Ceiling fan be used to reduce the stratification of warm air in a room by forcing it down to affect both occupants' sensations and thermostat readings, thereby improving climate control energy efficiency. Punkah-type ceiling fans date back to 500 BC, and are native to India. Unlike modern rotary fans, these punkah fans move air by moving to and fro, and were operated manually by cord. The first rotary ceiling fans appeared in the early 1860s and 1870s in the United States. At that time, they were not powered by any form of electric motor. Instead, a stream of running water was used,
Nasal reconstruction using a paramedian forehead flap vessels are lined vertically and permit safe and effective transfer of the forehead flap on multiple individual vascular pedicles. The pedicle is the anatomic part that resembles the stem of the flap. The perfusion of the paramedian forehead flap comes from three sources: randomly, through the frontalis muscle and through the supratrochlear artery. Because the forehead flap is an axial flap with a pedicle containing its dominant vessel, the pedicle can safely be narrowed to 1 to 1.2 cm. Four types of flap design are historically described in literature: the median forehead flap, oblique forehead flap, sickle flap and vertical