Histopathologic parameters as predictors of response to endoscopic sinus surgery in nonallergic patients with chronic rhinosinusitis

OBJECTIVE: To estimate the predictable value of histopathologic parameters in chronic rhinosinusitis (CRS) for response to endoscopic sinus surgery (ESS). - - - - - STUDY DESIGN: Symptomatology was rated in 100 patients prior to as well as 12 and 24 months after surgery. Specimens taken during the procedure were examined and scored for goblet cells, subepithelial thickening, mast cells, and eosinophils. Multiple regression analysis was performed to predict the total score of subjective symptoms before treatment by histopathologic parameters. The correlation between histopathologic parameters and postoperative symptoms was then evaluated. - - - - - RESULTS: Goblet cells were the best predictor correlating with 5 symptoms. Subepithelial thickening correlated with 4 symptoms. Mast cell infiltration correlated with 3 symptoms. Eosinophilic infiltration correlated with only one symptom (P<0.05). - - - - - CONCLUSION: Certain histopathologic parameters in CRS are predictive of favorable response to ESS. - - - - - SIGNIFICANCE: Pathologic evaluation may help the ENT surgeon to predict the persistence of certain CRS symptoms after ESS, even in patients at low risk for surgical failure. - - - - - EBM rating: C-4

Higher Curvature Gravity and the Holographic fluid dual to flat spacetime

Recent works have demonstrated that one can construct a (d+2) dimensional solution of the vacuum Einstein equations that is dual to a (d+1) dimensional fluid satisfying the incompressible Navier-Stokes equations. In one important example, the fluid lives on a fixed timelike surface in the flat Rindler spacetime associated with an accelerated observer. In this paper, we show that the shear viscosity to entropy density ratio of the fluid takes the universal value 1/4\pi in a wide class of higher curvature generalizations to Einstein gravity. Unlike the fluid dual to asymptotically anti-de Sitter spacetimes, here the choice of gravitational dynamics only affects the second order transport coefficients. We explicitly calculate these in five-dimensional Einstein-Gauss-Bonnet gravity and discuss the implications of our results.Comment: 13 pages; v2: modified abstract, added references; v3: added clarifying comments, modified discussio

Degenerate Stars and Gravitational Collapse in AdS/CFT

We construct composite CFT operators from a large number of fermionic primary fields corresponding to states that are holographically dual to a zero temperature Fermi gas in AdS space. We identify a large N regime in which the fermions behave as free particles. In the hydrodynamic limit the Fermi gas forms a degenerate star with a radius determined by the Fermi level, and a mass and angular momentum that exactly matches the boundary calculations. Next we consider an interacting regime, and calculate the effect of the gravitational back-reaction on the radius and the mass of the star using the Tolman-Oppenheimer-Volkoff equations. Ignoring other interactions, we determine the "Chandrasekhar limit" beyond which the degenerate star (presumably) undergoes gravitational collapse towards a black hole. This is interpreted on the boundary as a high density phase transition from a cold baryonic phase to a hot deconfined phase.Comment: 75 page

Evaluating the Impact of a ‘Virtual Clinic’ on Patient Experience, Personal and Provider Costs of Care in Urinary Incontinence: A Randomised Controlled Trial.

