bluuebunny/crossref_metadata_2025 huggingface dataset:
Oropharyngeal Kaposi Sarcoma in Related Persons Negative for Human Immunodeficiency Virus
Authors: Sikora Andrew G. , Shnayder Yelizaveta , Yee Herman , DeLacure Mark D.
Published: May 2017

Objectives: Kaposi sarcoma (KS) is a vascular tumor that can affect the mucosa of the upper aerodigestive tract. Although KS is the most common malignancy in patients with acquired immunodeficiency syndrome, it is rare in immunocompetent persons. We describe an unusual presentation of KS in 2 related individuals and describe our attempts to determine whether oropharyngeal KS is associated with human herpesvirus 8 (HHV-8).

Methods: All relevant clinical and surgical information, including information on tumor histopathologic and human immunodeficiency virus (HIV) serologic tests, was abstracted from the patient charts and electronic databases. HHV-8 immunohistochemistry was performed on paraffin-fixed specimens.

Results: Both patient 1 and patient 2 (the nephew of patient 1) were referred for workup of a tonsillar mass that was pathologically confirmed to be KS. In each case, HIV serologic testing was negative, and a screening immunologic workup, including a quantitative natural killer cell count, a B- and T-lymphocyte count, and immunoglobulin analysis, also yielded findings that were within normal limits. Immunohistochemistry performed on 1 pathological specimen showed positive staining for the presence of HHV-8, the etiologic agent of KS.

Conclusions: The presence of oropharyngeal KS in 2 related HIV-negative individuals supports a role for genetic factors in susceptibility to KS, a common exposure to an infectious agent such as HHV-8, or both. Whereas most KS cases in industrialized countries are associated with immunodeficiency, clinical and laboratory data do not suggest that either of the patients described in this report are immunodeficient. Their susceptibility to KS may be secondary to a subtle inherited defect in host resistance to HHV-8, or another unknown factor.
Expression and Clinical Significance of Epidermal Growth Factor Receptor and Type 1 Insulin-Like Growth Factor Receptor in Nasopharyngeal Carcinoma
Authors: Yuan Yulin , Zhou Xuhong , Song Jian , Qiu Xiaoping , Li Jun , Ye Linfeng , Meng Xiaoping , Xia Dong
Published: May 2017

Objectives: Epidermal growth factor (EGF) and type 1 insulin-like growth factor (IGF-1) receptors play an important role in the growth and apoptosis of nasopharyngeal carcinoma (NPC). They were separately found to be associated with prognosis in patients with NPC. To date, their expression correlation and clinicopathologic significance have never been specifically addressed in NPC.

Methods: Seventy-five patients with NPC and 21 noncancerous nasopharyngeal epithelial samples were accrued between 1998 and 2006 in a single hospital. The expressions of EGF and IGF-1 receptors were detected by immunohistochemical staining in the 75 NPC samples and the 21 noncancerous samples. Furthermore, the messenger RNA and protein expressions were assessed by real-time quantitative polymerase chain reaction and the Western blot technique, respectively, in NPC cell lines and normal nasopharyngeal epithelial cells.

Results: The 5-year survival rates, assessed by the Kaplan-Meier method, were 71.4% and 66.6% in the EGF and IGF-1 receptor protein-negative groups, respectively, whereas they were only 28.6% and 33.3% in the receptor protein-positive groups. The levels of these two proteins significantly correlated with each other, and the overexpression rates of EGF and IGF-1 receptors were 65.3% and 56% in nasopharyngeal samples, respectively. Furthermore, both protein expressions were significantly higher in NPC patients with cervical lymph node or distant metastasis than in NPC patients without lymph node or distant metastasis. Recurrence more often appears in cases positive for both proteins than in cases negative for both proteins. The expression levels of the receptor messenger RNA and proteins were higher in several NPC cell lines than in normal nasopharyngeal epithelial cells.

Conclusions: These findings demonstrate that both receptor proteins may play an important role in the invasion, metastasis, and recurrence of NPC. Both receptors are valuable markers for assessing the prognosis of NPC. Their expression at such high frequencies provides the basis of combined targeted therapy with specific pharmacologic inhibitors to enhance the effects of radiotherapy and chemotherapy.
Characteristics of Experimental Recurrent Laryngeal Nerve Surgical Injury in Dogs
Authors: Xu Wen , Han Demin , Hu Huiying , Fan Erzhong
Published: May 2017

Objectives

We characterized various recurrent laryngeal nerve (RLN) injuries in dogs.

Methods

Sixteen dogs were classified as having complete injuries (transection) or incomplete injuries (ligation, half-section, and crush). The characteristics of nerve injuries were evaluated by endoscopic examination, laryngeal electromyography (LEMG), and histopathologic examination at 0 to 12 months after the injury.

