16,622 research outputs found
Penile length is preserved after implant surgery
No full textObjective: To investigate if there is a correlation between penile size measured preoperatively and erect penis after penile implant surgery (PI). A common cause of patient dissatisfaction after PI is caused by patients complaining that surgery has shortened the penis. It has been suggested that stretched penile length preoperatively is almost the same after surgery when the prosthesis is in erect status. However, no comprehensive data supports this theory. This prospective study was done to investigate this theory. Patients and Methods: Standardised measurements of stretched penile length and girth were performed in theatre before PI implantation then re-measured at the end of the procedure with the penis in the erect position. We recorded type of PI, cylinder lengths and malleable rod diameters. All patients had data recorded on body mass index (BMI), hypertension (HTN), glycated haemoglobin (HbA1c), and Peyronie's disease (PD). Results: In all, 133 patients were assessed; 88 (66.2%) had a malleable penile prosthesis (MPP) and 45 (33.8%) an inflatable penile prosthesis (IPP). The median age and BMI were 56 years and 30 kg/m2, respectively. In all, 40 (30.1%) patients had HTN, 37 (27.8%) had PD, and 89 (66.9%) were diabetic. The mean (SD) pre-implant stretched length was 12.8 (1.8) cm. The mean (SD) flaccid girth was 10.3 (1.2) cm. Postoperatively, the mean (SD) erect length and girth were 13.1 (1.7) cm and 11.3 (1.3) cm, respectively. Overall, there was a significant (P < 0.05) increase in both the mean (SD) length at +0.36 (0.63) cm, and girth at +1.04 (1.02) cm. Patients who had an IPP, had a greater increase in both length (mean [SD] 0.62 [0.72] cm) and girth (mean [SD] 1.7 [1.0] cm) compared to those who had a MPP (mean [SD] 0.22 [0.53] cm and 0.7 [0.87] cm, respectively) (P < 0.05). We investigated correlations between pre- and postoperative outcomes related to BMI, HTN, diabetes, and PD. None of these variables affected outcome. Conclusions: PI surgery does not significantly decrease penile size compared to the preoperative assessment. The outcome was not affected by co-morbidities. The preoperative length and girth correlated well with the immediate postoperative erect penis, although girth was not necessarily comparable in this series of patients measured under anaesthesia. Recording penile dimensions in the clinic and agreeing these with patients’ preoperatively may be a way of improving satisfaction levels with this surgery
The politics and economics of regulatory impact assessment
No full textThis is the author accepted manuscript. The final version is available from the publisher via the link in this record
Phase Distribution Efficiency of cm-Scale Ultrasonically Powered Receivers
No full textIn the domain of ultrasonically powered biomedical implants, there is an increasing interest in cm-scale ultrasonic receivers (RX). However, when a single-element transducer is used as the RX transducer, an uneven phase distribution across the RX area can significantly reduce the harvestable power. In this paper, we investigate the impact of lateral and angular misalignment on the acoustic field phase distribution across the RX surface. We show that, for a single-element RX transducer, lateral misalignment has minimal effect on the harvestable power, whereas even small angular misalignments can cause a considerable reduction, especially for larger RX sizes. We present a potential solution that consists of subdividing a large RX transducer (e.g. 20 × 20mm2) into smaller elements, which significantly improves power transfer efficiency by taking advantage of the smaller phase variation across the surface of each element. The trade-offs between achieving a minimum acceptable power transfer efficiency and managing the increased complexity in packaging and matching circuitry are also discussed.Green Open Access added to TU Delft Institutional Repository 'You share, we take care!' - Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Electronic Components, Technology and MaterialsBio-Electronic
Highly efficient laser-driven Compton gamma-ray source
No full textThe recent advancement of high-intensity lasers has made all-optical Compton scattering become a promising way to produce ultrashort brilliant gamma-rays in an ultra-compact system. However, so far achieved Compton gamma-ray sources are limited by low conversion efficiency and spectral intensity. Here we present a highly efficient gamma photon emitter obtained by irradiating a high-intensity laser pulse on a miniature plasma device consisting of a plasma lens and a plasma mirror. This concept exploits strong spatiotemporal laser-shaping process and high-charge electron acceleration process in the plasma lens, as well as an efficient nonlinear Compton scattering process enabled by the plasma mirror. Our full three-dimensional particle-in-cell simulations demonstrate that in this novel scheme, brilliant gamma-rays with very high conversion efficiency (higher than 10(-2)) and spectral intensity (similar to 10(9) photons/0.1%BW) can be achieved by employing currently available petawatt-class lasers with intensity of 10(21) W cm(-2). Such efficient and intense gamma-ray sources would find applications in wide-ranging areas. ©2019 The Author(s)
