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Topical nasal decongestants are frequently used as part of the medical management of symptoms related to Eustachian tube dysfunction.
This study aimed to assess the effect of topical xylometazoline hydrochloride sprayed in the anterior part of the nose on Eustachian tube active and passive opening in healthy ears.
Active and passive Eustachian tube function was assessed in healthy subjects before and after intranasal administration of xylometazoline spray, using tympanometry, video otoscopy, sonotubometry, tubo-tympano-aerodynamic-graphy and tubomanometry.
Resting middle-ear pressures were not significantly different following decongestant application. Eustachian tube opening rate was not significantly different following the intervention, as measured by all function tests used. Sonotubometry data showed a significant increase in the duration of Eustachian tube opening following decongestant application.
There remains little or no evidence that topical nasal decongestants improve Eustachian tube function. Sonotubometry findings do suggest that further investigation with an obstructive Eustachian tube dysfunction patient cohort is warranted.
Advances in material science and semiconductor technology have enabled a variety of inventions to be implemented in electronic systems and devices used in the medical, telecommunications, and consumer electronics sectors. In this paper, a wireless charging system is described as a wearable body heater that uses a chair as a transmitter (Tx). This system incorporates the widely accepted Qi wireless charging standard. Alignment conditions of a linear three-element coil arrangement and a 3 × 3 coil matrix array are investigated using voltage induced in a coil as a performance indicator. The efficiency obtained is demonstrated to be up to 80% for a voltage of over 6.5 Volts and a power transfer of over 5 Watts. Our results and proposed approach can be useful for many applications. This is because the wireless charging system described herein can help design seating areas for the elderly and disabled, commercial systems, consumer electronics, medical devices, electronic textiles (e-textiles), and other electronic systems and devices.
Detailed numerical simulations have been carried out on a spiked blunt body with multiple hemispherical disks using a commercial CFD code in order to investigate their effectiveness in reducing the aerodynamic drag and heating. The base configuration is a hemispherical cylinder whose diameter is 40 mm with an overall length of 70 mm. The lengths of the aerospikes investigated are 1, 1.5, 2 and 2.5 times the base diameter of the cylinder and the radii of the aerodisks are varied between 0.05, 0.1, 0.15 and 0.2 times the diameter of the cylinder. Besides these, the position of the aerodisks is varied with the rearmost aerodisk placed at 25%, 50% and 75% along the length of the aerospike and the intermediate aerodisk for three-disk cases, positioned at 25%, 50% and 75% of the distance between the front and the rearmost disk. All the investigations have carried out at a freestream Mach number of 6.2 and Reynolds number of 2.64 × 107/m. It has been observed that the multidisk spikes are advantageous for the purpose of reduction of both aerodynamic drag and heating at hypersonic speed. The two aerodisk spiked configurations show better results in terms of aerodynamic heating and drag in comparison to the single-disk aerospikes while the three-disk spikes yield only a marginal reduction in aerodynamic drag over the two-disk configurations. For reduction of heat fluxes and heat transfer rates though, the three-disk configurations are extremely advantageous and give much larger reductions are compared to the two-disk configurations.
Predicting mango mealybug, Rastrococcus iceryoides (Green) (Hemiptera: Pseudococcidae), populations in an organic mango (Mangiferaindica Linnaeus; Anacardiaceae) ecosystem well in advance with reasonable accuracy, will facilitate biological control. In this study, an attempt was made to predict the population of mango mealybug using abiotic weather parameters as independent variables. The study was conducted at the Indian Council of Agricultural Research – Indian Institute of Horticultural Research, Bengaluru, India (12°8'N; 77°35'E). Among the abiotic variables, maximum temperature was found relevant for predicting the population of the mealybug based on significant correlations. It was found that a prediction model using maximum temperature as independent variable with R2 is most ideal. This prediction model, when considered three to four weeks in advance of an infestation, could help farmers to gear up with biological control.
