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A noise source characteristic of an unheated compressible jet is experimentally investigated for the jet with exit Mach number 0.8. Measurements of acoustic pressure fluctuations were performed in the near-field and far-field independently to identify noise source characteristics using the correlation technique. Near-field and far-field acoustic pressure fluctuations were also measured simultaneously to identify the acoustic component in near-field pressure fluctuations measured. Measurements were taken for the base and chevron nozzle with the nozzle exit diameter of 30 mm. From auto-correlation and cross-correlation in the near and far fields, it is observed that region surrounding to mixing layer is dominated by random small scale structures which radiate noise to sideline direction in the far-field. Correlation obtained at downstream of the potential core in the near-field represents the dominance of coherent large scale structure which radiates the noise to the far-field in the aft angle direction. Chevron changes the characteristics of noise sources. The size of the dominant large-scale noise source reduces due to chevron. Coherence of the noise source in the region surrounding to mixing layer reduces due to chevron which is responsible for reducing the energy of the dominant noise sources downstream of the potential core. Near-field far-field cross-correlation confirms that spatial near-field location for radiating acoustic pressure fluctuations more efficiently to the far-field at polar angle 30° is dependent on axial as well as transverse position in the near-field. Chevron reduces the convective velocity of the flow. Chevron also reduces the spatial correlation length scale of the dominant noise source. Chevron changes the acoustic pressure in the near-field thereby shifting the dominant noise source towards the nozzle exit.

In the last one decade, there has been a surge in design and development of micro aerial vehicles (MAV). These MAVs utilize low aspect ratio wing to provide effective battlefield surveillance capability. In the present study a low aspect wing having aspect ratio wing ~ 1.0 is studied at Reynolds number ~ 7.6 × 104. At first, clean wing is studied to ascertain the flow physics involved in low aspect ratio wings and a comparison with existing literature is carried out to validate the same. Sinusoidal serrations with varying A/λ of 0.25, 0.35 and 0.50 were applied at the leading and trailing edge of the clean wing. It was observed that applying the sinusoidal serrations at the leading edge reduces the aerodynamic efficiency of the wing while when the serrations are placed at the trailing edge the aerodynamic efficiency in terms of CL/CD improves when compared with the clean wing.

The purpose of this study was to evaluate the performance of solid-state sensor based computed tomography dose profiler (CTDP) probe for measurement of standard computed tomography dose metric CTDI100 and free in air geometric efficiency for various beam widths available in a 128-slice CT scanner and also to estimate the efficiency of CTDI100 metric. The response accuracy of CTDP probe was verified using a standard 100 mm long ionization chamber. The geometric efficiency measurements performed by the CTDP probe were validated using XR-QA2 radiochromic film measurements. The efficiency of CTDI100 metric was assessed by calculating the ratio of CTDI100 measured in the center hole position to CTDI∞ measured in the same position of both head and body phantoms. The weighted CTDI values derived from CTDI100 measured by the CTDP probe showed an average difference of 8% from ionization chamber measured values. The efficiency of CTDI100 metric estimated using CTDP probe and 150 mm long phantoms was in the range of 82% to 86% and 76% to 80% for head and body phantom measurements respectively. The differences in the geometric efficiency values for various beam settings and tube voltages measured by the CTDP probe and films were within 7%. Taken together, the results of this study proved that unlike the 100 mm long ionization chamber, the CTDP probe can be efficiently used to determine CTDI for any length over which dose integration is desired and also measure geometric efficiency of MDCT scanners for various beam widths in helical mode of operation.

Department of Chemistry, Hindu College, Moradabad-244 001 Manuscript received 30 December 1981, revised 18 April 1983,accepted 11 February 1984 Synthesis and lon-Exchange Properties of Thermally Stable Stannic Silico Selenite :Separation of Cu2+ from Zn2+ and Mn2+

There is ongoing debate over the optimal surgical approach for cholesteatoma treatmentMedline, Embase, Cochrane databases and clinicaltrials.gov were searched for studies reporting outcomes of patients undergoing primary CWD-MO for cholesteatoma and directly compared with CWD and CWU mastoidectomies. Data were collated and meta-analysis performed.2379 patients were included from 12 studies that met the inclusion criteria. CWD-MO was found to be associated with significantly less risk of recurrence when compared to CWU (OR = 0.330 (95 % CI 0.191-0.570, p 0.001). When compared to CWD, CWD-MO was associate with significantly lower incidence of persistent otorrhoea (OR 0.405 (95 % CI 0.232-0.706, p 0.001) while the rates of recurrence were comparable (OR: 1.231 [95 % CI: 0.550-2.757] p = 0.613). Otorrhoea rates between CWD-MO and CWU were equivalent as was reoperation. Quality of life and hearing outcomes were variably reported.This systematic review demonstrates that CWD-MO technique achieves lower recurrence rates comparable to CWD approaches and superior to CWU, while offering improved long-term control of otorrhoea. The final procedural choice should be decided based on surgeon experience, skill set and individual patient factors. To address the risk of selection bias, a randomised controlled trial is needed to answer this important research question.

