The gender and side asymmetry of length of the styloid process

The styloid process is a sharp bony projection, at the base of the skull, and part of the temporal bone. Muscles and ligaments are attached to this process, but they are rarely of any clinical significance unless the styloid process is fractured or severely elongated. Pathology of the styloid process is referred to as Eagle’s syndrome. This was after a publication by Eagle (1937) in which he reported a 4% prevalence of elongated styloid processes. Later studies reported much higher percentages of elongated processes. The aims of this study was to investigate the mean length of the styloid process and compare this with what is accepted as the “normal” length after the Eagle publication. The study also looked at evidence of asymmetry between the two sides within the same specimen. Comparison in the lengths between the two sexes were also made. Forty-five styloid processes from 28 different individuals were measured for comparison. The sample group consisted out of 18 males- and 10 female subjects. The lengths of the styloid processes varied from 7.17 – 50.54mm, with a mean of 27.48mm. Styloid processes were on average 0.87mm longer on the right side and 3.12mm longer in the male specimens. This mean length of 27mm supports the claim by Eagle that the “normal” length is around 25mm. Ten out of 25 individuals (40%) exhibited “elongated” styloid processes measuring over 25mm. These findings were higher than those reported by Eagle. Elongated styloid processes are clinically important in order to make the correct diagnosis.Keywords: Styloid process; Eagel’s Syndrome; Elongated (abnormal length) styloid process

3D Neuro-electronic interface devices for neuromuscular control: Design studies and realisation steps

In order to design the shape and dimensions of new 3D multi-microelectrode information transducers properly, i. e. adapted to the scale of information delivery to and from peripheral nerve fibres, a number of studies were, and still are, being performed on modelling and simulation of electrical volume conduction inside and outside nerves, on animal experiments on stimulation and recording with single wires and linear arrays, and on new technologies for 3D micro-fabrication. This paper presents a selection of the results of these `Neurotechnology¿ studies at the University of Twente. The experimental and simulation results apply primarily to the peripheral motor nerves of the rat, but are also of interest for neural interfacing with myelinated nerves in man, as fascicles in man are about the same size as in the rat

Foraminiferal transition across the K-P boundary in the Gulf of Mexico and the Chicxulub crater

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An Approximate Maximum Common Subgraph Algorithm for Large Digital Circuits

This paper presents an approximate Maximum Common Subgraph (MCS) algorithm, specifically for directed, cyclic graphs representing digital circuits. \ud Because of the application domain, the graphs have nice properties: they are very sparse; have many different labels; and most vertices have only one predecessor. The algorithm iterates over all vertices once and uses heuristics to find the MCS. It is linear in computational complexity with respect to the size of the graph. Experiments show that very large common subgraphs were found in graphs of up to 200,000 vertices within a few minutes, when a quarter or less of the graphs differ. The variation in run-time and quality of the result is low

Social Network Analysis to Optimize Tax Enforcement Effort

The tax gap is a phenomenon experienced by revenue collection agencies which describes the difference between the taxes due, as prescribed by legislation, and the actual taxes collected. The tax gap is mostly a result of taxpayer non-compliance, such as the failure to submit a tax return. Recent theories suggest that a taxpayer’s social structure is a significant determinant of a taxpayer’s attitude towards tax compliance. This study explores the proposal that social network analysis through decision support systems can facilitate the objective of revenue collection agencies to minimize the tax gap. The results suggest that an agency’s limited enforcement capacity can achieve a greater impact on tax compliance by focusing on non-compliant social structures as opposed to single instances of non-compliance. The research fills a gap in literature by demonstrating IT’s value proposition towards government financial services

Growing Pains in the Administrative State: The Patent Office’s Troubled Quest for Managerial Control

In the last ten years, the workload of the Patent and Trademark Office ( PTO ) has increased dramatically. Complaints about the PTO\u27s ability to manage its workload have increased in tandem. Interestingly, although Congress has explicitly given the PTO rulemaking authority over the processing of patent applications, and withheld from it authority over substantive patent law, the PTO has arguably enjoyed more success in influencing substantive law than in executing direct efforts to manage its workload. This Article explores the multiple, mutually reinforcing reasons for this anomaly. It argues that although there are good reasons to be frustrated with the PTO\u27s past performance, the anomaly should not persist. To the contrary, incremental reform that gave the new PTO administration greater control over its procedures and its budgetary outlook would move us a long way toward a more efficient system of patent examination

Smartphone-based safety planning and self-monitoring for suicidal patients: Rationale and study protocol of the CASPAR (Continuous Assessment for Suicide Prevention And Research) study