Assaultive violence events are associated with increased risk for adverse psychiatric outcomes, including post-traumatic stress (PTS), depression, and generalized anxiety. Prior research has indicated that economic, legal, and social stressors that could follow assaultive events may explain the increased risk for adverse psychiatric outcomes, yet longitudinal studies have not adequately examined this pathway. In the current study, we aimed to address this limitation.
Participants (N = 1360) were part of a longitudinal population-based study of adults living in Detroit. At three waves, participants indicated their exposure to assaultive violence and economic, legal, and social stressors, and completed inventories of PTS, depression, and generalized anxiety. Longitudinal mediation models were used to test the hypothesized pathway from assaultive violence to each psychiatric outcome.
The hypothesized models evidenced good fit with the data and, in each, the paths from Wave 1 (W1) assaultive violence to W2 stressors, and from W2 stressors to W3 symptoms were significant (range of Standardized Estimates: 0.09–0.15, all p < 0.01). Additionally, the indirect paths from W1 assaultive violence to W3 symptoms were significant (range of Standardized Estimates: 0.01–0.02, all p < 0.05).
The findings illustrate that the economic, legal, and social stressors that could follow assaultive violence increase risk for a range of psychiatric symptoms. Although future research is needed, the results suggest that investment in interventions that prevent and mitigate assaultive violence survivors’ exposure to such stressors may be an effective way to prevent mental illness in the aftermath of violent assaults.
Lead poisoning is a stealthy threat to human physiological systems as chronic exposure can remain asymptomatic for long periods of time before symptoms manifest. We presently review the biophysical mechanisms of lead poisoning that contribute to male infertility. Environmental and occupational exposure of lead may adversely affect the hypothalamic−pituitary−testicular axis, impairing the induction of spermatogenesis. Dysfunction at the reproductive axis, namely testosterone suppression, is most susceptible and irreversible during pubertal development. Lead poisoning also appears to directly impair the process of spermatogenesis itself as well as sperm function. Spermatogenesis issues may manifest as low sperm count and stem from reproductive axis dysfunction or testicular degeneration. Generation of excessive reactive oxygen species due to lead-associated oxidative stress can potentially affect sperm viability, motility, DNA fragmentation, membrane lipid peroxidation, capacitation, hyperactivation, acrosome reaction, and chemotaxis for sperm-oocyte fusion, all of which can contribute to deter fertilization. Reproductive toxicity has been tested through cross-sectional analysis studies in humans as well as in vivo and in vitro studies in animals.
Changes in seroprevalence of cysticercosis diagnosed in Chandigarh, India between 1998 and 2014 were investigated by extraction and analysis of data from records held at the Postgraduate Institute of Medical Education and Research in Chandigarh. Among the total number of samples for which cysticercosis had been suspected during this period (N = 9650), 1716 (17·8%) were seropositive. Adults were more likely to be seropositive than children, and women were more likely to be seropositive than men. In addition to there being fewer patients with suspicion of cysticercosis over the data analysis period, the proportion of patients seropositive also reduced significantly. Despite these reductions, which are probably associated with improved infrastructure and sanitation within Chandigarh, and despite meat consumption being relatively rare in this area, the extent of cysticercosis in this population remains problematic. Further efforts should be made to reduce transmission of this infection, with particular emphasis on women. Such efforts should follow the One Health concept, and involve medical efforts (including diagnosis and treatment of T. solium tapeworm carriers), veterinary efforts directed towards meat inspection and prevention of infection of pigs, and environmental health and sanitation engineers (to minimize environmental contamination with human waste).
