96,989 research outputs found
Management of recurrent otitis media with rapid maxillary expansion: our experience
No full textManagement of recurrent otitis media with rapid maxillary expansion: our experience. Problems/objectives: Recurrent otitis media is a frequent problem in the paediatric population. It is commonly associated with adenoid hypertrophy and occasionally with skeletal development syndrome characterised by maxillary anatomical alterations.
When this syndrome is present in conjunction with adenoid hypertrophy, surgical management with adenoidectomy
and/or myringotomy with ventilation tube positioning does not necessarily ensure a resolution of conductive hearing disorders.
Methodology: We used maxillary rapid expansion in 27 children with a mean age of 7 years affected by recurrent otitis media associated with skeletal development syndrome and adenoid hypertrophy.
Results: Rapid maxillary expansion acting directly on the median palatine suture expands the palate and the nasal floor, improving nasal breathing. In addition, maxillary expansion stretches elevator and tensor palatine muscles, helping to restore normal Eustachian tube function, even in the presence of adenoid hypertrophy.
Conclusion: In our opinion, rapid maxillary expansion results in an improvement in skeletal-facial abnormalities associated with skeletal development syndrome and it can be considered a valid treatment for preventing recurrent otitis media in children affected by maxillary anatomical alterations
Otoneurological management of petrous apex cholesterol granuloma
No full textObjective: The aim of the study is to review the management of petrous apex cholesterol granuloma. The surgical approaches for drainage or total removal and the wait and see policy were analyzed, and outcomes were evaluated. Methods: Retrospective charts of 27 patients managed for petrous apex cholesterol granuloma with a minimum follow-up of 12 months were analyzed in a quartenary skull base center. Presenting symptoms and signs were recorded, and radiologic imaging was evaluated. Management options included wait and see policy and surgery by several approaches. Results: The mean age of patients affected by the lesion was 38.8 years. The mean follow-up was 56.7 months. Patients complained of hearing loss, vertigo, tinnitus, diplopia, hemifacial spasm, trigeminal neuralgia, and facial paresthesia. Twelve patients were managed by wait and see policy, and in this category, only one lesion showed growth during the follow-up. Depending upon size and location, 15 patients were surgically treated by infralabyrinthine approach (9 patients), infratemporal type B approach (3 patients), combined infratemporal type B transotic approach (2 patients), and transotic approach (1 patient). One recurrence was recorded during the follow-up. Conclusions: Radiologic evaluation is required for diagnosis and management. Patients with good hearing can be treated by infralabyrinthine approach. Infratemporal fossa type B approach is advocated in patients with extensive disease and internal carotid artery involvement. Wait and see policy is recommended for asymptomatic cases. Drainage and permanent ventilation are the goals of treatment. Complete removal is indicated in selected cases where placement of drainage tube is not feasible. © 2009 Elsevier Inc. All rights reserved
FINANCING COMMUNITY FACILITIES: A CASE STUDY OF THE PARKS AND RECREATIONAL GENERAL OBLIGATION BOND MEASURE OF SAN JOSE, CALIFORNIA
No full textThis study of the City of San Jose’s Parks and Recreation General Obligation (GO) Bond Measure seeks to identify the politics-, management-, and planning-related lessons learned by the City as it developed its community facilities using the GO bonds proceeds. The study finds that these lessons include: be conservative in what you promise the residents; be prepared for changes in economic environment by identifying supplementary funding sources should the primary source not yield adequate funds; make sure that the jurisdiction is organizationally capable of handling the increased workload; and prepare detailed project plans prior to the bond issuance.Community Infrastructure and Services; Municipal Bonds; Public Finance
Active tonal and broadband noise control tests on a composite panel wth smart foam treatment
No full textGopal P. Mathur, C.R. Fuller, M. Kidne
Absolute and Conditional Convergence: Its Speed for Selected Countries for 1961--2001
No full textThe study gives the theoretical justification for the per capita growth equations using Solovian model(1956) and its factor accumulation assumptions. The different forms of the per capita growth equation is used to test for 'absolute convergence' and 'conditional convergence' hypotheses and also work out the speed of absolute and conditional convergence for selected countries from 1961-2001.Only EU and East Asian countries together have shown uniform evidence of absolute convergence in all periods. While EU as a region has shown significant evidence of absolute convergence in two periods, 1961-2001 and 1970-2001, there is no convincing statistical evidence in favor of absolute convergence in the last two periods: 1980-2001 and 1990-2001. The speed of absolute convergence in the four periods range between 0.99-2.56 % p.a. (2% for the EU was worked out by Barro and Xavier Sala-i-Martin, 1995, for European regions) for EU while it ranges between 0.57-1.16 % p.a. for the countries in East Asia and EU regions together. However, there is no evidence of convergence among the South Asian countries in all periods and some major CIS republics since 1966.There is however tendency for absolute convergence among countries of South Asia, East Asia and European Union together particularly after the 1980s. Conditional convergence is prevalent among almost all pairs of regions in our sample except East Asian and South Asian nations together. Speed of conditional convergence ranges from 0.2 % in an year to 22%.In the European nations, the speed of conditional convergence works out be nearly 20 % unlike the speed of absolute convergence which hovered around 2 %.Such results would mean that countries in Europe are converging very quickly to their own potential level of incomes per capita but not so quickly to a common potential level of income per capita.Growth equation; absolute convergence; conditional convergence; speed of absolute and conditional convergence; elasticity of output with respect to capital; half life of convergence
