To assess the current standard of consent for functional endoscopic sinus surgery and determine whether it complies with the law following the Montgomery ruling.
Ten complications following ...functional endoscopic sinus surgery were identified as common or serious from a literature search. Using questionnaires, ENT surgeons were asked which of these complications they discussed with patients, and patients were asked how seriously they regarded those risks using a five-point Likert scale.
Consent practice from 21 ENT surgeons and data from 103 patients were analysed. The 'reasonable patient' would expect to be consented for all risks, except for pain, and scarring or adhesions. Most ENT surgeons would routinely discuss all risks that were considered significant, except for facial paraesthesia (29 per cent) and damage to the nasolacrimal duct (24 per cent). A negative change in sense of smell was not mentioned by 29 per cent of surgeons.
This paper demonstrates that the current consent process for functional endoscopic sinus surgery is likely to be substandard medicolegally.
We have presented an algorithm of digital image watermarking for color images which we implemented in frequency domain. Before inserting the watermark, we added the Hamming codes row wise as well ...column wise in the intensity component of color image. Two encryption techniques were implemented on the ECC inserted watermark for its security. The pixel position for inserting the watermark was calculated using starting row and column number for that 8 × 8 block. Pixel embedding strength is calculated using criteria that low frequency is robust in general signal processing attacks, thus choosing less value to be embedded and vice-versa. Results show that the watermarking algorithm is robust against common signal processing attacks. The algorithm is tested against multiple attacks also.
Full text
Available for:
CEKLJ, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
The Ar36(n,γ)Ar37 (t1/2=35 d) and Ar38(n,γ)Ar39 (269 yr) reactions were studied for the first time with a quasi-Maxwellian (kT ~47 keV) neutron flux for Maxwellian average cross section (MACS) ...measurements at stellar energies. Gas samples were irradiated at the high-intensity Soreq applied research accelerator facility-liquid-lithium target neutron source and the Ar37/Ar36 and Ar39/Ar38 ratios in the activated samples were determined by accelerator mass spectrometry at the ATLAS facility (Argonne National Laboratory). The Ar37 activity was also measured by low-level counting at the University of Bern. Experimental MACS of Ar36 and Ar38, corrected to the standard 30 keV thermal energy, are 1.9(3) and 1.3(2) mb, respectively, differing from the theoretical and evaluated values published to date by up to an order of magnitude. The neutron-capture cross sections of Ar36,38 are relevant to the stellar nucleosynthesis of light neutron-rich nuclides; the two experimental values are shown to affect the calculated mass fraction of nuclides in the region A=36–48 during the weak s process. The new production cross sections have implications also for the use of Ar37 and Ar39 as environmental tracers in the atmosphere and hydrosphere.
Full text
Available for:
CMK, CTK, FMFMET, IJS, NUK, PNG, UL, UM
Painless hematuria is the presenting symptom in 85–90% of patients with bladder cancer.
To evaluate the efficacy of voided urinary cytology and ultrasonography in the diagnosis and follow up of ...bladder cancer compared to cystoscopy as a gold standard with reference to its grade. To recommend a protocol that improves the overall sensitivity and specificity of detection of new cases and recurrence in the follow up of patients with bladder cancer.
A prospective analysis of patients with painless hematuria and follow up patients of bladder cancer was done. They were subjected to voided urinary cytology and ultrasonography. The results were compared with the inferences drawn from cystoscopy and histopathological examination of the resected tumor, wherever applicable.
The sensitivity of urinary cytology and ultrasonography was 13.33% and 66.67%, respectively, compared to cystoscopy as a gold standard, whereas the specificity of urinary cytology and ultrasonography was 100% and 93.33%, respectively. Cytology was positive only in high grade cases.
