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Maeda Y, Nakamura M, Ninomiya cheap levitra pills H, et al. Trends in intensive neonatal care during the erectile dysfunction treatment outbreak in Japan. Arch Dis cheap levitra pills Child Fetal Neonatal Ed 2021;106:327–29. Doi. 10.1136/archdischild-2020-320521The authors have noticed an error in table 1 of their short report recently published.

They mistakenly showed values for weeks 10–17 cheap levitra pills of 2019 instead of those for weeks 2–9 of 2020. The values for ‘Births before 33 6/7 weeks’ and ‘Births between 34 0/7 and 36 6/7 weeks’ of Table 1 should be amended as follows:Births before 33 6/7 weeksWeeks 2-9, 2020. 83, instead of 99Difference (% change). 17 (20.5), instead of 33 (33.3)Births between 34 0/7 and 36 cheap levitra pills 6/7 weeksWeeks 2-9, 2020. 207, instead of 211Difference (% change).

17 (8.2), instead of 21 (10.0)Accordingly, the second sentence of the subsection ‘Preterm births’ should also be corrected to “The number of preterm births showed a statistically significant reduction in weeks 2–9 vs weeks 10–17 of 2020. Births before 33 6/7 gestational weeks from 83 to 66 cheap levitra pills (aIRR, 0.71. 95% CI, 0.50 to 1.00. P=0.05) and births between 34 0/7 and 36 6/7 gestational weeks from 207 to 190 (aIRR, 0.85. 95% CI, 0.74 cheap levitra pills to 0.98.

P=0.02) (figure 1 and table 1).Reviewing recordings of neonatal resuscitation with parentsFew of us relish the thought of our performance in a challenging situation being recorded and reviewed by others, but many have accepted it for research purposes in the context of newborn resuscitation. At Leiden University Medical Centre Neonatal Unit they have been recording videos of all newborn resuscitations since 2014 in order to study cheap levitra pills and improve care during transition. The recordings are kept as a part of the medical record and, in contrast with other published practice to date, parents are offered an opportunity to review the recording with a professional and to have still images from it or a copy of the video. In this qualitative study Maria C den Boer and colleagues interviewed parents of preterm babies who had viewed their baby’s recording to provide insight into their experience. The study cheap levitra pills included 25 parents of 31 preterm babies with median gestational age 27+5 weeks.

Four of the babies had gone on to die in the neonatal unit. Most parents offered the opportunity to see the recording wished to do so and around two thirds asked for images or a copy. The parental experiences of viewing cheap levitra pills the videos were very positive. The experience improved their understanding of what had happened, enhanced their family relationships, and increased their appreciation of the care team.Colm O’Donnell discusses his own experience with researching video recordings of resuscitation, beginning with a visit to Neil Finer and Wade Rich at University of California, San Diego in 2003. Colm also has positive experiences of sharing the recordings with families.

The team in cheap levitra pills Leiden recommend this practice. Both articles are an interesting read that will challenge your assumptions and stimulate reflection. See page F346 and F344Physiological responses to facemask application in newborns immediately after birthVincent Gaertner and colleagues reviewed video recordings of initial stabilisation at birth of term and late-preterm infants who were enrolled in a randomised trial of different face-masks. 128 face-mask cheap levitra pills applications were evaluated. In eleven percent of face-mask applications the infant stopped breathing.

When apnoea occurred after mask application there was a median fall in heart rate of 38 beats per minute. These episodes are considered to represent cheap levitra pills the trigeminocardiac reflex and recovered within 30 s. Apnoea was also observed after face-mask reapplications, although less frequently. There were a median of 4 face-mask applications per infant, suggesting a lot of additional potential cheap levitra pills for avoidable interruption of support. This observation of apneoa after face-mask application is less frequent than in previous reports in more preterm infants but is still quite common.

See page F381Outcomes of a uniformly active approach to infants born at 22–24 weeks of gestationThis single centre report by Fanny Söderström and colleagues from Uppsala in Sweden describes the outcomes of infants born at 22 to 24 weeks gestation between 2006 and 2015. In this institution, all mother-infant dyads at risk for extremely preterm delivery are provided proactive cheap levitra pills treatment. This includes intrauterine referral when approaching 22 weeks of gestation, provision of tocolytics, antenatal steroids and family counselling. There were 222 liveborn infants born at the hospital or admitted soon after birth. There had been four fetal deaths during in utero cheap levitra pills transport to the centre and there were 14 stillbirths of fetuses that were alive at admission.

Two infants died in the delivery room after birth. Survival of the liveborn babies was 52% at 22 weeks, 64% at 23 weeks and 70% at 25 weeks. Follow-up information was available for 93% cheap levitra pills of infants. There were 10 infants with cerebral palsy and no infants who were blind or deaf. Around a third had diagnosis of developmental delay.

The study provides cheap levitra pills a measure of what can be achieved when decisions to initiate treatment are not selective according to the views of the parents and physicians. See page F413Bronchopulmonary dysplasia and growthTheodore Dassios and colleagues analysed data from the UK National Neonatal Research Database for the years 2014 to 2018. They looked cheap levitra pills at postnatal growth in all liveborn infants born before 28 weeks gestation and admitted to neonatal units. There were 11 806 infants. Bronchopulmonary dysplsia was defined as any requirement for respiratory support at 36 weeks and affected 57%.

As measured by change in weight and head circumference z-scores from birth to discharge, the infants who developed BPD grew slightly better than cheap levitra pills those who did not. See page F386Disorders of vision in neonatal hypoxic-ischaemic encephalopathyEva Nagy and colleagues undertook a systematic review of reports of outcome after hypoxic ischaemic encephalopathy to evaluate the evidence relating to visual impairment. Although this is a recognised complication of hypoxic ischaemic encephalopathy, it has not been well described. They identified six studies that enrolled 283 term born infants cheap levitra pills that met their inclusion criteria. Some form of visual impairment was reported in 35% but there was huge variation in the techniques used for assessment.

It remains difficult to advise families about the risks and nature of visual impairments that might be encountered. There are lots of barriers to obtaining good information in this area because of the need for prolonged follow-up and cheap levitra pills difficulty in testing individuals with other difficulties. See page F357Management of systemic hypotension in term infants with persistent pulmonary hypertension of the newbornHeather Siefkes and Satyan Lakshminrusimha present a beautifully illustrated review of the multiple factors contributing to haemodynamic disturbance in infants with PPHN, and the mechanisms of action of the various candidate therapeutic agents. This supports a reasoned approach to treatment. The challenge remains to supplement this with high cheap levitra pills quality evidence.

The HIP trial report illustrates the enormous challenge of studying treatments for haemodynamic disturbance in the immediate newborn period and the hurdles that need to be overcome to enable progress. See page F446 and F398Ethics statementsPatient consent for publicationNot required..

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Enabling works, including services diversion and potential in-ground works levitra directions. And Design works for the redevelopment, levitra directions including clinical design. Member for the South Coast Shelley Hancock released new artist impressions and said residents will benefit from the hospital expansion, with new and upgraded health facilities to be delivered sooner.“Additionally, as we can see in these stunning images, the completed hospital will return green space back to the community, with an inclusive playground a key component of the park,” Mrs Hancock said.Member for Kiama Gareth Ward said he’s pleased work can get underway on the expanded hospital as soon as possible.“With the ongoing investments we have already put into the Shoalhaven District Memorial Hospital, this is the next big step after the completion of the $11.8 million hospital car park project this year,” Mr Ward said.Construction will start on the redeveloped hospital in this term of Government, prior to March 2023The SDMH redevelopment is one of 29 health projects announced before the 2019 election and is a part of the NSW Government’s record $10.7 billion investment in health infrastructure over the next 4 years.In the Illawarra Shoalhaven, other health projects include $700 million for a new Shellharbour levitra directions Hospital, $37.1 million towards the Bulli Hospital and Aged Care Centre, and the Dapto and Ulladulla HealthOne projects, delivered as part of the $100 million HealthOne program.Artist impressions are available..

Hornsby Ku-ring-gai Hospital has become the first public hospital in NSW with a robotic pharmacy, with the $265 million Stage 2 redevelopment on track for completion http://2016.swissbiotechday.ch/kamagra-oral-jelly-online-shop/ next year.Health Minister Brad Hazzard, along with Member for Hornsby Matt Kean, saw the robotic dispensing and stocktaking system in motion today and toured the newly opened 12-bed Intensive Care Unit.“The $265 million Hornsby Ku-ring-gai Hospital Stage 2 redevelopment will provide a superior experience for patients, carers, staff and visitors, with a larger emergency department and an Intensive Care Unit about three times the size of the previous one,” Mr Hazzard said.“The cheap levitra pills new, state-of-the-art pharmacy is also more than double in size and, thanks to its advanced robotics, can select and dispense medications and conduct stocktakes faster, reducing errors and wastage and allowing pharmacists to spend more time with patients.”Mr Kean said the new Intensive Care Unit opened less than a month ago and is a modern, purpose-built department that includes single patient rooms, with large observation windows and a large staff station.“This new Intensive Care Unit brings Hornsby Ku-ring-gai Hospital into the 21st century by ensuring the building matches the superior care the clinicians deliver. There is vast space for clinicians to provide outstanding care, with patients’ needs at the centre of its design,” Mr Kean said.“There is more natural light which is important for the patient’s recovery, more privacy for patient care and family discussions and every room can be an isolation room if required, meaning better control.”Other departments to have opened as part of the redevelopment include Outpatients, Paediatrics and Medical Imaging.The $265 million Stage 2 redevelopment will deliver a new Clinical Services Building, due for completion next year, and a refurbished and expanded cheap levitra pills Emergency Department.The Clinical Services Building will include:A combined Intensive Care and High Dependency Unit;Combined Respiratory/Cardiac and Coronary Care beds co-located with a Cardiac Investigations Unit;Ambulatory Care Centre (Outpatients Department);Medical Imaging;Paediatrics;Medical Assessment Unit;Inpatients Units (including general medicine, rehabilitation, stroke and dementia/delirium beds);Co-located education space with The University of SydneyHelipadThe redevelopment will also deliver a refurbished and expanded Psychiatric Emergency Care Centre, new day chemotherapy unit and renal dialysis unit for the first time at Hornsby, expansion of oral health services and integration of community health services.The NSW Government is investing an additional $4 million to fast-track the redevelopment of Shoalhaven District Memorial Hospital to begin in 2020-21.Minister for Health Brad Hazzard said the funding boost will bring the total spend for the project to $438 million, which will also support the acquisition of nearby Nowra Park.“The NSW Government is committed to investing in regional hospitals to ensure patients receive high-quality healthcare closer to home,” Mr Hazzard said.“The land acquisition of Nowra Park is necessary to provide for the expansion of clincial services at Shoalhaven Hospital.”The existing hospital site with expansion into the adjacent Nowra Park has been identified as the best solution for the redeveloped hospital.Clinical services planning is already well underway to identify the range of health services the Illawarra Shoalhaven community will require into the future. The additional cheap levitra pills funding will allow planning activities to progress including:Detailed site investigations, including in-ground investigations. Enabling works, including cheap levitra pills services diversion and potential in-ground works. And Design cheap levitra pills works for the redevelopment, including clinical design.

Member for the South Coast Shelley Hancock released new artist impressions and said residents will benefit from the hospital expansion, with new and upgraded health facilities to be delivered sooner.“Additionally, as we can see in these stunning images, the completed hospital will return green space back cheap levitra pills to the community, with an inclusive playground a key component of the park,” Mrs Hancock said.Member for Kiama Gareth Ward said he’s pleased work can get underway on the expanded hospital as soon as possible.“With the ongoing investments we have already put into the Shoalhaven District Memorial Hospital, this is the next big step after the completion of the $11.8 million hospital car park project this year,” Mr Ward said.Construction will start on the redeveloped hospital in this term of Government, prior to March 2023The SDMH redevelopment is one of 29 health projects announced before the 2019 election and is a part of the NSW Government’s record $10.7 billion investment in health infrastructure over the next 4 years.In the Illawarra Shoalhaven, other health projects include $700 million for a new Shellharbour Hospital, $37.1 million towards the Bulli Hospital and Aged Care Centre, and the Dapto and Ulladulla HealthOne projects, delivered as part of the $100 million HealthOne program.Artist impressions are available..

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Haiti is still rebuilding from the massive earthquake that struck 11 years ago, as well as dealing with the fallout of Buy viagra online without a prescription its what is the difference between cialis and levitra president’s assassination in July. So the island nation was ill-prepared for the magnitude 7.2 earthquake that hit its western region on August 14. At the time of publication, the official death toll hovers around 2,000, although for the first few critical days after the quake, media reports listed a death toll in the hundreds.

But the true number of deaths is probably at least five to 50 what is the difference between cialis and levitra times that number, according to a scientific model from the U.S. Geological Survey. Its tool, known as Prompt Assessment of Global Earthquakes for Response (PAGER), automatically combines information about an earthquake with demographic and other data from the affected region to model the likely scale of the disaster, including deaths and economic impact.

PAGER, which was launched in 2007, does not predict the exact what is the difference between cialis and levitra number of fatalities. Rather it estimates the probability that the number lies within a certain range. For the recent earthquake in Haiti, PAGER gives a 35 percent chance that between 10,000 and 100,000 people have died and a 32 percent chance that the death toll will top 100,000.

