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Background: Asymmetric motor symptoms are typical in Parkinson’s disease (PD), with potential implications on disease course. Imaging modalities have demonstrated asymmetry, including thinning of motor-related cortex in the contralateral hemisphere of symptomatic side. The objective is to assess correlation between lateralized symptoms and Diffusion Tensor Imaging (DTI) characteristics of pyramidal tract. Methods: 34 PD patients and 30 controls were evaluated. Disease dominance was assessed using UDPRS III. DTI was performed with 60-directional 3Tesla MRI protocol. A 1cm3 subcortical region of interest was positioned underneath motor cortex. Primary outcome was the difference in fibers between disease-dominant and non disease-dominant cortex. Results: There was a significantly higher number of fibers in the hemisphere corresponding to disease dominance (p=0.0031). The same was true for seed number (p=0.0032) and fractional anisotropy (p=0.0427). Based on 23 patients operated on, the threshold for stimulation-induced side effects on the left side was inversely correlated with number of fibers in left ROI (Spearman -0.497, p=0.0158). Conclusions: Based on current literature we expected a reduction of fibers in the contralateral hemisphere to symptom dominant side. Surprisingly, DTI analysis showed an inverse correlation. The underlying pathophysiology remains unclear with the possibility of a compensatory mechanism or compacting of fibers underneath a shrinking motor cortex.
Medical equipment can transmit pathogenic bacteria to patients. This single-institution point prevalence study aimed to characterise the types and relative amount of bacteria found on surgical loupes, headlights and their battery packs.
Surgical loupes, headlights and battery packs of 16 otolaryngology staff and residents were sampled, cultured and quantified. Plate scores were summed for each equipment type, and the total was divided by the number of users to generate mean bacterial burden scores. Residents completed a questionnaire regarding their equipment cleaning practices.
The contamination rates of loupes, headlights and battery packs were 68.75 per cent, 100 per cent and 75 per cent, respectively. Battery packs cultured more bacteria (1.58 per swab ± 1.00) than loupes (0.75 per swab ± 0.66; p = 0.024). Headlights had non-significantly greater growth (1.50 per swab ± 0.71) than loupes (p = 0.052). Bacterial growth was significantly higher from inner surfaces of loupes (p = 0.035) and headlights (p = 0.037). Potentially pathogenic bacteria were cultured from the equipment of five participants, including: Pantoea agglomerans, Acinetobacter radioresistens, Staphylococcus aureus, Acinetobacter calcoaceticus baumannii complex and Moraxella osloensis.
This study demonstrates that surgical loupes and headlights used in otolaryngology harbour non-pathogenic skin flora and potentially pathogenic bacteria.
Magnetic field measurements in turbulent plasmas are often difficult to perform. Here we show that for
kG magnetic fields, a time-resolved Faraday rotation measurement can be made at the OMEGA laser facility. This diagnostic has been implemented using the Thomson scattering probe beam and the resultant path-integrated magnetic field has been compared with that of proton radiography. Accurate measurement of magnetic fields is essential for satisfying the scientific goals of many current laser–plasma experiments.
This study aimed to evaluate the oncological and voice outcomes of transoral laser microsurgery for tumour stage T1b stage glottic cancer patients.
A prospective cohort study in a tertiary care head and neck cancer centre included tumour–node–metastasis stage T1bN0M0 glottic cancer patients scheduled to undergo transoral laser microsurgery from January 2002 until June 2014. Kaplan–Meier five-year analyses of local control, overall survival, disease-specific survival and laryngeal preservation were performed. Voice Handicap Index-10 scores and maximum phonation times were also recorded.
Twenty-one participants with a mean age of 66.8 years were enrolled. The mean follow up was 56.5 months. Kaplan–Meier 5-year survival analysis illustrated a local control rate of 82 per cent, overall survival of 88 per cent, disease-specific survival of 100 per cent, and laryngeal preservation of 100 per cent. The pre-operative Voice Handicap Index-10 score was 19.1 ± 9.47 (mean ± standard deviation (SD)) and the post-operative scores were 13.5 ± 9.29 at three months, 10.44 ± 9.70 at one year and 5.83 ± 4.91 at two years. The pre-operative maximum phonation time was 16.23 ± 5.46 seconds (mean ± SD) and the post-operative values were 14.44 ± 6.73 seconds at three months, 15.27 ± 5.71 seconds at one year and 14.33 ± 6.44 seconds at two years.
Transoral laser microsurgery yields relatively high rates of oncological control and acceptable voice outcomes, and thus shows utility as a primary treatment modality for T1b glottic cancer.
To report our outcomes with salvage CO2 laser surgery following recurrence of laryngeal and oropharyngeal cancer after radiotherapy.
This study entailed a prospective review of patients treated with transoral laser microsurgery for recurrent laryngeal and oropharyngeal cancer between 2002 and 2010 at the Queen Elizabeth II Health Science Centre in Canada.
