Endoscopic transcanal coblation excision of glomus tympanicum: a novel technique.

OBJECTIVE: To evaluate the feasibility of coblation in excision of glomus tympanicum tumors. PATIENTS AND METHODS: A retrospective study carried out over 28 patients with types I and II glomus tympanicum tumors according to GLASSCOCK-JACKSON classification. Preoperative radiological and endocrinal evaluation were performed. All patients underwent endoscopic transcanal excision of their glomus tympanicum tumors using coblation. RESULTS: None of the patients developed recurrence during the 1-year follow up period proved radiologically. None of the patients developed facial palsy postoperatively. Differences between preoperative and postoperative dizziness and taste disturbance were statistically non-significant. Tinnitus disappeared completely in 22 patients postoperatively. A statistically significant reduction in Tinnitus Handicap Inventory (THI) after surgery was found. Statistically significant reductions in postoperative air conduction (AC) threshold and air bone gap (ABG) were recorded while bone conduction (BC) threshold showed statistically non-significant change. CONCLUSION: Coblation is an effective and safe tool in excision of glomus tympanicum tumors. Further studies comparing coblation with laser and piezosurgery are strongly recommended.

An interconnect-free micro-electromechanical 7-bit arithmetic device for multi-operand programmable computing.

Computational power density and interconnection between transistors have grown to be the dominant challenges for the continued scaling of complementary metal-oxide-semiconductor (CMOS) technology due to limited integration density and computing power. Herein, we designed a novel, hardware-efficient, interconnect-free microelectromechanical 7:3 compressor using three microbeam resonators. Each resonator is configured with seven equal-weighted inputs and multiple driven frequencies, thus defining the transformation rules for transmitting resonance frequency to binary outputs, performing summation operations, and displaying outputs in compact binary format. The device achieves low power consumption and excellent switching reliability even after 3 × 103 repeated cycles. These performance improvements, including enhanced computational power capacity and hardware efficiency, are paramount for moderately downscaling devices. Finally, our proposed paradigm shift for circuit design provides an attractive alternative to traditional electronic digital computing and paves the way for multioperand programmable computing based on electromechanical systems.

Is vitamin B12 deficiency a risk factor for gastroparesis in patients with type 2 diabetes?

BACKGROUND: Diabetic gastroparesis is a severe diabetic complication refers to delayed gastric emptying in the absence of mechanical obstruction of the stomach. Vitamin B12 affects the dynamics of autonomic nervous system and its deficits has been linked to cardiovascular autonomic neuropathy therefore, vitamin B12 deficiency was hypothesized to be implicated in the development of diabetic gastroparesis. This study was conducted to explore the possible association between vitamin B12 deficiency and gastroparesis in patients with type 2 diabetes (T2D). METHODS: A total of 100 T2D patients with diabetes duration > 10 years and 50 healthy controls matched for age and sex were recruited for this study. T2D patients were divided into 2 groups: patients with gastroparesis and patients without gastroparesis. The diagnosis of gastroparesis was based on Gastroparesis Cardinal Symptom Index (GCSI) Score ≥ 1.9 and ultrasonographic findings including gastric emptying ˂ 35.67% and motility index ˂ 5.1. Anthropometric measurements, plasma glucose, glycosylated hemoglobin (HbA1c), lipids profile, vitamin B12 and transabdominal ultrasonography were assessed. RESULTS: The frequency of vitamin B12 deficiency in total patients with T2D was 35% (54.5% in patients with gastroparesis vs. 11.1% in patients without gastroparesis, P < 0. 001). Vitamin B12 level was negatively correlated with GCSI Score whereas, it was positively correlated with gastric emptying and motility index. Vitamin B12 deficiency was an independent predictor for gastroparesis in patients with T2D; it predicts gastroparesis at a cut off value of 189.5 pmol/L with 69.1% sensitivity and 64.4% specificity, P = 0.002. CONCLUSIONS: Beside the known risk factors of diabetic gastroparesis, vitamin B12 deficiency is an independent predictor of diabetic gastroparesis in patients with T2D.

Superior protective effects of febuxostat plus alpha-lipoic acid on renal ischemia/reperfusion-induced hepatorenal injury in rats.

A complex cascade of pathological events including oxidative stress and inflammation is involved in ischemia/reperfusion (I/R)-induced local and remote organ injuries. This study was performed to evaluate the effects of febuxostat (FEB), a selective xanthine oxidase (XO) inhibitor, and alpha-lipoic acid (ALA), a strong antioxidant, on the kidney and liver changes induced by renal I/R in rats. Renal I/R was induced in rats by clamping renal pedicles for 1 h followed by 2 h reperfusion. Fifty rats were assigned to five groups as follows: sham operated; vehicle + I/R; FEB + I/R; ALA + I/R, and (FEB + ALA) + I/R. Drug treatment was given 24 h and 1 h before I/R induction. Serum and tissue biochemical parameters and histopathological changes were examined after reperfusion. Serum creatinine, urea and uric acid levels, and alanine aminotransferase and aspartate aminotransferase activities were elevated after renal I/R. An increase in XO, myeloperoxidase, and malondialdehyde levels was observed in kidney and liver tissues with a concomitant decrease in both the glutathione level and superoxide dismutase activity. In addition, kidney and liver sections of vehicle-pretreated rats subjected to I/R exhibited a pronounced alteration in microanatomy. FEB, ALA, or FEB + ALA pretreatment attenuated the serum and tissue biochemical changes with amelioration of the histopathological changes in both the kidney and liver. The findings of this study revealed that FEB in combination with ALA had a greater protective effect than either drug alone. Thus, FEB and ALA co-administration may provide a potential superior therapeutic strategy to protect the kidney and liver against renal I/R-induced injury.

