Venous sinus stenting for intractable pulsatile tinnitus: A review of indications and outcomes

Background: Pulsatile tinnitus presents as a unique variation of tinnitus in which a conscious perception of the heartbeat is localized to the ears in either unilateral or bilateral fashion. The sensation is typically caused by an increase in turbulent blood flow in the affected ear, in most cases, due to a structural abnormality of the venous sinuses – the most common of which being stenosis. Herein, we discuss the etiology of pulsatile tinnitus followed by indications for treatment of various pathologies which have been successfully treated with venous sinus stenting and have led to resolution of auditory symptoms. Methods: The authors queried PubMed database using combinations of the keywords “venous sinus stenting,” “endovascular treatment,” and “pulsatile tinnitus” to identify relevant studies published in English after 2001 and before December 1, 2020 and verified selected. Results: Our results corroborate those published in prior reviews reporting a high rate of pulsatile tinnitus resolution with venous sinus stenting. Conclusion: The success of venous sinus stenting is clinically relevant as an effective treatment option for patients suffering from pulsatile tinnitus. Future applications and studies are needed and are currently being developed to further demonstrate the effectiveness of stents in the treatment of pulsatile tinnitus.

Retroperitoneal Exposure of the Anterior Lumbar Spine

BACKGROUND Anterior lumbar spine procedures such as anterior lumbar interbody fusion (ALIF) are used commonly to treat multiple pathologies, including pseudoarthrosis and degenerative disk disease. It is generally a safe and effective procedure, but an anterior approach to the lumbar spine requires critical navigation of the surgical window to avoid delicate structures. An operative technique should maximize the exposure without an increased risk of iatrogenic injury. OBJECTIVE To describe in detail a retroperitoneal exposure of the anterior lumbar spine. METHODS This surgical approach is a unique variation of standard anterior lumbar spine exposure techniques. This technique is described and illustrated in detail with an accompanying Supplemental Digital Content: video. Institutional Review Board (IRB) approval was not required because this is a variation of current techniques. Patient consent was obtained for the procedure and use of operative pictures and videos. RESULTS Precise details of the technique are described. The surgical video demonstrates the technique for the L5-S1 ALIF approach. CONCLUSION This technique is a novel variation of the standard retroperitoneal exposure of the anterior lumbar spine. The incision placement, size, and dynamic blunt retraction of this approach limit tissue disruption and provide an efficient exposure that has not been previously described in the literature.

Identification of Variation Sources for High Precision Fabrication in a Digital Twin Context

The aerospace industry is increasing its focus on fabrication in manufacturing, foregoing large castings to instead assemble and join smaller parts into final products. This increases the total amount of geometrical variation introduced during the production process, since the unique variation from each individual part can add to a propagating effect putting the final assembled product outside of tolerance limits. Geometry assurance and variation simulation has traditionally been applied as a part of the design process to develop robust manufacturing concepts that are as insensitive as possible to variation. A concept for geometry assurance has been proposed where variation simulation is conducted for each individual assembly using real measurements from incoming parts, making it possible to make adaptive adjustments to production parameters to optimize results. It is however not feasible to measure and simulate every aspect of the process. This paper provides a summary of relevant sources of geometrical variation for a high precision fabrication process, based on input from a fabrication process in the aerospace industry. Variation sources are analyzed and discussed from an industrial perspective, putting them in the context of an actual fabrication process as well as in the context of digital twins for geometry assurance.

Climate extremes, variability, and trade shape biogeographical patterns of alien species

Understanding how alien species assemble is crucial for predicting changes to community structure caused by biological invasions and for directing management strategies for alien species, but patterns and drivers of alien species assemblages remain poorly understood relative to native species. Climate has been suggested as a crucial filter of invasion-driven homogenization of biodiversity. However, it remains unclear which climatic factors drive the assemblage of alien species. Here, we compiled global data at both grid scale (2,653 native and 2,806 current grids with a resolution of 2° × 2°) and administrative scale (271 native and 297 current nations and sub-nations) on the distributions of 361 alien amphibians and reptiles (herpetofauna), the most threatened vertebrate group on the planet. We found that geographical distance, a proxy for natural dispersal barriers, was the dominant variable contributing to alien herpetofaunal assemblage in native ranges. In contrast, climatic factors explained more unique variation in alien herpetofaunal assemblage after than before invasions. This pattern was driven by extremely high temperatures and precipitation seasonality, 2 hallmarks of global climate change, and bilateral trade which can account for the alien assemblage after invasions. Our results indicated that human-assisted species introductions combined with climate change may accelerate the reorganization of global species distributions.

Khoe-San Genomes Reveal Unique Variation and Confirm the Deepest Population Divergence in Homo sapiens

The southern African indigenous Khoe-San populations harbor the most divergent lineages of all living peoples. Exploring their genomes is key to understanding deep human history. We sequenced 25 full genomes from five Khoe-San populations, revealing many novel variants, that 25% of variants are unique to the Khoe-San, and that the Khoe-San group harbors the greatest level of diversity across the globe. In line with previous studies, we found several gene regions with extreme values in genome-wide scans for selection, potentially caused by natural selection in the lineage leading to Homo sapiens and more recent in time. These gene regions included immunity-, sperm-, brain-, diet-, and muscle-related genes. When accounting for recent admixture, all Khoe-San groups display genetic diversity approaching the levels in other African groups and a reduction in effective population size starting around 100,000 years ago. Hence, all human groups show a reduction in effective population size commencing around the time of the Out-of-Africa migrations, which coincides with changes in the paleoclimate records, changes that potentially impacted all humans at the time.