Sixteen patients were identified, with a mean follow up of 30.6 months. Five patients died of recurrence. Complications were common in patients with oropharyngeal cancer. The overall survival and disease-free survival rates at an average of 29.8 months follow up were 50 per cent and 68.8 per cent respectively.
Salvage surgery using transoral laser microsurgery should be considered in the management of patients with recurrent laryngeal and oropharyngeal cancer. This technique offers acceptable salvage rates with less comorbidity than other treatments.
In the lead-up to the Square Kilometre Array (SKA) project, several next-generation radio telescopes and upgrades are already being built around the world. These include APERTIF (The Netherlands), ASKAP (Australia), e-MERLIN (UK), VLA (USA), e-EVN (based in Europe), LOFAR (The Netherlands), MeerKAT (South Africa), and the Murchison Widefield Array. Each of these new instruments has different strengths, and coordination of surveys between them can help maximise the science from each of them. A radio continuum survey is being planned on each of them with the primary science objective of understanding the formation and evolution of galaxies over cosmic time, and the cosmological parameters and large-scale structures which drive it. In pursuit of this objective, the different teams are developing a variety of new techniques, and refining existing ones. To achieve these exciting scientific goals, many technical challenges must be addressed by the survey instruments. Given the limited resources of the global radio-astronomical community, it is essential that we pool our skills and knowledge. We do not have sufficient resources to enjoy the luxury of re-inventing wheels. We face significant challenges in calibration, imaging, source extraction and measurement, classification and cross-identification, redshift determination, stacking, and data-intensive research. As these instruments extend the observational parameters, we will face further unexpected challenges in calibration, imaging, and interpretation. If we are to realise the full scientific potential of these expensive instruments, it is essential that we devote enough resources and careful study to understanding the instrumental effects and how they will affect the data. We have established an SKA Radio Continuum Survey working group, whose prime role is to maximise science from these instruments by ensuring we share resources and expertise across the projects. Here we describe these projects, their science goals, and the technical challenges which are being addressed to maximise the science return.
To investigate the effect of transoral laser microsurgery for early glottic cancer on subjective and objective vocal outcome measures.
Prospective cohort study.
Tertiary care cancer centre.
All patients scheduled for transoral laser microsurgery for untreated early primary glottic cancer over a 22-month period and offered voice assessment (31 patients; 19 tumour stage one, 12 tumour stage two).
Main outcome measures:
Fundamental frequency, maximum phonation time, calculated jitter, shimmer and subjective voice rating, analysed by tumour stage.
Tumour stage T1 patients had significantly different fundamental frequencies and maximum phonation times at three months post-operatively, compared with pre-operative values; these differences resolved by 12 months. At 12 months, tumour stage T2 patients had significantly shorter maximum phonation times, and all patients reported significantly worse subjective voice ratings, compared with pre-operative values.
We found no change in fundamental frequency, jitter and shimmer, one year post-operatively. Maximum phonation time deteriorated but stage one patients appeared to compensate, whereas stage two patients did not. Resection size may be a factor. All patients reported significantly worse subjective voice ratings at one year. Aerodynamic and subjective voice measures appear most sensitive to change in this patient group.
To report the results of transoral laser microsurgery for the treatment of early glottic cancer at our institution.
Cohort study. Retrospective review of charts of patients diagnosed with tumour stage 1 or 2 (early stage; no nodes or metastases), previously untreated, primary glottic cancer, treated with transoral laser microsurgery at the Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada. The minimum follow-up period was two years.
Tertiary care head and neck cancer centre.
Fifty-three patients treated between January 2002 and November 2007.
Kaplan–Meier survival analysis for disease-free survival, overall survival and laryngectomy-free survival, at five years.
The group comprised 46 men and seven women, with a mean age of 66 years (range 30–84 years). Mean follow up was 40 months (range 12–89 months). There were four cases of complications (7.5 per cent). Kaplan–Meier survival analysis revealed a five-year disease-free survival (including salvage) of 96.2 per cent, a five-year overall survival (all causes) of 88.8 per cent and a five-year laryngectomy-free survival of 98.1 per cent.
Transoral laser microsurgery is a safe and effective initial treatment for early laryngeal cancer, and has high rates of laryngeal preservation and disease-free survival.
Escherichia coli was found in a similar proportion of stool specimens from infants who were breast-fed and from others fed on three different artificial-milk preparations. When E. coli was present its mean colony count in the stools of breast-fed infants was within the range of the mean counts for infants receiving the artificial-milk feeds.
There was no consistent relation between high counts of bifidobacteria (Lacto-bacillus bifidus) and low counts of E. coli. This suggests that measures aimed at implanting or stimulating the growth of bifidobacteria in the large intestine of artificially fed infants may not greatly influence the E. coli population therein.