Transformational silicon electronics.

In today's traditional electronics such as in computers or in mobile phones, billions of high-performance, ultra-low-power devices are neatly integrated in extremely compact areas on rigid and brittle but low-cost bulk monocrystalline silicon (100) wafers. Ninety percent of global electronics are made up of silicon. Therefore, we have developed a generic low-cost regenerative batch fabrication process to transform such wafers full of devices into thin (5 µm), mechanically flexible, optically semitransparent silicon fabric with devices, then recycling the remaining wafer to generate multiple silicon fabric with chips and devices, ensuring low-cost and optimal utilization of the whole substrate. We show monocrystalline, amorphous, and polycrystalline silicon and silicon dioxide fabric, all from low-cost bulk silicon (100) wafers with the semiconductor industry's most advanced high-κ/metal gate stack based high-performance, ultra-low-power capacitors, field effect transistors, energy harvesters, and storage to emphasize the effectiveness and versatility of this process to transform traditional electronics into flexible and semitransparent ones for multipurpose applications.

Integrated bio-behavioural HIV surveillance surveys among female sex workers in Sudan, 2011-2012.

OBJECTIVES: To assess HIV and syphilis prevalence, HIV-related behaviours and testing for HIV in female sex workers (FSW) in Sudan. DESIGN: Bio-behavioural surveys using respondent-driven sampling were carried out among FSW in the capital cities of 14 states in Sudan in 2011-2012. HIV and syphilis testing was done by rapid tests. RESULTS: 4220 FSW aged 15-49 years were recruited. The median age of recruited women varied from 21 to 28 years per site. The highest HIV prevalence was measured at two sites in the eastern zone (5.0% and 7.7%), while in the other zones it ranged from 0% to 1.5%. Syphilis prevalence ranged from 1.5% in the northern zone to 8.9% in the eastern zone. Ever having been tested for HIV was reported by 4.4%-23.9% of FSW across all sites. Condom use at last sex with a client varied from 4.7% to 55.1%, while consistent condom use with clients in the month preceding the surveys was reported by 0.7%-24.5% of FSW. The highest reporting of ever injecting drugs was measured at a site in the western zone (5.0%). CONCLUSIONS: The surveys' findings indicate that the highest burden of HIV in FSW is in the eastern states of the country. Condom use and HIV testing data demonstrate the need for HIV interventions that should focus on HIV testing and risk reduction strategies that include stronger condom promotion programmes in FSW and their clients.

The effect of averaging time on oximetry values in the premature infant.

BACKGROUND: The effect of a pulse oximeter's averaging time on time spent by premature infants in established saturation ranges, as well as on desaturation events, has not previously been reported. OBJECTIVE: Our goal for this pilot study was to evaluate the effect of 2 distinct averaging times on the amount of time spent outside target oxygen saturation (SPo(2)) as well as the types and durations of desaturation events. METHODS: Neonates <32 weeks' gestation requiring respiratory support were included. Each infant was studied with 2 simultaneous pulse oximeters: 1 with a short averaging time (2 seconds) and 1 with a longer averaging time (16 seconds). Time spent within different saturation ranges and the number, duration, and severity of desaturation events for each averaging time were compared by using Student's 2-tailed t test, and a P value of <.05 was considered significant. RESULTS: The number of desaturations was greater with the 2-second averaging time; however, it did not reach significance when only desaturations of clinically significant duration were included (22.3 vs 19.4 significant events were detected by 2- and 16-second averaging time; P = .1). There was a trend for the longer averaging time to underestimate brief desaturation lasting <30 seconds (16 vs 41). Longer averaging time also tended to overestimate events of long duration that lasted >300 seconds (40 vs 20 long events). Longer averaging time tended to underestimate desaturation events of greater severity when SPo(2) was <70% (P = .01). Averaging time did not affect the time spent within various target SPo(2) ranges (P > .05). CONCLUSIONS: These preliminary results suggest that use of longer averaging time reduces the detection of brief periodic desaturation events and of greater severity. It may also interpret a cluster of shorter events as a single, prolonged episode and, thus, potentially overestimate the frequency of long events. The significance of these findings lies in the potential impact on neurodevelopmental outcomes and growth, which will need additional study.

Perinatal testicular torsion: preoperative radiological findings and the argument for urgent surgical exploration.

Perinatal testicular torsion is an infrequent event, the management of which has been controversial. Occurrence is rare, estimated at 1 in 7500 newborns (Kaplan, G. W., Silber, I.: Neonatal torsion--to pex or not? In: Urologic surgery in neonates and young infants. Edited by King, L.R. Philadelphia: W.B. Saunders Co., 1988; Chapter 20, pp. 386-395). The frequency of bilateral perinatal torsion is up to 22% (J Urol. 2005;174:1579). Here, we describe two cases of bilateral asynchronous perinatal torsion, in which the only presenting abnormality on exam after birth was a unilateral scrotal mass. These cases illustrate that contralateral perinatal torsion may be present even when physical exam findings suggest unilateral involvement.