Congenital aural atresia is the failure of development of the external auditory canal. It usually occurs in conjunction with microtia, which is the malformation of the auricle due to a failure of ...development of the external ear. Aural atresia, with or without microtia, may significantly affect the hearing and social life of the patients. It is important for every medical practitioner to be aware of the possible treatment options for hearing rehabilitation in this group of patients. In the era of modern technology, new choices, including Bone-Anchored Hearing Aid (BAHA) (Cochlear Ltd. and Oticon Medical), Vibrant Soundbridge (VSB) (MED-EL, Innsbruck, Austria), and Bonebridge system (BB) (MED-EL, Innsbruck, Austria), provide high-end alternatives to traditional Bone Conduction Hearing Aid and Auditory Canal Reconstruction. All these options have advantages and disadvantages, and they are appropriate for different patients and/or at different ages. This paper aims to provide an overview of the management of hearing rehabilitation in congenital aural atresia patients and a discussion of each treatment option.
Objective: Among intravesical instillation protocol in patients with non-muscle-invasive bladder cancer (NMIBC), chemotherapy agents have been widely used during the bacillus Calmette-Guérin (BCG) ...shortage era since the patient might under the risk of BCG discontinuation. This study evaluates the efficacy of incomplete BCG instillation compared with pure chemotherapy instillation protocol. Materials and Methods: Patients newly diagnosed with intermediate- and high-risk NMIBC who received incomplete BCG intravesical instillation or chemotherapy instillation were retrospectively included. Patients were divided into three groups according to different intravesical instillation schedules: BCG only, BCG + Chemo, and Chemo only. Comparisons between these three groups were performed. Bladder recurrence-free survival (RFS) was analyzed as the primary endpoint. Results: A total of 475 patients who received intravesical instillations were enrolled. Compared to the Chemo only group, the BCG + Chemo group had significantly better bladder RFS (p = 0.027). Multivariate analysis of recurrence revealed the BCG + Chemo regimen has a hazard ratio 0.381 (95% CI 0.154– 0.941, p = 0.037). The total instillation number > 12 was associated with better RFS (p = 0.001) compared with other instillation numbers. Conclusion: For NMIBC patients facing the risk of unexpected BCG instillation interruption, instead of starting instillation with chemotherapy agents, receiving BCG first till stoppage then shifting to chemotherapy agents is recommended.
To investigate whether the approach used to the nasopharynx to perform a salvage nasopharyngectomy for recurrent or residual nasopharyngeal carcinoma influences survival.
A retrospective case series.
...Eighty patients underwent a nasopharyngectomy via a transpalatal, maxillary swing, or midfacial degloving approach. Local progression-free, locoregional progression-free, and overall survival rates were calculated for each approach.
For the whole group (N = 80), there were no significant differences in the survival rates between the three approaches. For the subgroup of patients with recurrent T1 and T2 tumors (n = 68), the local progression-free and locoregional progression-free survival rates were significantly better when a maxillary swing approach was used than when a midfacial degloving approach was used.
The maxillary swing approach is associated with significantly better survival rates than the midfacial degloving approach when used to perform a salvage nasopharyngectomy for residual or recurrent T1 and T2 nasopharyngeal carcinoma.
The discovery of cell-free fetal DNA in maternal plasma has opened up new possibilities for noninvasive prenatal diagnosis and monitoring. Among the fetal markers that have been described, ...methylation markers are sex and polymorphism independent. Methylation-sensitive restriction endonucleases are commonly used to digest hypomethylated DNA molecules, and the hypermethylated molecules remain intact for detection. The positive detection of the cleaved hypomethylated molecules would be useful for certain targets but has not been reported.
The use of a stem-loop primer in microRNA detection has previously been described. In this study, DNA assays were designed and performed on maternal plasma, which contained the hypomethylated placental serpin peptidase inhibitor, clade B (ovalbumin), member 5 (SERPINB5; maspin) gene in an excess background of hypermethylated maternal SERPINB5. Detection of the enzyme-digested placenta-derived hypomethylated SERPINB5 molecules was achieved by performing stem-loop extension followed by real-time PCR on maternal plasma. The placental origin of the stem-loop-extended SERPINB5 molecules was confirmed by genotyping.
From the real-time PCR results on maternal plasma, stem-loop-extended SERPINB5 promoter sequences were detectable in all 11 enzyme-digested predelivery maternal plasma samples. Postpartum clearance was demonstrated. In 9 cases in which the fetal and maternal SERPINB5 genotypes were distinguishable, the placental-specific genotypes were detected in all predelivery maternal plasma samples.
Detection of restriction enzyme-digested hypomethylated placental DNA molecules in maternal plasma by the use of a stem-loop primer represents a novel approach in fetal epigenetic marker detection. The analytical approach may also be generally applicable to the detection of restriction enzyme-digested nucleic acid fragments.
To improve the understanding of the structure network of chalcogenide glass, we report an investigation of the structure and vibrational property of the Ge-S-Br system chalcogenide glass. The ...structural origin was interpreted by the result of ab initio calculation performed on the basic units such as ethane-like(ETH) structure(Ge2S6 and Ge2Br6),edge-sharing(ES) structure Ge2S2SnBr4-n (n=0,1,2,3,4) and isolated GeSnBr4-n tetrahedron (n=0,1,2,3,4), which represent the local structure of Ge-S-Br glassy system. In addition, We have compared the experimental spectra of GeS2, GeS3Br, GeSBr2 glasses and liquid GeBr4 to the calculated main vibrational modes of basic units by ab initio calculation. The calculated vibrational modes of the GeSnBr4-n cluster are assigned by group theory. Moreover, the symmetrical stretching modes related to the Ge-S and Ge-Br bond are in accordance with the vibrational coupling theory. The variation of calculated main vibrational modes of GeSmBrn clusters reveals the structure formations of Ge-S-Br glassy system with different S/Br ratios, which can be in agreement with vibrational spectra of Ge-S-Br glass.
Solar (UVA + UVB) exposure was assessed using the Gafchromic EBT3 film. The coloration change was represented by the net reflective optical density (Net ROD). Through calibrations against a UV-tube ...lamp, operational relationships were obtained between Net ROD and the (UVA + UVB) exposures (in J cm(-2) or J m(-2)). The useful range was from ∼0.2 to ∼30 J cm(-2). The uniformity of UV irradiation was crucial for an accurate calibration. For solar exposures ranging from 2 to 11 J cm(-2), the predicted Net ROD agreed with the recorded values within 9%, while the predicted exposures agreed with the recorded values within 15%.
Currently, mould design and the setting of the process parameters of transfer moulding for electronic packages are done manually in a trial-and-error manner. The effectiveness of the setting of ...parameters is largely dependent on the experience of engineers. The paper describes an intelligent process design system for transfer moulding of electronic packages that is used to determine optimal mould design parameters and the setting of the process parameters mainly based on case-based reasoning, artificial neural networks and a multiobjective optimization scheme. The system consists of two modules: a case-based reasoning module and a process optimization module. The former module is used to determine initial mould design parameters and the setting of the process parameters while the latter module is used to determine optimal mould design parameters and the setting of the process parameters. Implementation of the intelligent system has demonstrated that the time for the determination of optimal mould design parameters and the setting of the process parameters can be greatly reduced, and the setting of parameters recommended by the system can contribute to the good quality of moulded packages.
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