Voided urinary cytology can be omitted as a screening test. Ultrasonography can be recommended as the initial imaging investigation for detection of bladder carcinoma in patients presenting with hematuria and for follow up of bladder carcinoma patients.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Upper pole nephrectomy has been the traditional surgical management of children with poorly functioning upper pole moieties in duplex renal collecting systems having ureteral ectopia and ureterocele. ...However, ablative surgery confers a risk of functional loss to the remnant moiety due to vasospasm or vascular injury. It was hypothesized that ipsilateral ureteroureterostomy (IUU) is a safe and feasible approach for the management of these patients and that residual function in the obstructed upper pole does not affect surgical outcomes.
All patients with duplex systems who underwent IUU between 2010 and 2016 were retrospectively reviewed. Patients were sorted into two groups based on pre-operative imaging: those having <10% upper pole moiety function (UPMF) and those having ≥ 10% UPMF. Outcomes assessed were postoperative complications (Clavien–Dindo classification), need for secondary surgery, and radiological outcomes.
The study cohort comprised 53 children with ectopia or ureterocele affecting the upper pole in a duplex system, 21 with UPMF <10% (median function 0% and median age 1.49 years) and 32 with UPMF ≥ 10% (median function 15% and median age 0.91 years). Median follow-up was 27.4 months and 27.6 months. In both the groups, prenatal hydronephrosis was the most common presentation (57% and 56%, respectively; p = 0.18) followed by urinary tract infection. Mann–Whitney U test comparing the two groups revealed no significant differences in any of the outcomes assessed. No patient required secondary surgery.
Ipsilateral ureteroureterostomy is a safe, definitive surgical intervention that preserves the renal architecture in children with duplex collecting systems regardless of upper pole function. Display omitted
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Employing the Argonne Fragment Mass Analyzer and the implantation-decay-decay correlation technique, a weak 0.50(21)% proton decay branch was identified in 108I for the first time. The 108I ...proton-decay width is consistent with a hindered l=2 emission, suggesting a d52 origin. Using the extracted 108I proton-decay Q value of 597(13) keV, and the Qα values of the 108I and 107Te isotopes, a proton-decay Q value of 510(20) keV for 104Sb was deduced. Similarly to the 112,113Cs proton-emitter pair, the Qp(I108) value is lower than that for the less-exotic neighbor 109I, possibly due to enhanced proton-neutron interactions in N≈Z nuclei. In contrast, the present Qp(Sb104) is higher than that of 105Sb, suggesting a weaker interaction energy. For the present Qp(Sb104) value, network calculations with the one-zone X-ray burst model Mazzocchi et al. (2007) 18 predict no significant branching into the Sn-Sb-Te cycle at 103Sn.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
We report the first observation of the Xe108→Te104→Sn100 α-decay chain. The α emitters, Xe108 Eα=4.4(2) MeV, T1/2=58−23+106 μs and Te104 Eα=4.9(2) MeV, T1/2<18 ns, decaying into doubly magic Sn100 ...were produced using a fusion-evaporation reaction Fe54(Ni58,4n)Xe108, and identified with a recoil mass separator and an implantation-decay correlation technique. This is the first time α radioactivity has been observed to a heavy self-conjugate nucleus. A previous benchmark for study of this fundamental decay mode has been the decay of Po212 into doubly magic Pb208. Enhanced proton-neutron interactions in the N=Z parent nuclei may result in superallowed α decays with reduced α-decay widths significantly greater than that for Po212. From the decay chain, we deduce that the α-reduced width for Xe108 or Te104 is more than a factor of 5 larger than that for Po212.
Full text
Available for:
CMK, CTK, FMFMET, IJS, NUK, PNG, UL, UM
Using inelastic α-scattering at extremely forward angles, including 0°, the strength distributions of the isoscalar giant monopole resonance (ISGMR) have been measured in the 204,206,208Pb isotopes ...in order to examine the proposed mutually enhanced magicity (MEM) effect on the nuclear incompressibility. The MEM effect had been suggested as a likely explanation of the “softness” of nuclear incompressibility observed in the ISGMR measurements in the Sn and Cd isotopes. Our experimental results rule out any manifestation of the MEM effect in nuclear incompressibility and leave the question of the softness of the open-shell nuclei unresolved still.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
PDF
