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Objectives. TARGET randomised 376 children with persistent OME to 3 regimens: watchful waiting (WW), ventilation-tubes only (VTO), and ventilation tubes-adenoidectomy (VTA). At 2-year follow-up, the demonstrated greater benefits of VTA than VTO in terms of respiratory problems and hearing thresholds were still present. Records from the largest centre were examined to determine how long benefits of +adenoidectomy continue beyond 2 years. Methods. Retrospective records analyses of Leicester children captured consultations and treatments outside the TARGET protocol, plus pure-tone-average (0.5–4 kHz) at latest clinical entry. Results. Ninety-four of 95 notes (99%) were available, with time-lags of 7.5–11.6 years. On intention-to-treat analysis, children receiving treatment additional to allocation comprised 61% of WW, 59% of VTO, and 44% of VTA, with average surgical procedures numbering 1.0, 2.1, and 1.7. Proportions of children requiring >1 additional procedure were 13%, 34%, and 15%. Differences (VTO-VTA) for consultations, operations and combined were marginal for this single centre but consistent with the significant all-centre data for 3–6 years from randomisation. Mean latest pure-tone-averages were 15.84, 11.73, and 12.44 dBHL. Conclusions. (1) Additional adenoidectomy has enduring benefits over VTO, although most clinical benefit appears to arise in the early years. (2) The two fifths of children randomised to WW not requiring surgery merit detailed epidemiological characterisation. (3) The benefits of surgery in OME are modest, requiring large-number trials, but are genuine. [ABSTRACT FROM AUTHOR]

Coronary artery calcium scoring (CACS), a non-invasive measure of coronary atherosclerosis, has significantly enhanced cardiovascular (CV) risk assessment and stratification in asymptomatic individuals. More recently, a higher score for CAC has been associated with an increased risk of non-CV diseases and all-cause mortality. This review consolidated evidence supporting the role of CAC in assessing non-CV diseases, emphasizing its potential in early diagnosis and prognosis. We observed a strong association between CACS and non-CV diseases, viz., chronic obstructive pulmonary disease, pulmonary embolism, pneumonia, diabetes, chronic kidney disease, osteoporosis, metabolic dysfunction-associated steatotic liver disease, nephrolithiasis, stroke, dementia, malignancies, and several autoimmune diseases. Also, CAC may aid in evaluating the risk of CV conditions developing secondary to the non-CV diseases mentioned earlier. Further evidence from prospective studies, intervention trials, and population-based behavioral studies is needed to establish CAC cutoff values and explore preventative care applications, facilitating their broader integration into healthcare practices.

Mifepristone is a progesterone and glucocorticoid receptor antagonist. Medical abortion with mifepristone and prostaglandin has revolutionized the abortion process extending abortion care to the doors of females. From as low as 2 mg/day to doses extending to 600 mg, from daily dosing to single dosage treatment, mifepristone has a wide perspective in the treatment of various pathologies. Cervical dilatation and myometrial contractility have made the utility of mifepristone feasible for second-trimester termination of pregnancy and induction of labor awaiting Food and Drug Administration approvals. Its anti-progesterone action on the menstrual cycle has a new dimension of use as a contraceptive, as well as use as a menstruation inductive agent. Its role in endometriosis, ectopic pregnancy, and adenomyosis requires more intensive research. Apoptotic action of mifepristone, interference of heterotypic cell adhesion to the basement membrane, cell migration, growth inhibition of various cancer cell lines, decreased epidermal growth factor expression, suppression of invasive and metastatic cancer potential, increase in tumor necrosis factor, downregulation of cyclin-dependent kinase 2, B-cell lymphoma 2, and Nuclear factor kappa B have opened its potential to be explored as anti-cancer treatment and its effects on leiomyoma. The drug needs to be studied more for the prospectus of its anti-glucocorticoid actions in a wider dimension beyond its acquiescence for the treatment of Cushing syndrome., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Karena et al.)

