Umrao Hospital

Objectives Despite its established efficacy and safety, and wide international use, there is currently limited experience of the CI632 cochlear implant system (Cochlear™ Nucleus ® CI632 Profile™ Plus Implant with Slim Modiolar Electrode) in China. The aim of this study was to evaluate the performance and safety of the CI632 system in a Chinese population and gain insights from surgeons implanting this device in a real-world setting. Methods This prospective, real-world observational study enrolled children and adults with bilateral moderate sloping to profound sensorineural hearing loss who were identified as candidates for the CI632 system. Participants traveled to the Bo'ao Lecheng International Medical Tourism pilot area for implant surgery, which was performed by experienced cochlear implant surgeons at the Bo'ao Super Hospital. Participants returned to their home province for activation of the device and follow-up management, performed at clinics located across mainland China. Hearing performance was evaluated pre- and post-operatively (3 and 6 months after activation of the device) using aided 4-frequency pure tone thresholds (PTA4 at 500, 1000, 2000, and 4000 Hz) and age-appropriate functional listening questionnaires. At the time of surgery, cochlear implant surgeons completed a survey that assessed ease of implantation and satisfaction with the CI632. Results Participants ( n = 25; 18 males, 7 females) were aged between 2 and 62 years (mean 22.6 years). All participants tested were able to access the speech spectrum for PTA4 (500, 1000, 2000, and 4000 Hz) at 6 months post device activation. Improvements in hearing thresholds were evident at 3 and 6 months post device activation [mean within-subject improvement in PTA4 from best-aided baseline: 30 dB (95% confidence interval 34.5, 25.4) at 6 months]. Hearing function as measured with age-appropriate questionnaires showed mean improvements from baseline at both 3 and 6 months post device activation for both adults and children across all domains assessed. No surgical complications were reported. Six mild ear-related adverse events were reported during follow up, all resolved during the study. Surgeons ( n = 4) gave high ratings for the ease and satisfaction of the surgical procedure with the CI632 implant, and all surgeons indicated they would consider using this device in future surgeries. Conclusion This real-world, observational study demonstrated the safety and hearing performance achieved in children and adults with the CI632 implant system when implemented via a representative cochlear implant-management setting in China (travel to a central location for surgery with device activation and follow up at local clinics in mainland China). Surgeons reported high levels of confidence and satisfaction with device insertion. Improvements in hearing function and audiometric outcomes were demonstrated across a wide age-range of participants at 3 and 6 months post activation.

Abstract A lotus leaf like self‐cleaning superhydrophobic coating has high demand in industrial applications. Such coatings are prepared by alternative dip and spray deposition techniques. A layer of polyvinyl chloride is applied on glass substrate by dip coating and then spray coated a suspension of hydrophobic silica nanoparticles at substrate temperature of 50 °C. This coating procedure is repeated for three times to achieve rough surface morphology which exhibits a water contact angle of 169 ± 2° and sliding angle of 6°. The superhydrophobic state of the coating is still preserved when water volume of 1.2 L is used to impact the water drops on coating surface. The stability of the wetting state of the coating is analyzed against the water jet, adhesive tape and sandpaper abrasion tests. The prepared superhydrophobic coating strongly repelled the muddy water suggesting its importance in self‐cleaning applications.

Abstract In this study, the hydrophobic silica nanoparticles (NPs) are synthesized by simple sol–gel processing of polymethylhydrosiloxane (PMHS). The nanocomposite solution is prepared by adding hydrophobic silica NPs in polystyrene solution and applied on the skeleton of polyurethane sponge by simple immersion‐drying process. The as‐prepared sponges exhibited superhydrophobic property with water contact angle 161° and oil contact angle nearly 0° and can separate oil from oil–water and oil–muddy water mixture. The superhydrophobic sponge has sustainable anti‐wetting property under cross sectional cutting, pressing and twisting, and different pH environment. Such superhydrophobic sponge is suitable for practical application on a large scale.

