Topical analgesia for acute otitis media

BACKGROUND: Acute otitis media (AOM) is a spontaneously remitting disease of which pain is the most distressing symptom. Antibiotics are now known to have less benefit than previously assumed. Topical pain relief may be a satisfactory intervention for AOM sufferers and encourage clinicians to prescribe fewer antibiotics. OBJECTIVES: To assess the effectiveness of topical analgesia for AOM in adults and children. SEARCH METHODS: For this second update we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1), Ovid MEDLINE (2008 to February Week 1 2011), Ovid MEDLINE (In‐Process & Other Non‐Indexed Citations 10 February 2011), Ovid EMBASE (2008 to 2011 Week 05), EBSCO CINAHL (2008 to 4 February 2011) and Ovid AMED (2008 to April 2011). SELECTION CRITERIA: Double‐blind randomised controlled trials (RCTs) or quasi‐RCTs comparing an otic preparation with an analgesic effect (excluding antibiotics) versus placebo or an otic preparation with an analgesic effect (excluding antibiotics) versus any other otic preparation with an analgesic effect, in adults or children presenting at primary care settings with AOM without perforation. DATA COLLECTION AND ANALYSIS: Three review authors independently screened studies, assessed trial quality and extracted data. Attempts to obtain additional information from the trial authors of the included trials were unsuccessful. MAIN RESULTS: Five trials including 391 children aged three to 18 years met our criteria. Two studies (117 children) compared anaesthetic ear drops versus placebo immediately at diagnosis. All children received some form of oral pain relief. In all five studies it was clear that ear pain diminishes rapidly for most sufferers. Nevertheless there was a statistically significant difference in the proportion of children achieving a 50% reduction in pain in favour of anaesthetic drops 10 minutes after instillation (risk ratio (RR) 2.13, 95% confidence interval (CI) 1.19 to 3.80) and 30 minutes after instillation (RR 1.43, 95% CI 1.12 to 1.81) on the day AOM was diagnosed but not at 20 minutes (RR 1.24, 95% CI 0.88 to 1.74). Three trials (274 children) compared anaesthetic ear drops with naturopathic herbal ear drops. Naturopathic drops were favoured 15 and 30 minutes after instillation, one to three days after diagnosis, but the differences were not statistically significant. Only one trial looked at adverse reactions and found none. Overall the findings of this review are based on trial evidence that is at low or unclear risk of bias. AUTHORS' CONCLUSIONS: Evidence from five RCTs, only two of which addressed the most relevant question of primary effectiveness, provides limited evidence that ear drops are effective 30 minutes after administration in older children with AOM. Uncertainty exists as to the magnitude of this effect and more high‐quality studies are needed

An extension problem for the CR fractional Laplacian

We show that the conformally invariant fractional powers of the sub-Laplacian on the Heisenberg group are given in terms of the scattering operator for an extension problem to the Siegel upper halfspace. Remarkably, this extension problem is different from the one studied, among others, by Caffarelli and Silvestre.Comment: 33 pages. arXiv admin note: text overlap with arXiv:0709.1103 by other author

A recollimation shock 80 mas from the core in the jet of the radio galaxy 3C120: Observational evidence and modeling

We present Very Long Baseline Array observations of the radio galaxy 3C120 at 5, 8, 12, and 15 GHz designed to study a peculiar stationary jet feature (hereafter C80) located ~80 mas from the core, which was previously shown to display a brightness temperature ~600 times lager than expected at such distances. The high sensitivity of the images -- obtained between December 2009 and June 2010 -- has revealed that C80 corresponds to the eastern flux density peak of an arc of emission (hereafter A80), downstream of which extends a large (~20 mas in size) bubble-like structure that resembles an inverted bow shock. The linearly polarized emission closely follows that of the total intensity in A80, with the electric vector position angle distributed nearly perpendicular to the arc-shaped structure. Despite the stationary nature of C80/A80, superluminal components with speeds up to ~3 c have been detected downstream from its position, resembling the behavior observed in the HST-1 emission complex in M87. The total and polarized emission of the C80/A80 structure, its lack of motion, and brightness temperature excess are best reproduced by a model based on synchrotron emission from a conical shock with cone opening angle \eta=10 degrees, jet viewing angle \theta=16 degrees, a completely tangled upstream magnetic field, and upstream Lorentz factor \gamma=8.4. The good agreement between our observations and numerical modeling leads us to conclude that the peculiar feature associated with C80/A80 corresponds to a conical recollimation shock in the jet of 3C120 located at a de-projected distance of ~190 pc downstream from the nucleus.Comment: Accepted for publication in Ap