Background: It remains difficult to predict and prevent suicidal behaviour, despite growing understanding of the aetiology of suicidality. Clinical guidelines recommend that health care professionals develop a safety plan in collaboration with their high-risk patients, to lower the imminent risk of suicidal behaviour. Mobile health applications provide new opportunities for safety planning, and enable daily self-monitoring of suicide-related symptoms that may enhance safety planning. This paper presents the rationale and protocol of the Continuous Assessment for Suicide Prevention And Research (CASPAR) study. The aim of the study is two-fold: to evaluate the feasibility of mobile safety planning and daily mobile self-monitoring in routine care treatment for suicidal patients, and to conduct fundamental research on suicidal processes. Methods: The study is an adaptive single cohort design among 80 adult outpatients or day-care patients, with the main diagnosis of major depressive disorder or dysthymia, who have an increased risk for suicidal behaviours. There are three measurement points, at baseline, at 1 and 3 months after baseline. Patients are instructed to use their mobile safety plan when necessary and monitor their suicidal symptoms daily. Both these apps will be used in treatment with their clinician. Conclusion: The results from this study will provide insight into the feasibility of mobile safety planning and self-monitoring in treatment of suicidal patients. Furthermore, knowledge of the suicidal process will be enhanced, especially regarding the transition from suicidal ideation to behaviour

Reproducibility of lymphovascular space invasion (LVSI) assessment in endometrial cancer

Aims Lymphovascular space invasion (LVSI) in endometrial cancer (EC) is an important prognostic variable impacting on a patient's individual recurrence risk and adjuvant treatment recommendations. Recent work has shown that grading the extent of LVSI further improves its prognostic strength in patients with stage I endometrioid EC. Despite this, there is little information on the reproducibility of LVSI assessment in EC. Therefore, we designed a study to evaluate interobserver agreement in discriminating true LVSI from LVSI mimics (Phase I) and reproducibility of grading extent of LVSI (Phase II). Methods and results Scanned haematoxylin and eosin (H&E) slides of endometrioid EC (EEC) with a predefined possible LVSI focus were hosted on a website and assessed by a panel of six European gynaecological pathologists. In Phase I, 48 H&E slides were included for LVSI assessment and in Phase II, 42 H&E slides for LVSI grading. Each observer was instructed to apply the criteria for LVSI used in daily practice. The degree of agreement was measured using the two-way absolute agreement average-measures intraclass correlation coefficient (ICC). Reproducibility of LVSI assessment (ICC = 0.64, P < 0.001) and LVSI grading (ICC = 0.62, P < 0.001) in EEC was substantial among the observers. Conclusions Given the good reproducibility of LVSI, this study further supports the important role of LVSI in decision algorithms for adjuvant treatment

Randomized controlled trial on cardiovascular risk management by practice nurses supported by self-monitoring in primary care

BACKGROUND: Treatment goals for cardiovascular risk management are generally not achieved. Specialized practice nurses are increasingly facilitating the work of general practitioners and self-monitoring devices have been developed as counseling aid. The aim of this study was to compare standard treatment supported by self-monitoring with standard treatment without self-monitoring, both conducted by practice nurses, on cardiovascular risk and separate risk factors. METHODS: Men aged 50–75 years and women aged 55–75 years without a history of cardiovascular disease or diabetes, but with a SCORE 10-year risk of cardiovascular mortality ≥5% and at least one treatable risk factor (smoking, hypertension, lack of physical activity or overweight), were randomized into two groups. The control group received standard treatment according to guidelines, the intervention group additionally received pro-active counseling and self-monitoring (pedometer, weighing scale and/ or blood pressure device). After one year treatment effect on 179 participants was analyzed. RESULTS: SCORE risk assessment decreased 1.6% (95% CI 1.0–2.2) for the control group and 1.8% (1.2–2.4) for the intervention group, difference between groups was .2% (−.6–1.1). Most risk factors tended to improve in both groups. The number of visits was higher and visits took more time in the intervention group (4.9 (SD2.2) vs. 2.6 (SD1.5) visits p < .001 and 27 (P(25) –P(75):20–33) vs. 23 (P(25) –P(75):19–30) minutes/visit p = .048). CONCLUSIONS: In both groups cardiovascular risk decreased significantly after one year of treatment by practice nurses. No additional effect of basing the pro-active counseling on self-monitoring was found, despite the extra time investment. TRIAL REGISTRATION: trialregister.nl NTR218

When should root remnants and unrestorable broken teeth be extracted in frail older adults?

BACKGROUND: Many frail older adults have an unhealthy dentition; unrestorable broken teeth and root remnants with open root canals, commonly accompanied by periapical and periodontal inflammation, are often seen. Improving oral health in the growing group of frail older adults with remaining teeth is a considerable challenge for dental care professionals. Dentists are often uncertain how to deal with root remnants and unrestorable broken teeth in frail older adults. METHODS: The authors aim was to provide recommendations to dentists to help in their clinical decision making about the extraction or retention of roots remnants and broken teeth in frail older adults. CONCLUSIONS: Decisions about the extraction or retention of root remnants should made on the basis of preventing pain and oral discomfort, preventing severe inflammation, and preventing additional decline in oral health. Both root-related and patient-related factors are considered. PRACTICAL IMPLICATIONS: Decision-making trees can help dentists decide whether to extract root remnants and unrestorable broken teeth in frail older adults