Abstract Background: A history of preoperative obstructive pyelonephritis has been reported as a risk factor for febrile urinary tract infection (fUTI) after ureteroscopic lithotripsy (URSL). But there is no clear evidence of risk factors for developing fUTI including the optimal timing of URSL after obstructive pyelonephritis treatment. Methods: Of the 1361 patients, who underwent URSL at our hospital from January 2011 to December 2017, 239 patients had a history of pre-URSL obstructive pyelonephritis. The risk factors were analyzed by comparing the patients’ backgrounds with the presence or absence of fUTI after URSL. The factors examined were age, gender, body mass index, comorbidity, presence or absence of preoperative ureteral stent, stone position, stone laterality, stone size, Hounsfield unit (HU) value on computed tomography scan, history of sepsis during obstructive pyelonephritis, period from antipyresis to URSL, ureteral stenting period, operation time, and presence or absence of access sheath at URSL. In addition, the stone components and renal pelvic urinary culture bacterial species during pre-URSL pyelonephritis were also examined. Results: Post-URSL fUTI developed in 32 of 239 patients (13.4%), and 11 of these 32 cases led to sepsis (34.4%). Univariate analysis showed that stone position, stone maximum HU value, presence of sepsis during obstructive pyelonephritis, period from antipyresis to URSL, pre-URSL ureteral stent placement, operation time were risk factors of fUTI. Stone components and urinary cultures during pyelonephritis were not associated with risk of fUTI. Multivariate analysis showed that renal stone position, pre-URSL ureteral stent placement > 21 days, and operation time > 75 minutes were independent risk factors of fUTI following the URSL. Conclusions: F-UTI following the URSL could be avoided by ureteral stent placement period 21 days or less and operation time 75 minutes or less in patients with obstructive pyelonephritis.

BackgroundWe evaluated the clinical significance and prognostic value of histopathological features of bladder cancer, such as subepithelial growth patterns and tumor growth pattern at the invasion front.MethodsIn total, 130 patients newly diagnosed with non-muscle invasive bladder cancer and underwent transurethral resection between 1998 and 2009 were enrolled. Subepithelial growth patterns consisting of endophytic growth pattern (EGP) and von Brunn's nest involvement (VBNI) were investigated using hematoxylin and eosin-stained slides, and their frequency of occurrence, prognostic value, and correlation with other clinicopathological features was evaluated.ResultsEGP and VBNI were found in 40 (30.8%) and 5 (3.9%) of the 130 cases, respectively. Of the 26 pT1 tumors, the growth pattern at the invasion front was trabecular in 17 (65.4%) and infiltrative in 9 (34.6%). Although 8 (47.1%) of 17 trabecular tumors coexisted with EGP, no cases with infiltrative tumors had EGP (p = 0.023). VBNI correlated with high tumor grades (p = 0.006) and lymphovascular involvement (p = 0.026). The multivariate Cox proportional hazards analysis revealed that tumor diameter less than 3 cm (p = 0.04) and intravesical bacillus Calmette-Guérin therapy (p = 0.004) were independent favorable prognostic factors for recurrence-free survival, whereas tumor stage was an independent poor prognostic factor for disease progression (p = 0.006).ConclusionsSubepithelial growth patterns were not a significant prognostic factor in this study. Additionally, no tumors with an infiltrative growth pattern coexisted with EGP, suggesting that determining the presence of EGP might be helpful for managing non-muscle invasive bladder cancers.

No presente estudo objetivamos comparar a aprendizagem resultante da aplicacao de um metodo informatizado de ensino com aquela produzida pela aplicacao de um metodo tradicional. O estudo foi realizado junto a 30 estudantes de enfermagem, os quais foram divididos em dois grupos denominados 1 e 2. Para o grupo 1 foi aplicado um trabalho de leitura grupal com posterior discussao, enquanto que para o segundo foi aplicado um software de estrutura nao-linear do tipo tutorial. Os resultados demonstraram que a media geral do rendimento aumentou de 38,75% para 55%, acompanhado de um aumento do desvio-padrao de 15,51 para 16,60. No grupo 1, a media de rendimento aumentou de 45,83% para 52,50%, entretanto, pelo valor modal, o rendimento se concentrou na faixa dos 37,50% apos a aplicacao do metodo. No grupo 2, tanto a media de rendimentos como o valor modal aumentaram de 31,66% para 57,50% e 37,50% para 50% respectivamente, associados ao aumento significativo de desvio-padrao de 13,25 para 18,78, indicando forte influencia de desempenhos individuais. Conclui-se que o metodo informatizado prima pela aprendizagem individualizada respeitando o ritmo e as caracteristicas pessoais de cada aluno.