Objective: To evaluate the impact of using a ‘virtual clinic’ on patient experience and cost in the care of women with urinary incontinence. Materials and Methods: Women, aged > 18 years referred to a urogynaecology unit were randomised to either (1) A Standard Clinic or (2) A Virtual Clinic. Both groups completed a validated, web-based interactive, patient-reported outome measure (ePAQ-Pelvic Floor), in advance of their appointment followed by either a telephone consultation (Virtual Clinic) or face-to-face consultation (Standard Care). The primary outcome was the mean ‘short-term outcome scale’ score on the Patient Experience Questionnaire (PEQ). Secondary Outcome Measures included the other domains of the PEQ (Communications, Emotions and Barriers), Client Satisfaction Questionnaire (CSQ), Short-Form 12 (SF-12), personal, societal and NHS costs. Results: 195 women were randomised: 98 received the intervention and 97 received standard care. The primary outcome showed a non-significant difference between the two study arms. No significant differences were also observed on the CSQ and SF-12. However, the intervention group showed significantly higher PEQ domain scores for Communications, Emotions and Barriers (including following adjustment for age and parity). Whilst standard care was overall more cost-effective, this was minimal (£38.04). The virtual clinic also significantly reduced consultation time (10.94 minutes, compared with a mean duration of 25.9 minutes respectively) and consultation costs compared to usual care (£31.75 versus £72.17 respectively), thus presenting potential cost-savings in out-patient management. Conclusions: The virtual clinical had no impact on the short-term dimension of the PEQ and overall was not as cost-effective as standard care, due to greater clinic re-attendances in this group. In the virtual clinic group, consultation times were briefer, communication experience was enhanced and personal costs lower. For medical conditions of a sensitive or intimate nature, a virtual clinic has potential to support patients to communicate with health professionals about their condition

Constraining Bosonic Supersymmetry from Higgs results and 8 TeV ATLAS multi-jets plus missing energy data

The collider phenomenology of models with Universal Extra Dimensions (UED) is surprisingly similar to that of supersymmetric (SUSY) scenarios. For each level-1 bosonic (fermionic) Kaluza-Klein (KK) state, there is a fermionic (bosonic) analog in SUSY and thus UED scenarios are often known as bosonic supersymmetry. The minimal version of UED (mUED) gives rise to a quasi-degenerate particle spectrum at each KK-level and thus, can not explain the enhanced Higgs to diphoton decay rate hinted by the ATLAS collaboration of the Large Hadron Collider (LHC) experiment. However, in the non-minimal version of the UED (nmUED) model, the enhanced Higgs to diphoton decay rate can be easily explained via the suitable choice of boundary localized kinetic (BLK) terms for higher dimensional fermions and gauge bosons. BLK terms remove the degeneracy in the KK mass spectrum and thus, pair production of level-1 quarks and gluons at the LHC gives rise to hard jets, leptons and large missing energy in the final state. These final states are studied in details by the ATLAS and CMS collaborations in the context of SUSY scenarios. We find that the absence of any significant deviation of the data from the Standard Model (SM) prediction puts a lower bound of about 2.1 TeV on equal mass excited quarks and gluons.Comment: 19 page

Search for Higgs bosons of the Universal Extra Dimensions at the Large Hadron Collider

The Higgs sector of the Universal Extra Dimensions (UED) has a rather involved setup. With one extra space dimension, the main ingredients to the construct are the higher Kaluza-Klein (KK) excitations of the Standard Model Higgs boson and the fifth components of the gauge fields which on compactification appear as scalar degrees of freedom and can mix with the former thus leading to physical KK-Higgs states of the scenario. In this work, we explore in detail the phenomenology of such a Higgs sector of the UED with the Large Hadron Collider (LHC) in focus. We work out relevant decay branching fractions involving the KK-Higgs excitations. Possible production modes of the KK-Higgs bosons are then discussed with an emphasis on their associated production with the third generation KK-quarks and that under the cascade decays of strongly interacting UED excitations which turn out to be the only phenomenologically significant modes. It is pointed out that the collider searches of such Higgs bosons face generic hardship due to soft end-products which result from severe degeneracies in the masses of the involved excitations in the minimal version of the UED (MUED). Generic implications of either observing some or all of the KK-Higgs bosons at the LHC are discussed.Comment: 25 pages, 9 figures and 1 tabl

Evaluation of oil/gas infrastructure exposure to climate change burdens in the Niger Delta