Antibiotic treatment of pediatric infections in primary healthcare setting: evaluation and comparison of 80 national treatment guidelines with the WHO AWaRe book recommendations
No full textBackground: Antibiotic recommendations for pediatric infections in national standard treatment guidelines (STGs) vary widely, particularly for Access and Watch antibiotics. The WHO AWaRe book recommends Access antibiotics as first-line treatment for over 80% of common infections managed in primary healthcare. This study aims to evaluate the agreement between first and second-line antibiotics in national STGs with AWaRe book recommendations and the inclusion of these antibiotics in Essential Medicine Lists (EMLs). Methods: National STGs of 80 countries were systematically collected from databases and grey literature (up to May 2025). Antibiotic recommendations for the ten most common primary healthcare infections in children were compared with the WHO AWaRe book (2022), the WHO Essential Medicines List for children (EMLc) and national Essential Medicines Lists (nEMLs) where available. Findings: A median of eight STGs per country were collected, with higher numbers in LMICs due to guidelines for cholera and enteric fever. A total of 1124 first-line and 841 second-line antibiotic recommendations were identified. Over 70% of first-line recommended treatments were Access antibiotics, while Watch antibiotics accounted for more than 50% of second-line recommended treatments. First-line recommendations showed strong agreement with WHO guidance, whereas second-line treatments exhibited lower agreement and greater variability across regions. More than 80% of first-line antibiotics were included in the EMLc and nEMLs, although some high-income countries lacked nEMLs. Interpretation: First-line antibiotic recommendations in national pediatric STGs largely align with the WHO AWaRe book guidance focusing on Access antibiotic use. In contrast, second-line treatments vary considerably, commonly recommending Watch antibiotics. Strengthening the evidence base of national STGs and aligning second-line recommendations with the WHO AWaRe book could help meet the 79th UNGA High-Level Meeting on AMR target, which aims for 70% of all human antibiotic use to come from the Access group. Funding: PRIN 2022 “A Cluster randomized clinical trial to change Antibiotic Prescribing behavior in Outpatient pediatric primary care setting in Italy (CAPO project)", funded in the framework of the National Recovery and Resilience Plan (NRRP), Mission 4, Component 2, Investment 1.1, funded by the European Union–Next Generation EU, Project 2022A7LA2W, CUP C53D23006050006
Analyzing the squeezed state generated by a twist deformation
No full textThe D1D5 conformal field theory has provided a useful microscopic model for studying black holes. The coupling in this theory is a twist deformation whose action on the vacuum generates a squeezed state. We give a new derivation of the expression for this squeezed state using the conformal Ward identity; this derivation provides an insight into several features of the state. We also examine the squeezed state in a continuum limit where we describe it in terms of position space correlations created by the twist
Land cover classification using multi-temporal MERIS vegetation indices
No full textThe spectral, spatial, and temporal resolutions of Envisat's Medium Resolution Imaging Spectrometer (MERIS) data are attractive for regional- to global-scale land cover mapping. Moreover, two novel and operational vegetation indices derived from MERIS data have considerable potential as discriminating variables in land cover classification. Here, the potential of these two vegetation indices (the MERIS global vegetation index (MGVI), MERIS terrestrial chlorophyll index (MTCI)) was evaluated for mapping eleven broad land cover classes in Wisconsin. Data acquired in the high and low chlorophyll seasons were used to increase inter-class separability. The two vegetation indices provided a higher degree of inter-class separability than data acquired in many of the individual MERIS spectral wavebands. The most accurate landcover map (73.2%) was derived from a classification of vegetation index-derived data with a support vector machine (SVM), and was more accurate than the corresponding map derived from a classification using the data acquired in the original spectral wavebands
Lifting of D1-D5-P states
No full textAbstract We consider states of the D1-D5 CFT where only the left-moving sector is excited. As we deform away from the orbifold point, some of these states will remain BPS while others can ‘lift’. We compute this lifting for a particular family of D1-D5-P states, at second order in the deformation off the orbifold point. We note that the maximally twisted sector of the CFT is special: the covering surface appearing in the correlator can only be genus one while for other sectors there is always a genus zero contribution. We use the results to argue that fuzzball configurations should be studied for the full class including both extremal and near-extremal states; many extremal configurations may be best seen as special limits of near extremal configurations
Feasibility study of geospatial mapping of chronic disease risk to inform public health commissioning
No full textThis final article is available for use under the terms of the Creative Commons Attribution Non-Commercial 2.0 Licence; see http://bmjopen.bmj.co
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