Pediatric Laryngotracheal Stenosis and Airway Reconstruction: A Review of Voice Outcomes, Assessment, and Treatment Issues

Laryngotracheal stenosis is defined as a congenital or acquired narrowing of the airway. Congenital causes may include subglottic membranous or cartilaginous narrowing. Acquired causes may include trauma due to prolonged endotracheal or tracheal intubation or laryngotracheal injury. Although advances have been made over the past 30 years in reconstructive surgeries to improve airway patency in these patients, long-term laryngeal function for voice production is not well defined in this population. This review examines causes, symptoms and signs, and methods for diagnosing laryngotracheal stenosis. Surgical management procedures are briefly summarized. The current literature on voice outcomes is summarized. The predominant voice characteristics in the population are presented, although results are challenged by the heterogeneity of voice presentation and paucity of data from instrumental measures. Considerations for subjective and instrumental assessment, measures of quality of life, instrumental methods, and treatment options specific to the needs of this population are discussed. Research strategies to identify long-term outcomes of surgical and behavioral treatments in this population are posed.     

The cardinality of manifold atlases

It is shown that any finite dimensionalC ⁰ manifold (connected and Hausdorff but otherwise unrestricted) has an atlas of cardinality not greater than that of the continuum; while if it has a Hölder continuous pseudo-Riemannian metric then there is a countable atlas.     

Structure of solid monolayers and multilayers of n -hexane on graphite

We present all-atom molecular dynamics simulations ofn-hexane on the basal plane of graphite at monolayer and multilayer coverages. In keeping with experimental data, we find the presence of ordered adsorbed layers both at single monolayer coverage and when the adsorbed layer coexists with excess liquid adsorbate. Using a simulation method that does not impose any particular periodicity on the adsorbed layer, we quantitatively compare our results to the results of neutron diffraction experiments and find a structural transition from a uniaxially incommensurate lattice to a fully commensurate structure on increasing the coverage from a monolayer to a multilayer. The zig-zag backbone planes of all the alkane molecules lie parallel to the graphite surface at the multilayer coverage, while a few molecules are observed to attain the perpendicular orientation at monolayer coverage. Dedicated to Professor C N R Rao on his 70th birthday     

Palladium-catalyzed pseudo-domino cyclizations: An easy entry toward polycondensed pyrrolidone derivatives

A new type I palladium-catalyzed pseudo-domino process is developed, in which a single Pd-based catalytic system promotes two mechanistically unrelated, sequential catalytic cycles in chronologically distinct order. Suitable precursors undergo an allylic alkylation and a Heck coupling in sequence, affording polycondensed pyrrolidone derivatives. Depending on the starting precursors, intra/inter or doubly intramolecular processes can be obtained. The allylic alkylation process takes place always very smoothly. On the other hand, the Heck coupling turns out to be rather difficult either when the process is intermolecular, or when an intramolecular process generates polycondensed structures featuring three fused bonds connected to a common carbon atom. In such difficult cases, use of the Herrmann-Beller phosphapalladacycle allowed to catalyze the coupling. This study demonstrates also that allylic alkylations can be catalyzed by the Herrmann-Beller phosphapalladacycle.     

Dynamic programming in cricket: optimizing batting order for a sticky wicket

In cricket, a rain-affected pitch can make batting more difficult than normal. Several other conditions such as poor light or an initially lively pitch, may also result in difficulties for the batsmen. In this note, we refer to all of them as ‘sticky wickets’. On sticky wickets, lower order batsmen are often sent into ‘hold the fort’ until conditions improve. In this paper, a stochastic dynamic programming model is used to examine the appropriateness of this policy. The model suggests that the tactic is often optimal when the sticky wicket persists until the end of the day's play, but not often when the sticky wicket is transitory. In some circumstances, it is worthwhile, on a normal wicket near the end of the day, to send in a lower order batsman to hold the fort (a night watchman): when the wicket is sticky, this tactic is even more worthwhile.     

Cube factorizations of complete graphs

A cube factorization of the complete graph on n vertices, K_n, is a 3‐factorization of K_n in which the components of each factor are cubes. We show that there exists a cube factorization of K_n if and only if n ≡ 16 (mod 24), thus providing a new family of uniform 3‐factorizations as well as a partial solution to an open problem posed by Kotzig in 1979. © 2004 Wiley Periodicals, Inc.