Purpose. The paper describes the application of unlaminated Gafchromic EBT3 film dosimeter for quantification of dose enhancement using locally synthesized silver nanoparticle-embedded alginate film (AgNPs-Alg film) for nanoparticles-aided radiotherapy. Materials and Methods. AgNPs-Alg film was synthesized and characterized using standard techniques. The unlaminated Gafchromic EBT3 film was specially customized for dosimetric measurement. The dose enhancements due to AgNPs-Alg film was experimentally determined for ISO wide spectrum x-rays series (average energy ranging from 57–137 keV) and 6 and 10 MV x-rays using laminated and unlaminated Gafchromic EBT3 film. The radiation dose of 1 Gy was delivered to a combination of AgNPs-Alg films and EBT3 film. Results. Ultraviolet-Visible spectroscopy of silver nanoparticles shows a surface plasmon resonance peak at 400 nm. The average particle size of 13 ± 2 nm was measured using Atomic Force Microscopy. For unlaminated film, the dose enhancements of 29%, 23%, 14% and 2% was observed for ISO wide spectrum x-rays having average energy of 57, 79, 104 and 137 keV, respectively. The dose enhancement was negligible for 6 and 10 MV x-rays. In the case of laminated film, no significant dose enhancement was measured for all the x-ray energies. Conclusion. The unlaminated Gafchromic EBT3 film can be a suitable choice for the measurement of dose enhancement. Further, silver nanoparticles can be used during nanoparticle-aided radiotherapy when irradiated at low x-ray energy.

ObjectiveThis paper reviews our experience of potassium titanyl phosphate (KTP) laser in transcanal totally endoscopic cholesteatoma surgery.MethodsA prospective cohort study was conducted in a tertiary referral centre, involving a consecutive series of children with cholesteatoma who underwent totally endoscopic cholesteatoma surgery with a KTP laser.ResultsThe patients’ mean age was 10.5 years (range, 1.8–18 years). A KTP laser was used in 70 of the 83 cases (84 per cent). The laser was not used in 13 ‘clean’ cases, in which disease was removed more easily. Residual disease was detected in five cases (6 per cent), of which the KTP laser had been used in four (5 per cent). No complications were associated with KTP laser use.ConclusionThe combination of KTP laser use with endoscopic visualisation is effective for minimising the risk of residual disease using a minimally invasive surgical approach. The thin, semi-flexible fibre carrier of the KTP laser is ideally suited to work alongside the endoscope within the narrow confines of the ear canal.

The statistical computation of an ideal gas state thermodynamic functions namely enthalpy, entropy, free energy, heat capacity of 1,2,3 – Trimethoxy benzene, m-methyl methoxybenzene have been performed. These calculations have been made at a pressure of 1 atmosphere in the temperature range 100°K to 1500°K under rigid rotor harmonic oscillator approximation for 1 mole of perfect gas and on the basis of vibrational frequencies obtained from FTIR and Raman spectra and also with the help of moment of inertia.

Study design A biomechanical study. Purpose To develop a predictive model for pullout strength. Overview of literature Spine fusion surgeries are performed to correct joint deformities by restricting motion between two or more unstable vertebrae. The pedicle screw provides a corrective force to the unstable spinal segment and arrests motions at the unit that are being fused. To determine the hold of a screw, surgeons depend on a subjective perioperative feeling of insertion torque. The objective of the paper was to develop a machine learning based model using density of foam, insertion angle, insertion depth, and reinsertion to predict the pullout strength of pedicle screw. Methods To predict the pullout strength of pedicle screw, an experimental dataset of 48 data points was used as training data to construct a model based on different machine learning algorithms. A total of five algorithms were tested in the Weka environment and the performance was evaluated based on correlation coefficient and error matrix. A sensitive study of various parameters for obtaining the best combination of parameters for predicting the pullout strength was also preformed using the L9 orthogonal array of Taguchi Design of Experiments. Results Random forest performed the best with a correlation coefficient of 0.96, relative absolute error of 0.28, and root relative squared error of 0.29. The difference between the experimental and predicted value for the six test cases was not significant (p >0.05). Conclusions This model can be used clinically for understanding the failure of pedicle screw pullout and pre-surgical planning for spine surgeon.