Results

After the RLN injury, the average muscle fiber diameter and the average muscle bundle diameter of the affected muscles were decreased, and the average number of muscular cell nuclei per square inch increased. Fibrillation potentials were found 1 to 3 months after injury, and reinnervation potentials appeared 3 to 6 months after incomplete injury. For nerve transection and ligation, there was no reaction with LEMG instantly after injury involving vocal fold fixation. Vocal fold motion did not improve in members of the complete injury group, whereas all of the vocal folds in the members of the nerve ligation subgroup had limited activity in the later period. Various forms of vocal fold mobility were observed after injury in the half-section subgroup. Animals in the crush subgroup had normal EMG signals combined with abnormal LEMG signals with lower amplitudes after injury. Vocal fold fixation was not observed in this subgroup.

Conclusions

We found the causes of nerve injury, in order of decreasing severity, to be transection, ligation, half-section, and crush.
Unilateral True Vocal Fold Synkinesis Presenting with Airway Obstruction
Authors: Azadarmaki Roya , Mirza Natasha , Soliman Ahmed M. S.
Published: May 2017

Objectives

We present a case series of 10 patients with unilateral true vocal fold paralysis who presented with airway obstruction.

Methods

A retrospective review of the authors' patients at 2 institutions with unilateral true vocal fold motion impairment was carried out over a 10-year period. Of these, 10 patients were identified who presented with stridor and dyspnea as a result of synkinesis. Six cases were a result of thyroidectomy, 1 case resulted from recurrent laryngeal nerve section for spasmodic dysphonia, 1 case occurred after anterior cervical diskectomy and fusion, and in 2 cases no cause was identified.

Results

Three patients underwent tracheotomy. Two patients underwent partial arytenoidectomy. Seven patients underwent botulinum toxin injection; 2 were treated with breathing therapy, and in 1 case breathing therapy was recommended. Seven patients underwent treatment with more than 1 method.

Conclusions

Unilateral vocal fold paralysis may present with airway obstruction as a result of synkinesis. Treatment should be incremental and starts with breathing therapy and botulinum toxin injection. Partial arytenoidectomy or tracheotomy may be necessary for refractory cases.
Vocal Exercise versus Voice Rest following Botulinum Toxin Injections: A Randomized Crossover Trial
Authors: Paniello Randal C. , Edgar Julia D. , Perlmutter Joel S.
Published: May 2017

Objectives

The intensity of muscle activity immediately following intramuscular botulinum toxin injection may affect the clinical efficacy of the injection. We tested this effect in patients who underwent botulinum toxin injections for adductor spasmodic dysphonia.

Methods

Patients were studied over 3 to 5 injection cycles. Cycle 1 was the baseline control; cycle 2 was randomized between a 1-hour reading aloud task (“exercise”) and a 24-hour period of complete voice rest. For cycle 3, the patient completed the task not performed in cycle 2. Patients who were willing to continue for cycles 4 and 5 repeated the experiment at one half the injection dosage. Efficacy was determined with a battery of voice recordings and clinical outcomes instruments administered via telephone at 2- to 4-week intervals. The primary outcome measure was the result of the Voice-Related Quality of Life (VRQOL) instrument.

Results

Nine patients (8 women, 1 man) with a mean age of 60.8 years (range, 42 to 76 years) completed at least 3 injection cycles. The VRQOL results were significantly higher for cycles that followed the exercise task. The patients reported subjectively that these were some of the best injection cycles they had ever experienced. Some achieved equivalent results with the half-dose injection plus exercise. The VRQOL results after voice rest cycles were not significantly different from the patients' baseline cycles.

Conclusions

These results support the conclusion that a period of intense vocalization immediately following laryngeal botulinum toxin injections improves the efficacy of the injection. Possible mechanisms are proposed.
Bioengineered Trachea with Fibroblasts in a Rabbit Model
Authors: Okano Wataru , Nomoto Yukio , Wada Ikuo , Kobayashi Ken , Miyake Masao , Nakamura Tatsuo , Omori Koichi
Published: May 2017

Objectives

Although our group has had mostly successful results with clinical application of a tracheal prosthesis, delayed epithelial regeneration remains a problem. In our previous studies using rats, it was demonstrated that tracheal fibroblasts accelerated proliferation and differentiation of the tracheal epithelium in vitro and in vivo. The purpose of this study was to evaluate the effects of fibroblasts on epithelial regeneration in larger tracheal defects in rabbits.

Methods

We developed a bioengineered scaffold, the luminal surface of which was coated with fibroblasts. This scaffold was implanted into tracheal defects in 12 rabbits (bioengineered group), and scaffolds without fibroblasts were implanted in 12 rabbits (control group). The regenerated epithelium was histologically examined by light microscopy, scanning electron microscopy, and immunohistochemical studies.

