A rare case of a middle ear glomangioma

Glomus tumors are benign hyperplasia of glomus bodies, and they are rarely found in the head and neck. The middle ear is an exceptionally rare site for a true glomus tumor, and there are only three previously reported cases in this location. Glomus tumors are etiologically different than glomus tympanicum, which are paragangliomas of the middle ear that are often mistakenly referred to as “glomus tumors.” This is a common misconception due to the “glomus” misnomer. We report a case of a patient diagnosed with a middle ear glomangioma after initially presenting to our clinic with tinnitus and hearing loss. The mass was surgically removed through a transcanal approach with carbon dioxide laser and sharp dissection. Literature review is also reported and revealed similar presentations in patients with middle ear glomangiomas.

Opioid Receptor-Mediated and Non-Opioid Receptor-Mediated Roles of Opioids in Tumour Growth and Metastasis

Opioids are administered to cancer patients in the period surrounding tumour excision, and in the management of cancer-associated pain. The effects of opioids on tumour growth and metastasis, and their consequences on disease outcome, continue to be the object of polarised, discrepant literature. It is becoming clear that opioids contribute a range of direct and indirect effects to the biology of solid tumours, to the anticancer immune response, inflammation, angiogenesis and importantly, to the tumour-promoting effects of pain. A common misconception in the literature is that the effect of opioid agonists equates the effect of the mu-opioid receptor, the major target of the analgesic effect of this class of drugs. We review the evidence on opioid receptor expression in cancer, opioid receptor polymorphisms and cancer outcome, the effect of opioid antagonists, especially the peripheral antagonist methylnaltrexone, and lastly, the evidence available of a role for opioids through non-opioid receptor mediated actions.

Pediatric Home Tracheostomy Care: The Importance of Knowledge Assessment

Assessment of caregiver knowledge is an essential part of home healthcare education for pediatric tracheostomy care, however, there is a paucity of evidence in long term. This study aims to determine how caregiver knowledge and misconceptions, as assessed by our knowledge test, changed over a 12-month period following our educational program and whether the test score was associated with any demographics of the caregivers and children with tracheostomy. A prospective cohort study was undertaken to evaluate the knowledge at 3 timepoints after tracheostomy education: baseline (T1), 6 months (T2), and 12 months (T3). Test scores were analyzed for trend and relationship with demographics. Items for which less than 80% caregivers gave correct responses at T1 were considered common misconceptions. Fifty-four caregivers were enrolled. Out of a maximum score of 25, the median (IQR) scores were 22 (21-23), 23 (22-24), and 23 (22-25), at T1, T2, and T3, respectively. The scores at T2 and T3 were significantly higher than at T1 ( P ≤ .01). One common misconception “how to manage when suction got less secretion than expected” was found at all timepoints. Caregivers of children with >2 comorbidities scored slightly higher than those of children with 0 to 2 comorbidities ( P = .01). In conclusion, our caregivers achieved high knowledge scores which increased over the 12-month study period potentially because of repeated assessment and practical experience. Common misconceptions and a factor associated with the knowledge were also identified. These advantages highlighted the importance of knowledge assessment for quality improvement.

The nature and origin of cratons constrained by their surface geology

To the memory of Nicholas John (Nick) Archibald (1951−2014), master of cratonic geology. Cratons, defined by their resistance to deformation, are guardians of crustal and lithospheric material over billion-year time scales. Archean and Proterozoic rocks can be found in many places on earth, but not all of them represent cratonic areas. Some of these old terrains, inappropriately termed “cratons” by some, have been parts of mobile belts and have experienced widespread deformations in response to mantle-plume-generated thermal weakening, uplift and consequent extension and/or various plate boundary deformations well into the Phanerozoic. It is a common misconception that cratons consist only of metamorphosed crystalline rocks at their surface, as shown by the indiscriminate designation of them by many as “shields.” Our compilation shows that this conviction is not completely true. Some recent models argue that craton formation results from crustal thickening caused by shortening and subsequent removal of the upper crust by erosion. This process would expose a high-grade metamorphic crust at the surface, but greenschist-grade metamorphic rocks and even unmetamorphosed supracrustal sedimentary rocks are widespread on some cratonic surfaces today, showing that craton formation does not require total removal of the upper crust. Instead, the granulitization of the roots of arcs may have been responsible for weighing down the collided and thickened pieces and keeping their top surfaces usually near sea level. In this study, we review the nature and origin of cratons on four well-studied examples. The Superior Province (the Canadian Shield), the Barberton Mountain (Kaapvaal province, South Africa), and the Yilgarn province (Western Australia) show the diversity of rocks with different origin and metamorphic degree at their surface. These fairly extensive examples are chosen because they are typical. It would have been impractical to review the entire extant cratonic surfaces on earth today. We chose the inappropriately named North China “Craton” to discuss the requirements to be classified as a craton.

