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 firstname.lastname@example.org
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.
To assess the effect of tranexamic acid on intra-operative bleeding and surgical field visualisation.
Fifty patients undergoing various endoscopic ear surgical procedures, including endoscopic tympanoplasty, endoscopic atticotomy or mastoidectomy, endoscopic ossiculoplasty, and endoscopic stapedotomy, were randomly assigned to: a study group that received tranexamic acid or a control group which received normal saline. The intra-operative bleeding and operative field visualisation was graded using the Das and Mitra endoscopic ear surgery bleeding and field visibility score, which was separately analysed for the external auditory canal and the middle ear.
The Das and Mitra score was better (p < 0.05) in the group that received tranexamic acid as a haemostat when working in the external auditory canal; with respect to the middle ear, no statistically significant difference was found between the two agents. Mean values for mean arterial pressure, heart rate and surgical time were comparable in both groups, with no statistically significant differences.
Tranexamic acid appears to be an effective haemostat in endoscopic ear surgery, thus improving surgical field visualisation, especially during manipulation of the external auditory canal soft tissues.
This chapter reviews the systematics of partial melting of mantle lithologies – like peridotite and eclogite – in the presence of carbon dioxide. It discusses the composition of mantle-derived magmas generated in the presence of carbon dioxide and whether magmas erupted on Earth’s surface resemble carbonated magmas from the mantle. It reviews how the production of carbon dioxide-rich magma in the mantle varies as a function of tectonic settings – beneath continents and oceans and in subduction zones – and time.
In this paper, longitudinal and lateral-directional aerodynamic characterisation of the Cropped Delta Reflex Wing (CDRW) configuration–based unmanned aerial vehicle is carried out by means of full-scale static wind-tunnel tests followed by full-scale flight testing. A predecided set of longitudinal and lateral/directional manoeuvres is performed to acquire the respective flight data, using a dedicated onboard flight data acquisition system. The compatibility of the acquired dynamics is quantified, in terms of scale factors and biases of the measured variables, using Kinematic consistency check. Maximum likelihood (ML), least squares and newly emerging neural Gauss–Newton (NGN) methods were implemented for a wing-alone delta configuration, mainly to capture the dynamic derivatives for both longitudinal and lateral directional cases. Estimated damping and weak dynamic derivatives, which are in general challenging to capture for a wing alone configuration, are consistent using ML and NGN methods. Validation of the estimated parameters with aerodynamic model is performed by proof-of-match exercise and are presented therein.
Background: Buprenorphine/naloxone (bup/nal) is a partial opioid agonist/antagonist and recommended first line treatment for opioid use disorder (OUD). Emergency departments (EDs) are a key point of contact with the healthcare system for patients living with OUD. Aim Statement: We implemented a multi-disciplinary quality improvement project to screen patients for OUD, initiate bup/nal for eligible individuals, and provide rapid next business day walk-in referrals to addiction clinics in the community. Measures & Design: From May to September 2018, our team worked with three ED sites and three addiction clinics to pilot the program. Implementation involved alignment with regulatory requirements, physician education, coordination with pharmacy to ensure in-ED medication access, and nurse education. The project is supported by a full-time project manager, data analyst, operations leaders, physician champions, provincial pharmacy, and the Emergency Strategic Clinical Network leadership team. For our pilot, our evaluation objective was to determine the degree to which our initiation and referral pathway was being utilized. We used administrative data to track the number of patients given bup/nal in ED, their demographics and whether they continued to fill bup/nal prescriptions 30 days after their ED visit. Addiction clinics reported both the number of patients referred to them and the number of patients attending their referral. Evaluation/Results: Administrative data shows 568 opioid-related visits to ED pilot sites during the pilot phase. Bup/nal was given to 60 unique patients in the ED during 66 unique visits. There were 32 (53%) male patients and 28 (47%) female patients. Median patient age was 34 (range: 21 to 79). ED visits where bup/nal was given had a median length of stay of 6 hours 57 minutes (IQR: 6 hours 20 minutes) and Canadian Triage Acuity Scores as follows: Level 1 – 1 (2%), Level 2 – 21 (32%), Level 3 – 32 (48%), Level 4 – 11 (17%), Level 5 – 1 (2%). 51 (77%) of these visits led to discharge. 24 (47%) discharged patients given bup/nal in ED continued to fill bup/nal prescriptions 30 days after their index ED visit. EDs also referred 37 patients with OUD to the 3 community clinics, and 16 of those individuals (43%) attended their first follow-up appointment. Discussion/Impact: Our pilot project demonstrates that with dedicated resources and broad institutional support, ED patients with OUD can be appropriately initiated on bup/nal and referred to community care.