This earthquake was what is the difference between cialis and levitra probably less deadly than the one that hit Haiti in 2010, for which PAGER correctly predicted more than 100,000 deaths. The tool also estimates a 66 percent chance that the cost of damage for this year’s quake lies between $100 million and $10 billion. For comparison, the 2010 earthquake cost between $7 billion and $14 billion.

Having an accurate what is the difference between cialis and levitra estimate of deaths and damage early on could greatly influence the scale of the response. News organizations tend to report the official death count, which is the number of bodies found so far. In a country such as Haiti, which has poor infrastructure and limited access to remote regions, determining the real toll this way could take months.

This creates a problem for international responders, humanitarian aid organizations and other nations, all of who need to assess the extent of the damage and determine an what is the difference between cialis and levitra appropriate response. Scientific American spoke with David Wald, a seismologist at the USGS who helped develop PAGER and other earthquake modeling tools. [An edited transcript of the interview follows.] Why are Haiti’s official fatality numbers so much lower than PAGER’s?.

There are a lot of what is the difference between cialis and levitra things that you don’t see that the models predict. What you’re not seeing is all the small towns and villages and remote buildings, some of them on these hillsides that may be affected not only by shaking but by landslides. It’ll be a long time before those areas are all reached, especially because access and civil infrastructure and governance are all challenged.

So those what is the difference between cialis and levitra [fatality] numbers will tend to grow over time, as we always expect. We can say, very definitively, that there are going to be problems with the roads because of landslides—because the roads cross the steep terrain where there was strong shaking. What data are used by PAGER to model fatalities?.

Getting the exact number what is the difference between cialis and levitra of fatalities is unachievable. There are just too many uncertainties and too many unknowns. But to create a prediction, there are three ingredients.

The shaking, the population exposed to each shaking level and how vulnerable that population is, based on the buildings [people] what is the difference between cialis and levitra are in. We know that for larger earthquakes, the pattern of shaking can be extremely complicated, so we try to capture that as best we can through a tool called ShakeMap. If you had thousands of stations, you would know the shaking everywhere, and it would be a really well-constrained map.

In California, what is the difference between cialis and levitra you have hundreds of stations. If you go to Haiti, where there are not very many seismic stations, there is additional uncertainty. It’s always going to be more uncertain until we help equip Haiti with more instruments.

The second what is the difference between cialis and levitra ingredient is the population exposed to these different shaking levels. You can just take a population grid and calculate the population exposed for all of the different shaking intensity levels. The final question is the impact of that.

In China or Haiti, you have very what is the difference between cialis and levitra vulnerable buildings. For the same shaking level, you can get many times more fatalities than you would in, say, California or New Zealand or Japan, where you have better building codes. In the case of Haiti, there’s a high population, strong shaking and very vulnerable buildings.

And that leads you to the conclusion that there’s going to be what we call a red alert on PAGER, what is the difference between cialis and levitra where we have probably 1,000 fatalities or higher. Why is there so much uncertainty?. You don’t have many instruments.

Haiti has a seismic network where what is the difference between cialis and levitra it can locate earthquakes. But we can’t use those instruments for the ShakeMap. They have to be special instruments called strong motion instruments.

There are probably six or seven in Haiti, and we only have what is the difference between cialis and levitra the data from two of them. An additional source of uncertainty in our calculations is trying to figure out [the location and shape of] the fault. It also has dependencies on the data and how good the data are and how complicated the earthquake was.

In this case, it’s a pretty complicated, challenging what is the difference between cialis and levitra fault to determine. Sometimes those things take months to really iron out. But we always do our best to do it within the first few hours and days.

For the modeling, a what is the difference between cialis and levitra big problem is. We don’t even know how many people died in 2010. The estimates range from 100,000 to 320,000.

Most countries have very good reporting, and if the number of fatalities is three, what is the difference between cialis and levitra four or five, you can assume it’s pretty damn accurate. But once you get into these really big losses, such as in Haiti, the truth is uncertain. We can never be exact in this business, but we can be useful.

And for Haiti, it was in the what is the difference between cialis and levitra red alert, no matter what, so it was an international type of response. How does PAGER record an earthquake when it strikes?. First of all, the National Earthquake Information Center [determines] the magnitude and epicenter.

It operates 24/7, so that what is the difference between cialis and levitra information gets sent out and triggers ShakeMap, which will generate a map of the shaking with the seismic data that are available. As soon as the ShakeMap is made, PAGER runs. It takes the shaking, and it overlays population.

And with the model what is the difference between cialis and levitra for that country, it estimates fatalities. It also sends that ShakeMap around the world to systems that estimate shaking and damage. Most earthquakes are in the green zone because they’ll be in the ocean or a low population area.

Even magnitude 8.0s are what is the difference between cialis and levitra often in the subduction zones [collisions between tectonic plates in which one sinks beneath the other] offshore and don’t affect anything. One of the most important things about PAGER is to say that nothing happened as opposed to that something happened. If it’s an orange or red alert like this was for Haiti, however, it will page us, and we can watch the model get generated.

We will review the results before sending those what is the difference between cialis and levitra out. We sit on it for maybe 10 or 20 minutes while we look at the other information that’s coming in, such as better magnitudes and better locations, and we’re confident that that’s a good starting place. News reports use the official numbers, which are probably far lower than the actual numbers.

Does that mean people will pay less attention to the what is the difference between cialis and levitra disaster?. With the media, there have been a number of cases where an earthquake will happen at night, and nobody will be paying attention. Then it’ll be another news cycle, with Afghanistan and erectile dysfunction treatment and so many other things, so the media are paying attention to those.

We’re saying, what is the difference between cialis and levitra “It’s going to be worse than the initial reports. It’s going to be much worse.” We may be overestimating the total losses, based on some of these uncertainties. It’s a challenge for the media to work with uncertain numbers.

And it’s a challenge for the agencies and the financial institutions and urban search-and-rescue teams what is the difference between cialis and levitra. But we’re pushing them in the direction of “it’s worse than we’ve seen so far.” Different PAGER users have different timelines. Urban search and rescue should begin within hours, so you go with these uncertain numbers.

Whether to send $1 billion worth of aid can what is the difference between cialis and levitra wait a little bit longer. Over days, things tend to stabilize, and you reach the answer that’s a little bit more constrained than the initial estimates. So you can take the model as an uncertain estimate, along with what’s happened on the ground, and weigh those appropriately..

Haiti is cheap levitra pills still rebuilding from the massive earthquake that struck 11 years ago, as well as dealing Buy viagra online without a prescription with the fallout of its president’s assassination in July. So the island nation was ill-prepared for the magnitude 7.2 earthquake that hit its western region on August 14. At the time of publication, the official death toll hovers around 2,000, although for the first few critical days after the quake, media reports listed a death toll in the hundreds.

But the true number of deaths is probably at least five to 50 times that number, according to a scientific model from the U.S cheap levitra pills. Geological Survey. Its tool, known as Prompt Assessment of Global Earthquakes for Response (PAGER), automatically combines information about an earthquake with demographic and other data from the affected region to model the likely scale of the disaster, including deaths and economic impact.

PAGER, which was launched in 2007, cheap levitra pills does not predict the exact number of fatalities. Rather it estimates the probability that the number lies within a certain range. For the recent earthquake in Haiti, PAGER gives a 35 percent chance that between 10,000 and 100,000 people have died and a 32 percent chance that the death toll will top 100,000.

This earthquake was probably less deadly than the cheap levitra pills one that hit Haiti in 2010, for which PAGER correctly predicted more than 100,000 deaths. The tool also estimates a 66 percent chance that the cost of damage for this year’s quake lies between $100 million and $10 billion. For comparison, the 2010 earthquake cost between $7 billion and $14 billion.

Having an accurate estimate of cheap levitra pills deaths and damage early on could greatly influence the scale of the response. News organizations tend to report the official death count, which is the number of bodies found so far. In a country such as Haiti, which has poor infrastructure and limited access to remote regions, determining the real toll this way could take months.

This creates a problem for international responders, humanitarian aid organizations and other nations, all of who need to assess the extent of the damage and determine an appropriate cheap levitra pills response. Scientific American spoke with David Wald, a seismologist at the USGS who helped develop PAGER and other earthquake modeling tools. [An edited transcript of the interview follows.] Why are Haiti’s official fatality numbers so much lower than PAGER’s?.

There are a lot of cheap levitra pills things that you don’t see that the models predict. What you’re not seeing is all the small towns and villages and remote buildings, some of them on these hillsides that may be affected not only by shaking but by landslides. It’ll be a long time before those areas are all reached, especially because access and civil infrastructure and governance are all challenged.

So those [fatality] numbers will tend cheap levitra pills to grow over time, as we always expect. We can say, very definitively, that there are going to be problems with the roads because of landslides—because the roads cross the steep terrain where there was strong shaking. What data are used by PAGER to model fatalities?.

Getting the exact number of cheap levitra pills fatalities is unachievable. There are just too many uncertainties and too many unknowns. But to create a prediction, there are three ingredients.

The shaking, the population exposed to each shaking cheap levitra pills level and how vulnerable that population is, based on the buildings [people] are in. We know that for larger earthquakes, the pattern of shaking can be extremely complicated, so we try to capture that as best we can through a tool called ShakeMap. If you had thousands of stations, you would know the shaking everywhere, and it would be a really well-constrained map.

In California, you have hundreds cheap levitra pills of stations. If you go to Haiti, where there are not very many seismic stations, there is additional uncertainty. It’s always going to be more uncertain until we help equip Haiti with more instruments.

The second ingredient is the population exposed to these different shaking levels cheap levitra pills. You can just take a population grid and calculate the population exposed for all of the different shaking intensity levels. The final question is the impact of that.

In China or Haiti, you have very cheap levitra pills vulnerable buildings. For the same shaking level, you can get many times more fatalities than you would in, say, California or New Zealand or Japan, where you have better building codes. In the case of Haiti, there’s a high population, strong shaking and very vulnerable buildings.

And that leads you to the conclusion that there’s going to be what we call a red alert on PAGER, where we have probably 1,000 fatalities or higher cheap levitra pills. Why is there so much uncertainty?. You don’t have many instruments.

Haiti has a seismic network where cheap levitra pills it can locate earthquakes. But we can’t use those instruments for the ShakeMap. They have to be special instruments called strong motion instruments.

There are probably six or seven in Haiti, and we only have the data from two of them cheap levitra pills. An additional source of uncertainty in our calculations is trying to figure out [the location and shape of] the fault. It also has dependencies on the data and how good the data are and how complicated the earthquake was.

In this case, it’s cheap levitra pills a pretty complicated, challenging fault to determine. Sometimes those things take months to really iron out. But we always do our best to do it within the first few hours and days.

For the modeling, a big cheap levitra pills problem is. We don’t even know how many people died in 2010. The estimates range from 100,000 to 320,000.

Most countries have very good reporting, and if the number of fatalities is three, cheap levitra pills four or five, you can assume it’s pretty damn accurate. But once you get into these really big losses, such as in Haiti, the truth is uncertain. We can never be exact in this business, but we can be useful.

And for Haiti, it cheap levitra pills was in the red alert, no matter what, so it was an international type of response. How does PAGER record an earthquake when it strikes?. First of all, the National Earthquake Information Center [determines] the magnitude and epicenter.

It operates 24/7, so that information gets sent out and triggers ShakeMap, which will generate a map of the shaking cheap levitra pills with the seismic data that are available. As soon as the ShakeMap is made, PAGER runs. It takes the shaking, and it overlays population.

And with the model for that cheap levitra pills country, it estimates fatalities. It also sends that ShakeMap around the world to systems that estimate shaking and damage. Most earthquakes are in the green zone because they’ll be in the ocean or a low population area.

Even magnitude 8.0s are often in the subduction zones [collisions between tectonic plates in which one sinks beneath the other] offshore cheap levitra pills and don’t affect anything. One of the most important things about PAGER is to say that nothing happened as opposed to that something happened. If it’s an orange or red alert like this was for Haiti, however, it will page us, and we can watch the model get generated.

We will review the results before sending those out cheap levitra pills. We sit on it for maybe 10 or 20 minutes while we look at the other information that’s coming in, such as better magnitudes and better locations, and we’re confident that that’s a good starting place. News reports use the official numbers, which are probably far lower than the actual numbers.

Does that mean people will pay cheap levitra pills less attention to the disaster?. With the media, there have been a number of cases where an earthquake will happen at night, and nobody will be paying attention. Then it’ll be another news cycle, with Afghanistan and erectile dysfunction treatment and so many other things, so the media are paying attention to those.

We’re saying, cheap levitra pills “It’s going to be worse than the initial reports. It’s going to be much worse.” We may be overestimating the total losses, based on some of these uncertainties. It’s a challenge for the media to work with uncertain numbers.

And it’s a challenge for the agencies and the financial institutions and urban search-and-rescue cheap levitra pills teams. But we’re pushing them in the direction of “it’s worse than we’ve seen so far.” Different PAGER users have different timelines. Urban search and rescue should begin within hours, so you go with these uncertain numbers.

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Levitra in usa

The 24-hour news cycle is just as important to medicine as it levitra in usa is to politics, finance, or sports. At MedPage Today, new information is posted daily, but keeping up can be a challenge. As an aid for our readers and for a little amusement, here is a 10-question quiz based on the news of the week.