The Impact of Media Influence About Hair Texture on Internalized Racial Oppression, Ethnic Identity, and Self-Efficacy

Problem African American women and matters of importance pertaining to African American women are understudied and lacking within research. Understanding the ways in which majority culture media influences aspects related to women of color, especially those pertaining to hair texture, and their impact is essential to bring about awareness and mobilize changes that will positively affect the lives of Black women. Representation matters. When minority women of any culture value the majority culture they tend to devalue themselves. Representation matters and is important because if self-esteem, worth, goodness, and virtue is only portrayed in majority culture aesthetics, internalization of those influential concepts of good and bad takes place, and that begins to transform and seep into every orifice of the Black women’s life. The impact of beauty on power and economic and social mobility leaves many African American women disenfranchised and disempowered because the definition of beauty, especially as it pertains to hair texture, is narrow and the standard of beauty by cultural and societal standards denies benefits, economic, social, education, vocation, and otherwise, to those who are not defined as such. Method Participants completed surveys that measured a) media influence about hair texture, b) internalized racial oppression, c) ethnic identity, and d) self-efficacy. This work employed structural equation modeling to test the hypothesized model for the impact of media influence about hair texture on internalized racial oppression, ethnic identity, and self-efficacy; as well as three within group models for ethnic identification, hair texture, and skin tone. Results Structural equation modeling indicated that the original hypothesized theoretical model was a poor fit to the data. Therefore, the model was revised on the basis of theory and modification indices. The revised model revealed that media influence about hair texture had a positive direct effect on internalized racial oppression. Media influence about hair texture had a positive direct effect on ethnic identity but also a negative direct effect on ethnic identity as it pertains to affirmation, commitment, and belonging. Media influence about hair texture had a negative direct effect on self-efficacy. The revised model was also well fitted to the between groups ethnic identification, hair texture, and skin tone with the impact of media influence about hair texture on internalized racial oppression being two times greater in African American women than black women. Conclusions This study added to the limited body of literature concerning African American women and the role that media influence plays on internalized racial oppression, aspects of ethnic identity, and self-efficacy. It suggests that high media influence about hair texture contribute to high levels of internalized racial oppression; low levels of ethnic affirmation, commitment, and belonging; and low levels of self-efficacy. It also confirmed that media influence about hair texture on internalized racial oppression, ethnic identity, and self-efficacy impacts African American and Black ethnically identified women, hair textures, and skin tones differently. In particular, this study suggests that higher levels of media influence increases minorities’ adoption of racist messages; higher levels of media influence lower one’s confidence of success and achievement; and higher levels of media influence lower minorities’ desire to affirm, belong, and commit to their ethnic group

The first meeting of the European Register of Cystic Echinococcosis (ERCE)

6 páginas, 3 figuras, 1 tablaCystic echinococcosis (CE) is a zoonotic parasitic disease endemic in southern and eastern European countries. The true prevalence of CE is difficult to estimate due to the high proportion of asymptomatic carriers who never seek medical attention and to the underreporting of diagnosed cases, factors which contribute to its neglected status. In an attempt to improve this situation, the European Register of Cystic Echinococcosis (ERCE), was launched in October 2014 in the context of the HERACLES project. ERCE is a prospective, observational, multicentre register of patients with probable or confirmed CE. The first ERCE meeting was held in November 2015 at the Italian National Institute of Health (Istituto Superiore di Sanita, ISS) in Rome, to bring together CE experts currently involved in the Register activities, to share and discuss experiences, and future developments. Although the Register is still in its infancy, data collected at the time of writing this report, had outnumbered the total of national cases reported by the European endemic countries and published by the European Centre for Disease Prevention and Control in 2015. This confirms the need for an improved reporting system of CE at the European level. The collection of standardized clinical data and samples is expected to support a more rational, stage-specific approach to clinical management, and to help public authorities harmonize reporting of CE. A better understanding of CE burden in Europe will encourage the planning and implementation of public health policies toward its control.This research received funding from the European Community’s Seventh Framework Programme under the grant agreement 602051 (Project HERACLES: Human cystic Echinococcosis ReseArch in CentraL and Eastern Societies; http:// www.heracles-fp7.eu/).Peer reviewe