Unconventional Monetary Policy and Bank Lending Relationships

We explore how banks transmit central bank liquidity injections using unique variation in the ECB’s 2011-12 Very Long-Term Refinancing Operations (VLTROs) which affected lending to firms discontinuously across credit ratings (i.e., within banks). We show that banks transmit liquidity differently to multi-bank firms than to firms with only one bank. Single-bank firms receive longer-term relationship lending and increase investment, while multi-bank firms receive short-term transactions-style lending only. Policy effects are attributable to increasing the maturity of bank borrowing from the ECB in combination with allowing banks to use loans to firms as collateral for such borrowing.

Crimped and Hooked End Steel Fibre Impacts on Self compacting Concrete

Self-compacting concrete is gaining importance in recent years due to its highest versatility in replacing compacting equipment and there by reducing the constructional flaws. The only limitation of SCC of compromising with strength has been challenged by the addition of steel fibers in this paper. In this research work two types of steel fibers such as crimped type and hook end type are utilized in various proportions such as 0.4%,0.8%, 1.0% and 1.25%. SCC mandatory tests such as Flowing ability, filling ability and passing ability were determined and then the mechanical properties such as compressive strength and split tensile strength have been determined. Results show the unique variation with reference to the different type of fiber and different volume of fiber. This unleashes a lot of scope in the field of Fiber reinforced Self compacting concrete

Correlated Unique Variation of Electrical Resistivity to Crystallization Behavior of the Zr52.5Cu17.9Ni14.6Al10Ti5 Metallic Glass

Due to the differences between the glass and crystalline phases, crystallization of metallic glass occurs with heat release, volume shrinkage, and electrical resistivity drastic changes. Electrical resistivity of the Zr52.5Cu17.9Ni14.6Al10Ti5 metallic glass during crystallization was investigated under both continuous heating and isothermal annealing. This amorphous alloy exhibits a continuous variation instead of sharp decline when reaches the onset crystallization temperature. This unique variation was found to be related to the formation of a few quasicrystalline phases. The slower phase transformation process of this metallic glass brings lots of grain boundaries, which results in increasing of resistivity at the last stage during isothermal annealing. These results imply that electrical resistivity measurement is a more intuitive approach to investigate structure evolution of metallic glasses.

Genetic diversity and core subset selection in ex situ seed collections of the banana crop wild relative Musa balbisiana

Crop wild relatives (CWRs) play a key role in crop breeding by providing beneficial trait characteristics for improvement of related crops. CWRs are more efficiently used in breeding if the plant material is genetically characterized, but the diversity in CWR genetic resources has often poorly been assessed. Seven seed collections of Musa balbisiana, an important CWR of dessert and cooking bananas, originating from three natural populations, two feral populations and two ex situ field collections were retrieved and their genetic diversity was quantified using 18 microsatellite markers to select core subsets that conserve the maximum genetic diversity. The highest genetic diversity was observed in the seed collections from natural populations of Yunnan, a region that is part of M. balbisiana's centre of origin. The seeds from the ex situ field collections were less genetically diverse, but contained unique variation with regards to the diversity in all seed collections. Seeds from feral populations displayed low genetic diversity. Core subsets that maximized genetic distance incorporated almost no seeds from the ex situ field collections. In contrast, core subsets that maximized allelic richness contained seeds from the ex situ field collections. We recommend the conservation and additional collection of seeds from natural populations, preferentially originating from the species' region of origin, and from multiple individuals in one population. We also suggest that the number of seeds used for ex situ seed bank regeneration must be much higher for the seed collections from natural populations.

Syllable Contact and Emergent Lenition in Bashkir

This study examines the syllable contact phonology of Bashkir (Kipchak, southern Urals, Russia), a language which exhibits a unique variation on general Turkic syllable contact phenomena, and proposes an Optimality Theoretic analysis, drawing on previous approaches to syllable contact in Turkic (Baertsch & Davis 2001, 2004, Gouskova 2001, 2004, Washington 2010). Bashkir desonorizes affix-initial coronal sonorants (/qullar/ --> [qul.dar]) to mandate compliance with the Syllable Contact Law (Davis, 1998). This occurs even at boundaries which would otherwise exhibit falling sonority, thereby maximizing sonority fall. Bashkir also exhibits a unique continuancy alternation pattern in desonorized affixes (taw-ðar, uram-dar, gaz-dar). This study adopts the Syllable Contact Hierarchy analysis proposed in Gouskova (2004), with ranking of relevant faithfulness constraints below all *DIST constraints mandating maximal sonority fall. It is proposed that continuancy alternations derived from a synchronically active lenition process, otherwise dominated by relevant faithfulness constraints, which emerges when unfaithfulness is forced to satisfy constraints on syllable contact.