Topics include Arnold Schwarzenegger's recent procedure, Open levitra in usa Payments, and pro-inflammatory diets. After taking the quiz, scroll down in your browser window to find the correct answers and explanations, as well as links to the original articles. Last Updated November 06, 2020.

The 24-hour news cycle is just https://jordanguidedesign.com/2010/04/collaging-memories-as-art/ as important to medicine as it cheap levitra pills is to politics, finance, or sports. At MedPage Today, new information is posted daily, but keeping up can be a challenge. As an aid for our readers and for a little amusement, here is a 10-question quiz based on the news of the week.

Topics include Arnold Schwarzenegger's recent procedure, Open Payments, cheap levitra pills and pro-inflammatory diets. After taking the quiz, scroll down in your browser window to find the correct answers and explanations, as well as links to the original articles. Last Updated November 06, 2020.

Levitra vs cialis

Ask any nutritionist and they'll tell you that our levitra vs cialis health is a reflection of the lifestyle we lead and what we put on our plates. The food we eat not only satisfies our hunger. It also levitra vs cialis fuels our bodies with energy to carry on. In today’s fast-paced life, there's limited time to make elaborate home-cooked meals.

It's no wonder that 80 percent of Americans' total calorie consumption is thought to come from store-bought foods and beverages. Many of these food items are considered ua-processed, causing a growing rate of concern for human health among scientists.Breaking Down Ua-Processed FoodsYou may be wondering what exactly levitra vs cialis ua-processed foods are. The concept of processing refers to changing food from its natural state, according to Harvard Health Publishing. Methods of accomplishing this include canning, smoking, pasteurizing and drying.

Ua-processed foods take processing one step further by adding levitra vs cialis multiple ingredients such as sugar, preservatives and artificial flavors and colors. Commercially prepared cookies, chips and sodas are just a few of many examples of foods that fall into the highly processed category. In order to further understand ua-processed foods, we must first explore the different levels of food processing. The term ua-processed was first coined by Carlos Monteiro, a professor of nutrition and levitra vs cialis public health at the University of Sao Paulo, Brazil.

Monteiro also created a food classification system called NOVA that has become a popular tool in categorizing different food items. The NOVA Food Classification system contains four different groups:Unprocessed/Minimally Processed Foods. Think 100 levitra vs cialis percent natural and healthy. This group includes foods such as fruits, vegetables, eggs, meats and milk.

Unprocessed foods are considered completely natural and are typically obtained directly from plants and animals. Minimally processed foods are also natural foods that have had very minor changes such as removal of inedible parts, fermentation, cooling, freezing, and any other processes that won't add extra ingredients or substances to the levitra vs cialis original product.Processed Culinary Ingredients. This group has everything to do with flavor and typically contains ingredients such as fats and aromatic herbs that are extracted from natural foods. These ingredients are then used in homes and restaurants to season and cook items such as soups, salads and sweets.

Many of these extracted ingredients can also levitra vs cialis be stored for later use. Processed Foods. Most processed foods contain at least two or three added ingredients such as salt, sugar and oil. Think of this group as a combination levitra vs cialis of the first two groups.

In other words, processed culinary ingredients or flavors that are added to natural foods. Examples include fruits in sugar syrup, bacon, beef jerky and salted nuts. Ua-Processed Foods levitra vs cialis. Last and least healthy on the NOVA scale are ua-processed foods.

This group is considered highly processed due to a large amount of added ingredients. Nova typically classifies this group as industrial formulations made entirely or mostly from substances such as oils, fats, sugar, starch and proteins as well as flavor enhancers and artificial colors that levitra vs cialis make these foods appear more attractive. Frozen items such as pre-prepared burgers or pizzas, candies, sodas, chips and ice cream are a few examples. On a daily basis, the ua-processed category is not the best source of your nutritional intake.

But there's levitra vs cialis still hope for our frozen pizza and chocolate lovers. Caroline Passerrello, spokesperson for the Academy of Nutrition and Dietetics, suggests that there may be a place on our plates for processed foods. Everything in ModerationIt's often said that most things are OK in moderation. But does this saying ring levitra vs cialis true for ua-processed foods?.

According to Passerrello, ua-processed foods like cookies, chips and sodas are more energy than nutrient-dense. This means that while the energy and calories are present, the nutrients we require like vitamins and minerals are often lacking. This can become a cause for concern because our bodies require both energy and levitra vs cialis nutrients to function properly.A 2017 study that followed the dietary intakes of 9,317 participants found that Americans were eating ua-processed foods at alarming rates. Foods, in this case, were classified according to the NOVA scale.

The results levitra vs cialis of the study showed that on average more than half of the calories of the participants came from ua-processed foods. These foods failed to deliver proper nutrients. Participants that consumed more ua-processed food lacked proper protein, calcium, fiber, potassium, and vitamins A, C, D and E in their diets. In contrast, participants that consumed higher amounts of unprocessed or minimally processed foods had a better overall diet with adequate amounts of the different nutrients.So, a levitra vs cialis balanced diet of the different food groups may just be the way to go.

But what happens when we overindulge in ua-processed foods on a regular basis?. Because ua-processed foods are typically filled with sugar and fat, they've been linked to numerous health risks including obesity, heart disease and stroke, type-2 diabetes, cancer and depression.Passerrello explains that overconsumption of highly processed foods over time can also lead to vitamin and mineral deficiencies. In addition, processed foods tend to have higher amounts of sodium, levitra vs cialis which is often used to extend their shelf life. Consuming too much sodium can lead to feelings of dehydration and cause muscle twitches.The health risks associated with overconsumption of ua-processed foods can easily pile up, but luckily, there are some healthy alternatives that we can choose to incorporate into our diet.

Eat This Not ThatCutting down on ua-processed foods definitely seems like a good start to a healthy and balanced diet, but it's only the first step. "It's not just the ua-processed food itself that is the concern, but what else we are, or are not, eating — as well as what our bodies levitra vs cialis need and ultimately, what foods we have access to on a regular basis," says Passerrello.Health and nutrition can vary from person to person, so there is definitely no hard and fast rule as to what goes and what stays. However, Passerrello advises that if you are in a position in life with your time, taste and budget to make a choice between an ua-processed food item and a minimally processed food item, you should typically opt for the minimally processed food.Yes, frozen dinners may be an easy option after a long day of work. However, an easy alternative that can save time could be meal prepping in advance.

A homemade alternative such as a simple rice dish or burritos can be levitra vs cialis easy to make in batches and store away for the week. Another simple way to slowly decrease your intake of processed foods is to check food labels for excess amounts of salt or sugar. Instead of sodas, Passerrello suggests opting for orange juice or milk that are fortified with calcium and vitamin D.Ultimately, choosing healthy foods is a matter of providing your body with the proper nutrients it needs while also incorporating your personal tastes and preferences. A handful of chips and a frozen pizza may not be the healthiest treat, but they won't do serious damage as long as ua-processed foods aren't your main and only form of nutrients.Like many people, Stephanie Holm made holiday levitra vs cialis cookies with her family last year.

Her daughter found a recipe on the internet, and the two of them set to making them in the kitchen of their apartment.Together, they mixed the dough, rolled it out, put the cookies on a pan and popped it in the oven — “literally covered in sprinkles on the outside…cute, and very delicious,” says Holm, a pediatric environmental medicine specialist at UC San Francisco.But as the cookies baked, Holm noticed that the cute sugary coating burned a little in the oven, though not enough to ruin the cookies. Then Holm heard her daughter exclaim, “Mama, it’s purple!. € and she saw that the air quality sensor she keeps in their apartment had levitra vs cialis indeed turned from green (good air quality) to purple (very unhealthy). Could a single batch of slightly singed cookies have been to blame?.

What happened with Holm’s cookies wasn’t a fluke. All cooking releases a complex mixture of levitra vs cialis chemicals, some of which would be classified as unhealthy pollutants. As for whether cooking is hazardous to your health — the short answer is, it depends. But generally, if you have good ventilation, you should be fine.“We all cook, and the average life expectancy is 78 or 79 years old.

So we shouldn’t get too worried,” says Delphine levitra vs cialis Farmer, an atmospheric chemist at Colorado State University. €œBut it is an opportunity to think about how to reduce your exposure to pollutants.”Out of the Frying PanFarmer’s research found that cooking releases a mixture of hundreds of different chemical compounds into the air. Every ingredient gives off its own unique blend of particles and gases. Proteins in meat can break down and give off levitra vs cialis ammonia.

Roasting can produce isocyanates. Oils from frying and sautéing can aerosolize (that’s how your counters end up with a fine layer of grease on them). The airborne molecules can continue to react and change levitra vs cialis as they drift around your kitchen and bump into each other.“You can see some of these really interesting compounds,” Farmer says. €œBut are they at levels that are toxic?.

We don't know.” Part of the uncertainty when it comes to health effects comes from the fact that most air quality studies and standards are based on outdoor air — despite our world where people today spend an estimated 90 percent of their time indoors. While Canada and the World Health Organization have levitra vs cialis indoor air quality guidelines, the U.S. Does not.In general, indoor air chemistry fluctuates a lot more than outdoor air. The average air quality can be good, but as Holm and her daughter experienced, some activities — like cooking and cleaning — can cause dramatic changes.

Pollutant levels will spike in the kitchen while cooking is actively happening and then drift back levitra vs cialis down as the airborne molecules disperse.“The pattern of exposure is different. And we really don't have great scientific data on what the difference of that pattern of exposures means for people's health.” Holm says.Acquiring that scientific data is no easy task. Variables that can affect cooking fumes and their contents include how often a person cooks, what they cook, how they cook it, what kind of appliance they use, what kind of ventilation they have and maybe even the type of pots and pans they use, says Iain Walker, an engineer at Lawrence Berkeley National Lab who studies home air quality and ventilation. The best researchers can do is try to levitra vs cialis gauge the relative impact of each factor.

Gas stove or electric?. Boiling or frying? levitra vs cialis. Meat or vegetables?. Nonstick pan or stainless steel?.

Into the FireThe main pollutant of concern linked to cooking is particulate levitra vs cialis matter. This catchall term refers to a complex mix of microscopic solid bits and uafine liquid droplets that could be made up of hundreds of different chemical compounds. The chemistry doesn’t matter nearly as much as the size. Particles smaller than 10 microns (less than 1/5 the width of a human levitra vs cialis hair) can make their way into the lungs and lodge there.

Even smaller particles can make their way into the bloodstream.Particulate matter is the reason you don’t want to breathe in smoke or car exhaust. Chronic exposure to high levels of particulate matter exacerbates asthma, but also makes it more likely that a child will develop asthma, says Holm. It’s also linked to changes in childhood growth, metabolism and brain development, and it’s classified as a carcinogen levitra vs cialis by the WHO.All cooking produces some particulate matter in the form of aerosols and tiny bits of char generated from food and dust being heated up. If you can smell burning, you’re likely breathing in quite a bit of particulate matter.

€œAnything with a red-hot element is going to generate particles,” says Walker. That includes most stovetops, ovens and even small appliances like levitra vs cialis toasters. Frying and roasting cook methods both produce a lot more particulate matter than boiling or steaming. And fatty foods give off more than veggies.Gas stoves are particularly bad for indoor air quality.

Not only do they produce more particulate matter by virtue of creating an open flame, but the actual fossil levitra vs cialis fuel combustion also generates other gases, such as carbon dioxide and nitrogen dioxide. From a health perspective, the thing that raises the biggest concern in this scenario is nitrogen dioxide.Nitrogen dioxide, like particulate matter, contributes to breathing problems like asthma and is regulated in outdoor air. The gas has also been linked to heart problems, lower birth weight in newborns and shorter lifespans for people who are chronically exposed.A 2016 study from Lawrence Berkeley National Lab found that simply boiling water on a gas stove produces nearly twice the amount of nitrogen dioxide as the EPA’s outdoor standard. Considering that about a third of levitra vs cialis American homes use natural gas for cooking, that’s a lot of potential exposure.“Somehow, we've just become used to an unvented fossil fuel device in our homes,” says Brady Seals, who manages the carbon-free buildings program at the Rocky Mountain Institute, a clean energy think tank.

She wants to raise awareness of nitrogen dioxide’s health risks as a way to discourage natural gas use in homes. And she’s not alone in this mission. The Massachusetts Medical Society passed a resolution levitra vs cialis in 2019 to recognize the link between gas stoves and pediatric asthma. Several cities in California, including San Francisco, have passed bans on natural gas in new construction, citing both climate and health hazards.If you have a gas cooktop, Seals and Walker recommend swapping it out for an electric one if you have the means and ability to do so.

€œNot only are you reducing carbon impact [on the environment], but you can have a healthier home if you get rid of combustion appliances,” Walker says.The best option from both an energy-efficiency and air-quality perspective, he says, is an induction stove, which uses magnets to transfer heat directly to your pots and pans. No red-hot elements means levitra vs cialis less particulate matter. If you can’t replace your gas stove, Seals recommends a plug-in induction cooktop.Vented AirRealistically, few people are going to swear off stir frying or using their oven for the sake of producing less particulate matter. €œEverybody’s going to cook what they’re going to cook,” says Farmer, noting that people use whatever kitchen appliances they have.

That’s why all these experts stress the importance of good ventilation.Holm was part of a 2018 study looking at particulate matter in the homes of children levitra vs cialis with asthma. One of the most surprising findings. In homes that never used a range hood or range fan, people were exposed to unhealthy levels of particulate matter for roughly 10 percent more time than in homes that used range ventilation.Walker, the ventilation expert, recommends that people should use a high setting on their kitchen range hood whenever possible, since the quieter low settings capture only about half of pollutants. Since most range hoods don’t extend over the front burners, you might want to consider using the back burners, especially if levitra vs cialis you have a gas stove.