Determining the regimes of cold and warm inflation in the susy hybrid model

The SUSY hybrid inflation model is found to dissipate radiation during the inflationary period. Analysis is made of parameter regimes in which these dissipative effects are significant. The scalar spectral index, its running, and the tensor-scalar ratio are computed in the entire parameter range of the model. A clear prediction for strong dissipative warm inflation is found for n_S-1 \simeq 0.98 and a low tensor-scalar ratio much below 10^{-6}. The strong dissipative warm inflation regime also is found to have no \eta-problem and with the field amplitude much below the Planck scale. As will be discussed, this has important theoretical implications in permitting a much wider variety of SUGRA extensions to the basic model.Comment: paragraph added at the end of section V; references added; accepted for publication in Phys. Rev.

Prevalence of incidental breast cancer and precursor lesions in autopsy studies: A systematic review and meta-analysis

Abstract Background Autopsy studies demonstrate the prevalence pool of incidental breast cancer in the population, but estimates are uncertain due to small numbers in any primary study. We aimed to conduct a systematic review of autopsy studies to estimate the prevalence of incidental breast cancer and precursors. Methods Relevant articles were identified through searching PubMed and Embase from inception up to April 2016, and backward and forward citations. We included autopsy studies of women with no history of breast pathology, which included systematic histological examination of at least one breast, and which allowed calculation of the prevalence of incidental breast cancer or precursor lesions. Data were pooled using logistic regression models with random intercepts (non-linear mixed models). Results We included 13 studies from 1948 to 2010, contributing 2363 autopsies with 99 cases of incidental cancer or precursor lesions. More thorough histological examination (≥20 histological sections) was a strong predictor of incidental in-situ cancer and atypical hyperplasia (OR = 126·8 and 21·3 respectively, p < 0·001), but not invasive cancer (OR = 1·1, p = 0·75). The estimated mean prevalence of incidental cancer or precursor lesion was 19·5% (0·85% invasive cancer + 8·9% in-situ cancer + 9·8% atypical hyperplasia). Conclusion Our systematic review in ten countries over six decades found that incidental detection of cancer in situ and breast cancer precursors is common in women not known to have breast disease during life. The large prevalence pool of undetected cancer in-situ and atypical hyperplasia in these autopsy studies suggests screening programs should be cautious about introducing more sensitive tests that may increase detection of these lesions

Voltage-controlled electron tunnelling from a single self-assembled quantum dot embedded in a two-dimensional-electron-gas-based photovoltaic cell

We perform high-resolution photocurrent (PC) spectroscopy to investigate resonantly the neutral exciton ground-state (X0) in a single InAs/GaAs self-assembled quantum dot (QD) embedded in the intrinsic region of an n-i-Schottky photodiode based on a two-dimensional electron gas (2DEG), which was formed from a Si delta-doped GaAs layer. Using such a device, a single-QD PC spectrum of X0 is measured by sweeping the bias-dependent X0 transition energy through that of a fixed narrow-bandwidth laser via the quantum-confined Stark effect (QCSE). By repeating such a measurement for a series of laser energies, a precise relationship between the X0 transition energy and bias voltage is then obtained. Taking into account power broadening of the X0 absorption peak, this allows for high-resolution measurements of the X0 homogeneous linewidth and, hence, the electron tunnelling rate. The electron tunnelling rate is measured as a function of the vertical electric field and described accurately by a theoretical model, yielding information about the electron confinement energy and QD height. We demonstrate that our devices can operate as 2DEG-based QD photovoltaic cells and conclude by proposing two optical spintronic devices that are now feasible.Comment: 34 pages, 11 figure