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The mainstay of management of epistaxis refractory to first aid and cautery is intranasal packing. This review aimed to identify evidence surrounding nasal pack use.
A systematic review of the literature was performed using standardised methodology.
Twenty-seven eligible articles were identified relating to non-dissolvable packs and nine to dissolvable packs. Nasal packing appears to be more effective when applied by trained professionals. For non-dissolvable packs, the re-bleed rates for Rapid Rhino and Merocel were similar, but were higher with bismuth iodoform paraffin paste packing. Rapid Rhino packs were the most tolerated non-dissolvable packs. Evidence indicates that 96 per cent of re-bleeding occurs within the first 4 hours after nasal pack removal. Limited evidence suggests that dissolvable packs are effective and well tolerated by patients. There was a lack of evidence relating to: the duration of pack use, the economic effects of pack choice and the appropriate care setting for non-dissolvable packs.
Rapid Rhino packs are the best tolerated, with efficacy equivalent to nasal tampons. FloSeal is easy to use, causes less discomfort and may be superior to Merocel in anterior epistaxis cases. There is no strong evidence to support prophylactic antibiotic use.
Gambling disorder is a relatively common psychiatric disorder recently re-classified within the DSM-5 under the category of ‘substance-related and addictive disorders'.
To compare white matter integrity in patients with gambling disorder with healthy controls; to explore relationships between white matter integrity and disease severity in gambling disorder.
In total, 16 participants with treatment-resistant gambling disorder and 15 healthy controls underwent magnetic resonance imaging (MRI). White matter integrity was analysed using tract-based spatial statistics.
Gambling disorder was associated with reduced fractional anisotropy in the corpus callosum and superior longitudinal fasciculus. Fractional anisotropy in distributed white matter tracts elsewhere correlated positively with disease severity.
Reduced corpus callosum fractional anisotropy is suggestive of disorganised/damaged tracts in patients with gambling disorder, and this may represent a trait/vulnerability marker for the disorder. Future research should explore these measures in a larger sample, ideally incorporating a range of imaging markers (for example functional MRI) and enrolling unaffected first-degree relatives of patients.
The partial excavation under rescue conditions in 1961–63 of the ditches and
interior of an enclosure of the earlier neolithic period is described. The
enclosure, covering a total area of approximately 2.4 ha, was defined by
double concentric interrupted ditches, which were for the most part
naturally filled. There were many traces of activity within the interior,
presumed to be contemporary with the ditches, including pits, gullies, post-
and stake-holes, and varying concentrations of struck and burnt flint and
pottery. Human burials were found. There is a little Ebbsfleet pottery in
secondary contexts and there are later prehistoric, Roman and medieval
finds. It is probably not possible to ascribe a single or specific role to
the site, which may have been important as a place where several activities
were concentrated, including occupation, subsistence, exchange, enclosure or
defence, burial and ritual.
The current status of the DRIFT (Directional Recoil Identification From Tracks)
experiment at Boulby Mine is presented, including the latest limits on the WIMP
spin-dependent cross-section from 1.5 kg days of running with a mixture of CS2
and CF4. Planned upgrades to DRIFT IId are detailed, along with ongoing work
towards DRIFT III, which aims to be the world’s first 10 m3-scale directional
Dark Matter detector.
Recent studies have shown that trusting attitudes and behavior are biologically influenced. Focusing on the classic trust game, it has been demonstrated that oxytocin increases trust and that humans are endowed with genetic variation that influences their behavior in the game. Moreover, several studies have shown that a large share of the variation in survey responses to trust items is accounted for by an additive genetic component. Against this backdrop, this article makes two important contributions. First, utilizing a unique sample of more than 2,000 complete Swedish twin pairs, we provide further evidence of the heritability of social trust. Our estimates of the additive genetic component in social trust were consistent across the sexes – .33 for males and .39 for females – and are similar to the results reported in earlier studies. Secondly, we show that social trust is phenotypically related to three psychological traits – extraversion, personal control, and intelligence – and that genetic factors account for most of these correlations. Jointly, these psychological factors share around 30% of the genetic influence on social trust both for males and females. Future studies should further explore the possible causal pathways between genes and trust using panel data on both psychological traits and social trust.
The influence of five monoamine candidate genes on depressive symptom trajectories in adolescence and young adulthood were examined in the Add Health genetic sample. Results indicated that, for all respondents, carriers of the dopamine receptor D4 5-repeat allele were characterized by distinct depressive symptom trajectories across adolescence and early adulthood. Similarly, for males, individuals with the monoamine oxidase A 3.5-repeat allele exhibited unique depressive symptom trajectories. Specifically, the trajectories of those with the dopamine receptor D4 5-repeat allele were characterized by rising levels in the transition to adulthood, while their peers were experiencing a normative drop in depressive symptom frequency. Conversely, males with the monoamine oxidase A 3.5-repeat allele were shown to experience increased distress in late adolescence. An empirical method for examining a wide array of allelic combinations was employed, and false discovery rate methods were used to control the risk of false positives due to multiple testing. Special attention was given to thoroughly interrogate the robustness of the putative genetic effects. These results demonstrate the value of combining dynamic developmental perspectives with statistical genetic methods to optimize the search for genetic influences on psychopathology across the life course.