Walker also advises that people keep the ventilation on for about 15 minutes after they’re done cooking. That’s about how long it takes for all of the air in the room to be replaced. But that only applies if your vent is sending fumes outside, which is not often the case.Unless you have a new, higher-end kitchen and stove, your built-in range ventilation might essentially be a fan levitra vs cialis. It’s just pushing the fumes around the room, which helps disperse the concentration of pollutants more quickly but doesn’t actually remove them from your house.

Many homes and apartments, including Holm’s, don’t even have that option. In that case, Holm recommends opening some windows if the outside air quality is good, or using a portable air purifier with a HEPA filter.In the end, levitra vs cialis there are still a lot of unknowns about how cooking fumes affect us. To some extent, we simply have to accept them as a byproduct of enjoying our favorite foods, much like we accept pet hair as a part of having a furry friend. €œYou start realizing how pollutants are a part of our life,” Seals says.

€œLet’s reduce pollution wherever we levitra vs cialis can. But I’m not going to give up my dog and I’m not going to stop cooking.”[Correction. A previous version of this story erroneously stated the findings of levitra vs cialis Holm's 2018 air quality study and the type of portable air purifier that Holm recommends using in homes. We apologize for the errors, which have been corrected in this current version.]A happy accident with a chocolate bar led to one of the most reliable kitchen appliances around today.

Engineer Percy Spencer was standing in front of a device emitting high-frequency radio waves when the chocolate in his shirt pocket began to melt. The change led him and levitra vs cialis his colleagues to investigate what electromagnetic radiation could do to food, and the microwave was born in 1947.Since its earliest days, the technology has gotten smaller and lighter, and the kind of radiation used has shifted. Spencer’s discovery happened with radio waves, and the devices now rely on microwave radiation to cook our meals. Despite the changes — and how permanent a fixture microwaves have become in households — some people are still uneasy around the devices and worry about potential health effects.

€œAs a professor working in this area, safety is important levitra vs cialis to me,” says Vijaya Raghavan, a bioresource engineer at McGill University, who studies how industrial microwave settings can pasteurize and sterilize foods. Luckily, a lot of the safety concerns are handled by regulations, and there are simple ways for people to minimize the very small risks they face.Microwaves Bring the HeatMicrowaves are a kind of radiation, just like infrared, visible light, and x-rays. They are also relatively large. In terms of size and speed, microwaves are more like radio waves than they are the kind of levitra vs cialis light we see.

Put to work inside kitchen appliances, the radiation is useful for cooking food fast. Microwaves emit from one side of the appliance while it’s running and bounce around, reflecting off the metal interior and going into your meal. There, microwaves force all the water molecules in your food to move levitra vs cialis. The spinning water molecules generate heat and voila — your leftovers, vegetables or frozen dinner gets cooked.When it comes to making water molecules spin and create heat, microwaves don’t discriminate.

They’ll do the same to your arm or leg, which is why microwave exposure can be dangerous. Exposure can burn levitra vs cialis skin. Eyes and testicles are particularly vulnerable, according to the Food and Drug Administration, because there’s relatively little blood flow in the area to carry away the building heat. Highly-Controlled and Low RiskHowever, microwave burns only happen after someone has had a lot of exposure to the radiation — which is not something that will happen from your microwave oven.

For one, levitra vs cialis microwaves can only operate if the door is closed, per FDA requirements. As soon as it opens, the radiation production stops. Any microwaves that were still within the device dissipate into the air right away, Raghavan says. Theoretically, a tiny bit of levitra vs cialis the microwaves could leak out of any cracks, like where the door shuts.

But the FDA regulates seeping radiation, too. The amount of microwave radiation the agency lets the kitchen appliances emit is significantly less than how much cell phones are allowed to release — and the levels our smartphones can generate are also considered safe. And because any radiation coming out of an operating microwave levitra vs cialis starts to fall apart very quickly, someone would have to be standing practically up against the microwave for a long time for the rays to cause any damage. Sure, the farther away from the microwave you are, the safer it is, Raghavan says.

€œBut if you’re certain that a microwave unit is being used, why do you want to stand next to it anyways?. €In his own lab, Raghavan uses all kinds of microwave ovens to levitra vs cialis see how they can help with industrial food preparation. He often buys standard microwaves most people put in their homes and reworked them to create the wavelength frequency he needs. Raghavan also keeps track of how much power is generated in the first place as well as how much of the microwaves are absorbed by the food or reflected.

Even in levitra vs cialis this laboratory setting, he and his colleagues don’t wear protective gear. Instead, they put leakage meters near the devices. People at home probably don’t need to stand right next to the microwave, as Raghavan points out. Also, don’t run it without anything levitra vs cialis inside.

The microwaves will bounce back and damage the internal mechanisms that help transmit the microwaves, Raghavan says. And if you find your microwave keeps running once you open the door, remove it and get a new model — you don’t want to be Percy Spencer and find that radiation is melting your pocket chocolate.Part one of this article began with a light-hearted anecdote about Count Volta sticking electrodes in his ears. Part two levitra vs cialis takes a more serious tone. Here, we address the reasons why cochlear implants aren’t available to everyone, and why they are nearly inaccessible to those who need them most in the developing world.

The most pressing barriers that prevent adults and children in developing countries from accessing the benefits of cochlear implants are plain enough. (1) the levitra vs cialis high cost of cochlear implant components. (2) the complexity and skill level required to perform the surgery. And (3) the lack of local levitra vs cialis post-operative rehab services and expertise.

Fortunately, there’s a light at the end of the tunnel. In part two of this article, we look at the tremendous efforts of nonprofit groups to overcome these barriers to cochlear implants in developing countries. We also look at an experimental (yet controversial) approach to cochlear implants that could dramatically reduce the cost and complexity of implant components and surgeries levitra vs cialis. Why Access to Cochlear Implants Is So Important for Children Cochlear implants can offer life-transforming help to adults with hearing loss, but they are even more important for children.

That’s because children with hearing loss have a limited period of time in which to develop speech and listening skills. If a hearing levitra vs cialis problem isn’t addressed with hearing aids or cochlear implants by the age of 3 (and preferably earlier), children with serious hearing conditions may not be able to develop auditory and speech skills naturally. Without listening and spoken language skills, it is more difficult for children with deafness and profound hearing loss to attend mainstream school or fully participate in their hearing communities. Tragically, many of these children in developing nations are miscategorized as intellectually disabled – when in fact, there is a shining, beautiful mind hidden behind their inability to communicate.

Photo Courtesy of the Global Foundation For Children With Hearing Loss According to Paige Stringer, Executive Director of the Global Foundation For levitra vs cialis Children With Hearing Loss (GFCHL). €œIt is essential that hearing loss be identified as early as possible in newborns and young children so they can get the hearing technology and early intervention support they need to learn to listen and speak. For a child to develop on par with typically hearing peers in the areas of speech, language, and audition, they must have access to the sounds of speech. Early access to hearing aids or cochlear implants is key for successful outcomes.” levitra vs cialis A landmark 2010 study echoes Stringer’s perspective by confirming what most in the hearing and speech-language professions already knew.

The study found that children who receive cochlear implants before the age of 18 months achieved a speaking ability closer to that of hearing children. In contrast, those who received cochlear implants after the age of 3 continued to exhibit certain gaps in speaking ability compared to children without hearing loss. In developing countries, where access to cochlear implants and hearing aids is scarce, some deaf children may be able to levitra vs cialis attend schools where they can learn sign language and benefit from a specialized curriculum. But children in rural, undeveloped areas don’t tend to have this option.

Without cochlear implants, access to affordable hearing aids, or proper schooling, these children may not be able to develop their language and communication skills in a mainstreamed environment. To say that these children face levitra vs cialis severe discrimination, social isolation, and extreme socio-economic challenges as a result of their hearing difficulties would be an understatement. Image source. BBC When children are born with hearing impairment and deafness in developed countries like the United States or the United Kingdom, technologies, therapies, and educational opportunities are more readily available and help to remove the barriers to living a normal life.

These children have the levitra vs cialis potential to grow up without impediments as developing children typically do. Why Are Cochlear Implants Difficult to Access in Developing Countries?. There are three main reasons why cochlear implants are difficult to access in developing countries. (1) the levitra vs cialis cost of the components and surgeries.

(2) the complexity and surgical skill required to perform the procedures. And, (3) the need for post-operative rehabilitation services. (1) The High Cost of Cochlear Implant Components The levitra vs cialis cost of cochlear implant components and surgeries depends on a number of factors, but one thing is certain. The prices far exceed what the average person in a developing country can afford.

In the United States, the components alone – without factoring in surgical costs – can exceed $25,000 per ear, and total costs with surgery can exceed $80,000 per ear. In developed nations, private or national insurance usually covers these levitra vs cialis costs, so access isn’t an issue. In many Asian, African, and Latin American countries, the cost of cochlear implant components is less, but the prices are still prohibitively high. In the article, “The Challenges of Starting a Cochlear Implant Programme in a Developing Country,” Dr.

Kumaresh Krishnamoorthy writes that Cochlear Implant components cost from levitra vs cialis $12,000 to $25,000 in India. With surgery, total costs come to $17,000 to $29,500. If you consider that the average Indian salary is $2,120 per year – and that these individuals are living paycheck to paycheck – it’s easy to see why cochlear implants are absolutely unaffordable for most Indians without any available government or insurance financial support. According levitra vs cialis to Stringer.

€œThere are also the ongoing costs associated with cochlear implants after surgery – which includes a lifelong commitment to paying for post-op rehabilitation, replacement parts, servicing, and upgrades. Many families focus on the cost of the initial device and surgery, but they don’t have the means to pay for these ongoing costs.” As Krishnamoorthy points out. €œCochlear implants are a proven auditory rehabilitative option for individuals with severe to profound sensorineural levitra vs cialis hearing loss, who otherwise do not benefit from hearing aids. Nevertheless, only a small percentage of these individuals receive cochlear implants, and cost remains a leading prohibitive factor, particularly in developing countries […] the technology is virtually unavailable to the masses.” Unfortunately, even though many developing countries have government-sponsored cochlear implant programs, most do not have enough surgeons or facilities – or rehabilitation support post-surgery – to service all of the people who need them.

(2) The Complexity and Skill Level Required to Perform Cochlear Implant Surgeries Once fully trained, a neurotologist can safely perform a cochlear implant procedure, but the surgical training is long, involved, and expensive – and it’s only levitra vs cialis available in developed countries. As a result, there are not enough surgeons in developing countries who can safely perform cochlear implant procedures. Image Source. Blausen.com staff levitra vs cialis (2014).

€œMedical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.

When you see the steps involved, it’s easy to understand the complexity of the procedure. Administer general anesthesia. General anesthesia is required during the two- to four-hour procedure. Make an incision behind the ear.

The surgeon makes an incision behind the ear to expose the mastoid bone. Identify the facial nerves. The surgeon finds the facial nerves and drills an opening between them through the mastoid bone to expose the cochlea. Place the electrode array.

The surgeon opens the cochlea and threads the electrode array into the cochlea. Place the receiver. The surgeon makes a shallow indentation into the skull behind the ear and fixes the round, flat receiver into the bone just beneath the ear. Close the incisions.

The surgeon closes the incisions and the procedure is complete. Considering these steps, the cochlear implant procedure is neither “simple” nor “easy” to perform. It requires general anesthesia, drilling through the mastoid bone, and the removal of a portion of the skull. There is also the risk of facial nerve damage.

While the use of surgical robots for cochlear implant procedures could reduce the skill requirement, this technology is still largely inaccessible in developing countries. As we will discuss in further detail below, there is the possibility that an experimental cochlear implant design could one day reduce the cost and surgical complexity associated with this technology. (3) The Need for Post-Operative Rehabilitation and Training Beyond the cost and complexity of cochlear implant surgeries, implant recipients need several months – or years in the case of infants and young children – of training as they learn to recognize sounds and understand speech. For children, speech-language therapy is particularly important.

This training requirement often prevents those living in rural areas from getting cochlear implants – simply because they cannot access an in-person therapist for post-op rehab and speech-language training. Stringer from GFCHL offered the following perspectives on this. €œCochlear implant technology is not a stand-alone solution. It is an intensive medical device that needs a lot of support.

CIs are not like glasses where you put them on and instantly see better. A CI is just a tool to enable access to the sounds of speech. There is a great deal of rehabilitation involved after the CI surgery, particularly in young children, to fully benefit from it.” Getting cochlear implants to those who need them isn’t just a question of funding and sourcing surgeons. To make this technology available to more people in developing countries, national governments also need to conquer the serious logistical challenge of building a medical infrastructure that (1) has enough skilled surgeons and surgical facilities to serve everyone.

And (2) has enough local training facilities where cochlear implant recipients can receive post-operative rehab and speech-language therapy. (4) The Lack of Awareness Surrounding the Benefits of Cochlear Implants There is also a lack of awareness surrounding (1) the need to screen babies and young children for signs of deafness, and (2) the benefits of cochlear implants and hearing aids when treating deafness and other hearing conditions. Without a general understanding of these issues, children born with hearing loss may never be identified – and even if they are identified, parents may not be aware that treatments and therapies are available. As for adults with hearing loss, they also might not realize that they are suffering from hearing loss – and if they do realize it, they might not know that a pair of hearing aids or cochlear implants can dramatically improve their lives.