Results

In the bioengineered group, a stratified squamous epithelium was observed on the surface 7 days after transplantation. However, in the control group, the scaffolds were exposed. Fourteen days after implantation, a columnar ciliated epithelium was observed in the bioengineered group. The average thickness of the regenerated epithelium in the bioengineered group was significantly greater than that in the control group.

Conclusions

This study indicated that fibroblasts had a stimulatory effect that hastened regeneration of the epithelium in large tracheal defects.
Atelocollagen Sponge as a Stem Cell Implantation Scaffold for the Treatment of Scarred Vocal Folds
Authors: Ohno Satoshi , Hirano Shigeru , Tateya Ichiro , Kanemaru Shin-Ichi , Umeda Hiroo , Suehiro Atsushi , Kitani Yoshiharu , Kishimoto Yo , Kojima Tsuyoshi , Nakamura Tatsuo , Ito Juichi
Published: May 2017

Objectives

Treatment of vocal fold scarring remains a therapeutic challenge. Our group previously reported the efficacy of treating injured vocal folds by implantation of bone marrow–derived stromal cells containing mesenchymal stem cells. Appropriate scaffolding is necessary for the stem cell implant to achieve optimal results. Terudermis is an atelocollagen sponge derived from calf dermis. It has large pores that permit cellular entry and is degraded in vivo. These characteristics suggest that this material may be a good candidate for use as scaffolding for implantation of cells. The present in vitro study investigated the feasibility of using Terudermis as such a scaffold.

Methods

Bone marrow–derived stromal cells were obtained from GFP (green fluorescent protein) mouse femurs. The cells were seeded into Terudermis and incubated for 5 days. Their survival, proliferation, and expression of extracellular matrix were examined.

Results

Bone marrow–derived stromal cells adhered to Terudermis and underwent significant proliferation. Immunohistochemical examination demonstrated that adherent cells were positive for expression of vimentin, desmin, fibronectin, and fsp1 and negative for beta III tubulin. These findings indicate that these cells were mesodermal cells and attached to the atelocollagen fibers biologically.

Conclusions

The data suggest that Terudermis may have potential as stem cell implantation scaffolding for the treatment of scarred vocal folds.
Rational Diagnostic and Therapeutic Management of Deep Neck Infections: Analysis of 233 Consecutive Cases
Authors: Marioni Gino , Staffieri Alberto , Parisi Saverio , Marchese-Ragona Rosario , Zuccon Andrea , Staffieri Claudia , Sari Marianna , Speranzoni Chiara , de Filippis Cosimo , Rinaldi Roberto
Published: May 2017

Objectives

Although deep neck infections are less common nowadays because of the widespread use of antibiotics, they continue to carry significant morbidity and mortality rates.

Methods

Between 2000 and 2008, deep neck infections were treated in 233 patients at the University of Padova. Cases of peritonsillar abscess, superficial infections, infections due to external neck injuries, and infections in head and neck tumors were excluded. Clinical, radiologic, laboratory, and microbiological assessments were analyzed.

Results

The site of origin was identified in 189 of the 233 cases (81.1%), and the most common cause of deep neck infection was dental infection (39.5%). Intravenous antibiotic therapy was given to 78 patients, and 155 required both medical and surgical procedures. The bacteria most often isolated were gram-positive anaerobic cocci. None of our patients died of the deep neck infection or its complications.

Conclusions

It is worth emphasizing that airway support is the priority in patients with deep neck infections. Empirical antibiotic treatments must cover gram-positive and gram-negative aerobic and anaerobic pathogens. Surgical exploration and drainage may be mandatory in selected cases at presentation or in cases that fail to respond to parenteral antibiotics within the first 24 to 48 hours. It is important to perform cultures during operation to establish the pathogen(s) involved and to obtain an antibiogram to tailor the antibiotic treatment.
Preoperative Embolization in Carotid Body Tumor Surgery: Is it Required?
Authors: Zeitler Daniel M. , Glick Joelle , Har-El Gady
Published: May 2017

Objectives

We compared estimated blood loss (EBL) in patients who underwent surgical excision of carotid body tumors (CBTs) after preoperative superselective angiography with embolization (PSE) with that in patients who underwent excision of CBTs without PSE.

Methods

We performed a retrospective chart review of a consecutive case series in a single surgeon's practice within an academic tertiary care medical center. Twenty-five patients underwent surgical resection of a CBT from 1989 to 2009. From 1989 to 1996, 10 consecutive patients had PSE of the CBT, whereas the subsequent 15 patients (1996 to 2009) had no PSE. Demographic data including age, sex, and tumor size were collected. The EBL was obtained from intraoperative records and operative notes dictated at the time of surgery. Tumor size was based on preoperative radiographic measurements by a senior radiologist and the surgeon.