The present experimental investigation reports the effect of chevron on flow characteristics and associated acoustic characteristics at different jet exit Mach numbers in high subsonic compressible jet. Flow characteristics are investigated with mean pressure measurement using miniature pitot tube in the flow, and acoustic characteristics are investigated using fluctuating pressure measurement with array of four microphones in the far field of jet. Chevron is used as a flow control device on the lip of the nozzle. Chevron converts axisymmetric jet development into corrugated shear layer, closer to the nozzle exit. This effect diminishes as jet grows downstream away from the nozzle exit. Corrugation of jet shear layer closer to the nozzle exit increases with increase in Mach number. Compressibility effect with change in Mach number is seen from potential core length and jet growth rate for base nozzle; however, chevron is found to reduce the compressibility effect with change in jet exit Mach number due to enhancement in mixing. Chevron reduces far-field overall sound pressure level at shallow polar angle (30°) by about to 2 dB at all the Mach number; however, increase in noise level at higher frequency observed at higher polar angle is mainly due to high-frequency noise sources produced from chevron petals. Noise level at higher polar angles and higher frequencies increases with increase in Mach number.

This study aims to numerically investigate the effect of bi-leaflet mechanical heart valve (BMHV) orientation on flow pattern in a realistic human aorta model with branches. The aorta model geometry is based on anatomical shape and dimensions involving aortic arch with twist and branches. Unsteady numerical simulations have been carried out to investigate the peak systolic flow in aorta through a BMHV installed at three different orientations, marked as 0°, 45°, and 90°. Velocity, vorticity, and strain fields were obtained in various cross sectional planes for all the cases to examine the spatial flow evolution starting from the sinus along the aortic arch. The valve leaflets were seen to produce small-scale stream wise contra-rotating vortices. These vortices changed their positions around the axis of aorta while advecting from one cross-sectional plane to another; thereby, clearly indicating swirl in the aortic flow. The net viscous dissipation energy loss (EL), obtained from strain field, was found to rise because of the presence of BMHV. The increase in the EL varied depending on the valve orientation as it changed from 43% for 0° to a maximum of 53% for 90° compared with no valve case. Similarly, the wall shear stress registered an increase by up to 4 Pa in the ascending aorta because the presence of BMHV; however, no significant effect of the valve orientation was noticed.

Objective: The objective of this study was to validate the performance characteristics of in-house developed four-dimensional (4D) dynamic phantom (FDDP). Materials and Methods: There are three target inserts of 1.0, 1.5 and 2.0 cm diameter. The targets were driven in sinusoidal pattern in the longitudinal direction, using the combinations of amplitudes of 0.5, 1.0, and 1.5 cm with frequencies of 0.2 and 0.25 Hz. The amplitude and frequency of motion were measured manually, and by using Real-Time Position Management (RPM) system also. The static, free-breathing, and 4D computed tomography (CT) scans of the phantom were acquired with 1.0 mm slice thickness. The 4DCT scans were sorted into 0%–90% phase, and the maximum intensity projection (MIP) images were also generated. The static, free-breathing, and 4DCT data sets and MIP images were contoured to get VStatic, VFB, V00......V90, and internal target volume ITV MIP, respectively. The individual phase volumes were summed to obtain V4D. The length of the target in the motion was measured using MIP image and compared with theoretical length (TL). The variation of 3D displacement vector of individual phase volume with respect to V00 with the phase of motion was studied at amplitude and frequency of 1.0 cm and 0.25 Hz, respectively. The degree of similarity between VFB and V4D and VFB and ITVMIP was also studied for all the target sizes at amplitude and frequency of 1.0 cm and 0.2 Hz and 1.0 cm and 0.25 Hz, respectively. Results: The amplitude and frequency of motion agreed within the limits of uncertainty with the manually and RPM measured values. The length of target in the motion matched within 1.0 mm with TL. The 3D displacement of individual phase volume showed no target size dependence, and the degree of similarity between VFB and V4D and VFB and ITVMIP decreases with increase in the displacement between the two volumes. Conclusions: The mechanical and imaging performances of FDDP were found within the acceptable limits. Therefore, this phantom can be used for quality assurance of 4D imaging process in radiotherapy.

The effect of a chevron on a radiated (acoustic) component of near-field pressure fluctuations in a high-speed compressible jet is experimentally investigated for a nozzle exit Mach number of 0.8. ...

Bergeyella (B.) zoohelcum is a non-motile, aerobic, gram-negative rod, with only a few cases in the literature. Most of the human infections are related to dog or cat bites; however, there are also reports related to the ingestion of food prepared with goat's blood. We present a case of Bergeyella zoohelcum bacteremia in a patient with acquired immunodeficiency syndrome (AIDS) following close contact with their service dog. To the best of our knowledge, this is the first case of B. zoohelcum bacteremia in an AIDS patient.