The detection of a neutron star merger by the Advanced Laser Interferometer Gravitational-Wave Observatory and Advanced Virgo gravitational wave detectors, and the subsequent detection of an electromagnetic counterpart have opened a new era of transient astronomy. With upgrades to the Advanced Laser Interferometer Gravitational-Wave Observatory and Advanced Virgo detectors and new detectors coming online in Japan and India, neutron star mergers will be detected at a higher rate in the future, starting with the O3 observing run which will begin in early 2019. The detection of electromagnetic emission from these mergers provides vital information about merger parameters and allows independent measurement of the Hubble constant. The Australian Square Kilometre Array Pathfinder is expected to become fully operational in early 2019, and its 30 deg2 field of view will enable us to rapidly survey large areas of sky. In this work we explore prospects for detecting both prompt and long-term radio emission from neutron star mergers with Australian Square Kilometre Array Pathfinder and determine an observing strategy that optimises the use of telescope time. We investigate different strategies to tile the sky with telescope pointings in order to detect radio counterparts with limited observing time, using 475 simulated gravitational wave events. Our results show a significant improvement in observing efficiency when compared with a naïve strategy of covering the entire localisation above some confidence threshold, even when achieving the same total probability covered.
The problem of unsteady boundary layer flow of a nanofluid over a stretching surface is studied. Heat transfer due to melting is analyzed. Using a similarity transformation the governing coupled nonlinear partial differential equations of the model are reduced to a system of nonlinear ordinary differential equations, and then solved numerically by a Runge-Kutta method with a shooting technique. Dual solutions are observed numerically and their characteristics are analyzed. The effects of the pertinent parameters such as the acceleration parameter, the Brownian motion parameter, the thermophoresis parameter, the Prandtl number and the Lewis number on the velocity, temperature and concentration fields are discussed. Also the effects of these parameters on the skin friction coefficient, the Nusselt number and the Sherwood number are analyzed through graphs. It is observed that the melting phenomenon has a significant effect on the flow, heat and mass transfer characteristics.
Crystal structure analysis of a pyrazole carboxylic acid derivative, 5-(trifluoromethyl)-1-phenyl-1H-pyrazole-4-carboxylic acid (1) has been carried out from laboratory powder X-ray diffraction data. The crystal packing in the pyrazole carboxylic acid derivative exhibits an interplay of strong O–H…O, C–H…N and C–H…F hydrogen bonds to generate a three-dimensional molecular packing via the formation of R22(8) and R22(9) rings. Molecular electrostatic potential calculations indicated that carbonyl oxygen, pyrazole nitrogen and fluorine atoms to be the strongest acceptors. The relative contribution of different interactions to the Hirshfeld surface of pyrazole carboxylic acid and a few related structures retrieved from CSD indicates that H…H, N…H and O…H interactions can account for almost 70% of the Hirsfeld surface area in these compounds.
We report the synthesis and optical properties of pure ZnS and Ag doped ZnS nanostructures. ZnS(Ag) was synthesized by using the hydrothermal technique and later annealed at different temperatures under vacuum conditions. It was observed that the photoluminescence (PL) emission from the ZnS(Ag) nanostructures can be easily tuned from the blue (445 nm) to green (530 nm) region of visible light by varying the annealing temperature. This tunability has been attributed to the introduction of excess sulfur vacancy states, which is evident from the PL excitation spectra. This observed change in the PL emission wavelength can be highly beneficial in the imaging screens where ZnS is regularly used and can be easily interfaced with the silicon photodiodes showing maximum sensitivity at 550 nm.
Building on the recent advances in next-generation sequencing, the integration of genomics, proteomics, metabolomics, and other approaches hold tremendous promise for precision medicine. The approval and adoption of these rapidly advancing technologies and methods presents several regulatory science considerations that need to be addressed. To better understand and address these regulatory science issues, a Clinical and Translational Science Award Working Group convened the Regulatory Science to Advance Precision Medicine Forum. The Forum identified an initial set of regulatory science gaps. The final set of key findings and recommendations provided here address issues related to the lack of standardization of complex tests, preclinical issues, establishing clinical validity and utility, pharmacogenomics considerations, and knowledge gaps.
An electron acoustic super solitary wave has been derived using the Sagdeev pseudopotential technique for a four component magnetized plasma consisting of the beam and bulk fluid electrons and two ions with Maxwell Boltzmann distributions. This is the first theoretical report of a super solitary wave in a magnetized plasma which has no direct association with the singularity of the pseudopotential. It shows a narrow and spiky subwell near the low potential which causes the lateral inversion of the wiggle for the bipolar electric field vis-á-vis the unmagnetized plasma. An analytical formalism was developed to identify these novel kinds of super solitary waves and their transition processes have been characterized. It was observed that the super solitary wave is directly influenced by the singularity of the pseudopotential lying in the vicinity of the solution. The first ever prediction of the electron acoustic super solitary wave raises the possibility of its application to the interpretation of the satellite observations of the electrostatic field data.