Incidentally, this lack of awareness is also a problem in the developed world, but adults – no matter where they are – can quickly assess their level of hearing loss by taking a free online hearing test. If you’re curious to check your hearing, here’s a free, 5-minute hearing test from MDHearingAid. Overcoming the Challenges of Cochlear Implant Access The most common approach to overcoming the lack of access to cochlear implants is to increase nonprofit support and international aid for government cochlear implant programs. This involves helping developing nations overcome the logistical challenges of sourcing surgeons, establishing surgical and post-operative facilities, and educating the public on hearing loss treatment options.

A second approach to increasing access involves a radical rethinking of the technology and its surgical techniques. By redesigning cochlear implants to be more affordable – and making surgeries simpler and less invasive – overcoming the cost and logistical challenges of cochlear implants becomes a great deal easier. (1) Nonprofit Efforts to Boost Cochlear Implant Access in Developing Countries There aren’t many organizations expressly dedicated to increasing access to cochlear implants to children in developing countries. However, the Global Foundation for Children with Hearing Loss (GFCHL) is one such organization that’s passionately engaged with achieving this goal.

Led by its Founder and Executive Director Page Stringer – a public health specialist and cochlear implant recipient herself – GFCHL has a mission to bring direct and lasting change for babies and young children who are deaf or hard of hearing and living in developing countries. Watch this video from Stringer to get a sense for the organization. According to Stringer. €œA sustainable cochlear implant program in a country requires LOCALLY based expertise and services in cochlear implant surgery, audiology, cochlear implant mapping, auditory-verbal therapy, and early intervention.

Not only do parents and family members need access to professional expertise and support, but they also need ongoing servicing and equipment. In many developing countries, these elements are lacking. There is also the high cost of all the elements, which makes it challenging for many families to afford if there is no insurance or government subsidy to support it.” Photo Courtesy of the Global Foundation For Children With Hearing Loss Stringer says that bringing hearing technology to children in developing countries is a two-fold effort. Raising awareness.

Helping governments, local health administrations, caregivers, and the community at large understand that children with hearing loss can learn to listen and speak when they receive the proper support at an early enough stage. This is a process of educating and involving family members and caregivers while raising awareness among the general public. Organization and Logistics. Offering training programs that help developing countries establish local services and professional expertise.

This is a process of showing countries how to develop screening programs that support early identification, encouraging timely fitting of hearing aids and cochlear implants, and ensuring access to locally-based professionals – such as audiologists, cochlear implant specialists, and speech therapists. With programs in Vietnam, Bhutan, and Mongolia, and previously in Ecuador, the efforts of GFCHL have made possible. The training of hundreds of teachers, therapists, and medical professionals Educational support about hearing loss in children for hundreds of families The fitting of over 400 children with digital hearing aids with ongoing support from professionals trained by GFCHL The GFCHL has also partnered with the global hearing care organization Hear the World Foundation (the charitable arm of Sonova that manufactures Advanced Bionics cochlear implants) to provide 10 Vietnamese children in need with cochlear implants along with 15 years of complimentary audiology support and technical upgrades. The children also receive complementary auditory-verbal therapy support by Vietnamese professionals trained by GFCHL for several years.

Other organizations are also involved in providing hearing aid assistance to those in need. For example, key leadership from the affordable hearing aid manufacturer MDHearingAid (CEO Doug Breaker and VP of Product Sourcing Paul Bryant) recently helped sponsor the AllHear Foundation’s 2020 mission to Belize. The AllHear Foundation completed 100 free hearing tests and provided 91 free hearing aids to those in need. Image source.

AllHear Foundation, Photos of Hearing Loss Patients in Belize, Photo Dr. Chip Goldsmith (Center Left) with Patient (Right) The Belize mission with AllHear Foundation was MDHearingAid’s first participation in an overseas project. Locally, MDHearingAid also partnered with H.O.M.E. To give away $100,000 worth of hearing aids to Chicago seniors in need.

MDHearingAid says it will participate in more overseas and local missions to provide further hearing assistance in the future. Doug Breaker, MDHearing CEO commented, “Giving back is very important to us. Our mission is to provide affordable, high-quality hearing aids to as many people as possible. As part of that, we give to those in need whenever we can, and hope to expand those efforts in the future.” According to Stringer, overcoming the financial, organizational, and logistical challenges of providing hearing assistance to children in developing countries takes time.

Nevertheless, the profound results of GFCHL’s efforts – and those of other organizations – can already be seen. (2) An Experimental Technology that Could Make Cochlear Implants More Accessible So far, we’ve discussed how nonprofit groups are working to bring cochlear implants to more people around the world. However, there could be another way to boost access to cochlear implants even more. This involves a fundamental redesign of cochlear implant technology to make the devices more affordable to buy and the surgical techniques easier and safer to perform.

We reached out to Dr. Chip Goldsmith, a neurotologist and cochlear implant surgeon who founded the nonprofit AllHear Foundation, to learn more about the latest in low-cost cochlear implant design. Goldsmith is working on an experimental – yet safer and more cost-effective – approach to cochlear implants. According to Goldsmith, the larger medical community views his approach with skepticism, but he believes that once fully developed and tested in patient trials, his design could dramatically improve access to cochlear implants for those living in low- to medium-income countries.

Goldsmith’s ideas center around the question of whether the long, multi-channel electrode arrays in modern cochlear implants are necessary. Neurotologists usually agree that a multi-channel cochlear implant is required to stimulate key areas of the cochlea. Without this specific stimulation, they believe that perceiving speech and other complex sounds isn’t possible (see part one of this article to understand how conventional cochlear implants work). Unfortunately, the multi-channel requirement makes cochlear implants expensive to manufacture, and the surgery is invasive and difficult to perform.

Moreover, inserting the long, multi-channel electrode array into the cochlea usually destroys any natural hearing ability the patient still has. According to Goldsmith, his late mentor, Dr. William F. House (who is credited as one of the inventors of cochlear implants), believed in a different approach to cochlear implant design.

Dr. House maintained that a short, single-channel cochlear implant could serve as an affordable, less invasive solution to treat hearing loss. Goldsmith adds that “Dr. House was known as the Father of Neurotology, and he was not too often wrong with his theories.” Image Source.

Edited Image from Advanced Bionics As a continuation of Dr. House’s ideas, Goldsmith argues that we can achieve similar treatment results using a tiny cochlear implant with a short, single-channel electrode array, instead of a long, multi-channel array. Goldsmith alleges that – even with a short, single-channel implant – the brain has the ability to interpret sounds with sufficient clarity to understand speech and experience a rich complexity of sounds. Putting he and Dr.

House’s theories into practice, Goldsmith has designed an affordable, single-channel cochlear implant that – after human trials and development – could retail for about $1,800, representing a considerable savings over the cost of conventional implants. The device is so tiny that the surgery for installing it is far less invasive and less complicated than traditional cochlear implant surgeries. Unlike conventional cochlear implants, installing the device would not pose a risk to the patient’s remaining hearing capabilities. Note the tiny size of Goldsmith’s single-channel implant compared to a multi-channel device.

Image source. AllHear Foundation According to Goldsmith. €œOur smaller and far less expensive cochlear implant system can be inserted through a simpler trans-canal surgical approach that goes through the ear canal and eardrum. This ‘transtympanic’ procedure is safer than conventional cochlear implant surgeries because it does not require drilling through the mastoid bone or skull.

We have also demonstrated that this procedure can be performed under local anesthesia.” Goldsmith also wanted to add the following. €œI worked with Dr. House on his AllHear short electrode system for many years, and my AllHear Foundation is named after this implant. My transtympanic configuration is merely an offshoot of Dr.

House’s fundamental theories.” At this time, Goldsmith’s team has built a new sound processor for single-channel implant recipients. Researchers are currently retrofitting patients who received one of Dr. House’s single-channel implants with this sound processor. If they can improve the hearing of these patients, they will adapt the new sound processor to fit Dr.

Goldsmith’s transtympanic configuration. Goldsmith’s single-channel cochlear implant still requires extensive trials and testing – and the technology needs to gain acceptance and approval from the larger medical community. However, we spoke with Brandy Klann, MA, a cochlear implant audiologist at the Michigan Ear Institute who offered the following. "Dr.

Goldsmith's ideas are intriguing. I look forward to seeing the clinical trial data on his single-channel cochlear implant." It is encouraging to see that certain medical innovators are working to make cochlear implants more affordable and accessible to everyone – especially when efforts like these are often hindered by a lack of funding and support from governments and the industry at large. Final Thoughts To think that the road to overcoming deafness and hearing loss began with scientists like Allessandro Volta, Giuseppe Veratti, and Benjamin Wilson sticking electrodes in their ears over 200 years ago – and to see where we’re at today – is absolutely inspiring. Considering what we've already achieved, the barriers to cochlear implant access in developing countries are not insurmountable.

We have all the technology and organizational tools at our disposal to make this miraculous technology available to everyone – regardless of their economic status. All we need is the continued determination of organizations like the Global Foundation for Children with Hearing Loss, Hear the World Foundation, and AllHear Foundation, and innovative physicians like Dr. Chip Goldsmith, who are willing to think outside the box. Like a ripple effect, their efforts will bring transformative assistance to more children and adults with hearing loss, until eventually, no one is left behind.

This article was sponsored in full by MDHearingAid, a hearing aid manufacturer that offers high-quality, affordable, FDA-registered hearing aids for a fraction of the cost of traditional aids. By selling its medical-grade hearing aids directly to consumers for just $399.98 to $999.99 a pair, MDHearingAid cuts out the middleman – transferring thousands of dollars in cost savings to its customers. This has opened the door to effective hearing loss treatment for millions of people who couldn’t previously afford to purchase hearing aids. If you’d like to support MDHearingAid in its mission to break the cost barriers associated with hearing loss treatment, tell your friends and family who need hearing aids about MDHearingAid and its affordable product line.

Also, if you want to check your hearing to see if you could benefit from a pair of aids, click this link to take a free 5-minute hearing test from MDHearingAid now. Biography Fascinated by emerging science, Jeremy Hillpot’s background in consumer litigation and technology offers a unique perspective on the latest developments in medical science, agrotechnology, blockchain, data engineering, app development, and the law. Contact Jeremy at jhillpot@legalwritingFINRA.com or follow him on Quora.The lymph nodes were known in antiquity—you can see them without a microscope—and were first described in Peri Adenon (On Glands), the Hippocratic treatise that has been described as a “milestone” in the history of immunology.” But the rest of the lymphatic system was more inscrutable. It wasn’t until relatively recently that science really began to understand the lymph system.

We are, in fact, still uncovering some of the secrets of this crucial part of our physiology.On Guard Against AntigensThe word lymph comes from the Latin word lympha, which means water. Lympha was in turn derived from the Greek word nymph, those divine ladies who haunt forests and streams. This one inhabits your immune system. While the image of a water nymph is a lovely one, the lymphatic system might be best thought of more prosaically as a complex drainage and purifying system.

It is a network of tiny vessels, smaller even than capillaries, that transports lymph throughout the body. Lymph is made from fluid that seeps out of the capillaries and into the body’s tissues. This fluid nourishes those tissues with oxygen, proteins and other nutrients, but it also picks up a lot of not-so-beneficial material — waste, toxins, and bits and pieces of bacteria and levitraes. Some of this is pulled into the vessels of the lymphatic system, where it is turned into lymph, a thin, whitish fluid that contains immune cells that fight off .

Strategically placed along this network of vessels are the lymph nodes, small bean-shaped clumps of tissue. David Weissmann, a pathologist at the Robert Wood Johnson Medical School, foregoes both mythological and engineering metaphors, and describes lymph nodes as a combination of burglar alarm and West Point. €œLike a burglar alarm they are on guard against intrusive antigens. Like West Point, the nodes are in the business of training a militant elite.

Lymphoid cells that respond to the intruder by making antibodies and forming a corps of B and T-cells that will remember the intruder's imprint for years.” As the lymph passes through, the nodes filter out damaged cells, cancer cells, and other toxins and waste materials. They also scan any foreign material and create immune cells that can recognize and destroy these invaders. Lymph nodes are loaded with T cells, B cells, dendritic cells, and macrophages — all cells that are involved in identifying and mounting a response to . Some lymph nodes are just under the skin in your armpits, groin and neck.

When you get a lump in your neck when you have a throat , it’s because your lymph system is scuttling bits and pieces of the bacteria (or levitra) that’s making you sick to the nearest lymph nodes, in this case, in your neck, where loads more white blood cells are generated to help wipe out the . There are hundreds of lymph nodes, though, and most of them are much deeper in the body, such as around the heart or the lungs and in the abdomen. Brain ConnectionUntil recently, it was thought that the lymphatic system did not reach as far as the brain. But in 2015 a team of researchers at the University of Virginia discovered in the central nervous system lymphatic vessels that drain cerebrospinal fluid into the cervical lymph nodes below.

Knowing that the brain interacts with the immune system could open possibilities for new research into neurological diseases, including Alzheimer’s.The tonsils, adenoids, spleen, and thymus are also part of the lymphatic system. All of these organs, in one way or another, filter out the waste and help kill dangerous bacteria and levitraes. While the lymphatic system plays a big role in protecting us from cancer, it can also help spread it. Cancer cells that manage to survive that militant elite get a free ride on the lymphatic network to other parts of the body.

