Consistent Technique Limits Suspension Laryngoscopy Complications

ntroduction Suspension laryngoscopy (SL) is a commonly performed procedure among otolaryngologists. Several studies have shown that adverse effects occur regularly with SL. Objective To evaluate the postoperative complications of SL, and to determine if protecting the dentition and the oral mucosa and limiting suspension times decrease the overall incidence of oral cavity and pharyngeal complications of SL. Methods All of the cases of SL performed by 1 surgeon from November 2008 through September 2014 were retrospectively reviewed. A consistent technique for dental and mucosal protection was utilized, and suspension times were strictly limited to 30 consecutive minutes. The incidence of postoperative complications was calculated and analyzed with respect to gender, smoking status, dentition, laryngoscope type, and suspension system. Results A total of 213 consecutive SL cases were reviewed, including 174 patients (94 male, 80 female). The overall postoperative complication rate was of 3.8%. Four patients experienced tongue-related complications, two experienced oral mucosal alterations, one had a dental injury, and one experienced a minor facial burn. The complication incidence was greater with the Zeitels system (12.5%) compared with the Lewy suspension system (3.3%), although it was not significant (p = 0.4). Likewise, the association of complications with other patient factors was not statistically significant. Conclusion Only 8 out of 213 cases in the present series experienced complications, which is significantly less than the complication rates observed in other reports. Consistent and conscientious protection of the dentition and of the oral mucosa and limiting suspension times to 30 minutes are factors unique to our series that appear to reduce complications in endolaryngeal surgery

Temporal Dynamics of Hypothesis Generation: The Influences of Data Serial Order, Data Consistency, and Elicitation Timing

The pre-decisional process of hypothesis generation is a ubiquitous cognitive faculty that we continually employ in an effort to understand our environment and thereby support appropriate judgments and decisions. Although we are beginning to understand the fundamental processes underlying hypothesis generation, little is known about how various temporal dynamics, inherent in real world generation tasks, influence the retrieval of hypotheses from long-term memory. This paper presents two experiments investigating three data acquisition dynamics in a simulated medical diagnosis task. The results indicate that the mere serial order of data, data consistency (with previously generated hypotheses), and mode of responding influence the hypothesis generation process. An extension of the HyGene computational model endowed with dynamic data acquisition processes is forwarded and explored to provide an account of the present data

Next Generation Higgs Bosons: Theory, Constraints and Discovery Prospects at the Large Hadron Collider

Particle physics model building within the context of string theory suggests that further copies of the Higgs boson sector may be expected. Concerns regarding tree-level flavor changing neutral currents are easiest to allay if little or no couplings of next generation Higgs bosons are allowed to Standard Model fermions. We detail the resulting general Higgs potential and mass spectroscopy in both a Standard Model extension and a supersymmetric extension. We present the important experimental constraints from meson-meson mixing, loop-induced $b\to s\gamma$ decays and LEP2 direct production limits. We investigate the energy range of valid perturbation theory of these ideas. In the supersymmetric context we present a class of examples that marginally aids the fine-tuning problem for parameter space where the lightest Higgs boson mass is greater than the Standard Model limit of 114 GeV. Finally, we study collider physics signatures generic to next generation Higgs bosons, with special emphasis on $Ah\to hhZ\to 4b+2l$ signal events, and describe the capability of discovery at the Large Hadron Collider.Comment: 43 pages, 12 figures; v3: minor corrections, published in Physical Review

WeFaceNano:a user-friendly pipeline for complete ONT sequence assembly and detection of antibiotic resistance in multi-plasmid bacterial isolates

Background: Bacterial plasmids often carry antibiotic resistance genes and are a significant factor in the spread of antibiotic resistance. The ability to completely assemble plasmid sequences would facilitate the localization of antibiotic resistance genes, the identification of genes that promote plasmid transmission and the accurate tracking of plasmid mobility. However, the complete assembly of plasmid sequences using the currently most widely used sequencing platform (Illumina-based sequencing) is restricted due to the generation of short sequence lengths. The long-read Oxford Nanopore Technologies (ONT) sequencing platform overcomes this limitation. Still, the assembly of plasmid sequence data remains challenging due to software incompatibility with long-reads and the error rate generated using ONT sequencing. Bioinformatics pipelines have been developed for ONT-generated sequencing but require computational skills that frequently are beyond the abilities of scientific researchers. To overcome this challenge, the authors developed ‘WeFaceNano’, a user-friendly Web interFace for rapid assembly and analysis of plasmid DNA sequences generated using the ONT platform. WeFaceNano includes: a read statistics report; two assemblers (Miniasm and Flye); BLAST searching; the detection of antibiotic resistance- and replicon genes and several plasmid visualizations. A user-friendly interface displays the main features of WeFaceNano and gives access to the analysis tools. Results: Publicly available ONT sequence data of 21 plasmids were used to validate WeFaceNano, with plasmid assemblages and anti-microbial resistance gene detection being concordant with the published results. Interestingly, the “Flye” assembler with “meta” settings generated the most complete plasmids. Conclusions: WeFaceNano is a user-friendly open-source software pipeline suitable for accurate plasmid assembly and the detection of anti-microbial resistance genes in (clinical) samples where multiple plasmids can be present.</p