The results are discussed in relation to the protection of artificially fed infants from E. coli enteritis.
In W. G. Runciman's words, ‘all societies can be characterised in terms of the nature and degree of institutionalised differences of privileges among their members’. However, the precise nature of the social privileges characteristic of pre-industrial societies such as medieval England has proved a controversial issue amongst historians and social scientists. For instance, can medieval English society be analysed in terms of the class divisions characteristic of modern societies, or should it be seen, like other pre-industrial societies, as stratified in terms of orders or estates? Was conflict inherent within medieval social relations or can instances of conflict be explained by more immediate, short-term factors? Such debates are linked to broader methodological questions such as whether historians should describe a society in the terms employed by members of that society or whether societies of the past can be analysed using the concepts of modern social theory. Here it will be argued that, rather than being stratified exclusively in terms of classes, orders or any other single form of social inequality, medieval English society was made up of a number of different axes of social inequality. Any one individual thus had a variety of social identities, including those of class, order, status group and gender. The first part of this chapter examines how these forms of social inequality came together to create the particular social hierarchy to be found in late medieval England; the second assesses the forces working to produce economic and social change in the later middle ages.
We report the discovery of two peculiar galaxies infalling into the lensing clusters of galaxies Abell 1689 (z~ 0.18) and 2667 (z~ 0.23). Hubble Space Telescope images show extraordinary trails composed by blue bright knots and stellar streams associated with both these systems, an ~L* and ~0.1L* galaxy. Under the combined action of tidal interaction with the cluster potential and of ram pressure by the intra-cluster medium the morphologies and star formation histories of these two galaxies are strongly perturbed. While in the massive system tidal interactions are the dominant effect and are able to produce a sinking of gas towards the galaxy center triggering a strong burst of star formation and changing galaxy's morphology, in the smaller galaxy the effects of gravitation are reduced by ram pressure stripping which blows away the neutral hydrogen from the galactic disk, quenching the star formation activity and transforming a gas rich late type spiral into quiescent disk dominated early type system. This result is a new additional evidence that galaxy mass represents the main driver of galaxy evolution, even during their dive into the harsh cluster environment and can give additional insights on the origin of S0s and dwarf cluster galaxies.
Examples of the “hydrozoan” Radiotrabeculopora reticulata Fan, Rigby, and Zhang, 1991 have been recently recovered from Lower Permian rocks in the Inyo Mountains, Owens Valley area, of east-central California by G. Linder and C. Stevens. That genus and species were originally described from the Middle Permian (Leonardian-Lower Guadalupian) Maokou Formation from western Hubei, China, by Fan et al. (1991). This the first report of the genus and species from North America.
In 1956 two fossil specimens were exposed in concretions associated with two crushed body chambers of the orthoconic nautiloid Rayonnoceras sp. recovered from the Fayetteville Shale (Chesterian, upper Mississippian) of northern Arkansas. The two specimens were subsequently described as a new genus and species of demosponge, Vintonia doris Nitecki and Rigby and placed in the new family Vintoniidae (Nitecki and Rigby, 1966). The specimens were described as silicified. Nitecki and Rigby's analysis, based on the presence of an assumed skeletal net resembling the spongin net of Recent sponges, suggested that the specimens were demosponges with sycon structure. The “net” was considered spongin because of its geometric pattern and cellular appearance. That interpretation led to the placement of the specimens in the Order Keratosida despite the presence of an apparently well-developed ectosomal region, a feature that is not common in the Keratosida (Nitecki and Rigby, 1966).
The nature and development of late medieval town government remains an extremely controversial issue amongst urban historians. Was this, as some claim, a time of growing exclusivity and oligarchy or was it an era of increasing popular participation in town government? Was urban political conflict, particularly that of the communitas against the mercantile oligarchy, the inevitable result of opposing class interests or were shared ideological norms and a sense of civic community effective in legitimating the authority of town rulers and minimising conflict? Is the concept of ‘oligarchy’ itself a loaded anachronism when applied to a society which saw the rule of the rich as ‘aristocratic’ (i.e. rule by the ‘better sort’ for the ‘common profit’) rather than as ‘oligarchic’ (i.e rule by the self-interested few)? Did urban political conflicts revolve around the corruption of individual rulers rather than issues of political principle or a desire for structural change in town government?
the extent of self-government
The survival of the records of civic administration generated by the self-governing royal boroughs has tended to give a misleading impression of late medieval town government. In fact, in England, only a minority of towns achieved the degree of autonomy enjoyed by royal towns such as York and Winchester, where the burgesses elected their own mayor and bailiffs to govern the town, to collect royal revenues and account for the fee-farm, and to administer justice in the borough court. By the thirteenth century, many of these self-governing towns had acquired a ‘mayor's council’ but, in the later middle ages, many added a second or ‘common’ council.