Comparing Thirty30 Tennis with Traditional Tennis

Thirty30 is a shorter format of tennis where games start at 30-30. This means that a greater proportion of points are game points or break points than would be the case in traditional tennis. The purpose of the current paper is to compare the probability of players of different abilities winning games, sets and matches between Thirty30 tennis and traditional tennis. This is done using probabilistic models of each format of tennis. The results show that there is reduced dominance of the serve and a greater probability of upsets in Thirty30 tennis than in traditional tennis. The models are also experimented with, adjusting the probability of winning points where the point is a game point or a break point. The paper shows that such scoreline effects have a greater impact in Thirty30 tennis than they do in traditional tennis. This has implications for player preparation for Thirty30 tennis

Redistribution in the Irish Tax-Benefit System.

The primary objective of the thesis is to study the degree of redistribution in the Irish Tax-Benefit System. The first part of the thesis (chapter 2) describes the main features of the system and examines the potential redistributive effect of the system. It also sets the system in its historical context by charting the development of the system in the post war era. Chapter 3 examines the redistributive effect of the sub-components of the tax-benefit system separately on a cross-section of the population by decomposing standard redistributive and progressivity measures. This chapter examines in detail the effect of the reforms from 1987 to 2000. The use of a short accounting period such as a month will tend to exaggerate the degree of redistribution within a tax-benefit system. It is desirable therefore to examine the degree of redistribution over a measure such as lifetime income, as this more fully reflects the standard of living an individual faces. As lifetime income data is not available, a dynamic microsimulation model has been constructed to generate synthetic life histories of a sample of the Irish population, so that lifetime incomes can be constructed. A number of chapters then describe the characteristics of this model. Chapter 4 considers the main issues involved in designing a dynamic microsimulation model and assesses how the main dynamic models internationally have dealt with the issues discussed. Chapter 5 describes how this model dealt with these design issues. Chapters 6 and 7 respectively describe the behavioural equations used by the model to simulate demographic/education and market behaviour respectively. A number of analytical chapters have been included using the dynamic microsimulation model. Chapter 8 examines the degree of redistribution over life-cycle. Chapter 9 analyses the redistributive effect of taxes and benefits over the lifetime. Chapter 10 examines the degree of intra versus inter personal redistribution in the tax-benefit system. The previous chapters examine the redistributive effect of the tax-benefit system in isolation by considering its effect in a steady state world. However neither the world nor the tax-benefit system are in a steady state. The system has evolved over time. In Chapter 11, we examine the degree of inter-generational redistribution of the Irish Welfare State since the foundation of the state in 1921

Recommended Personal Protective Equipment for Cochlear Implant and Other Mastoid Surgery During the COVID-19 Era

© 2020 American Laryngological, Rhinological and Otological Society Inc, "The Triological Society" and American Laryngological Association (ALA) Objectives/Hypothesis: The overall aim of this study was to evaluate personal protective equipment (PPE) that may facilitate the safe recommencement of cochlear implantation in the COVID-19 era, with the broader goal of minimizing the period of auditory deprivation in prelingually deaf children and reducing the risk of cochlear ossification in individuals following meningitis. Methods: The study design comprised 1) an objective assessment of mastoid drilling-induced droplet spread conducted during simulated cochlear implant (CI) surgery and its mitigation via the use of a protective drape tent and 2) an evaluation of three PPE configurations by otologists while performing mastoid drilling on ex vivo temporal bones. The various PPE solutions were assessed in terms of their impact on communication, vital physiological parameters, visual acuity and fields, and acceptability to surgeons using a systematic risk-based approach. Results: Droplet spread during simulated CI surgery extended over 2 m, a distance greater than previously reported. A drape tent significantly reduced droplet spread. The ensemble of a half-face mask and safety spoggles (foam lined safety goggles) had consistently superior performance across all aspects of clinical usability. All other PPE options were found to substantially restrict the visual field, making them unsafe for microsurgery. Conclusions: The results of this preclinical study indicate that the most viable solution to enable the safe conduct of CI and other mastoid surgery is a combination of a filtering facepiece (FFP)3 mask or half-face respirator with safety spoggles as PPE. Prescription spoggles are an option for surgeons who need to wear corrective glasses to operate. A drape tent reduces droplet spread. A multicenter clinical trial to evaluate the effectiveness of PPE should be the next step toward safely performing CI surgery during the COVID-19 era. Level of Evidence: 4 Laryngoscope, 2020