So while you’re going about your day, blissfully unaware of the drama unfolding inside your body, your lymphatic system is busily cleaning up after you, scanning for disease-causing microbes and creating immune cells to quickly dispatch them. She’s one busy water nymph..

Ask any nutritionist and they'll tell you that our health is a reflection cheap levitra pills of the lifestyle we lead and what we put on our plates. The food we eat not only satisfies our hunger. It also fuels our bodies cheap levitra pills with energy to carry on. In today’s fast-paced life, there's limited time to make elaborate home-cooked meals.

It's no wonder that 80 percent of Americans' total calorie consumption is thought to come from store-bought foods and beverages. Many of these food items are considered ua-processed, causing a growing rate of concern for human health among scientists.Breaking Down Ua-Processed cheap levitra pills FoodsYou may be wondering what exactly ua-processed foods are. The concept of processing refers to changing food from its natural state, according to Harvard Health Publishing. Methods of accomplishing this include canning, smoking, pasteurizing and drying.

Ua-processed foods take processing one step further by adding multiple ingredients cheap levitra pills such as sugar, preservatives and artificial flavors and colors. Commercially prepared cookies, chips and sodas are just a few of many examples of foods that fall into the highly processed category. In order to further understand ua-processed foods, we must first explore the different levels of food processing. The term ua-processed was first coined by Carlos Monteiro, cheap levitra pills a professor of nutrition and public health at the University of Sao Paulo, Brazil.

Monteiro also created a food classification system called NOVA that has become a popular tool in categorizing different food items. The NOVA Food Classification system contains four different groups:Unprocessed/Minimally Processed Foods. Think 100 percent natural and healthy cheap levitra pills. This group includes foods such as fruits, vegetables, eggs, meats and milk.

Unprocessed foods are considered completely natural and are typically obtained directly from plants and animals. Minimally processed foods cheap levitra pills are also natural foods that have had very minor changes such as removal of inedible parts, fermentation, cooling, freezing, and any other processes that won't add extra ingredients or substances to the original product.Processed Culinary Ingredients. This group has everything to do with flavor and typically contains ingredients such as fats and aromatic herbs that are extracted from natural foods. These ingredients are then used in homes and restaurants to season and cook items such as soups, salads and sweets.

Many of these extracted ingredients cheap levitra pills can also be stored for later use. Processed Foods. Most processed foods contain at least two or three added ingredients such as salt, sugar and oil. Think of cheap levitra pills this group as a combination of the first two groups.

In other words, processed culinary ingredients or flavors that are added to natural foods. Examples include fruits in sugar syrup, bacon, beef jerky and salted nuts. Ua-Processed Foods cheap levitra pills. Last and least healthy on the NOVA scale are ua-processed foods.

This group is considered highly processed due to a large amount of added ingredients. Nova typically classifies this group as industrial formulations made entirely or mostly from substances such as oils, fats, sugar, starch and cheap levitra pills proteins as well as flavor enhancers and artificial colors that make these foods appear more attractive. Frozen items such as pre-prepared burgers or pizzas, candies, sodas, chips and ice cream are a few examples. On a daily basis, the ua-processed category is not the best source of your nutritional intake.

But there's still hope cheap levitra pills for our frozen pizza and chocolate lovers. Caroline Passerrello, spokesperson for the Academy of Nutrition and Dietetics, suggests that there may be a place on our plates for processed foods. Everything in ModerationIt's often said that most things are OK in moderation. But does cheap levitra pills this saying ring true for ua-processed foods?.

According to Passerrello, ua-processed foods like cookies, chips and sodas are more energy than nutrient-dense. This means that while the energy and calories are present, the nutrients we require like vitamins and minerals are often lacking. This can become a cause for concern because our bodies require both energy and nutrients to function properly.A 2017 study that followed the cheap levitra pills dietary intakes of 9,317 participants found that Americans were eating ua-processed foods at alarming rates. Foods, in this case, were classified according to the NOVA scale.

The results of the study showed that on average more than half of cheap levitra pills the calories of the participants came from ua-processed foods. These foods failed to deliver proper nutrients. Participants that consumed more ua-processed food lacked proper protein, calcium, fiber, potassium, and vitamins A, C, D and E in their diets. In contrast, participants that consumed higher amounts of unprocessed or minimally processed foods had a better overall diet with adequate amounts of the different nutrients.So, a balanced diet of the different food groups may just be the cheap levitra pills way to go.

But what happens when we overindulge in ua-processed foods on a regular basis?. Because ua-processed foods are typically filled with sugar and fat, they've been linked to numerous health risks including obesity, heart disease and stroke, type-2 diabetes, cancer and depression.Passerrello explains that overconsumption of highly processed foods over time can also lead to vitamin and mineral deficiencies. In addition, processed foods tend to have higher amounts of cheap levitra pills sodium, which is often used to extend their shelf life. Consuming too much sodium can lead to feelings of dehydration and cause muscle twitches.The health risks associated with overconsumption of ua-processed foods can easily pile up, but luckily, there are some healthy alternatives that we can choose to incorporate into our diet.

Eat This Not ThatCutting down on ua-processed foods definitely seems like a good start to a healthy and balanced diet, but it's only the first step. "It's not just the ua-processed food itself that is the concern, but what else we are, or are not, eating — as well as what our bodies need and ultimately, what foods we have access to on a regular basis," says Passerrello.Health and nutrition can vary from person to person, so there is definitely no hard cheap levitra pills and fast rule as to what goes and what stays. However, Passerrello advises that if you are in a position in life with your time, taste and budget to make a choice between an ua-processed food item and a minimally processed food item, you should typically opt for the minimally processed food.Yes, frozen dinners may be an easy option after a long day of work. However, an easy alternative that can save time could be meal prepping in advance.

A homemade alternative such as a cheap levitra pills simple rice dish or burritos can be easy to make in batches and store away for the week. Another simple way to slowly decrease your intake of processed foods is to check food labels for excess amounts of salt or sugar. Instead of sodas, Passerrello suggests opting for orange juice or milk that are fortified with calcium and vitamin D.Ultimately, choosing healthy foods is a matter of providing your body with the proper nutrients it needs while also incorporating your personal tastes and preferences. A handful of chips and a frozen cheap levitra pills pizza may not be the healthiest treat, but they won't do serious damage as long as ua-processed foods aren't your main and only form of nutrients.Like many people, Stephanie Holm made holiday cookies with her family last year.

Her daughter found a recipe on the internet, and the two of them set to making them in the kitchen of their apartment.Together, they mixed the dough, rolled it out, put the cookies on a pan and popped it in the oven — “literally covered in sprinkles on the outside…cute, and very delicious,” says Holm, a pediatric environmental medicine specialist at UC San Francisco.But as the cookies baked, Holm noticed that the cute sugary coating burned a little in the oven, though not enough to ruin the cookies. Then Holm heard her daughter exclaim, “Mama, it’s purple!. € and she saw that the air quality sensor cheap levitra pills she keeps in their apartment had indeed turned from green (good air quality) to purple (very unhealthy). Could a single batch of slightly singed cookies have been to blame?.

What happened with Holm’s cookies wasn’t a fluke. All cooking releases cheap levitra pills a complex mixture of chemicals, some of which would be classified as unhealthy pollutants. As for whether cooking is hazardous to your health — the short answer is, it depends. But generally, if you have good ventilation, you should be fine.“We all cook, and the average life expectancy is 78 or 79 years old.

So we shouldn’t get too worried,” says Delphine Farmer, an atmospheric chemist at Colorado State University cheap levitra pills. €œBut it is an opportunity to think about how to reduce your exposure to pollutants.”Out of the Frying PanFarmer’s research found that cooking releases a mixture of hundreds of different chemical compounds into the air. Every ingredient gives off its own unique blend of particles and gases. Proteins in meat can break down and give off ammonia cheap levitra pills.

Roasting can produce isocyanates. Oils from frying and sautéing can aerosolize (that’s how your counters end up with a fine layer of grease on them). The airborne molecules can continue to react and change as they drift around your kitchen and bump into each other.“You can see some of these really cheap levitra pills interesting compounds,” Farmer says. €œBut are they at levels that are toxic?.

We don't know.” Part of the uncertainty when it comes to health effects comes from the fact that most air quality studies and standards are based on outdoor air — despite our world where people today spend an estimated 90 percent of their time indoors. While Canada and the World Health Organization cheap levitra pills have indoor air quality guidelines, the U.S. Does not.In general, indoor air chemistry fluctuates a lot more than outdoor air. The average air quality can be good, but as Holm and her daughter experienced, some activities — like cooking and cleaning — can cause dramatic changes.

Pollutant levels will spike in cheap levitra pills the kitchen while cooking is actively happening and then drift back down as the airborne molecules disperse.“The pattern of exposure is different. And we really don't have great scientific data on what the difference of that pattern of exposures means for people's health.” Holm says.Acquiring that scientific data is no easy task. Variables that can affect cooking fumes and their contents include how often a person cooks, what they cook, how they cook it, what kind of appliance they use, what kind of ventilation they have and maybe even the type of pots and pans they use, says Iain Walker, an engineer at Lawrence Berkeley National Lab who studies home air quality and ventilation. The best researchers can do is cheap levitra pills try to gauge the relative impact of each factor.

Gas stove or electric?. Boiling cheap levitra pills or frying?. Meat or vegetables?. Nonstick pan or stainless steel?.

Into the FireThe main cheap levitra pills pollutant of concern linked to cooking is particulate matter. This catchall term refers to a complex mix of microscopic solid bits and uafine liquid droplets that could be made up of hundreds of different chemical compounds. The chemistry doesn’t matter nearly as much as the size. Particles smaller than 10 cheap levitra pills microns (less than 1/5 the width of a human hair) can make their way into the lungs and lodge there.

Even smaller particles can make their way into the bloodstream.Particulate matter is the reason you don’t want to breathe in smoke or car exhaust. Chronic exposure to high levels of particulate matter exacerbates asthma, but also makes it more likely that a child will develop asthma, says Holm. It’s also linked to changes in childhood growth, metabolism and brain development, and it’s classified as a carcinogen by the WHO.All cooking produces some particulate matter in the form of aerosols and tiny bits of char generated from food and dust cheap levitra pills being heated up. If you can smell burning, you’re likely breathing in quite a bit of particulate matter.

€œAnything with a red-hot element is going to generate particles,” says Walker. That includes most stovetops, ovens and even small appliances like cheap levitra pills toasters. Frying and roasting cook methods both produce a lot more particulate matter than boiling or steaming. And fatty foods give off more than veggies.Gas stoves are particularly bad for indoor air quality.

Not only do they produce more particulate matter by virtue of creating an cheap levitra pills open flame, but the actual fossil fuel combustion also generates other gases, such as carbon dioxide and nitrogen dioxide. From a health perspective, the thing that raises the biggest concern in this scenario is nitrogen dioxide.Nitrogen dioxide, like particulate matter, contributes to breathing problems like asthma and is regulated in outdoor air. The gas has also been linked to heart problems, lower birth weight in newborns and shorter lifespans for people who are chronically exposed.A 2016 study from Lawrence Berkeley National Lab found that simply boiling water on a gas stove produces nearly twice the amount of nitrogen dioxide as the EPA’s outdoor standard. Considering that about a third of American homes use natural gas for cooking, that’s a lot of potential exposure.“Somehow, we've just become used to an unvented fossil fuel device in our homes,” says Brady Seals, who manages the carbon-free buildings program at the Rocky Mountain cheap levitra pills Institute, a clean energy think tank.

She wants to raise awareness of nitrogen dioxide’s health risks as a way to discourage natural gas use in homes. And she’s not alone in this mission. The Massachusetts Medical Society passed a resolution in cheap levitra pills 2019 to recognize the link between gas stoves and pediatric asthma. Several cities in California, including San Francisco, have passed bans on natural gas in new construction, citing both climate and health hazards.If you have a gas cooktop, Seals and Walker recommend swapping it out for an electric one if you have the means and ability to do so.

€œNot only are you reducing carbon impact [on the environment], but you can have a healthier home if you get rid of combustion appliances,” Walker says.The best option from both an energy-efficiency and air-quality perspective, he says, is an induction stove, which uses magnets to transfer heat directly to your pots and pans. No red-hot elements cheap levitra pills means less particulate matter. If you can’t replace your gas stove, Seals recommends a plug-in induction cooktop.Vented AirRealistically, few people are going to swear off stir frying or using their oven for the sake of producing less particulate matter. €œEverybody’s going to cook what they’re going to cook,” says Farmer, noting that people use whatever kitchen appliances they have.

That’s why all these experts stress the importance of good ventilation.Holm was part of a 2018 study looking at particulate cheap levitra pills matter in the homes of children with asthma. One of the most surprising findings. In homes that never used a range hood or range fan, people were exposed to unhealthy levels of particulate matter for roughly 10 percent more time than in homes that used range ventilation.Walker, the ventilation expert, recommends that people should use a high setting on their kitchen range hood whenever possible, since the quieter low settings capture only about half of pollutants. Since most range hoods don’t extend over the front burners, you might want to cheap levitra pills consider using the back burners, especially if you have a gas stove.