Aim: To review the literature using a systematic approach to answer the question: 'Are zirconia dental implants an alternative to titanium dental implants?' This was evaluated by assessing the evidence for survival rate, success rate and marginal bone loss of the two implant materials., Methods: Relevant studies were identified after searching PUBMED, EMBASE and the Cochrane library. Two reviewers assessed the papers using the specified inclusion criteria, title and abstracts. Studies that were not related to the outcomes of: survival rate, success rate or marginal bone loss of zirconia dental implants were excluded., Results: From a total of 1617 titles and abstracts, 33 potentially relevant full text papers were identified. Of these, 18 met the criteria for inclusion in the review. The review revealed heterogeneity between the studies in terms of surgical characteristics, implant characteristics, defining success and measuring marginal bone loss therefore making comparisons between studies difficult. However, in the three randomised control studies included in this review, which compared zirconia implants to titanium implants, the survival rate was lower for zirconia implants, but the success rate and marginal bone loss were found to be similar., Conclusion: Overall, initial studies indicate that zirconia dental implants could be a viable alternative to titanium implants but need further well-designed studies need to be carried out to assess their long-term survival rate, success rate and marginal bone loss. At present, zirconia implants should be used with caution but can be an alternative option if a patient has an absolute contraindication to titanium., (Copyright© 2022 Dennis Barber Ltd.)

The constantly increasing energy consumption along with the depleting fossil fuel resources as well as owing to the fact that the nuclear fission not being an intrinsically safe method of energy generation, it has become necessary to look for other solutions to fulfil the future energy demands. Nuclear fusion, the source of energy for billions of stars, has attracted the attention of scientists and engineers despite a lot of technical challenges in the replication of the fusion process in laboratories. For fusion to take place in a device, one of the major challenges faced is the strong magnetic confinement of the plasma using large superconducting (SC) magnets, which need efficient cryogenic cooling techniques to maintain the required low temperatures for the superconducting state. In order to maintain the compactness, the SC magnets generally employ Cable in Conduit Conductor (CICC) windings, carrying high current densities, which are cooled by the forced flow of helium at ~4 K temperature to maintain the required superconducting temperatures. The construction of CICC aims to maintain the superconductivity state by optimization of various parameters such as thermal stability, the ratio of normal conductor to SC material, mechanical strength, low hydraulic impedance, current density, magnetic field, etc. The cryogenic thermal stability of the CICC is of prime importance for safe, stable and reliable operation of SC magnets. The prediction of thermal and hydraulic behavior of the CICC in large SC magnets is difficult due to the complex geometry involved, the variation in fluid properties, various heat in-flux incidences over the long length of CICC and a complex heat transport phenomenon. Another application which utilizes a forced flow cryogenic cooling in the fusion devices is a cryo-adsorption pump for creating clean and high vacuum with large pumping speed. This paper presents an overview of the forced flow cryogenic cooling schemes in fusion devices along with a systematic review of the thermal and hydraulic studies related to CICC and cryo-adsorption pump, thereby highlighting the challenges and opportunities for further improvement in their design and performance., Competing Interests: The authors declare no conflict of interest., (© 2021 Published by Elsevier Ltd.)

Nasal dermoid sinus cysts (NDSC) are rare congenital lesions that most frequently present in children, but have been reported in adults. This article reviews adult (more than 16 years of age) nasal dermoid sinus cysts as they present, their radiological investigation, surgical approach and outcome. Thirty-eight previously published cases are reviewed, to which a further six cases are added. All 44 cases are tabulated and reviewed. The risk of intracranial extension is 27.5 per cent, especially men with a dermal sinus. Recurrences are likely if the NDSC is not completely excised. Curative treatment is surgical. It is recommended that all adults who present with a dermal cyst and/or sinus in the region of the nasal dorsum should be investigated by computed tomography (CT) and/or magnetic resonance (MRI). This is to delineate deep tissue involvement and to exclude a possible associated intracranial extension, prior to recommending surgical excision.