BACKGROUND: Adult medulloblastomas account for less than 1% of adult neoplasms. They are challenging to treat due to their rarity and the heterogeneity of treatment options, all of which have limited evidence. In this retrospective review, we examined cases of adult medulloblastoma diagnosed in Alberta during a 70-year period. METHODS: We reviewed the charts of patients diagnosed with medulloblastoma between 1944 and 2014. We performed Cox and logistic regression analysis to elucidate features that may influence recurrence risk and survival. RESULTS: We found 86 and analyzed 78 cases. The median age at diagnosis was 27 (range 16 to 71). Most were male (68%). Most had surgery (92%). By COG risk stratification, 54% were standard risk while 21% were poor risk. RT was administered to 85% of patients, and craniospinal irradiation (CSI) to 81%. Chemotherapy was administered to 48%. Median survival was 4.4 years from diagnosis (range 0 to 20). At last follow-up, 39% were alive and recurrence-free. Patients who had CSI and posterior fossa boost had longer survival (p=0.047 and<0.01, respectively) and were less likely to recur (p=0.041 and<0.01). Chemotherapy was also associated with decreased recurrence (p=0.025). CONCLUSIONS: Medulloblastomas carry a significant recurrence risk, especially for patients who had subtotal resection. CSI and posterior fossa boost were associated with fewer recurrences and improved survival. COG risk stratification, Chang staging, desmoplastic histology, vermian location, 4th ventricle involvement, tumor enhancement, presence of hydrocephalus and cerebrospinal fluid (CSF) involvement are not significantly prognostic.
Artificial Neural Network based Nonlinear Autoregressive Model is designed to reconstruct and predict Forbush Decrease (FD) Data obtained from Izmiran, Russia. Result indicates that the model seems adequate for short term prediction of the FD data.
A new species, Gentiana arunii D.Maity, S.K.Dey, J.Ghosh & Midday, from alpine pasture in Sikkim Himalaya is described and illustrated, and placed in Gentiana section Chondrophyllae Bunge. The new species is compared morphologically with two related taxa, Gentiana glabriuscula T.N.Ho and Gentiana pluviarum W.W.Sm. subsp. subtilis (Harry Sm.) T.N.Ho.
Using reductive perturbation technique, small-amplitude ion-acoustic solitary wave has been investigated in multi-component dense plasma, in which an electron beam propagates along the general streaming motion. The electrons in plasma have the q-exponential distribution. The positive and negative ions follow a regular Maxwellian distribution. It has been found that the positive and negative ion densities as well as the beam concentration have significant effect on the formation and properties of solitary structures. The streaming velocities of corresponding particles also have pronounced effect on the features of the solitons.
The final stages of low-mass stellar evolution are characterized by significant mass loss due to stellar pulsations during the AGB phase, which lead to the development of planetary nebulae. Molecular masers of H2O, SiO, and ground state OH transitions are commonly detected in oxygen-rich late-type stars (OH/IR objects). In contrast, excited OH maser transitions are rare. We discuss our study of the carbon-rich pre-planetary nebula CRL618 (a prototypical post-AGB star). Observations conducted in May 2008 with the 305m Arecibo Telescope resulted in the first detection of a 4765MHz OH maser line in a late-type stellar object; the detection was confirmed a few months later also with Arecibo. Subsequent observations in 2015 and 2017 resulted in non-detection of the 4765MHz OH line. Our observations indicate that the 4765MHz OH maser in CRL 618 is highly variable, possibly tracing a short-lived phenomenon during the development of a pre-planetary nebula.
The reactions between O and N atoms and certain interstellar molecules (H2S, NH3, H2CO, CH3 OH, C2 H5 OH) are studied using the dynamicalflowing after glow method. It is found that NH and OH radicals are formed which can be used as a diagnostic probe to differentiate between interstellar shocked and heated regions.
Heterodyne spectroscopy at 11 μm combines high spectral resolution (λ/Δ λ ~106), high spatial resolution (< 1 arcsec at 3 m telescopes) and high penetration depth. Therefore, it seems promising to use it also for the investigation of bright circumstellar atmospheres.
IRAS has provided infrared maps of a large number of galaxies. However the size of IRAS survey detectors is quite large (∼5′ in the cross-scan direction) and there is a need for improving the resolution of these maps. In order to understand the spatial structure of galaxies, we have generated high resolution maps of 18 large galaxies by deconvolving the IRAS pointed observations from survey detectors as well as from Chopped Photometric Channel (CPC) using Maximum Entropy Method (MEM).