Search

ObjectivesThe aim of this systematic review was to develop International Stereotactic Radiosurgery Society (ISRS) consensus guideline statements for vestibular schwannoma.MethodsA systematic review of the literature was performed up to April 2015.ResultsA total of 55 full-text articles were included in the analysis. All studies were retrospective, except for 2 prospective quality of life studies. Five-year tumour control rates with Gamma Knife radiosurgery (RS), single fraction linac RS, or fractionated (either hypofractionated or conventional fractionation) stereotactic radiation therapy (FSRT) were similar at 81-100%. The single fraction RS series (linac or Gamma Knife) with tumour marginal doses between 12 and 14 Gy revealed 5-year tumour control rates of 90-99%, hearing preservation rates of 41-79%, facial nerve preservation rates of 95-100% and trigeminal preservation rates of 79-99%.There were 6 non-randomized studies comparing single fraction RS versus FSRT. There was no statistically significant difference in tumour control; HR=1.66 (95% CI 0.81, 3.42), p =0.17, facial nerve function; HR = 0.67 (95% CI 0.30, 1.49), p =0.33, trigeminal nerve function; HR = 0.80 (95% CI 0.41, 1.56), p =0.51, and hearing preservation; HR = 1.10 (95% CI 0.72, 1.68), p =0.65 comparing single fraction RS with FSRT.Nine quality of life reports yielded conflicting results as to which modality (surgery, observation, or radiation) was associated with better quality of life outcomes.ConclusionsThere are no randomized trials to help guide management of patients with vestibular schwannoma. Within the limitations of the retrospective series, a number of consensus statements were made.

Recent studies have focused on challenging deficit narratives and discourses perpetuating the criminalization of Latino men and boys. But even with this emerging literature, mainstream counter-narratives of young Latino boys and their attitudes towards manhood and masculinity stand in stark contrast to the dangerous and animalistic portrayals of Latino boys and men in the media and society. Utilizing a mixed-methods approach, the authors draw on the notion of counter-storytelling to explore how Latino boys try to reframe masculinity, manhood, and what they label as 'responsible manhood.' Counter-storytelling and narratives provide a platform from which to challenge the discourse, narratives, and imaginaries guiding the conceptualization of machismo. In their counter-narratives, Latino boys critiqued how they are raced, gendered, and Othered in derogatory ways. Keywords: counter-narratives, counter-storytelling, critical race theory, Latino males, mixed methods, masculinity, single-sex schools, urban education, Introduction In recent years growing scholarship and studies have focused on challenging deficit narratives and discourses perpetuating a criminalization of Latino men and boys. But even with this growing scholarship, [...]

Vertical-axis wind turbines (VAWTs) are considered promising solutions for urban wind energy generation due to their design, low maintenance costs, and reduced noise and visual impact compared to horizontal-axis wind turbines (HAWTs). However, deploying these turbines close to densely populated urban areas often triggers considerable local opposition to wind energy projects. Among the primary concerns raised by communities is the issue of noise emissions. Noise annoyance should be considered in the design and decision-making process to foster the social acceptance of VAWTs in urban environments. At the same time, maximising the operational efficiency of VAWTs in terms of power generation and actuation effort is equally important. This paper balances noise and aero-servo-elastic performance by formulating and solving a multi-objective optimisation problem from a controller calibration perspective. Psychoacoustic annoyance is taken as a novel indicator for the noise objective by providing a more reliable estimate of the human perception of wind turbine noise than conventional sound metrics. The computation of the psychoacoustic annoyance metric is made feasible by integrating it with an accurate and computationally efficient low-fidelity noise prediction model. For optimisation, an advanced partial-load control scheme – often used in industrial turbines – is considered, with the Kω2 controller as a baseline for comparison. Optimal solutions balancing the defined objectives are identified using a multi-criteria decision-making method (MCDM) and are subsequently assessed using a frequency-domain controller analysis framework and mid-fidelity time-domain aero-servo-elastic simulations. The MCDM results indicate the potential application of this controller in small-scale urban VAWTs to attain power gains of up to 39 % on one side and to trade off a reduction in actuation effort of up to 25 % at the cost of only a 2 % power decrease and a 6 % increase in psychoacoustic annoyance on the other side compared to the baseline. These findings confirm the flexible structure of the optimally calibrated wind speed estimator and tip-speed ratio (WSE–TSR) tracking controller, effectively balancing aero-servo-elastic performance with noise emissions and marking the first instance of integrating residential concerns into the decision-making process. [ABSTRACT FROM AUTHOR]