Climate change extreme weather events such as flood, rising temperature and windstorms pose significant threats to oil and gas infrastructure in the Niger. Due to a gap in evaluation of assets exposure in the region, little is known about their level of exposure hierarchies. In this paper, analytic hierarchy process (AHP) is used to evaluate the exposure of selected oil and gas infrastructure to prevailing climate burdens for sustainable adaptation planning. A combination of observational and interdisciplinary stakeholder decision-making process in four (4) multinational oil companies was used to elicit data through focus group and face-to-face interviews. Participants pairwise compared selected infrastructure using AHP questionnaire for pairwise comparison of infrastructure in a matrix system. Multiple-input (Mi-AHP) analysis revealed assets exposure to climate burdens in the following order; pipelines, terminals, roads/bridges, flow stations, loading bay, transformers/HVC and oil well-heads. Exposure is forces vulnerability of infrastructure to flood and direct heatwaves while the presence of climate burdens and proximity to areas below 4.5 m above sea level further exacerbate exposure. The research also found that interdependence, criticality, obsolescence, and adaptive capacity are other factors responsible for exposure and vulnerability of infrastructure in the Niger Delta. The result further revealed that infrastructure with weak adaptive capacities and significant obsolescence are more vulnerable if exposed to severe climate burdens. The outcome of this investigation provide hands-on data for responsible stakeholders and policymakers in the oil and gas industry for effective and sustainable planning and prioritisation of adaptation investment strategies

Improving local health through community health workers in Cambodia: challenges and solutions

Volunteer community health workers (CHWs) are an important link between the public health system and the community. The ‘Community Participation Policy for Health’ in Cambodia identifies CHWs as key to local health promotion and as a critical link between district health centres and the community. However, research on the challenges CHWs face and identifying what is required to optimise their performance is limited in the Cambodian context. This research explores the views of CHWs in rural Cambodia, on the challenges they face when implementing health initiatives

A computational study on outliers in world music

The comparative analysis of world music cultures has been the focus of several ethnomusicological studies in the last century. With the advances of Music Information Retrieval and the increased accessibility of sound archives, large-scale analysis of world music with computational tools is today feasible. We investigate music similarity in a corpus of 8200 recordings of folk and traditional music from 137 countries around the world. In particular, we aim to identify music recordings that are most distinct compared to the rest of our corpus. We refer to these recordings as ‘outliers’. We use signal processing tools to extract music information from audio recordings, data mining to quantify similarity and detect outliers, and spatial statistics to account for geographical correlation. Our findings suggest that Botswana is the country with the most distinct recordings in the corpus and China is the country with the most distinct recordings when considering spatial correlation. Our analysis includes a comparison of musical attributes and styles that contribute to the ‘uniqueness’ of the music of each country

Essential versus accessory aspects of cell death: recommendations of the NCCD 2015

Cells exposed to extreme physicochemical or mechanical stimuli die in an uncontrollable manner, as a result of their immediate structural breakdown. Such an unavoidable variant of cellular demise is generally referred to as ‘accidental cell death’ (ACD). In most settings, however, cell death is initiated by a genetically encoded apparatus, correlating with the fact that its course can be altered by pharmacologic or genetic interventions. ‘Regulated cell death’ (RCD) can occur as part of physiologic programs or can be activated once adaptive responses to perturbations of the extracellular or intracellular microenvironment fail. The biochemical phenomena that accompany RCD may be harnessed to classify it into a few subtypes, which often (but not always) exhibit stereotyped morphologic features. Nonetheless, efficiently inhibiting the processes that are commonly thought to cause RCD, such as the activation of executioner caspases in the course of apoptosis, does not exert true cytoprotective effects in the mammalian system, but simply alters the kinetics of cellular demise as it shifts its morphologic and biochemical correlates. Conversely, bona fide cytoprotection can be achieved by inhibiting the transduction of lethal signals in the early phases of the process, when adaptive responses are still operational. Thus, the mechanisms that truly execute RCD may be less understood, less inhibitable and perhaps more homogeneous than previously thought. Here, the Nomenclature Committee on Cell Death formulates a set of recommendations to help scientists and researchers to discriminate between essential and accessory aspects of cell death