Breathing straws

Following nasal, septal or endoscopic surgery, it is common practice to insert nasal packs in both nasal cavities to achieve haemostasis, if there has been any bleeding at the end of the procedure. However, such packs make it difficult for patients to breathe, mainly in the first post-operative night which leads to discomfort and poor sleep. To enable patients to breathe better with nasal packs in situ, we describe a simple technique using trimmed straws and wrapped Netcell® packs for post-operative care following septal surgery, rhinoplasty and endoscopic sinus surgery. These packs also assist suction of any blood or mucous from the post-nasal spac

Fettemboliesyndrom nach Unterschenkelfraktur trotz sofortiger Versorgung mit einem Fixateur externe: Zwei Kasuistiken und Literaturübersicht

Zusammenfassung: Das Auftreten eines Fettemboliesyndroms (FES) wird mit 0,9-2,2% als bekannte Komplikation bei Frakturen langer Röhrenknochen beschrieben. Die klassische Symptomtrias besteht aus Atemnot, neurologischen Symptomen und Petechien. Gemäß Literatur verringert eine frühzeitige Versorgung der Fraktur die Inzidenz eines FES. Diese Kasuistiken beschreiben jedoch interessanterweise die Entstehung eines FES trotz sofortiger operativer Versorgung der Unterschenkelfrakturen mittels Fixateur externe zweier völlig gesunder junger Männer. Somit sollte nach jeglichem Therapieverfahren bei der Versorgung langer Röhrenknochen an die Komplikation durch ein FES gedacht werde

Ear, nose and throat manifestations of Lyme disease

The manifestations of Lyme disease as they may present to the ENT surgeon are discussed. The most important ENT symptom is facial palsy. Particularly when combined with other cranial palsies, systemic illness or signs of meningeal irritation, the diagnosis must be considered. Three case reports are used to illustrate the presentation and diagnosis and treatment of Lyme disease. The characteristics of the disease are reviewed and the limitations of serological testing outlined. The literature has concentrated on bilateral or relapsing facial palsy. A review of palsies in Zurich that presented to the ENT clinic found only unilateral and partial palsies. The diagnosis should be considered in every case of facial palsy of unknown aetiology especially in childre

Asymptotic Level Density of the Elastic Net Self-Organizing Feature Map

Whileas the Kohonen Self Organizing Map shows an asymptotic level density following a power law with a magnification exponent 2/3, it would be desired to have an exponent 1 in order to provide optimal mapping in the sense of information theory. In this paper, we study analytically and numerically the magnification behaviour of the Elastic Net algorithm as a model for self-organizing feature maps. In contrast to the Kohonen map the Elastic Net shows no power law, but for onedimensional maps nevertheless the density follows an universal magnification law, i.e. depends on the local stimulus density only and is independent on position and decouples from the stimulus density at other positions.Comment: 8 pages, 10 figures. Link to publisher under http://link.springer.de/link/service/series/0558/bibs/2415/24150939.ht

On the relationship between sweet taste and seasonal body weight changes in a primate (Microcebus murinus)

The relationship between obesity and taste, especially sweet taste, has been and is of interest. From this point of view of a small primate, the lesser mouse lemur (Microcebus murinus), is of particular interest. It goes through a yearly cycle of physiological changes, one of which is an extreme variation in body weight of up to 100%. This occurs concomitantly with significant changes of the animal's liking for sucrose; measured by two-bottle preference tests, the threshold for sucrose changes from 28-45 in lean to 77-105 mM in obese animals. It is possible that a change in peripheral taste sensitivity might be the cause for these preference changes. To test this possibility we studied the ability of M.murinus to taste sucrose with electrophysiological and conditioned taste aversion techniques. The electrophysiological recordings were obtained from the chorda tympani proper nerve in two heavy and three lean animals. We did not record any difference between the two groups in their neural response to a series of sucrose concentrations. Conditioned taste aversion experiments with 200 mM sucrose as conditioning stimulus and 50 and 200 mM sucrose as test stimuli gave similar results. No difference was found between three heavy and four lean animals; both groups rejected the sucrose concentrations. The results support the notion that the seasonal variations in preference threshold to sucrose were unrelated to the ability of M.murinus to taste sucros