CM Periods, CM Regulators, and Hypergeometric Functions, I
No full textWe prove the Gross-Deligne conjecture on CM periods for motives associated with H-2 of certain surfaces fibered over the projective line. Then we prove for the same motives a formula which expresses the K-1-regulators in terms of hypergeometric functions F-3(2), and obtain a new example of non-trivial regulators
Wait and see : you'll want me back
No full text1 vocal score (3 p.) ; 31 cm. Illustrated cover with images of Mary MacLaren, Jack Mulhall, Ed Lowry, and Irene Prince
Mapping SNOMED CT to ICD-10-CM
No full textA SNOMED CT-encoded problem list is required to satisfy the Certification Criteria for Stage 2 “Meaningful Use”. ICD-10-CM has replaced ICD-9-CM as the reimbursement code set in 2015. Having a cross-map from SNOMED CT to ICD-10-CM would promote the use of SNOMED CT as the primary problem list terminology, while easing the transition to ICD-10-CM. There is no established principle and methodology on systematically and semantically linking SNOMED CT to ICD-10-CM. This research project describes the development of mapping principle, mapping guidelines, mapping tools and mapping methodology for a rule-based crosswalk to support semi-automatic generation of ICD-10-CM codes from SNOMED CT-encoded data. A series of mapping guidelines were developed based on the clinical use case, SNOMED CT modeling convention, and ICD-10-CM classification guidelines. One of the important methodology in developing the map set is using triangulation in generating legacy maps. Using the SNOMED CT to ICD-9-CM map and General Equivalence Mappings sequentially, Indirect Map was generated from SNOMED CT to ICD-10-CM for 96.2% of the SNOMED CT concepts within the scope of the study. Another innovation in this crossmapping research is implementation of a principle to handle age specification. The age rule was one type of rule to handle cases in which one SNOMED CT concept can map to different ICD-10-CM codes depending on the age of the patient. The age rule quality assurance (QA) was a mechanism to capture the age specification that can be easily missed by manual mapping. The results showed that the mapping guidelines ensured the mapping consistency, which potentially would reduce the mapping discrepancy between the two independent parallel mapping efforts. It also made it possible that the map set can be used in a meaningful way when data is exchanged. On this triangulation method in generating legacy map, an Indirect Map generated from SNOMED CT to ICD-10-CM covered a very high percentage of SNOMED CT concepts. Overall, this Indirect Map had a moderate degree of agreement with the Direct SNOMED CT to ICD-10-CM map. However, the indirect synonymy maps have much higher precision and can be used for quality assurance (QA) of the three maps. The age rule QA identified 342 out of 7,277 concepts which potentially required age rules, among these 50.3% turned out to be true positives. Without this QA, a large proportion of age rules in the published Map would have been missed. The outcomes of this research project include a set of mapping principle, mapping guidelines, mapping tools and mapping methodology for a rule-based crosswalk from SNOMED CT to ICD-10-CM. All these could be used as a prototype in other cross standard mappings. For example, in the US, ICD-10-PCS officially replaced ICD-9-CM from October 2015 onwards. A project was formulating earlier this year (2015) for the purpose of creating the map from SNOMED CT procedure to ICD-10-PCS. It is a pleasant finding that tooling, principles and guidelines established in SNOMED CT to ICD-10-CM mapping can be re-used, with modifications, for the PCS mapping process.Ph.D.Includes bibliographical referencesby Junchuan X
Dihedral Artin representations and CM fields
No full textFor a fixed CM field K with maximal totally real subfield F, we
consider dihedral Artin representations of F induced from K. We prove that
a positive proportion of such representations have image D4.First author draf
Author reply
No full textHealth data linkage in Australia remains challenging1 as reflected in our recent experience of multi‐jurisdictional data linkage. We welcome the Population Health Research Network (PHRN) collaborative's initiatives in establishing a streamlined and unified application process in multi‐jurisdictional data linkage projects, and we fully support their vision. We acknowledge the concerns raised by Flack and Smith2 and take this opportunity to elaborate.Full Tex
- …