Plant breeding makes genetic gains over years, so growing newer varieties generally provides greater benefits than growing older ones. However, in low-altitude districts of Nepal, a few rice varieties covered 75% of the rice area and were more than 20 years old (first paper in this series). We test here if this slow rate of adoption of new varieties could be accelerated using a participatory method, Informal Research and Development (IRD), where packets of seeds of new rice varieties are widely distributed to many farmers. From 2008 to 2011, over 117 000 IRD packets were distributed in 18 districts of the Nepal Terai, including over 70 000 of three released varieties from a client-oriented breeding (COB) programme in Nepal. The IRD significantly increased the adoption of the three COB varieties. The benefits obtained by farmers in a single growing season equal the costs of IRD, if for every 75 kits distributed an additional 1 ha is grown. This assumes that the new varieties produce a 10% increase in yield (lower than that evidenced in their release proposals). On an average, fewer than three IRD kits were distributed for each hectare of a new variety grown by farmers in 2011. Furthermore, the effectiveness of IRD could be increased 1.2 to 2.7 fold (depending on the COB variety) if the IRD distribution were to be restricted to the region where the variety was most accepted. The best comparison of IRD with extension by the conventional system was their popularity compared with similar-aged varieties that had been promoted in the two systems. The adoption of three COB varieties was about twicethat of three varieties from the National Rice Research Programme (NRRP) that were closest in release date to the COB varieties. Unlike cost effectiveness assessed by hectares grown per IRD kit distributed, this comparison can only indicate efficacy because, as well as extension method, many factors influenced the adoption rates of the COB and NRRP varieties. The costs of IRD are small, both relative to the cost of breeding new varieties and to the benefits gained; so it is one of the simplest and most cost-effective interventions to increase agricultural productivity.
Farmers who continue to grow old and obsolete varieties do not gain the benefits they could get from growing newer ones. Given the potential large scale of these foregone benefits, relatively few studies have examined the age of varieties that farmers grow. In three surveys, members of over 3300 households were interviewed to find the rice varieties they grew in 2008 and 2011 in 18 districts in the Terai, the low-altitude region of Nepal. This provided the first description of detailed geographical patterns of adoption of rice varieties and their ages that were repeated over time. There were large differences between district and individual varieties that showed specific geographical patterns of adoption. Such detailed knowledge on spatial diversity of varieties is invaluable for planning extension activities and developing breeding programmes, and cheaper ways than household surveys of collecting this information are discussed. Some of the factors considered important in determining this complex pattern of adoption were seed availability, growing environments that differed from east to west and the continued popularity of varieties once they had established markets. Rice diversity was low because a small number of rice varieties occupied large areas. In 2011, nine varieties covered at least 75% of the total rice area in western districts, just four in central districts and eight in eastern districts. Of these, most were released before 1995 resulting in a high average age of the predominant varieties – they always had an average age of over 20 years no matter which region or year was considered. Even though there were some large changes in varietal composition from 2008 to 2011, the average age of the predominant varieties remained almost the same. In a second paper in this series, we examine how these very low varietal replacement rates, that reduce yields and increase risk to farmers, can be accelerated using a participatory research for development approach called Informal Research and Development (IRD) (Joshi et al., 2012).
In this study, an atmospheric pressure cold plasma jet has been generated based on dielectric barrier discharge plasma. The double ring electrode configuration is used and analysis has been performed subjected to wide range of supply frequencies up to 25 kHz and supply voltage up to 6 kV. The electrical characterization of the plasma jet has been carried out using a high voltage probe. The V-I characteristics of the developed cold plasma jet have been studied and the consumption of the power has been analyzed at various input combinations of supply frequency and applied voltage. Consequently, the supply voltage and supply frequency are optimized with respect to the discharge current and jet length for optimum power consumption. The peak power consumed for glow discharge operation has been found to be 1.27 W in the optimized configuration.
To demonstrate a spatial epidemiologic approach that could be used in the aftermath of disasters to (1) detect spatial clusters and (2) explore geographic heterogeneity in predictors for mental health and general wellness.
We used a cohort study of Hurricane Ike survivors (n=508) to assess the spatial distribution of postdisaster mental health wellness (most likely resilience trajectory for posttraumatic stress symptoms [PTSS] and depression) and general wellness (most likely resilience trajectory for PTSS, depression, functional impairment, and days of poor health) in Galveston, Texas. We applied the spatial scan statistic (SaTScan) and geographically weighted regression.
We found spatial clusters of high likelihood wellness in areas north of Texas City and spatial concentrations of low likelihood wellness in Galveston Island. Geographic variation was found in predictors of wellness, showing increasing associations with both forms of wellness the closer respondents were located to Galveston City in Galveston Island.
