cycles in the seismic data of Kepler solar-type stars. We find evidence for periodic variations in the acoustic properties of about half of the 87 analysed stars. In these proceedings, we highlight the results obtained for two such stars, namely KIC 8006161 and KIC 5184732.
The Solar Mean Magnetic Field (SMMF) is generally defined as the disc-averaged line-of-sight (LOS) magnetic field on the sun. The role of the active regions and the large-scale magnetic field structures (also called the background) has been debated over the past few decades to understand whether the origin of the SMMF is either due to the active regions or the background. We, in this paper have investigated contribution of sunspots, plages, networks and the background towards the variability of the SMMF using the datasets from the SDO-AIA & HMI, and found that 89% of the SMMF is due to the background whereas the remaining 11% originates from the active regions and the networks.
Sunspots are the most obvious and high contrast observable feature of solar magnetic activity in the photosphere. The morphological and kinematic behavior of sunspots on the solar surface need to be studied over a long time period to understand solar magnetic activity. For this, it is important to understand the long term emergence patterns, and developments, decay of the sunspots on the solar surface over many cycles. The long time sequence of the Kodaikanal white-light images provide a consistent data set for this study. The digitized images were calibrated for relative plate density and aligned in such a way that the solar north is in upward direction. A sunspot detection technique was used to identify the sunspots on the digitized images. In addition to describing the calibration procedure and availability of the data, we here present results on the sunspot, umbral and penumbral area measurements and their variation with time.
We have analyzed the data on yearly mean international sunspot number (RZ) during the period 1610 – 2015 and orbital positions (ecliptic longitudes) of the giant planets in each 10-day interval during the period 1600 – 2099. We determined mean absolute difference (
) of the orbital positions of the giant planets in each interval. We find that there exits a good correlation between cycle amplitude (RM, i.e. the maximum value of RZ) and the value of
at cycle maximum, suggesting that on longer time scales low/high solar activity associated with less/large spread in orbital positions of the giant planets (i.e. with a low/high value of
A number of complex systems arising in diverse disciplines may have certain quantitative features that are surprisingly similar which are classified under the paradigm of “universality”. The non-extensive Tsallis stastical mechanics and Lévy flight patterns provide a novel basis for analyzing non-equilibrium complex systems that may exhibit long-range correlations. The present work studies the scope of employing non-extensive Gutenberg-Richter (G-R) type law for the magnitude distribution of energy of solar wind, in order to investigate the existence of a universal behavior as well as to compute the relations of degree of non-extensivity and Lévy statistics in solar wind turbulence with heliographic distance during different solar cycles.
We study 30 solar flare events associated with coronal mass ejections (CMEs) that produced geomagnetic storms as measured in Dst index. Our study reveals that the magnitude of Dst index is significantly associated with maximum solar wind speed, peak of Bz component of the IMF and the product of peak Bz and solar wind speed (minimum and maximum). From our investigations, it can be inferred that CMEs travel with higher speed in the beginning and their speed reduces as they reach L1 location.
Both direct observations and reconstructions from various datasets, suggest that conditions were radically different during the Maunder Minimum (MM) than during the space era. Using an MHD model, we develop a set of feasible solutions to infer the properties of the solar wind during this interval. Additionally, we use these results to drive a global magnetospheric model. Finally, using the 2008/2009 solar minimum as an upper limit for MM conditions, we use results from the International Reference Ionosphere (ILI) model to speculate on the state of the ionosphere. The results describe interplanetary, magnetospheric, and ionospheric conditions that were substantially different than today. For example: (1) the solar wind density and magnetic field strength were an order of magnitude lower; (2) the Earth’s magnetopause and shock standoff distances were a factor of two larger; and (3) the maximum electron density in the ionosphere was substantially lower.
Here we report our recent prediction of the solar cycle 25 based on a newly developed scheme, which is used to investigate the predictability of the solar cycle over one cycle. The scheme is a combination of the empirical properties of solar cycles and a surface flux transport model to get the possible axial dipole moment evolution at a few years before cycle minimum, by which to get the subsequent cycle strength based on the correlation between the axial dipole moment at cycle minimum and the subsequent cycle strength. We apply this scheme to predict the large-scale field evolution since 2018 onwards. The results show that the northern polar field will keep on increasing, while the southern polar field almost keeps flat by the end of cycle 24. This leads to the cycle 25 strength of 125 ± 32, which is about 10% stronger than cycle 24 according to the mean value.
Our understanding of stellar dynamos has largely been driven by the phenomena we have observed of our own Sun. Yet, as we amass longer-term datasets for an increasing number of stars, it is clear that there is a wide variety of stellar behavior. Here we briefly review observed trends that place key constraints on the fundamental dynamo operation of solar-type stars to fully convective M dwarfs, including: starspot and sunspot patterns, various magnetism-rotation correlations, and mean field flows such as differential rotation and meridional circulation. We also comment on the current insight that simulations of dynamo action and flux emergence lend to our working knowledge of stellar dynamo theory. While the growing landscape of both observations and simulations of stellar magnetic activity work in tandem to decipher dynamo action, there are still many puzzles that we have yet to fully understand.