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Sudden onset sensorineural hearing loss has been associated with infection by severe acute respiratory syndrome coronavirus-2. However, little is known regarding how this differs from sudden onset sensorineural hearing loss of other aetiologies. This systematic review summarises existing literature on severe acute respiratory syndrome coronavirus-2 associated sudden onset sensorineural hearing loss treatment and outcomes.
Methods
A literature search using Ovid was performed for studies which evaluated treatments and outcomes of patients with sudden onset sensorineural hearing loss associated with severe acute respiratory syndrome coronavirus-2 infection.
Results
A total of 99 studies were identified, from which 14 studies were selected for inclusion - collectively including 154 patients. Nine of these studies were single participant case reports and five were larger case series. Corticosteroid treatment varied between studies in terms of administration route, dose, and duration. Only 63/154 patients in this review achieved complete resolution of their symptoms following steroid treatment.
Conclusion
Oral, intravenous, and intratympanic steroids demonstrate a good safety profile. However, the majority of patients are left with unresolved hearing loss.
Christopher Alexander famously maintained that traditional architecture is inherently more ‘whole’ – and consequently more beautiful and alive – than modern architecture because the former is the product of organic processes, while the latter is the product of mechanistic processes. The central concept in Alexander’s theory – that architecture can be more or less whole – has only rarely been quantitatively examined. Furthermore, his claims about the superior wholeness of organic architecture have similarly remained untested. In response, this paper critically re-examines Alexander’s definition of wholeness in the context of A Pattern Language, along with previous attempts to quantify its properties. From this basis, the paper proposes a new pattern-based quantitative method for examining and measuring wholeness. This method is then tested through the analysis of seven ‘organic’ houses by Frank Lloyd Wright and seven ‘mechanistic’ villas by Le Corbusier. Through this process, the paper demonstrates a method for measuring wholeness, and quantitatively tests Alexander’s assertion that organic environments are more whole than mechanistic ones.
The purpose of this paper is to review methods and tools for mapping, visualising and exploring geographic information to aid in primary health care (PHC) research and development.
Background
Mapping and spatial analysis of indicators of locality health profiles and healthcare needs assessment are well-established facets of health services research and development. However, while there are a range of different methods and tools used for these purposes, non-specialists responsible for managing the use of such information systems may find knowing where to start and what can be done a relatively steep learning curve. In this review, health and sociodemographic datasets are used to illustrate some key methods, tools and organisational issues, and builds upon two recent reviews in this journal, respectively, focusing on geographic data sources and geographic concepts. Those familiar with mapping and spatial analysis should find this a useful review of current matters.
Method
A thematic review is presented with illustrative case studies relevant to PHC. It begins with a section on visualising and interpreting geographic information. This is followed by a section critiquing analytical methods. Consideration is given to software and deployment issues in a third section. Content is based on domain knowledge of the authors as a team of geographic information scientists and a public health practitioner working in tandem, with its scope restricted to routine applications of mapping and analysis. Advanced techniques such as spatio-temporal modelling are not considered, neither are methodological technicalities, although guidance on further reading is provided.
Summary
Geographical perspectives are now playing a significant role in PHC delivery, and for those engaged in informatics and/or managing population-level care, understanding key geographic information systems methods and terminologies are important as is gaining greater familiarity with institutional aspects of implementation.
We used a complete audit cycle to assess the quality and completeness of current admission bookings by junior doctors and whether the introduction of a standardised admission form led to improvements.
Results
Following the introduction of the standardised form significant improvements were found in almost all areas, including the recording of basic data, history, mental state, physical examination, risk assessments and diagnosis.
Clinical Implications
The introduction of a standardised admission form improved the completeness of information obtained. The form may also be used as an educational tool and to assist trainees preparing for examinations.
The etiology of early age onset substance use disorder (SUD), an Axis I psychiatric illness, isexamined from the perspective of the multifactorial model of complex disorders. Beginning atconception, genetic and environment interactions produce a sequence of biobehavioralphenotypes during development which bias the ontogenetic pathway toward SUD. One pathwayto SUD is theorized to emanate from a deviation in somatic and neurological maturation, which,in the context of adverse environments, predisposes to affective and behavioral dysregulation asthe cardinal SUD liability-contributing phenotype. Dysregulation progresses via epigenesis fromdifficult temperament in infancy to conduct problems in childhood to substance use by earlyadolescence and to severe SUD by young adulthood.