The identification of CpG Islands play a major role in the analysis of DNA sequences because of association of CpG Islands with many epigenetic events. Some of these events are promoter activity and consequently gene prediction, chromosome inactivation, and for early detection of cancer etc. And hence the exact identification of CpG Islands in the stretch of DNA sequences has always remained a challenging task. Numerous computational algorithms have been developed for the identification of CpG Islands in DNA sequences. Recently various transform based methods have been reported for the CpG Islands detection in literature. In these transform based methods, there is a requirement of transforming the signal from time domain to frequency domain and correspondingly there is probability of transform biasing. Hence to overcome this issue, a modified P-spectrum based algorithm has been proposed in this paper. Also the performance of the proposed method has been compared with recently reported methods of CpG Islands detection using standard evaluation metrics. The performance of proposed method has been proved to be much better than the other methods and hence the proposed approach is an efficient method in detecting CpG Islands.

Objectives:To describe our experience and provide guidelines for maximum safe balloon sizes according to age in children undergoing balloon dilatation.Method:A retrospective review was conducted of children undergoing balloon dilatation for subglottic stenosis in a paediatric tertiary unit between May 2006 and February 2016.Results:A total of 166 patients underwent balloon dilatation. Mean ( ± standard deviation) patient age was 4.5 ± 3.99 years. The median balloon size was 8 mm, the median balloon inflation pressure was 10 atm, and the mean balloon inflation time was 65.1 ± 18.6 seconds. No significant unexpected events occurred. The Pearson correlation co-efficient for the relationship between patient age and balloon size was 0.85 (p = 0.001), suggesting a strongly positive correlation.Conclusion:This study demonstrated that balloon dilatation is a safe procedure for airway stenosis. The results suggest using a balloon diameter that is equal to the outer diameter of the age-appropriate endotracheal tube +1 mm for the larynx and subglottis and +2 mm for the trachea.

The LGBT community and the attitude towards it became one of the dividing factors between Russia and Europe long ago. This factor quite often creates political precedents and becomes a basis for various provocations. In the Russian mass conscience the topic, which has long been considered tabooed, today has a sensitive character; therefore classic survey methods are hardly suitable for its study; on the other hand, various projective techniques have proved to be more useful. This article presents the data of a number of Russian sociological surveys on the attitudes towards LGBT representatives and of the RUDN University Sociology Chair scientific team research on this subject. The article also presents the results of a number of focus groups aimed at identifying attitudes towards LGBT representatives and based on the application of the vignette method, which is a special type of projective techniques. The high efficiency of vignette method for the study of such a sensitive subject was proved. The method allows overcoming of some barriers in respondents’ conscience determined by the ‘radical’ character of the issues under study, and also reduces the general social pressure upon respondents. The research with the application of vignette method resembled a kind of a narrative game, therefore adapting this method to the focus group research helps to obtain more detailed and interesting data due to the group dynamics.

The influence of gamma irradiation on the structural, optical and electrical properties of indium oxide ( $$\hbox {In}_2\hbox {O}_3$$ ) thin films prepared by thermal evaporation has been reported. The X-ray diffraction analysis revealed that the gamma irradiated films up to a dose of 75 Gy exhibit better crystallinity, with a strong increase in the intensity of peak related to (222) plane of the cubic indium oxide structure. Further increase of the gamma dose results in the reduction of crystallinity and grain size. However, the dislocation density and micro strain show the reverse trend of the dose dependence. The transmittance of the films decreases with the gamma dose up to the same level, resulting in a decrease of bandgap from 3.65 to 3.30 eV. The increase of the band gap at higher doses might be due to increased structural disorder and more defect creation than annihilation. The I–V characteristics measured after each exposed dose showed a decrement in the resistance with the rise in radiation dose up to the same level and exceeding this level leads to damage of the device. This study also suggests that the gamma irradiation can be considered as a tool for the enhancement of the device properties amongst the other applications.