Predictors for postdisaster wellness may manifest differently across geographic space with concentrations of lower likelihood wellness and increased associations with predictors in areas of higher exposure. Our approach could be used to inform geographically targeted interventions to promote mental health and general wellness in disaster-affected communities. (Disaster Med Public Health Preparedness. 2016;10:261–273)
To report the International Nosocomial Infection Control Consortium surveillance data from 40 hospitals (20 cities) in India 2004–2013.
Surveillance using US National Healthcare Safety Network’s criteria and definitions, and International Nosocomial Infection Control Consortium methodology.
We collected data from 236,700 ICU patients for 970,713 bed-days
Pooled device-associated healthcare-associated infection rates for adult and pediatric ICUs were 5.1 central line–associated bloodstream infections (CLABSIs)/1,000 central line–days, 9.4 cases of ventilator-associated pneumonia (VAPs)/1,000 mechanical ventilator–days, and 2.1 catheter-associated urinary tract infections/1,000 urinary catheter–days
In neonatal ICUs (NICUs) pooled rates were 36.2 CLABSIs/1,000 central line–days and 1.9 VAPs/1,000 mechanical ventilator–days
Extra length of stay in adult and pediatric ICUs was 9.5 for CLABSI, 9.1 for VAP, and 10.0 for catheter-associated urinary tract infections. Extra length of stay in NICUs was 14.7 for CLABSI and 38.7 for VAP
Crude extra mortality was 16.3% for CLABSI, 22.7% for VAP, and 6.6% for catheter-associated urinary tract infections in adult and pediatric ICUs, and 1.2% for CLABSI and 8.3% for VAP in NICUs
Pooled device use ratios were 0.21 for mechanical ventilator, 0.39 for central line, and 0.53 for urinary catheter in adult and pediatric ICUs; and 0.07 for mechanical ventilator and 0.06 for central line in NICUs.
Despite a lower device use ratio in our ICUs, our device-associated healthcare-associated infection rates are higher than National Healthcare Safety Network, but lower than International Nosocomial Infection Control Consortium Report.
Infect. Control Hosp. Epidemiol. 2016;37(2):172–181
This study assessed the utility of current sialendoscopes in the paranasal sinuses in a cadaveric model and evaluated novel uses for sialendoscopes.
Currently available sialendoscopes were used for visualisation and performing interventions in the paranasal sinuses. Ten cadaver heads were studied before and after dissection. Outcomes included ostia identification, sinus cannulation, success of mucosal biopsy collection and image clarity.
Marchal and Erlangen sialendoscopes were found to be effective for both visualising and cannulating the sphenoid sinuses before and after dissection. Both types demonstrated poor maxillary ostia visualisation without dissection, but did allow treatment after antrostomy. Larger diameter sialendoscopes were associated with the lowest image distortion during maxillary ostia assessment. Mucosal biopsy collection within the sphenoid sinus, but not in the maxillary sinus, was possible before dissection.
Sialendoscopes can be used for visualisation and performing interventions in the sinonasal cavity, but their utility is mainly limited to the sphenoid sinus. They may be considered a minimally invasive method for drug delivery and/or biopsy collection in the post-operative setting for all sinuses. Design improvements are suggested.
We present a complete spatial and dynamical study of the poorly populated stellar system ESO65SC03. The radial distribution of the system gives a core and cluster radii of 1.10±0.63 and 5.36±0.24 arcmin, respectively. The SNDP does not show any clear enhancement of the surface stellar number density between the stars of the system and the field regions. We derive the optimum isochrone solution for a particular grid size in the CMD using the statistical cleaning procedure. Using the statistically cleaned CMDs, we find the distance modulus, (m − M)0, and reddening, E(B − V), of the system to be 11.8±0.2 and 0.45 mag, respectively. The mean proper motion of this system is − 5.37±0.81 mas yr−1 and 0.31±0.40 in RA and DEC directions, respectively. The mean proper motion of this system is found to be almost similar to the field region. The mass function for the brighter stars is found to be too high for the system to be an open cluster. These combined results place constraints on whether stellar system ESO65SC03 is a POCR or an Asterism. Our understanding is that the ESO65SC03 is in a stage of POCR by losing their main-sequence stars in the dynamic evolution processes.