General psychiatrists have recently been encouraged to provide treatment to heroin addicts, including in-patient detoxification. No comparison has previously been made of specialist versus general psychiatric in-patient care.
Method
During a randomised study of cue exposure, 186 opiate addicts were also randomised to either specialist in-patient (DDU; n=115) or general psychiatric (GEN; n=71) wards in the same hospital.
Results
From pre-treatment (post-randomisation) onwards, patient outcomes differed across the two in-patient settings. Of the original randomised sample, significantly more DDU than GEN subjects accepted their randomisation (100 v. 77%), were subsequently admitted (60 v. 42%), and completed in-patient detoxification (45 v. 18%). Of patients admitted, more DDU than GEN patients completed detoxification (75 v. 43%). During seven-month follow-up, of those 43 patients who reached the end of treatment, significantly more ex-DDU than ex-GEN subjects were opiate-free.
Conclusions
From pre-treatment onwards, significant differences in process and outcome were found after allocation to treatment on either DDU or GEN. Further randomised studies are required to replicate and explain these findings.
Thin diamond film coated WC-Co cutting tool inserts were produced using arc-jet and hot-filament chemical vapor deposition. The diamond films were characterized using SEM, XRD, and Raman spectroscopy to examine crystal structure, fracture mode, thickness, crystalline orientation, diamond quality, and residual stress. The performance of the tools was evaluated by comparing the wear resistance of the materials to brazed polycrystalline diamond-tipped cutting tool inserts (PCD) while machining A390 aluminum (18% silicon). Results from the experiments carried out in this study suggest that the wear resistance of the thin diamond films is primarily related to the grain boundary strength, crystal orientation, and the density of microdefects in the diamond film.
Realistic simulation of the atomic-scale properties of complex systems has long been a goal of scientists interested in the behavior of condensed matter. Until recently, the role of atomistic simulation techniques has been to address rather idealized problems in statistical mechanics. Treatment of more realistic materials has been uncommon not because suitable approaches toward simulating such materials were unknown, but rather because the computer power available was inadequate. Recently, major advances have occurred in the complexity of systems subject to atomistic simulation, primarily due to a dramatic increase in availability of computer power. These new capabilities have driven the development of atomic-scale descriptions of real materials accurate enough for atomistic simulation of a wide range of specific materials science problems.
In this section, we will outline several of the techniques used to simulate the microscopic behavior of an atomistic system. The first method introduced for atomistic simulation was the molecular dynamics technique, in which Newton's equations of motion for the individual atoms are integrated numerically for given interatomic and external forces. One of the first uses of this technique was the study, by Fermi, Pasta, and Ulam, of randomization of vibrational energy in a one-dimensional chain of atoms. Although the results of this initial application were to some extent unsatisfactory, the molecular dynamics technique has since been applied to a wide range of problems in the statistical mechanics of condensed media.
The computer simulation of the structure and fracture of interfaces on an atomic scale requires a computationally efficient prescription for the total energy that is reliable both for small deviations from the bulk as well as for the free surfaces produced during fracture. The recently developed Embedded Atom Method is such a method. It will be briefly described and compared to traditional pair interaction approaches. In particular, it will be shown that the many-body effects inherent in the Embedded Atom Method are essential to correctly describe the experimentally observed surface reconstructions of Au surfaces.
The necessary first step in simulating the fracture of an interface, such as a grain boundary, is the determination of the initial or equilibrium atomic configuration of the interface. Equilibrium Monte Carlo simulations using the Embedded Atom Method can determine this structure. This approach will be outlined and various results for grain boundary structure in fcc metals will be presented. The atomic structure of symmetric tilt boundaries is found to be significantly different from that deduced from energy minimization techniques. In addition, the Monte Carlo technique allows for the determination of thermal effects such as the vibrational amplitudes at the interface and the thermal expansion of the interface.
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