Walker also advises that people keep the ventilation on for about 15 minutes after they’re done cooking. That’s about how long it takes for all of the air in the room to be replaced. But that only applies if your vent is sending fumes outside, which is not often the case.Unless you have a new, higher-end kitchen and stove, your cheap levitra pills built-in range ventilation might essentially be a fan. It’s just pushing the fumes around the room, which helps disperse the concentration of pollutants more quickly but doesn’t actually remove them from your house.

Many homes and apartments, including Holm’s, don’t even have that option. In that case, Holm recommends opening some windows if the outside air quality is good, or using a portable air purifier with a HEPA filter.In the end, there cheap levitra pills are still a lot of unknowns about how cooking fumes affect us. To some extent, we simply have to accept them as a byproduct of enjoying our favorite foods, much like we accept pet hair as a part of having a furry friend. €œYou start realizing how pollutants are a part of our life,” Seals says.

€œLet’s reduce cheap levitra pills pollution wherever we can. But I’m not going to give up my dog and I’m not going to stop cooking.”[Correction. A previous version of this story erroneously stated the findings of Holm's 2018 air quality study and the cheap levitra pills type of portable air purifier that Holm recommends using in homes. We apologize for the errors, which have been corrected in this current version.]A happy accident with a chocolate bar led to one of the most reliable kitchen appliances around today.

Engineer Percy Spencer was standing in front of a device emitting high-frequency radio waves when the chocolate in his shirt pocket began to melt. The change led him and his colleagues to investigate what electromagnetic radiation could do to food, and the microwave was born in 1947.Since its cheap levitra pills earliest days, the technology has gotten smaller and lighter, and the kind of radiation used has shifted. Spencer’s discovery happened with radio waves, and the devices now rely on microwave radiation to cook our meals. Despite the changes — and how permanent a fixture microwaves have become in households — some people are still uneasy around the devices and worry about potential health effects.

€œAs a professor working in this area, safety is important to me,” says Vijaya Raghavan, a bioresource cheap levitra pills engineer at McGill University, who studies how industrial microwave settings can pasteurize and sterilize foods. Luckily, a lot of the safety concerns are handled by regulations, and there are simple ways for people to minimize the very small risks they face.Microwaves Bring the HeatMicrowaves are a kind of radiation, just like infrared, visible light, and x-rays. They are also relatively large. In terms of size and speed, microwaves are more like radio waves than they are the kind of cheap levitra pills light we see.

Put to work inside kitchen appliances, the radiation is useful for cooking food fast. Microwaves emit from one side of the appliance while it’s running and bounce around, reflecting off the metal interior and going into your meal. There, microwaves force all the water molecules cheap levitra pills in your food to move. The spinning water molecules generate heat and voila — your leftovers, vegetables or frozen dinner gets cooked.When it comes to making water molecules spin and create heat, microwaves don’t discriminate.

They’ll do the same to your arm or leg, which is why microwave exposure can be dangerous. Exposure can cheap levitra pills burn skin. Eyes and testicles are particularly vulnerable, according to the Food and Drug Administration, because there’s relatively little blood flow in the area to carry away the building heat. Highly-Controlled and Low RiskHowever, microwave burns only happen after someone has had a lot of exposure to the radiation — which is not something that will happen from your microwave oven.

For one, microwaves can only operate if the door is closed, per FDA requirements cheap levitra pills. As soon as it opens, the radiation production stops. Any microwaves that were still within the device dissipate into the air right away, Raghavan says. Theoretically, a tiny bit of the microwaves could leak out of any cracks, like where the cheap levitra pills door shuts.

But the FDA regulates seeping radiation, too. The amount of microwave radiation the agency lets the kitchen appliances emit is significantly less than how much cell phones are allowed to release — and the levels our smartphones can generate are also considered safe. And because any radiation coming out of an operating microwave starts to fall apart very quickly, someone would have to be standing practically up against the microwave for a long cheap levitra pills time for the rays to cause any damage. Sure, the farther away from the microwave you are, the safer it is, Raghavan says.

€œBut if you’re certain that a microwave unit is being used, why do you want to stand next to it anyways?. €In his own lab, Raghavan uses all cheap levitra pills kinds of microwave ovens to see how they can help with industrial food preparation. He often buys standard microwaves most people put in their homes and reworked them to create the wavelength frequency he needs. Raghavan also keeps track of how much power is generated in the first place as well as how much of the microwaves are absorbed by the food or reflected.

Even in cheap levitra pills this laboratory setting, he and his colleagues don’t wear protective gear. Instead, they put leakage meters near the devices. People at home probably don’t need to stand right next to the microwave, as Raghavan points out. Also, don’t run it without anything cheap levitra pills inside.

The microwaves will bounce back and damage the internal mechanisms that help transmit the microwaves, Raghavan says. And if you find your microwave keeps running once you open the door, remove it and get a new model — you don’t want to be Percy Spencer and find that radiation is melting your pocket chocolate.Part one of this article began with a light-hearted anecdote about Count Volta sticking electrodes in his ears. Part two cheap levitra pills takes a more serious tone. Here, we address the reasons why cochlear implants aren’t available to everyone, and why they are nearly inaccessible to those who need them most in the developing world.

The most pressing barriers that prevent adults and children in developing countries from accessing the benefits of cochlear implants are plain enough. (1) the high cost of cochlear implant cheap levitra pills components. (2) the complexity and skill level required to perform the surgery. And (3) the cheap levitra pills lack of local post-operative rehab services and expertise.

Fortunately, there’s a light at the end of the tunnel. In part two of this article, we look at the tremendous efforts of nonprofit groups to overcome these barriers to cochlear implants in developing countries. We also look at an experimental (yet controversial) approach to cheap levitra pills cochlear implants that could dramatically reduce the cost and complexity of implant components and surgeries. Why Access to Cochlear Implants Is So Important for Children Cochlear implants can offer life-transforming help to adults with hearing loss, but they are even more important for children.

That’s because children with hearing loss have a limited period of time in which to develop speech and listening skills. If a hearing problem isn’t addressed with hearing aids cheap levitra pills or cochlear implants by the age of 3 (and preferably earlier), children with serious hearing conditions may not be able to develop auditory and speech skills naturally. Without listening and spoken language skills, it is more difficult for children with deafness and profound hearing loss to attend mainstream school or fully participate in their hearing communities. Tragically, many of these children in developing nations are miscategorized as intellectually disabled – when in fact, there is a shining, beautiful mind hidden behind their inability to communicate.

Photo Courtesy of the Global Foundation For Children With Hearing Loss According to Paige Stringer, Executive Director of cheap levitra pills the Global Foundation For Children With Hearing Loss (GFCHL). €œIt is essential that hearing loss be identified as early as possible in newborns and young children so they can get the hearing technology and early intervention support they need to learn to listen and speak. For a child to develop on par with typically hearing peers in the areas of speech, language, and audition, they must have access to the sounds of speech. Early access to hearing aids or cochlear implants is key for successful outcomes.” A landmark 2010 study echoes Stringer’s perspective by cheap levitra pills confirming what most in the hearing and speech-language professions already knew.

The study found that children who receive cochlear implants before the age of 18 months achieved a speaking ability closer to that of hearing children. In contrast, those who received cochlear implants after the age of 3 continued to exhibit certain gaps in speaking ability compared to children without hearing loss. In developing countries, where access to cochlear implants and hearing aids is scarce, some cheap levitra pills deaf children may be able to attend schools where they can learn sign language and benefit from a specialized curriculum. But children in rural, undeveloped areas don’t tend to have this option.

Without cochlear implants, access to affordable hearing aids, or proper schooling, these children may not be able to develop their language and communication skills in a mainstreamed environment. To say that these children face severe discrimination, social isolation, and extreme socio-economic challenges as a cheap levitra pills result of their hearing difficulties would be an understatement. Image source. BBC When children are born with hearing impairment and deafness in developed countries like the United States or the United Kingdom, technologies, therapies, and educational opportunities are more readily available and help to remove the barriers to living a normal life.

These children have the potential to grow up cheap levitra pills without impediments as developing children typically do. Why Are Cochlear Implants Difficult to Access in Developing Countries?. There are three main reasons why cochlear implants are difficult to access in developing countries. (1) the cost of the components and cheap levitra pills surgeries.

(2) the complexity and surgical skill required to perform the procedures. And, (3) the need for post-operative rehabilitation services. (1) The High Cost of Cochlear Implant Components The cost of cochlear implant cheap levitra pills components and surgeries depends on a number of factors, but one thing is certain. The prices far exceed what the average person in a developing country can afford.

In the United States, the components alone – without factoring in surgical costs – can exceed $25,000 per ear, and total costs with surgery can exceed $80,000 per ear. In developed nations, private or national insurance usually covers these costs, so access isn’t an issue cheap levitra pills. In many Asian, African, and Latin American countries, the cost of cochlear implant components is less, but the prices are still prohibitively high. In the article, “The Challenges of Starting a Cochlear Implant Programme in a Developing Country,” Dr.

Kumaresh Krishnamoorthy cheap levitra pills writes that Cochlear Implant components cost from $12,000 to $25,000 in India. With surgery, total costs come to $17,000 to $29,500. If you consider that the average Indian salary is $2,120 per year – and that these individuals are living paycheck to paycheck – it’s easy to see why cochlear implants are absolutely unaffordable for most Indians without any available government or insurance financial support. According cheap levitra pills to Stringer.

€œThere are also the ongoing costs associated with cochlear implants after surgery – which includes a lifelong commitment to paying for post-op rehabilitation, replacement parts, servicing, and upgrades. Many families focus on the cost of the initial device and surgery, but they don’t have the means to pay for these ongoing costs.” As Krishnamoorthy points out. €œCochlear implants are a proven auditory rehabilitative option for individuals with severe to profound sensorineural hearing loss, who otherwise do not cheap levitra pills benefit from hearing aids. Nevertheless, only a small percentage of these individuals receive cochlear implants, and cost remains a leading prohibitive factor, particularly in developing countries […] the technology is virtually unavailable to the masses.” Unfortunately, even though many developing countries have government-sponsored cochlear implant programs, most do not have enough surgeons or facilities – or rehabilitation support post-surgery – to service all of the people who need them.

(2) The Complexity and Skill Level Required to Perform Cochlear Implant Surgeries Once fully trained, a neurotologist can safely perform a cochlear implant procedure, but the surgical training is long, involved, and expensive – and it’s cheap levitra pills only available in developed countries. As a result, there are not enough surgeons in developing countries who can safely perform cochlear implant procedures. Image Source. Blausen.com staff cheap levitra pills (2014).

€œMedical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.

When you see the steps involved, it’s easy to understand the complexity of the procedure. Administer general anesthesia. General anesthesia is required during the two- to four-hour procedure. Make an incision behind the ear.

The surgeon makes an incision behind the ear to expose the mastoid bone. Identify the facial nerves. The surgeon finds the facial nerves and drills an opening between them through the mastoid bone to expose the cochlea. Place the electrode array.

The surgeon opens the cochlea and threads the electrode array into the cochlea. Place the receiver. The surgeon makes a shallow indentation into the skull behind the ear and fixes the round, flat receiver into the bone just beneath the ear. Close the incisions.

The surgeon closes the incisions and the procedure is complete. Considering these steps, the cochlear implant procedure is neither “simple” nor “easy” to perform. It requires general anesthesia, drilling through the mastoid bone, and the removal of a portion of the skull. There is also the risk of facial nerve damage.

While the use of surgical robots for cochlear implant procedures could reduce the skill requirement, this technology is still largely inaccessible in developing countries. As we will discuss in further detail below, there is the possibility that an experimental cochlear implant design could one day reduce the cost and surgical complexity associated with this technology. (3) The Need for Post-Operative Rehabilitation and Training Beyond the cost and complexity of cochlear implant surgeries, implant recipients need several months – or years in the case of infants and young children – of training as they learn to recognize sounds and understand speech. For children, speech-language therapy is particularly important.

This training requirement often prevents those living in rural areas from getting cochlear implants – simply because they cannot access an in-person therapist for post-op rehab and speech-language training. Stringer from GFCHL offered the following perspectives on this. €œCochlear implant technology is not a stand-alone solution. It is an intensive medical device that needs a lot of support.

CIs are not like glasses where you put them on and instantly see better. A CI is just a tool to enable access to the sounds of speech. There is a great deal of rehabilitation involved after the CI surgery, particularly in young children, to fully benefit from it.” Getting cochlear implants to those who need them isn’t just a question of funding and sourcing surgeons. To make this technology available to more people in developing countries, national governments also need to conquer the serious logistical challenge of building a medical infrastructure that (1) has enough skilled surgeons and surgical facilities to serve everyone.

And (2) has enough local training facilities where cochlear implant recipients can receive post-operative rehab and speech-language therapy. (4) The Lack of Awareness Surrounding the Benefits of Cochlear Implants There is also a lack of awareness surrounding (1) the need to screen babies and young children for signs of deafness, and (2) the benefits of cochlear implants and hearing aids when treating deafness and other hearing conditions. Without a general understanding of these issues, children born with hearing loss may never be identified – and even if they are identified, parents may not be aware that treatments and therapies are available. As for adults with hearing loss, they also might not realize that they are suffering from hearing loss – and if they do realize it, they might not know that a pair of hearing aids or cochlear implants can dramatically improve their lives.