An assessment of the clinical acceptability of direct acoustic cochlear implantation for adults with advanced otosclerosis in the United Kingdom

Hypothesis: Assess the clinical acceptability of direct acoustic cochlear implantation for patients with advanced otosclerosis and the support for conducting a controlled trial of its effectiveness in the United Kingdom. Background: Emerging evidence supports the efficacy of direct acoustic cochlear implantation in patients with advanced otosclerosis whose needs cannot be managed using the combination of stapes surgery and hearing aids. A controlled trial would provide evidence for its effectiveness and cost-effectiveness to healthcare commissioners. Methods: An online survey of clinical professionals was constructed to characterise current standard of care for patients with advanced otosclerosis and to assess whether clinicians would be willing to refer patients into a trial to evaluate direct acoustic cochlear implantation. A consensus process was conducted to define inclusion criteria for the future trial. Results: No survey respondent considered direct acoustic cochlear implantation to be inappropriate with a majority indicating that they would refer patients into a future trial. The consensus was that there is a lack of available treatment options for those patients with bone conduction thresholds worse than 55 dB HL and who did not meet current criteria for cochlear implantation. Conclusions: The present study confirms that a controlled trial to evaluate the effectiveness of direct acoustic cochlear implantation would have the support of clinicians in the UK. A feasibility study would be required to determine whether patients who meet the inclusion criteria could be recruited in a timely manner and in sufficient numbers to conduct a formal evaluation of effectiveness

11 C-Metomidate PET/CT is a useful adjunct for lateralization of primary aldosteronism in routine clinical practice.

OBJECTIVE: To describe clinical practice experience of 11 C-Metomidate PET/CT as an adjunct to adrenal vein sampling (AVS) in the lateralization of aldosterone-producing adenomas (APA) in primary aldosteronism (PA). CONTEXT: Accurate lateralization of APA in the setting of PA offers the potential for surgical cure and improved long-term cardiovascular outcomes. Challenges associated with AVS, the current gold standard lateralization modality, mean that only a small proportion of potentially eligible patients currently make it through to surgery. This has prompted consideration of alternative strategies for lateralization, including the application of novel molecular PET tracers such as 11 C-Metomidate. DESIGN: Clinical Service Evaluation/Retrospective audit. PATIENTS: Fifteen individuals with a confirmed diagnosis of PA, undergoing lateralization with 11 C-Metomidate PET/CT prior to final clinical decision on surgical vs medical management. MEASUREMENTS: All patients underwent screening aldosterone renin ratio (ARR), followed by confirmatory testing with the seated saline infusion test, according to Endocrine Society Clinical Practice Guidelines. Adrenal glands were imaged using dedicated adrenal CT. 11 C-Metomidate PET/CT was undertaken due to equivocal or failed AVS. Management outcomes were assessed by longitudinal measurement of blood pressure, ARR, number of hypertensive medications following adrenalectomy or institution of medical therapy. RESULTS: We describe the individual lateralization and clinical outcomes for 15 patients with PA. CONCLUSION: 11 C-Metomidate PET/CT in conjunction with adrenal CT and AVS provided useful information which aided clinical decision-making for PA within a multidisciplinary hypertension clinic

Inner Ear

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International Classification of Reliability for Implanted Cochlear Implant Receiver Stimulators

To design an international standard to be used when reporting reliability of the implanted components of cochlear implant systems to appropriate governmental authorities, cochlear implant (CI) centers, and for journal editors in evaluating manuscripts involving cochlear implant reliability

The Orphan's Kaddish : The Paternal Thanatographies of Paul Auster and Philip Roth

EThOS - Electronic Theses Online ServiceGBUnited Kingdo