Resume Le but de cette revue etait d’examiner le taux de succes du traitement chirurgical par voie endonasale de la rhinorrhee de liquide cerebro-spinal (LCS) et l’impact des facteurs lies aux patients, des techniques de reparation et du traitement adjuvant. Deux des auteurs ont recherche, de maniere independante, toutes les etudes rapportant les resultats du traitement chirurgical de la rhinorrhee de LCS publiees jusqu’au 1er juin 2014 dans les bases de donnees PubMed, Medline et Cochrane Central, a l’aide des mots-cles cerebrospinal fluid leak, CSF leak, CSF fistula, CSF leak or fistula repair, endoscopic sinus surgery or ESS complications. Cette revue a retenu 67 articles. Au cours des trente dernieres annees, le traitement chirurgical de la rhinorrhee de LCS a connu une evolution rapide. Avant l’avenement de la chirurgie endoscopique, la craniotomie etait le traitement chirurgical standard mais celui-ci affichait un taux de succes et une morbidite variables. Plus recemment, plusieurs series de cas et rapports ont decrit l’utilisation de divers methodes et materiels endoscopiques pour le traitement chirurgical, avec un taux de reussite moyen de 90 % (extremes 60 %–100 %). La region du toit/de la lame criblee de l’ethmoide est le siege le plus frequent de l’ecoulement de LCS. L’ecoulement de LCS d’origine traumatique, en particulier iatrogene, reste la cause la plus frequente. L’imagerie par scanner et IRM demeure l’outil de reference pour localiser les ecoulements de LCS. Le sinus sphenoidal est le siege le plus frequent d’echec de reparation d’un ecoulement de LCS. Les drains lombaires et les antibiotiques sont utilises comme traitement d’appoint au traitement chirurgical par voie endonasale mais leurs benefices ne sont pas clairs ; l’injection intrathecale de fluoresceine peut etre utilisee pour localiser un ecoulement de LCS mais doit etre reservee aux cas les plus complexes. Des etudes supplementaires sur les types de greffon utilises et les traitements adjuvants sont necessaires pour pouvoir tirer des conclusions significatives sur leur efficacite. La litterature montre que le traitement chirurgical par voie endoscopique de la rhinorrhee de LCS est efficace et sur, avec un tres faible taux de complication. Il a quasiment totalement remplace les techniques ouvertes.

The objective of the present work is to provides a comprehensive overview on the thermal analysis of the virgin high-density polyethylene (VHDPE) graded AD60 material by means of a differential scanning calorimetry (DSC) equipments. In order to verify possible transformations in its molecular structure and change of phases present with the variation of temperature over time. Past literature results reported the testing-analysis of the samples which was carried out through 3 distinct cycles separated into 3 stages, the first of which the material will undergo a heating of the ambient temperature up to 178°C, at a rate of 10°C/min, the second stage a cooling from the temperature of 178°C at a temperature of 43°C, with a rate of 10°/min, and the third stage the test body will undergo a new heating from 43°C to 184°C with a rate of 10°C/min. As revealed from in-depth studies, results obtained from the thermograms for the seven samples of the high-density polyethylene for the three required cycles, showed approximate values, with variations in centesimal scales that can be disregarded if the slight variations have been analyzed in the air pressure that the equipment can present. With this, it was possible to conclude the values of the parameters of the crystallization temperature (Tc), the percentage of crystallinity (% C), Melt Temperature (Tm) and melting enthalpy change (ΔHfm).

In sixty-five years, merely nine percent of plastic waste was recycled and reused, twelve percent was incinerated, and the remaining seventy-nine percent has built up in landfills or ended up elsewhere in the environment. Statistically, the remaining seventy-nine percent of plastic wastes can be recycled in more than five-hundred years. Building and construction material is expensive due to the demand of the growing population with a low supply of the materials. To address this, the usage of solid-wastes for the manufacture of bricks and other building materials is an ideal-optimal approach towards tackling the challenges of handling waste-products as well as optimizing the production-cost of construction materials. Subsequently, plastic bottles, plastic containers, and plastic bags are flexible and possesses several characteristics includes good versatility, hardness, lightness, and resistance to chemicals and water and impact which can be heated and reshape to form a building material. Thus, this review briefly focusses on the possibility of utilizing non-hazardous wastes such as plastic wastes, glass bottles, and other solid-industrial wastes in making effective and quality and sand brick as substitute for expensive building material. This study is also aimed at educating the engineering public and professionals on the importance and necessity of waste management, reuse and recycling and also awareness on the benefits of conserving our environment through the reuse and utilization of waste within it. The review helps to identify the different types of wastes with potential of utilization towards construction and several key research factors and criteria which can provide focus and direction towards the choice of wastes-type to be used and ensuring that they have utilization potentials in the various value-addition applications. The piling of such wastes poses an environmental problem often on account of chemicals which the ecosystem has never been used to. These affect its proper functioning and in turn at the global level, are likely to affect even the stability of biosphere. The pool of information on Solid Wastes generation, disposal and management is increasing each year. A comprehensive review of available literature regarding Solid Wastes generation, disposal and management has been presented in this article.