Objective: Symptomatic neonates with Ebstein’s anomaly pose significant challenge. Within this cohort, neonates with associated anatomical pulmonary atresia have higher mortality. We review our experience with this difficult subset. Methods: A total of 32 consecutive symptomatic neonates with Ebstein’s anomaly underwent surgical intervention between 1994 and 2013. Of them, 20 neonates (62%, 20/32) had associated pulmonary atresia. Patients’ weights ranged from 1.9 to 3.4 kg. All patients without pulmonary atresia had two-ventricle repair. Of the 20 neonates, 16 (80%, 16/20) with Ebstein’s anomaly and pulmonary atresia had two-ventricle repair and 4 had single-ventricle palliation, of which 2 underwent Starnes’ palliation and 2 Blalock–Taussig shunts. Six recent patients with Ebstein’s anomaly and pulmonary atresia had right ventricle to pulmonary artery valved conduit as part of their two-ventricle repair. Results: Overall early mortality was 28% (9/32). For those without pulmonary atresia, mortality was 8.3% (1/12). For the entire cohort of neonates with Ebstein’s anomaly and pulmonary atresia, mortality was 40% (8/20; p=0.05). Mortality for neonates with Ebstein’s anomaly and pulmonary atresia having two-ventricle repair was 44% (7/16). Mortality for neonates with Ebstein’s anomaly and pulmonary atresia having two-ventricle repair utilising right ventricle to pulmonary artery conduit was 16% (1/6). For those having one-ventricle repair, the mortality was 25% (1/4). Conclusions: Surgical management of neonates with Ebstein’s anomaly remains challenging. For neonates with Ebstein’s anomaly and anatomical pulmonary atresia, single-ventricle palliation is associated with lower early mortality compared with two-ventricle repair. This outcome advantage is negated by inclusion of right ventricle to pulmonary artery conduit as part of the two-ventricle repair.
Microbe-associated molecular pattern (MAMP)-triggered immunity (MTI) is an important component of the plant innate immunity response to invading pathogens. Although several MTI responses can be measured in different plant species, their magnitude is probably plant species specific and even cultivar specific. In this study, a genome-wide transcriptome analysis of two soybean parental lines and two progeny lines treated for 30 min with the MAMPs flg22 and chitin was carried out. This analysis revealed a clear variation in gene expression, under both untreated and flg22+chitin-treated conditions. In addition, genes with potential additive and non-additive effects were identified in the two progeny lines, with several of these genes having a potential function in the control of innate immunity. The data presented herein represent the basis for further functional analysis that can lead to a better understanding of the soybean innate immunity response.
The prevalence of occult neck metastasis in patients undergoing salvage total laryngectomy remains unclear, and there is controversy regarding whether elective neck dissection should routinely be performed.
A retrospective case note review of 32 consecutive patients undergoing salvage total laryngectomy in a tertiary centre was performed, in order to correlate pre-operative radiological staging with histopathological staging.
The median patient age was 61 years (range, 43–84 years). With regard to lymph node metastasis, 28 patients were pre-operatively clinically staged (following primary radiotherapy or chemoradiotherapy) as node-negative, 1 patient was staged as N1, two patients as N2c and one patient as N3. Fifty-two elective and seven therapeutic neck dissections were performed. Pathological analysis up-staged two patients from clinically node-negative (following primary radiotherapy or chemoradiotherapy) to pathologically node-positive (post-surgery). No clinically node-positive patients were down-staged. More than half of the patients suffered a post-operative fistula.
Pre-operative neck staging had a negative predictive value of 96 per cent. Given the increased complications associated with neck dissection in the salvage setting, consideration should be given to conservative management of the neck in clinically node-negative patients (staged following primary radiotherapy or chemoradiotherapy).