Two classes of interatomic interactions, the embedded atom method and the model generalized pseudopotential theory are used to calculate the structure of tilt boundaries in bcc metals.These interactions differ in the inclusion of explicitlyangular dependent interactions. The results show that these different models of the interactions can lead to qualitatively different predictions for the atomic structure of the boundary. The applicability of the embedded atom method to bcc transition metals is also discussed.
For the class of materials in which covalent effects are important, there is still no simple and reliable scheme, adapted to computer simulations, that can handle angle de- pendent forces. Either they are based on the introduction of three body (or higher)  interactions, or demand unphysical behavior from the many body functions used [2,3]. In the first case, computer efficiency is considerably low due to the large amounts of calculations required; in the second case a negative curvature of the embedding function must be assumed for materials in which the Cauchy pressure is negative, and this is contrary to the current interpretations of that function.
In the present work we derive a method to introduce many body shear forces, suited to computer simulations, which is free from the shortcomings mentioned above.
The atomic origins of the intrinsic mechanical and thermal properties of the interfaces between niobium and its carbides and silicides are explored using both the layer Korringa-Kohn-Rostoker (LKKR) technique and model cluster calculations. The relative stability of an idealised  interface is predicted from charge transfer arguments.
This study assesses the relationship of social desirability response bias with self-reported physical, mental and cognitive health, successful ageing, and socio-demographic attributes among 1,860 older women at the University of California, San Diego's Clinical Center for the Women's Health Initiative and the Sam and Rose Stein Institute for Research on Aging. The women were aged between 57 and 91 years and lived in the San Diego community. Measures included a ten-item Marlowe–Crowne Social Desirability Scale, and self-report scales of physical, mental and cognitive health, successful ageing and wellbeing, as well as standard socio-demographic attributes. Bivariate correlation and multiple regression models indicated that social desirability scores negatively associated with self-reported levels of hostility, anxiety, perceived stress and self-reported cognitive failures, and that they predicted additional variance in multiple regression analyses above models containing socio-demographic predictors alone. On the other hand, even the strongest associations were what are generally considered ‘small effects’ (r<0.30). Overall, while the findings support the general validity of most of the self-report measures in studies of normal and successful ageing, consideration of social desirability response bias in the interpretation of self-reports of low levels of some key constructs (anxiety, hostility, stress, self-perceived cognitive deficits) is warranted.
EURECA (European Underground Rare Event Calorimeter Array) is an
astro-particle physics facility aiming to directly detect galactic dark
matter. The Laboratoire Souterrain de Modane has been selected as host
laboratory. The EURECA collaboration unites CRESST, EDELWEISS and the
Spanish-French experiment ROSEBUD, thus concentrating and focussing effort
on cryogenic detector research in Europe into a single facility. EURECA will
use a target mass of up to one ton, enough to explore WIMP – nucleon scalar
scattering cross sections in the region of 10-9 – 10-10 picobarn.
A major advantage of EURECA is the planned use of more than just one target
material (multi target experiment for WIMP identification).
To describe the pathophysiology of biofilm communities and their role in otorhinolaryngological disease, with reference to the published literature.
Review of relevant literature, using Medline and the combined search terms ‘biofilms’ and ‘otorhinolaryngology’, and also various related keywords such as ‘tonsil’ and ‘adenoid’.
Description of biofilm pathophysiology and of published reports of biofilms in otorhinolaryngological disease.
Virtually all microbes live in biofilm communities. Within these communities, the microbes assume differing specialised roles which confer survival advantages on the community. These communities cause chronic and device-associated infections. Within the specialist field of otorhinolaryngology, biofilms have been shown to play a role in many infections, including: chronic otitis media, cholesteatoma, chronic tonsillitis, chronic sinusitis, and infections of tracheostomies, endotracheal tubes and cochlear implants.
Orthodox, desiccation-tolerant seeds lose desiccation tolerance during germination. Here, we quantify the timing of the loss of desiccation tolerance, and explore the implications of this event for seed mortality and the shape of germination progress curves for pioneer tree species. For the nine species studied, all seeds in a seedlot lost desiccation tolerance after the same fixed proportion of their time to germination, and this proportion was fairly constant across the species (0.63–0.70). The loss of desiccation tolerance after a fixed proportion of the time to germination has the implication that the maximum number of seeds in a seedlot that can be killed by a single drying event during germination (Mmax) increases with an increasing time to 50% germination (t50) and an increasing slope of the germination progress curve. Consequently, to prevent the seed population from becoming highly vulnerable to desiccation-induced mortality, species with a greater t50 would be expected to have a shallower germination progress curve. In conclusion, these data suggest that the loss of desiccation tolerance during germination may constitute a significant, but previously unexplored, source of mortality for seeds in seasonal environments with unpredictable rainfall.