Background: The procurement in public sector in India was revolutionized by Government e marketplace (GeM). This study was undertaken to elaborate the implementation process, identify advantages and challenges in a tertiary care institute of North India.Methods: The process of implementation of GeM was studied by reviewing the orders, records. Data related to items procured from year 2017 to 2019 was retrieved.Results: The procurement through GeM portal has steadily increased through the year. The portal offers many advanatges like simplification of procurement, paperless, time bound, transparent system with minimal human interface. Innovative approaches like GeM helpdesk, GeMmy are used. There could be better provisions for stringent quality assurance, rate contract or extended warranty or annual and comprehensive maintenance contracts on GeM..Conclusions: GeM portal is a relatively novel dynamic concept in the country and continuously evolving with a mandate to revolutionize public procurement.

Retroperitoneal fibrosis is a rare condition characterized by the presence of fibrous inflammatory tissue in the retroperitoneal structures, such as the infrarenal great vessels and ureters. We are reporting an atypical case of an alcoholic who presented with chronic back pain and abnormal liver function tests. Abdominal imaging revealed an incidental, ill-defined, abnormal soft tissue mass in the left pelvis and mild to moderate left hydroureteronephrosis. Interventional radiology (IR)-guided core biopsy reported cores of dense fibrous tissue with extensive lymphoplasmacytic infiltrates, consistent with idiopathic retroperitoneal fibrosis (IRF). The patient had a left ureteral stent placed and, subsequently, had robotic surgery for ureteral reimplantation.

Background: Clavicle is one of the common bones to undergo fractures with incidence rate higher in second to third decade of one’s life as well as in elderly age. Management of these clavicle fractures have always been a subject of debate, where literature have been advocating both non-operative as well as operative methods.Methods: The present study was conceived to know the burden of these isolated clavicle fracture cases reporting to tertiary level healthcare institute of North India and to study about their management pattern.Results: During the five years study duration (2014-2018), a total of 38 patients had reported to the trauma centre of the institute. Out of total, males had more preponderance 77% (29) and incidences were reported more in younger population. All patients were managed well by opting conservative measures, besides deformity had been reported in 2 (5.26%) patients. 3 (7.9%) patients had reported with complaints of pain, weakness while doing work, fatigue and pain when lying on the affected shoulder None of the patient was managed by open reduction and fixation.Conclusions: The present study concludes that the number of patients having isolated clavicle fracture are not contributing to any sort of burden at tertiary level institutes and are not even time consuming.

Assessment and management of presumed branchial cleft cysts: our experience.The aim was to assess the accuracy of diagnosis and management of presumed branchial cleft cysts in our centre.Retrospective review of patients with a clinical diagnosis of branchial cleft cyst at B arts Health NHS Trust from 2009 to 2015.67 patients underwent surgical excision for presumed branchial cysts. Ninety per cent were histologically confirmed, 7% demonstrated cystic metastatic squamous cell carcinoma, and 3% lymph node metastases from papillary thyroid cancer. No patient had pre-operative Multi-Disciplinary Team (MDT) discussion. Pre-operative FNA had a positive predictive value of 90% (95% Cl 0.82-0.95). Age40 years (p=0.02) and presence of lymph nodes (p=0.02) carried a higher risk of malignancy.Patients40 years with or without multiple lymph nod 'es on imaging should be treated as presumed meta- static cancer. Consideration should be given to concurrent panendoscopy and intra-operative frozen section +/- selective neck dissection after discussion at the HeadNeck MDT.

In the present report, we have done specific heat measurements in glassy Se80−xTe20Sbx (0 ≤ x ≤ 15) alloys in glass transition region. Differential scanning calorimetry (DSC) technique is used for this purpose. We have observed a tremendously huge increase in the specific heat (Cp) values at the glass transition temperature. The thermal analysis shows that the values of Cp below glass transition temperature and the difference of Cp values before and after glass transition (∆Cp) are highly composition-dependent.

Objective:To assess the efficacy of endoscopic-guided botulinum toxin injection into the cricopharyngeus muscle and evaluate the duration of its effects.Methods:A 3-year prospective study of 12 patients undergoing injection of botulinum toxin was conducted, with a telephone survey to assess dysphagia pre-operatively, and at 1, 3 and 6 months post-treatment, using the MD Anderson Dysphagia Inventory.Results:Median age was 66.2 years. Causes of cricopharyngeal dysphagia included idiopathic cricopharyngeal hypertrophy (67 per cent), previous cerebrovascular accident (17 per cent), cranial nerve palsy (8 per cent) and previous chemoradiotherapy to the neck (8 per cent). There were no complications. Two patients had repeat injections after six months. There was significant improvement in MD Anderson Dysphagia Inventory scores at one and three months versus pre-operative scores (73.1 ± 14.9 vs 46.9 ± 7.6, p = 0.0001, and 65.1 ± 11.5 vs 46.9 ± 7.6, p = 0.0001), but not at six months (51.0 ± 11.0 vs 46.9 ± 7.6, p = 0.14).Conclusion:Endoscopic-guided injection of botulinum toxin into the cricopharyngeus muscle is a safe and effective method for treating cricopharyngeal muscle dysfunction, lasting up to six months.