Single-level degenerative cervical disc disease and driving disability: Results from a prospective, randomized trial

Study Design Post hoc analysis of prospective, randomized trial. Objective To investigate the disability associated with driving and single-level degenerative, cervical disc disease and to investigate the effect of surgery on driving disability. Methods Post hoc analysis of data obtained from three sites participating in a multicenter, randomized, controlled trial comparing cervical disc arthroplasty (TDA) with anterior cervical discectomy and fusion (ACDF). The driving subscale of the Neck Disability Index (NDI) was analyzed for all patients. A dichotomous severity score was created from the NDI. Statistical comparisons were made within and between groups. Results Two-year follow-up was available for 118/135 (87%) patients. One half of the study population (49.6%) reported moderate or severe preoperative driving difficulty. This disability associated with driving was similar among the two groups (ACDF: 2.5 ± 1.1, TDA: 2.6 ± 1.0, p = 0.646). The majority of patients showed improvement, with no or little driving disability, at the sixth postoperative week (ACDF: 75%, TDA: 90%, p = 0.073). At no follow-up point did a difference exist between groups according to the severity index. Conclusions Many patients suffering from radiculopathy or myelopathy from cervical disc disease are limited in their ability to operate an automobile. Following anterior cervical spine surgery, most patients are able to return to comfortable driving at 6 weeks

15N Values in Crassostrea virginica Shells Provides Early Direct Evidence for Nitrogen Loading to Chesapeake Bay

Crassostrea virginica is one of the most common estuarine bivalves in the United States? east coast and is frequently found in archaeological sites and sub-fossil deposits. Although there have been several sclerochronological studies on stable carbon and oxygen isotopes in the shells of this species, less is known about ?15N values within their shells, which could be a useful paleoenvironmental proxy to assess estuarine nitrogen dynamics. Modern C. virginica samples were collected in Chesapeake Bay for comparison with archaeological shells from nearby sites ranging in age from ~100 to 3,200 years old. Left valves were sampled by milling the hinge area and the resulting powder was analyzed for %N and ?15N values. Comparison of ?15N values between C. virginica shells shows relatively constant values from ~1250 BC to ~1800 AD. After ~1800 AD, there are rapid increases in 15N enrichment in the shells, which continue to increase in value up to the modern shell values. The increase in ?15N values is evidence of early anthropogenic impact in Chesapeake Bay. These results corroborate the observation that coastal nitrogen pollution occurred earlier than the 19th century and support the use of oyster shell ?15N values as a useful environmental proxy

Excavations and the afterlife of a professional football stadium, Peel Park, Accrington, Lancashire: towards an archaeology of football

Association football is now a multi-billion dollar global industry whose emergence spans the post-medieval to the modern world. With its professional roots in late 19th-century industrial Lancashire, stadiums built for the professionalization of football first appear in frequency in the North of England. While many historians of sport focus on consumerism and ‘topophilia’ (attachment to place) regarding these local football grounds, archaeological research that has been conducted on the spectator experience suggests status differentiation within them. Our excavations at Peel Park confirm this impression while also showing a significant afterlife to this stadium, particularly through children’s play

Using Forages to Conserve Water in Semi-Arid Irrigated Cropping Systems

The Texas High Plains are part of the largest, contiguously irrigated cropland in the USA, and draws water from the Ogallala aquifer. High crop prices, increased demand for maize for ethanol production, and severe drought have increased water depletion rates. Research has shown that integrating forages and grazing cattle into the cotton-dominant cropping system can reduce overall water use (Allen et al. 2012) while still offering farmers positive net returns (Johnson et al. 2013). Integrating forages with row crops also reduces needs for nitrogen (N) fertilizer, rebuilds soil organic matter (Acosta-Martinez et al. 2010), and reduces fossil energy use and associated carbon emissions (Zilverberg et al. 2012). Advances in irrigation delivery that minimize evaporation losses and the use of irrigation scheduling tools that factor in soil water availability and crop needs for evapotranspiration (ET) are keys to improving whole-system water use efficiency. The Texas Alliance for Water Conservation (TAWC) is a multi-disciplinary team of agricultural scientists, resource managers, and producers formed in 2004 to demonstrate tools and irrigation technologies for conserving water on commercial farms in the Southern High Plains of Texas. We report progress in demonstrating advances in water conservation in a region where production of forages and livestock can help alleviate the decline in ground water supplies used for crop irrigation