Current practice of ototoxicity management across the United Kingdom (UK)

OBJECTIVE: Effective management of patients diagnosed with ototoxicity is needed to reduce hearing and balance damage which affects communication and life quality. Despite widespread recommendations to monitor and manage ototoxicity in an early and effective manner, there is limited evidence to support the actual implementation of these recommendations for affected patient groups in healthcare services across the UK with limited publications available. In this study, an online questionnaire analysed the current practice of ototoxicity management and patient pathways across the UK once the diagnosis of ototoxicity was confirmed, targeting Audiologists, ENTs/AVPs and GPs. DESIGN: Qualitative Survey Study. STUDY SAMPLE: A randomised sample of hearing services in the UK, including audiology departments; GP practices and local health settings were targeted with a total of 134 completed surveys. RESULTS: About 72% reported the absence of ototoxicity management protocols within their centre. Results depicted great inconsistency and variation across the UK in ototoxicity management services provided, treatment modification, monitoring and referral pathways. CONCLUSION: Developing and advocating national guidelines are intended not only to inform clinical decision making but to provide minimum standards of care in ototoxicity management and offer greater awareness and education to improve patients' quality of life

Evaluation of outcome following clamp assisted mini open reduction and internal fixation with intramedullary nailing of subtrochanteric femoral fractures

Background: Subtrochanteric fractures of the proximal femur have been defined as the fractures extending from lesser trochanter distally for 5 cm. These fractures usually occur in two age distributions. In the elderly osteopenic population resulting from trivial trauma as fall from standing height or in the younger ones as a result of high energy trauma. Incidence has been on the rise and they comprise about 7 to 10% hip fractures and could lead quickly to large amount of blood loss and other complications.Methods: This is a multicentric prospective prognostic study level 1 consisting of 25 patients admitted in government civil hospital, Ahmedabad during April 2013 to May 2015 having high subtrochanteric femur fractures treated by clamp assisted reduction and intramedullary nailing. Out of these, 20 patients (80%) came for final follow up with average follow up of 11.5 months and evaluated for union, complication and functional outcome.Results: In our study final outcome is assessed based on hip outcome score (modified) based on which 85% had excellent outcome, 10% had good outcome and 5% had fair outcome with none of the patient having poor outcome.Conclusions: We found that clamp-assisted reduction and intramedullary nail fixation provides excellent reduction quality, high rate of fracture union, with no apparent increase in complications in subtrochanteric fractures of the femur.

Finite Gluon Fusion Amplitude in the Gauge-Higgs Unification

We show that the gluon fusion amplitude in the gauge-Higgs unification scenario is finite in any dimension regardless of its nonrenormalizability. This result is supported by the fact that the local operator describing the gluon fusion process is forbidden by the higher dimensional gauge invariance. We explicitly calculate the gluon fusion amplitude in an arbitrary dimensional gauge-Higgs unification model and indeed obtain the finite result.Comment: 15 pages, final version to appear in MPL

Development and validation of a pragmatic natural language processing approach to identifying falls in older adults in the emergency department

BACKGROUND: Falls among older adults are both a common reason for presentation to the emergency department, and a major source of morbidity and mortality. It is critical to identify fall patients quickly and reliably during, and immediately after, emergency department encounters in order to deliver appropriate care and referrals. Unfortunately, falls are difficult to identify without manual chart review, a time intensive process infeasible for many applications including surveillance and quality reporting. Here we describe a pragmatic NLP approach to automating fall identification. METHODS: In this single center retrospective review, 500 emergency department provider notes from older adult patients (age 65 and older) were randomly selected for analysis. A simple, rules-based NLP algorithm for fall identification was developed and evaluated on a development set of 1084 notes, then compared with identification by consensus of trained abstractors blinded to NLP results. RESULTS: The NLP pipeline demonstrated a recall (sensitivity) of 95.8%, specificity of 97.4%, precision of 92.0%, and F1 score of 0.939 for identifying fall events within emergency physician visit notes, as compared to gold standard manual abstraction by human coders. CONCLUSIONS: Our pragmatic NLP algorithm was able to identify falls in ED notes with excellent precision and recall, comparable to that of more labor-intensive manual abstraction. This finding offers promise not just for improving research methods, but as a potential for identifying patients for targeted interventions, quality measure development and epidemiologic surveillance

(S)fermion Masses in Fat Brane Scenario

We discuss the fermion mass hierarchy and the flavor mixings in the fat brane scenario of a five dimensional SUSY theory. Assuming that the matter fields lives in the bulk, their zero mode wave functions are Gaussians, and Higgs fields are localized on the brane, we find simple various types of the matter configurations generating the mass matrices consistent with experimental data. Sfermion mass spectrum is also discussed using the matter configurations found above. Which type of squark mass spectra (the degeneracy, the decoupling and the alignment) is realized depends on the relative locations of SUSY breaking brane and the brane where Higgs fields are localized.Comment: 18 pages, LaTe

Molten Salt Thermal Energy Storage Systems

The feasibility of storing thermal energy at temperatures of 450 C to 535 C in the form of latent heat of fusion was examined for over 30 inorganic salts and salt mixtures. Alkali carbonate mixtures were chosen as phase-change storage materials in this temperature range because of their relatively high storage capacity and thermal conductivity, moderate cost, low volumetric expansion upon melting, low corrosivity, and good chemical stability. Means of improving heat conduction through the solid salt were explored