Objective:To evaluate the effect of body mass index and neck length on endotracheal tube movement during neck extension in thyroidectomy.Methods:A prospective study was conducted of 30 patients undergoing thyroidectomy during an 8-month period. Patient characteristics were recorded and endotracheal tube displacement was determined.Results:Mean body mass index was 27.8 kg/m2 (range, 17.5–34.7 kg/m2) and mean neck circumference was 43.2 cm (range, 28–56 cm). The mean (± standard deviation) upward displacement of the endotracheal tube during neck extension was 7.17 ± 5.87 mm. Patients with a larger body mass index had a significantly greater amount of tube displacement (R2 = 0.67, p < 0.0001), as did patients with a smaller neck length (R2 = 0.48, p < 0.0001).Conclusion:Neck extension results in upward displacement of the endotracheal tube. The amount of displacement is significantly higher in patients with a larger body mass index or shorter neck length. This has particular relevance for nerve monitoring in thyroidectomy.

In the present work, an attempt has been made to correlate the structural modifications in glassy Se80Te20 alloy after incorporation of Ag as chemical modifiers in terms of some significant physico-chemical parameters. For this, we have determined some significant physic-chemical parameters i.e., coordination number, constraints, density, molar volume, cohesive energy, heat of atomization etc in glassy Se80-xTe20Agx (0 ≤ x ≤ 15) alloys. Our results indicate that there is a significant change in the structural environment of the parent glassy system due to rigidity percolation.

Hemophagocytic lymphohistiocytosis (HLH) is a severe inflammatory disorder characterized by the uncontrolled proliferation of lymphocytes and histiocytes with hemophagocytic activity in the bone marrow. To our knowledge, there have been a few reported cases of pregnancy-related HLH. This case highlights the importance of considering HLH in a pregnant woman along with other diagnoses, such as HELLP (which stands for hemolysis, elevated liver enzyme levels, and low platelet levels) syndrome and hemolytic anemias. It points to the challenges of diagnosing and managing pregnancy-related HLH due to a similarity in presentation with other conditions.

Today if you look at the financial system around the globe, more than half the population in the world- around three billion – do not qualify to take out a loan from a bank (Muhammad Yunus).This reason turned out to be the actual driving force behind the birth of the microfinance movement stating from Grameen Bank in Bangladesh in 1983 to Grameen America movement today. Microfinance has received increasing attention as an effective strategy to alleviate poverty by providing financial services to the poor who have little or no access to capital and formal financial services, as well as providing additional support services such as training on education, healthcare and other basic needs. Yet the increasing attention and reputation that microfinance institutions (MFIs) have achieved, their contribution to poverty alleviation on a global level remains limited. The research paper aims to take an insight into the impact of microfinance schemes on the standard of living of the beneficiaries who have availed the advantage of such schemes in the district of Bhopal. The study aims to reveal the experience of these beneficiaries through careful investigation and analysis. The Microfinance schemes propose to aim at poverty eradication among the society. The objective of this study thus brings under its purview the examination of how these schemes have impacted greatly on asset acquisition and savings of the beneficiaries tocurb down their poverty level. A total of 720 beneficiaries of State Bank of India in Bhopal were selected as the study sample who had alreadyavailed the benefits of these Microfinance schemes. A primary questionnaire was formulated to record the experiences of these beneficiaries and thus the results were analyzed. Furthermore, the paper also examines the level of awareness about the microfinance schemes amongst the target social groups for whom these schemes have been devised.

Biodiesel production from algae oil by transesterification reaction using ultrasonic irradiation on heterogeneous catalyst was done at atmospheric condition to make the process sustainable and parsimonious. Ultrasonication reduces the reaction time as compared to the conventional methods and the solid acid catalyst gives 99.15% biodiesel yield which was obtained for oil to methanol molar ratio 1:10, catalyst 2 wt.% of oil, metal 0.4 wt.% of catalyst and 15min. reaction time. Heterogeneous catalyst and ultrasonic irradiation gives good yield and handling for biodiesel production.

Tin oxide thin films were deposited on well cleaned glass substrates by thermal evaporation in vacuum and were annealed at 500 ∘C in the open atmosphere inside a furnace for 90 min for promoting the sensitivity of the films. The X-ray diffraction studies revealed that the as-deposited films were amorphous in nature and the annealed films showed appreciable crystalline behavior. The annealed thin films were then irradiated using 60Co gamma source. The radiation induced changes were then studied by X-ray diffraction, scanning electron microscopy, UV–vis spectroscopy and I–V characterization. The remarkable increase in the average grain size, the decrement in the energy band gap and resistivity due to the gamma irradiations up to a certain dose and the reversal of these properties at higher doses are the important observations. The large changes in the conductivity and energy band gap of the annealed thin films due to gamma irradiation make these films quite important device material for the fabrication of gamma sensors and dosimeters.

