The use of balloon dilation in revision sinus surgery.

BACKGROUND: Recent studies have demonstrated a dramatic increase in the use of balloon sinus dilation (BSD) in the United States. However, the use of BSD specifically in revision sinus surgery has not been investigated. This study addresses the question of how BSD is utilized as a tool in revision sinus surgery. METHODS: Data from MarketScan (Truven Health) over a 5-year period (2012-2016) were analyzed. Patients who underwent a sinus procedure with a minimum of 2 years of follow-up were included. RESULTS: A total of 62,304 patients met inclusion criteria; 6847 (10.99%) underwent revision. Age >55 years, the South geographical region, and medical comorbidities increased the odds of revision on multivariate analysis. For patients undergoing revision, BSD was used 11%, 21%, and 13% of the time for revisions of the maxillary, frontal, and sphenoid sinuses, respectively. For a sinus that underwent revision after an initial BSD, a repeat BSD was done close to 40% of the time. CONCLUSION: BSD is used frequently in the revision setting, especially for the frontal sinus and for patients who had already undergone an initial BSD. Our findings highlight the prevalent role of BSD in revision surgery and the need to evaluate such practices.

Two-Dimensional J_{eff}=1/2 Antiferromagnetic Insulator Unraveled from Interlayer Exchange Coupling in Artificial Perovskite Iridate Superlattices.

We report an experimental investigation of the two-dimensional J_{eff}=1/2 antiferromagnetic Mott insulator by varying the interlayer exchange coupling in [(SrIrO_{3})_{1}, (SrTiO_{3})_{m}] (m=1, 2 and 3) superlattices. Although all samples exhibited an insulating ground state with long-range magnetic order, temperature-dependent resistivity measurements showed a stronger insulating behavior in the m=2 and m=3 samples than the m=1 sample which displayed a clear kink at the magnetic transition. This difference indicates that the blocking effect of the excessive SrTiO_{3} layer enhances the effective electron-electron correlation and strengthens the Mott phase. The significant reduction of the Néel temperature from 150 K for m=1 to 40 K for m=2 demonstrates that the long-range order stability in the former is boosted by a substantial interlayer exchange coupling. Resonant x-ray magnetic scattering revealed that the interlayer exchange coupling has a switchable sign, depending on the SrTiO_{3} layer number m, for maintaining canting-induced weak ferromagnetism. The nearly unaltered transition temperature between the m=2 and the m=3 demonstrated that we have realized a two-dimensional antiferromagnet at finite temperatures with diminishing interlayer exchange coupling.

Heterointerface engineered electronic and magnetic phases of NdNiO3 thin films.

Mott physics is characterized by an interaction-driven metal-to-insulator transition in a partially filled band. In the resulting insulating state, antiferromagnetic orders of the local moments typically develop, but in rare situations no long-range magnetic order appears, even at zero temperature, rendering the system a quantum spin liquid. A fundamental and technologically critical question is whether one can tune the underlying energetic landscape to control both metal-to-insulator and Néel transitions, and even stabilize latent metastable phases, ideally on a platform suitable for applications. Here we demonstrate how to achieve this in ultrathin films of NdNiO3 with various degrees of lattice mismatch, and report on the quantum critical behaviours not reported in the bulk by transport measurements and resonant X-ray spectroscopy/scattering. In particular, on the decay of the antiferromagnetic Mott insulating state into a non-Fermi liquid, we find evidence of a quantum metal-to-insulator transition that spans a non-magnetic insulating phase.

Patient satisfaction with point-of-care testing in general practice.

BACKGROUND: Point-of-care testing is increasingly being used in general practice to assist GPs in their management of patients with chronic disease. However, patient satisfaction and acceptability of point-of-care testing in general practice has not been widely studied. AIM: To determine if patients are more satisfied with point-of-care testing than with pathology laboratory testing for three chronic conditions. DESIGN OF STUDY: As part of a large multicentre, randomised, controlled trial assessing the use of point-of-care testing in Australian general practice, satisfaction was measured for patients having pathology testing performed by point-of-care testing devices or pathology laboratories. Patients in the trial were managed by GPs for diabetes, hyperlipidaemia, and/or anticoagulant therapy. METHOD: Patient satisfaction was measured using level of agreement with a variety of statements at the end of the study with a patient satisfaction questionnaire for both the intervention and control groups. Analysis was performed using a mixed model analysis of variance (ANOVA) with allowance for clustering at the practice level following Box-Cox transformations of the data to achieve normality. RESULTS: Overall, intervention patients reported that they were satisfied with point-of-care testing. In comparison with the control group, the intervention group had a higher level of agreement than control patients with statements relating to their satisfaction with the collection process (P<0.001) and confidence in the process (P<0.001). They also viewed point-of-care testing as strengthening their relationship with their GP (P = 0.010) and motivational in terms of better managing their condition (P<0.001). CONCLUSION: The results from this trial support patient satisfaction and acceptability of point-of-care testing in a general practice setting.

Gender, socioeconomic status, need or access? Differences in statin prescribing across urban, rural and remote Australia.

OBJECTIVES: To assess differences in statin prescribing across Australia by geographic area. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional study using Pharmaceutical Benefits Scheme data on statin prescribing by rurality, gender and patient postcode for the period May to December 2002. Participants were the Australian population, stratified by gender, quintile of index of relative socioeconomic disadvantage and rural, remote and metropolitan areas classification. RESULTS: Statin prescribing (scripts per 1000 population per month) was higher in urban areas (women, 51.915; men, 51.892) than in rural (women, 48.311; men, 48.098) or remote (women, 39.679; men, 34.145) areas. In urban areas, weighted least squares regression analysis showed a significant negative linear association between statin prescribing and socioeconomic status for both women (weighted least squares slope, -3.358; standard error (SE) 0.057; P < 0.0001) and men (slope, -0.507; SE 0.056; P < 0.0001). A similar association occurred in rural areas: women (slope, -4.075; SE 0.122; P < 0.0001) and men (slope, -3.455; SE 0.117; P < 0.0001), but not in remote areas where there was a positive linear association (slope, 3.120; SE 0.451; P < 0.0001) and men (slope, 3.098; SE 0.346; P < 0.0001). CONCLUSION: Our results suggest differences in statin prescribing in Australia across geographic location, adjusting for age, gender and socioeconomic status. IMPLICATIONS: These findings suggest that health inequalities due to geography should be addressed.