Special Features of the Spiritual Leadership of St. Theofan the Recluse

Статья посвящена специфике аскетической практики известного русского подвижника благочестия епископа Феофана (Говорова). В начале статьи даётся историческое обоснование диалектическому противостоянию между миром и монастырём, которое разрешается в одну из благодатных форм христианской жизни. Далее проводится различение между понятиями «мир Божий», как сотворённая Богом Вселенная, и «мир греха», как господство зла, вторгшегося в окружающий мир по вине человека. Это различение помогает снять распространённое заблуждение относительно монашеского отречения от мира и выявить подлинные отношения, которые рождает человек, ставший на монашеский путь духовного возрождения. Развивая эти отношения, монах входит в целостное, органическое, духовное и благодатное единство с миром Божиим, что позволяет ему установить основанное на любви ко всему божественному творению подлинное отношение ко всем обитателям тварного мира. На этом основополагающем принципе монашеской жизни, как пишет епископ Феофан, Затворник Вышенский, как раз и нужно строить архипастырское руководство всеми членами Церкви - не только монашеским братством, но и мирскими людьми, тем самым продолжая духовную традицию русского старчества. The article is devoted to the specifics of the ascetic practice of the famous Russian devotee of piety, Bishop Theofan (Govorov). At the beginning of the article, a historical basis is given for the dialectical confrontation between the world and the monastery, which is resolved into one of the blessed forms of Christian life. Further, a distinction is made between the concepts of «the world of God», as the universe created by God, and the «world of sin», as the rule of evil that invaded the surrounding world through the fault of man. This distinction helps to remove the common misconception about monastic renunciation of the world and to reveal the true relationship that a person gives birth to when he embarks on the monastic path of spiritual rebirth. Developing these relationships, the monk enters into an integral, organic, spiritual and grace-filled unity with the world of God, which allows him to establish a genuine relationship based on love for the entire divine creation with all the inhabitants of the created world. On this fundamental principle of monastic life, as Bishop Theofan, the Recluse of Vyshensky writes, it is precisely necessary to build the archpastoral leadership of all members of the Church - not only the monastic brotherhood, but also the secular people, thereby continuing the spiritual tradition of the Russian eldership.

COUNTEREXAMPLES: CHALLENGES FACED BY ELEMENTARY STUDENTS WHEN TESTING A CONJECTURE ABOUT THE RELATIONSHIP BETWEEN PERIMETER AND AREA

One pedagogical approach to challenge a persistent misconception is to get students to test a conjecture whereby they are confronted with the misconception. A common misconception about a ‘direct linear relationship’ between area and perimeter is well-documented. In this study, Year 4-6 students were presented with a conjecture that a rectangle with a larger perimeter will always have a larger area. Eighty-two (82) students’ written responses from three elementary schools in Victoria, Australia were analyzed. The findings revealed that Year 4-6 students could find multiple examples to support the conjecture but they struggled to find counterexamples to refute the conjecture. The findings underscored the importance of developing elementary school students’ capacity to construct counterexamples and recognize that it is sufficient to offer one counterexample in refuting a conjecture about all cases. Implications for ­teaching practice to support investigating and testing a conjecture are discussed.

Decoding the smart city narrative

It is a common misconception that smart cities are simply those that use Information and Communication Technologies. In fact, it is not as straightforward as that. A wide range of definitions exists out there regarding the smart city concept. While they do have in common an innovative and creative approach to solving urban problems, they also differ in the extent, reach, method, goals, and strategies utilized to fulfil those definitions. The author of this paper examined over 50 definitions from various contexts and identified a common, but also inherently diverse, set of goals smart cities claimed to represent. They also vastly diverged in their strategies and time lines. From brand new cities designed to be smart to smart initiatives of varying complexity, there is no single and agreed-upon definition among the various stakeholders. This paper attempts to decode the smart city narrative that has been over two decades in the making.

Decoding the smart city narrative

It is a common misconception that smart cities are simply those that use Information and Communication Technologies. In fact, it is not as straightforward as that. A wide range of definitions exists out there regarding the smart city concept. While they do have in common an innovative and creative approach to solving urban problems, they also differ in the extent, reach, method, goals, and strategies utilized to fulfil those definitions. The author of this paper examined over 50 definitions from various contexts and identified a common, but also inherently diverse, set of goals smart cities claimed to represent. They also vastly diverged in their strategies and time lines. From brand new cities designed to be smart to smart initiatives of varying complexity, there is no single and agreed-upon definition among the various stakeholders. This paper attempts to decode the smart city narrative that has been over two decades in the making.

772 Quality Improvement Project – Establishment of The Breast Pain Clinic at Torbay Hospital

Introduction Breast pain alone should not be imaged. The common misconception that breast pain alone is a symptom of malignancy and the subsequent impact on the Triple Assessment Clinic (TAC), lead to the development of the Breast Pain Clinic (BPC), a holistic service to educate patients and reduce unnecessary imaging. Method Retrospective data was collected of TAC attendees between September-December 2018, noting patients presenting solely with breast pain (BPP); number of BPP imaged; and those with positive results. Prospective data collection of those attending the TAC and BPC were collected between September-December 2019. Results Retrospectively 17% (151/888) of TAC attendees were BPP, 23.8% (36/151) were imaged and 97.2% (35/36) had normal/benign changes. Following BPC creation 7% (67/940) of TAC attendees were BPP, 31.3% (21/67) were imaged all with no positive results. 1% (3/94) of BPC attendees were BPP, all with normal/benign imaging. 96% of questionnaire respondents felt more confident managing breast pain. Conclusions The development of a BPC was successful in educating patients and reducing anxiety. It also reduced the proportion of patients presenting to the TAC with pain and the proportion of patients imaged. With further education of community practitioners on referral adherence, this service could benefit breast services nationwide.

Cooking with Extra Virgin Olive Oil

Mediterranean cultures have used Extra Virgin Olive Oil (EVOO) as the only source of cooking oil for centuries, with their diet showing the highest amount of scientifically proven health benefits. However, there is a common misconception that EVOO is not suitable for cooking given its relatively lower smoke point, despite no scientific evidence that support this. This chapter aims to provide an overview of how EVOO is healthier, safer, and more stable to cook with than other common edible oils. Furthermore, this chapter aims to present EVOO’s suitability for use on Teflon coated pans, which is another common myth.