To assess whether a dedicated "1-stop" neck lump clinic has improved the percentage of adequate fine-needle aspiration cytology (FNAC) samples and reduced the need for repeat FNAC.Retrospective review.District General Hospital in the United Kingdom.Patients attending for ultrasound-guided FNAC over a 6-month period from August 2012 to February 2013. Patients were placed in 4 groups: group 1, FNAC performed by any of the subspecialist radiologists with cytology support (n = 100); group 2, FNAC performed by general radiologists without cytology support (n = 112); group 3, FNAC performed by a particular subspecialist radiologist with cytology support (n = 61); and group 4, FNAC performed by the same subspecialist radiologist without cytology support (n = 125).There was a significantly higher rate of adequacy of FNAC in the presence of a subspecialist radiologist with immediate cytology (group 1) versus a general radiologist without cytology support (group 2; 87/100 vs 63/112, P = .0001), a significantly higher rate of adequacy of FNAC in the presence of cytology support with the same radiologist (group 3 vs group 4, 55/61 vs 97/125, P = .04), and a significantly higher rate of adequacy of FNAC in the presence of a subspecialist radiologist versus a general radiologist without cytology support (group 4 vs group 2, 97/125 vs 63/112, P = .0005).Immediate cytology and the presence of a subspecialist radiologist increase the adequacy of FNAC. The adequacy rate of non-cytology-supported FNAC or nonsubspecialist FNAC is below the adequate rate expected from the literature or as recommended in national guidelines.

Sixteen samples of a new phase of stannic phosphor–silicate inorganic ion exchanger have been synthesized under different conditions of preparation. The sample possessing the maximum ion-exchange capacity (1.50 meq g−1 of dry exchanger) was chosen for the detailed study and its chemical composition was determined. The new phase is found to be thermally stable, possessing a high ion-exchange capacity, and showing an interesting regeneration phenomenon after heating at elevated temperatures when compared to the corresponding ion exchanger stannic phosphate. The ion-exchange capacity is found to be almost completely regained when determined on regenerated samples. The gain/loss of ion-exchange capacity has been studied as a function of temperature, in the range of 40–800 °C. Thermo gravimetric (TG) analysis, X-ray, pH titrations and IR spectral studies have been performed. TG of the exchanger shows a higher percent mass loss in H+ form than that in the K+ form. Thermal studies give an idea of the internal and the external water molecules present in the exchanger. On this basis, the empirical formula of the new phase of the stannic phosphor–silicate prepared in these studies has been proposed. Quantitative separation of UO 2 2+ from VO2+ and Zn2+, and that of Cu2+ from Al3+ and Ni2+ have been achieved on the basis of its adsorption behaviour. The reproducibility in the properties of the exchanger has been checked by duplicate preparations.

Five samples of stannic antimony silicate inorganic ion exchanger have been synthesized under different conditions of preparation. The sample possessing the maximum ion exchange capacity (0.90 meq g−1 of dry exchanger) was selected for detailed studies and its chemical composition was determined. The exchanger was found to be thermally stable, possessing good ion exchange capacity and exhibiting regeneration phenomenon after heating at elevated temperatures when compared to the corresponding ion exchanger stannic antimonate. The ion exchange capacity is almost completely regained when determined on regenerated exchanger samples. The gain/loss of ion exchange capacity has been studied in the temperature range 40–800 °C. The reproducibility in the properties of the exchanger has been checked by duplicate preparations. The X-ray, pH titrations, TG and FTIR spectral studies have been performed. TG curve of the exchanger shows a higher percent mass loss in H+ form than that in K+ form and also gives an idea of the internal and the external water molecules present in the exchanger. On the basis of the above studies, the empirical formula of stannic antimony silicate has been proposed. Quantitative separations of Zn2+ from Mn2+, Cu2+ and Ni2+ have been carried out on the exchanger columns.

The neutron dose is estimated by linear energy transfer (LET) spectrometry method for two reactions, viz. 1H+9Be and 1H+12C at 20 MeV proton energy using CR-39 track detectors. The LET spectrum is generated from the major, minor radii of each track and thickness of removed surface from each side of the detector due to chemical etching. Microdosimetric distributions of absorbed dose and dose equivalents are obtained from the LET spectrum. The absorbed dose and dose equivalent per incident proton obtained from the LET spectra are found to be about 12.5 and 8 times higher in 1H+9Be reaction than 1H+12C reaction.