Incidentally, this lack of awareness is also a problem in the developed world, but adults – no matter where they are – can quickly assess their level of hearing loss by taking a free online hearing test. If you’re curious to check your hearing, here’s a free, 5-minute hearing test from MDHearingAid. Overcoming the Challenges of Cochlear Implant Access The most common approach to overcoming the lack of access to cochlear implants is to increase nonprofit support and international aid for government cochlear implant programs. This involves helping developing nations overcome the logistical challenges of sourcing surgeons, establishing surgical and post-operative facilities, and educating the public on hearing loss treatment options.

A second approach to increasing access involves a radical rethinking of the technology and its surgical techniques. By redesigning cochlear implants to be more affordable – and making surgeries simpler and less invasive – overcoming the cost and logistical challenges of cochlear implants becomes a great deal easier. (1) Nonprofit Efforts to Boost Cochlear Implant Access in Developing Countries There aren’t many organizations expressly dedicated to increasing access to cochlear implants to children in developing countries. However, the Global Foundation for Children with Hearing Loss (GFCHL) is one such organization that’s passionately engaged with achieving this goal.

Led by its Founder and Executive Director Page Stringer – a public health specialist and cochlear implant recipient herself – GFCHL has a mission to bring direct and lasting change for babies and young children who are deaf or hard of hearing and living in developing countries. Watch this video from Stringer to get a sense for the organization. According to Stringer. €œA sustainable cochlear implant program in a country requires LOCALLY based expertise and services in cochlear implant surgery, audiology, cochlear implant mapping, auditory-verbal therapy, and early intervention.

Not only do parents and family members need access to professional expertise and support, but they also need ongoing servicing and equipment. In many developing countries, these elements are lacking. There is also the high cost of all the elements, which makes it challenging for many families to afford if there is no insurance or government subsidy to support it.” Photo Courtesy of the Global Foundation For Children With Hearing Loss Stringer says that bringing hearing technology to children in developing countries is a two-fold effort. Raising awareness.

Helping governments, local health administrations, caregivers, and the community at large understand that children with hearing loss can learn to listen and speak when they receive the proper support at an early enough stage. This is a process of educating and involving family members and caregivers while raising awareness among the general public. Organization and Logistics. Offering training programs that help developing countries establish local services and professional expertise.

This is a process of showing countries how to develop screening programs that support early identification, encouraging timely fitting of hearing aids and cochlear implants, and ensuring access to locally-based professionals – such as audiologists, cochlear implant specialists, and speech therapists. With programs in Vietnam, Bhutan, and Mongolia, and previously in Ecuador, the efforts of GFCHL have made possible. The training of hundreds of teachers, therapists, and medical professionals Educational support about hearing loss in children for hundreds of families The fitting of over 400 children with digital hearing aids with ongoing support from professionals trained by GFCHL The GFCHL has also partnered with the global hearing care organization Hear the World Foundation (the charitable arm of Sonova that manufactures Advanced Bionics cochlear implants) to provide 10 Vietnamese children in need with cochlear implants along with 15 years of complimentary audiology support and technical upgrades. The children also receive complementary auditory-verbal therapy support by Vietnamese professionals trained by GFCHL for several years.

Other organizations are also involved in providing hearing aid assistance to those in need. For example, key leadership from the affordable hearing aid manufacturer MDHearingAid (CEO Doug Breaker and VP of Product Sourcing Paul Bryant) recently helped sponsor the AllHear Foundation’s 2020 mission to Belize. The AllHear Foundation completed 100 free hearing tests and provided 91 free hearing aids to those in need. Image source.

AllHear Foundation, Photos of Hearing Loss Patients in Belize, Photo Dr. Chip Goldsmith (Center Left) with Patient (Right) The Belize mission with AllHear Foundation was MDHearingAid’s first participation in an overseas project. Locally, MDHearingAid also partnered with H.O.M.E. To give away $100,000 worth of hearing aids to Chicago seniors in need.

MDHearingAid says it will participate in more overseas and local missions to provide further hearing assistance in the future. Doug Breaker, MDHearing CEO commented, “Giving back is very important to us. Our mission is to provide affordable, high-quality hearing aids to as many people as possible. As part of that, we give to those in need whenever we can, and hope to expand those efforts in the future.” According to Stringer, overcoming the financial, organizational, and logistical challenges of providing hearing assistance to children in developing countries takes time.

Nevertheless, the profound results of GFCHL’s efforts – and those of other organizations – can already be seen. (2) An Experimental Technology that Could Make Cochlear Implants More Accessible So far, we’ve discussed how nonprofit groups are working to bring cochlear implants to more people around the world. However, there could be another way to boost access to cochlear implants even more. This involves a fundamental redesign of cochlear implant technology to make the devices more affordable to buy and the surgical techniques easier and safer to perform.

We reached out to Dr. Chip Goldsmith, a neurotologist and cochlear implant surgeon who founded the nonprofit AllHear Foundation, to learn more about the latest in low-cost cochlear implant design. Goldsmith is working on an experimental – yet safer and more cost-effective – approach to cochlear implants. According to Goldsmith, the larger medical community views his approach with skepticism, but he believes that once fully developed and tested in patient trials, his design could dramatically improve access to cochlear implants for those living in low- to medium-income countries.

Goldsmith’s ideas center around the question of whether the long, multi-channel electrode arrays in modern cochlear implants are necessary. Neurotologists usually agree that a multi-channel cochlear implant is required to stimulate key areas of the cochlea. Without this specific stimulation, they believe that perceiving speech and other complex sounds isn’t possible (see part one of this article to understand how conventional cochlear implants work). Unfortunately, the multi-channel requirement makes cochlear implants expensive to manufacture, and the surgery is invasive and difficult to perform.

Moreover, inserting the long, multi-channel electrode array into the cochlea usually destroys any natural hearing ability the patient still has. According to Goldsmith, his late mentor, Dr. William F. House (who is credited as one of the inventors of cochlear implants), believed in a different approach to cochlear implant design.

Dr. House maintained that a short, single-channel cochlear implant could serve as an affordable, less invasive solution to treat hearing loss. Goldsmith adds that “Dr. House was known as the Father of Neurotology, and he was not too often wrong with his theories.” Image Source.

Edited Image from Advanced Bionics As a continuation of Dr. House’s ideas, Goldsmith argues that we can achieve similar treatment results using a tiny cochlear implant with a short, single-channel electrode array, instead of a long, multi-channel array. Goldsmith alleges that – even with a short, single-channel implant – the brain has the ability to interpret sounds with sufficient clarity to understand speech and experience a rich complexity of sounds. Putting he and Dr.

House’s theories into practice, Goldsmith has designed an affordable, single-channel cochlear implant that – after human trials and development – could retail for about $1,800, representing a considerable savings over the cost of conventional implants. The device is so tiny that the surgery for installing it is far less invasive and less complicated than traditional cochlear implant surgeries. Unlike conventional cochlear implants, installing the device would not pose a risk to the patient’s remaining hearing capabilities. Note the tiny size of Goldsmith’s single-channel implant compared to a multi-channel device.

Image source. AllHear Foundation According to Goldsmith. €œOur smaller and far less expensive cochlear implant system can be inserted through a simpler trans-canal surgical approach that goes through the ear canal and eardrum. This ‘transtympanic’ procedure is safer than conventional cochlear implant surgeries because it does not require drilling through the mastoid bone or skull.

We have also demonstrated that this procedure can be performed under local anesthesia.” Goldsmith also wanted to add the following. €œI worked with Dr. House on his AllHear short electrode system for many years, and my AllHear Foundation is named after this implant. My transtympanic configuration is merely an offshoot of Dr.

House’s fundamental theories.” At this time, Goldsmith’s team has built a new sound processor for single-channel implant recipients. Researchers are currently retrofitting patients who received one of Dr. House’s single-channel implants with this sound processor. If they can improve the hearing of these patients, they will adapt the new sound processor to fit Dr.

Goldsmith’s transtympanic configuration. Goldsmith’s single-channel cochlear implant still requires extensive trials and testing – and the technology needs to gain acceptance and approval from the larger medical community. However, we spoke with Brandy Klann, MA, a cochlear implant audiologist at the Michigan Ear Institute who offered the following. "Dr.

Goldsmith's ideas are intriguing. I look forward to seeing the clinical trial data on his single-channel cochlear implant." It is encouraging to see that certain medical innovators are working to make cochlear implants more affordable and accessible to everyone – especially when efforts like these are often hindered by a lack of funding and support from governments and the industry at large. Final Thoughts To think that the road to overcoming deafness and hearing loss began with scientists like Allessandro Volta, Giuseppe Veratti, and Benjamin Wilson sticking electrodes in their ears over 200 years ago – and to see where we’re at today – is absolutely inspiring. Considering what we've already achieved, the barriers to cochlear implant access in developing countries are not insurmountable.

We have all the technology and organizational tools at our disposal to make this miraculous technology available to everyone – regardless of their economic status. All we need is the continued determination of organizations like the Global Foundation for Children with Hearing Loss, Hear the World Foundation, and AllHear Foundation, and innovative physicians like Dr. Chip Goldsmith, who are willing to think outside the box. Like a ripple effect, their efforts will bring transformative assistance to more children and adults with hearing loss, until eventually, no one is left behind.

This article was sponsored in full by MDHearingAid, a hearing aid manufacturer that offers high-quality, affordable, FDA-registered hearing aids for a fraction of the cost of traditional aids. By selling its medical-grade hearing aids directly to consumers for just $399.98 to $999.99 a pair, MDHearingAid cuts out the middleman – transferring thousands of dollars in cost savings to its customers. This has opened the door to effective hearing loss treatment for millions of people who couldn’t previously afford to purchase hearing aids. If you’d like to support MDHearingAid in its mission to break the cost barriers associated with hearing loss treatment, tell your friends and family who need hearing aids about MDHearingAid and its affordable product line.

Also, if you want to check your hearing to see if you could benefit from a pair of aids, click this link to take a free 5-minute hearing test from MDHearingAid now. Biography Fascinated by emerging science, Jeremy Hillpot’s background in consumer litigation and technology offers a unique perspective on the latest developments in medical science, agrotechnology, blockchain, data engineering, app development, and the law. Contact Jeremy at jhillpot@legalwritingFINRA.com or follow him on Quora.The lymph nodes were known in antiquity—you can see them without a microscope—and were first described in Peri Adenon (On Glands), the Hippocratic treatise that has been described as a “milestone” in the history of immunology.” But the rest of the lymphatic system was more inscrutable. It wasn’t until relatively recently that science really began to understand the lymph system.

We are, in fact, still uncovering some of the secrets of this crucial part of our physiology.On Guard Against AntigensThe word lymph comes from the Latin word lympha, which means water. Lympha was in turn derived from the Greek word nymph, those divine ladies who haunt forests and streams. This one inhabits your immune system. While the image of a water nymph is a lovely one, the lymphatic system might be best thought of more prosaically as a complex drainage and purifying system.

It is a network of tiny vessels, smaller even than capillaries, that transports lymph throughout the body. Lymph is made from fluid that seeps out of the capillaries and into the body’s tissues. This fluid nourishes those tissues with oxygen, proteins and other nutrients, but it also picks up a lot of not-so-beneficial material — waste, toxins, and bits and pieces of bacteria and levitraes. Some of this is pulled into the vessels of the lymphatic system, where it is turned into lymph, a thin, whitish fluid that contains immune cells that fight off .

Strategically placed along this network of vessels are the lymph nodes, small bean-shaped clumps of tissue. David Weissmann, a pathologist at the Robert Wood Johnson Medical School, foregoes both mythological and engineering metaphors, and describes lymph nodes as a combination of burglar alarm and West Point. €œLike a burglar alarm they are on guard against intrusive antigens. Like West Point, the nodes are in the business of training a militant elite.

Lymphoid cells that respond to the intruder by making antibodies and forming a corps of B and T-cells that will remember the intruder's imprint for years.” As the lymph passes through, the nodes filter out damaged cells, cancer cells, and other toxins and waste materials. They also scan any foreign material and create immune cells that can recognize and destroy these invaders. Lymph nodes are loaded with T cells, B cells, dendritic cells, and macrophages — all cells that are involved in identifying and mounting a response to . Some lymph nodes are just under the skin in your armpits, groin and neck.

When you get a lump in your neck when you have a throat , it’s because your lymph system is scuttling bits and pieces of the bacteria (or levitra) that’s making you sick to the nearest lymph nodes, in this case, in your neck, where loads more white blood cells are generated to help wipe out the . There are hundreds of lymph nodes, though, and most of them are much deeper in the body, such as around the heart or the lungs and in the abdomen. Brain ConnectionUntil recently, it was thought that the lymphatic system did not reach as far as the brain. But in 2015 a team of researchers at the University of Virginia discovered in the central nervous system lymphatic vessels that drain cerebrospinal fluid into the cervical lymph nodes below.

Knowing that the brain interacts with the immune system could open possibilities for new research into neurological diseases, including Alzheimer’s.The tonsils, adenoids, spleen, and thymus are also part of the lymphatic system. All of these organs, in one way or another, filter out the waste and help kill dangerous bacteria and levitraes. While the lymphatic system plays a big role in protecting us from cancer, it can also help spread it. Cancer cells that manage to survive that militant elite get a free ride on the lymphatic network to other parts of the body.

So while you’re going about your day, blissfully unaware of the drama unfolding inside your body, your lymphatic system is busily cleaning up after you, scanning for disease-causing microbes and creating immune cells to quickly dispatch them. She’s one busy water nymph..