Limitations of balloon sinuplasty in frontal sinus surgery

Balloon sinuplasty is a tool that is used to treat selected patients with paranasal sinus pathologies. No studies have investigated the aetiology of failed access to the frontal sinus. The aim of our study was to specify the intraoperative technical failure rate and to analyse the aetiology of the failed access to predict potential technical difficulties before surgery. We retrospectively analysed the charts of patients who underwent balloon sinuplasty from November 2007 to July 2010 at three different ENT-Centres. CT-analysis of the patients with failed access was performed. Of the 104 frontal sinuses, dilation of 12 (12%) sinuses failed. The anatomy of all failed cases revealed variations in the frontal recess (frontoethmoidal-cell, frontal-bulla-cell or agger-nasi-cell) or osteoneogenesis. In one patient, a lymphoma was overlooked during a balloon only procedure. The lymphoma was diagnosed 6months later with a biopsy during functional endoscopic sinus surgery. In complex anatomical situations of the frontal recess, balloon sinuplasty may be challenging or impossible. In these situations, it is essential to have knowledge of classical functional endoscopic sinus surgery of the frontal recess area. The drawbacks of not including a histopathologic exam should be considered in balloon only procedure

Assessing Authentically – Learnings From Marketing Educators

This paper demonstrates the importance and role of authentic assessments, that replicate industry practice, within Higher Education marketing programmes. We answer the call from employers, that students need to gain much-needed employability skills, and we illustrate how such assessments can be created to enable the development of employability skills. We provide an overview of four case studies, to illustrate different forms of authentic assessments, the theory which was used to underpin the designs, the skills developed during the assessments, and the outcomes of the assessments. As we emerge from the COVID-19 pandemic, which forced a move to online assessments, it is timely that we reflect on the value of authentic assessments and adjust our practice

Age- and Gender-Specific Normative Data of Grip and Pinch Strength in a Healthy Adult Swiss Population

Assessment of hand strength is used in a wide range of clinical settings especially during treatment of diseases affecting the function of the hand. This investigation aimed to determine age- and gender-specific reference values for grip and pinch strength in a normal Swiss population with special regard to old and very old subjects as well as to different levels of occupational demand. Hand strength data were collected using a Jamar dynamometer and a pinch gauge with standard testing position, protocol and instructions. Analysis of the data from 1023 tested subjects between 18 and 96 years revealed a curvilinear relationship of grip and pinch strength to age, a correlation to height, weight and significant differences between occupational groups. Hand strength values differed significantly from those of other populations, confirming the thesis that applying normative data internationally is questionable. Age- and gender-specific reference values for grip and pinch strength are presented

On the sense of taste in two Malagasy Primates (Microcebus murinus and Eulemur mongoz)

The relationship between phylogeny and taste is of growing interest. In this study we present recordings from the chorda tympani proper (CT) nerve of two lemuriforme primates, the lesser mouse lemur (Microcebus murinus) and the mongoose lemur (Eulemur mongoz), to an array of taste stimuli which included the sweeteners acesulfame-K, alitame, aspartame, D-glucose, dulcin, monellin, neohesperidin dihydrochalcone (NHDHC), saccharin, sodium superaspartame, stevioside, sucralose (TGS), sucrose, suosan, thaumatin and xylitol, as well as the non-sweet stimuli NaC1, citric acid, tannin and quinine hydrochloride. In M.murinus the effects of the taste modifiers gymnemic acid and miraculin on the CT response were recorded. Conditioned taste aversion (CTA) experiments in M.murinus and two-bottle preference (TBP) tests in E.mongoz were also conducted. We found that all of the above tastants except thaumatin elicited a CT response in both species. The CTA technique showed that M.murinus generalized from sucrose to monellin but not to thaumatin. The intake of aspartame, ranging in concentration from 0.1 to 30 mM was measured in E.mongoz with TBP tests. At no concentration did we see a preference, but there was a significant rejection of 10 and 30 mM aspartame (P←0.025). Miraculin had no effects on the CT response to acids, and gymnemic acid did not selectively suppress the CT response to sucrose or that of any other sweeteners. The absence of ability to taste thaumatin in these species supports the dichotomy between catarrhine and non-catarrhine species. The difference in results with thaumatin and monellin indicate that their sweet moieties are not identical. It also points to a phylogenetic difference in taste within the prosimian group. Further, the results with aspartame indicate that the perception of sweetness from aspartame is limited to catarrhine species. Finally, neither miraculin nor gymnemic acid exhibit the same taste modifying effects in lemuriformes as they do in hominoidea. Thus the results with gymnemic acid and miraculin corroborate those obtained earlier in other prosimian

Main Memory Implementations for Binary Grouping

An increasing number of applications depend on efficient storage and analysis features for XML data. Hence, query optimization and efficient evaluation techniques for the emerging XQuery standard become more and more important. Many XQuery queries require nested expressions. Unnesting them often introduces binary grouping. We introduce several algorithms implementing binary grouping and analyze their time and space complexity. Experiments demonstrate their performance