Winding number and non-BPS bound states of walls in nonlinear sigma models

Non-supersymmetric multi-wall configurations are generically unstable. It is proposed that the stabilization in compact space can be achieved by introducing a winding number into the model. A BPS-like bound is studied for the energy of configuration with nonvanishing winding number. Winding number is implemented in an ${\cal N}=1$ supersymmetric nonlinear sigma model with two chiral scalar fields and a bound states of BPS and anti-BPS walls is found to exist in noncompact spaces. Even in compactified space $S^1$, this nontrivial bound state persists above a critical radius of the compact dimension.Comment: 20pages, 14 figures, minor misprint corrections, figures added, explanation of winding number adde

High efficiency carbonate fuel cell/turbine hybrid power cycle

The hybrid power cycle studies were conducted to identify a high efficiency, economically competitive system. A hybrid power cycle which generates power at an LHV efficiency > 70% was identified that includes an atmospheric pressure direct carbonate fuel cell, a gas turbine, and a steam cycle. In this cycle, natural gas fuel is mixed with recycled fuel cell anode exhaust, providing water for reforming fuel. The mixed gas then flows to a direct carbonate fuel cell which generates about 70% of the power. The portion of the anode exhaust which is not recycled is burned and heat transferred through a heat exchanger (HX) to the compressed air from a gas turbine. The heated compressed air is then heated further in the gas turbine burner and expands through the turbine generating 15% of the power. Half the exhaust from the turbine provides air for the anode exhaust burner. All of the turbine exhaust eventually flows through the fuel cell cathodes providing the O2 and CO2 needed in the electrochemical reaction. Exhaust from the cathodes flows to a steam system (heat recovery steam generator, staged steam turbine generating 15% of the cycle power). Simulation of a 200 MW plant with a hybrid power cycle had an LHV efficiency of 72.6%. Power output and efficiency are insensitive to ambient temperature, compared to a gas turbine combined cycle; NOx emissions are 75% lower. Estimated cost of electricity for 200 MW is 46 mills/kWh, which is competitive with combined cycle where fuel cost is > $5.8/MMBTU. Key requirement is HX; in the 200 MW plant studies, a HX operating at 1094 C using high temperature HX technology currently under development by METC for coal gassifiers was assumed. A study of a near term (20 MW) high efficiency direct carbonate fuel cell/turbine hybrid power cycle has also been completed

New Form of the T-Duality Due to the Stability of a Compact Dimension

We study behaviors of a compact dimension and the $T$-duality, in the presence of the wrapped closed bosonic strings. When the closed strings interact and form another system of strings, the radius of compactification increases. This modifies the $T$-duality, which we call it as $T$-duality-like. Some effects of the $T$-duality-like will be studied.Comment: 12 pages, Latex, no figur

Effects of feeding different sorghum varieties on the haematological parameters and carcass measurements of growing rabbits

An eight-week feeding trial was conducted to investigate the effect of different sorghum varieties on the blood parameters and carcass measurements of cross-bred (Dutch x New Zealand) growing rabbits aged between five and seven weeks. Twenty five rabbits were randomly allocated to five dietary treatments; T1 (100% maize), T2 (50% maize and 50% “Chakalare” sorghum), T3 (100% Chakalare” sorghum), T4 (50% maize and 50% “Jigare” sorghum) and T5 (100% “Jigare” sorghum). The “Chakalare” and “Jigare” are low-tannin and high- tannin sorghum varieties respectively. The haematological parameters were Packed Cell Volume (PCV), Haemoglobin (Hb), Red Blood Cell (RBC), White Blood Cell (WBC), Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC), Monocytes (%) basophils (%), Neutrophils (%), Eosinophils (%) and Lymphocytes (%). The carcass parameters were Slaughter weight (g), Dressed weight (g), Dressing percentage %, (As % of slaughter weight) of Shoulder/forelegs, Rack, Loin, Thighs/Hind legs, Skin/pelt, Tail, Head, Feet, Heart Liver, Lungs, Kidneys, Kidneys Caecum, Stomach, Large intestine, Small intestine, Caecum length (cm), Stomach length (cm), Small intestine length (cm) and Body length (cm). The response showed that most of the haematological parameters were significantly affected (P<0.05) by the different varieties of sorghum in the diets except packed cell volume, mean corpuscular volume, mean corpuscular haemoglobin concentration and basophils which were not significantly affected (P>0.05) by the different varieties of sorghum in the diets. However, most of the haematological values fell within the normal ranges PCV (37.33 to 40.67 %), Hb (13.37- 156.73 %), RBC (5.57-6.93%) and WBC (12.67-14.83) of growing rabbits. The carcass measurements and organs expressed as percentage of slaughter weight were not significantly (P>0.05) different among the treatment groups except slaughter weight, dressing percentage, rack, loin, liver, caecum weight and stomach length which were significantly (P<0.05) different. The study indicated that the two varieties of sorghum (“Chakalare” and “Jigare”) can be included in the diets of growing rabbits as replacement for maize without adverse effect on haematology and carcass parameters of growing rabbits.Keywords: Growing rabbits, Sorghum varieties, Haematological parameters and carcass measurements, Nigeri