Results

In the 10 patients with PSE, the mean age was 41 years (range, 22 to 72 years) and the mean tumor size was 4.8 cm (range, 2.9 to 8.3 cm). The mean EBL was 305 mL (range, 50 to 1,000 mL); 2 patients had an EBL of more than 400 mL. In the 15 patients without PSE, the mean age was 43.7 years (range, 20 to 75 years) and the mean tumor size was 4.4 cm (range, 2.8 to 7.9 cm). The mean EBL was 265.6 mL (range, 40 to 900 mL); 2 patients had an EBL of more than 400 mL. There were no significant differences between the 2 groups with regard to age, tumor size, or EBL.

Conclusions

Preoperative superselective angiography with embolization of a CBT does not lead to a significant reduction in intraoperative EBL.
Risk Factors for Hearing Loss after Pediatric Meningitis in Japan
Authors: Adachi Nodoka , Ito Ken , Sakata Hideaki
Published: May 2017

Objectives

We sought to identify predictors for hearing loss in Japanese children with meningitis.

Methods

We analyzed 155 cases of pediatric meningitis without other entities causing hearing loss in children admitted to Saitama Children's Medical Center between 1990 and 2005 for potential risk factors for hearing loss, using multiple logistic regression. Auditory brain stem response tests were performed to evaluate hearing loss.

Results

Of 155 children, 35 (23%) developed hearing loss (21 unilaterally and 14 bilaterally). Profound hearing loss (greater than 90 dB normal hearing level) occurred in 15 patients (9.7%; 4 unilaterally and 11 bilaterally). Of 112 patients with positive cerebrospinal fluid cultures, 27 (24%) developed hearing loss and 13 (12%) showed profound loss. Of 22 patients with Streptococcus pneumoniae meningitis, 11 (50%) developed hearing loss and 7 (32%) showed profound loss. Of 54 patients with Haemophilus influenzae meningitis, 11 (20%) developed hearing loss and 4 (7.4%) showed profound loss. High serum C-reactive protein levels and cerebrospinal fluid cultures positive for Streptococcus pneumoniae were identified as significant risk factors for hearing loss.

Conclusions

A high serum C-reactive protein level was first identified as a risk factor for hearing impairment after pediatric meningitis.
Single-Stage Canal Wall-Down Tympanoplasty: Long-Term Results and Prognostic Factors
Authors: Redaelli De Zinis Luca Oscar , Tonni Daniela , Barezzani Maria Grazia
Published: May 2017

Objectives

We sought to identify factors associated with anatomic and functional results of canal wall–down tympanoplasty.

Methods

One hundred eighty-nine primary or relapsing cholesteatomas were consecutively operated on by a single surgeon. Cholesteatoma recurrence rates were evaluated. Predictive values of the patient, disease, and surgical characteristics on cholesteatoma recurrence were estimated. The effect of these variables on keratin pearl development, recurrent otorrhea or granulation tissue formation, and hearing function was tested.

Results

The mean follow-up was 8 years (range, 4 to 15 years). The cholesteatoma relapse rate (±SE) estimated by the Kaplan-Meier method was 2.1% ± 1.1%. No variables were associated with relapsing disease. The log-rank test showed a significantly higher probability of keratin pearls in male patients (16.7% versus 2.1%; p = 0.001), young patients (less than 16 years; 51.4% versus 6.2%; p = 0.0001),patients with unencapsulated cholesteatomas (19.5% versus 5.3%; p = 0.06), patients with petrous or accessory cellularity invasion (17.9% versus 7.1%; p = 0.02), and patients with overlay myringoplasty (25% versus 7.9%; p = 0.03). Recurrent otorrhea and granulation tissue were associated with homograft temporalis fascia myringoplasty (14.3% versus 3.8%; p = 0.04). The overall postoperative air-bone gap was within 20 dB in 30.7%; it was within 20 dB in 43.9% (47/107) for intact or reconstructed ossicular chains and in 13.4% (11/82) for nonreconstructed, eroded ossicular chains (p = 0.0001). The air-bone gap was within 20 dB in 42.6% (46/108) when the mucosa of the tympanic cavity was normal and in 14.8% (12/81) when there was granulation tissue within the tympanic cavity (p = 0.0001).

Conclusions

Single-stage canal wall–down tympanoplasty is an appropriate treatment for acquired tympanomastoid cholesteatoma.
Effects of Basic Fibroblast Growth Factor on Rat Vocal Fold Fibroblasts
Authors: Suehiro Atsushi , Hirano Shigeru , Kishimoto Yo , Tateya Ichiro , Rousseau Bernard , Ito Juichi
Published: May 2017

Objectives

The overarching goal of this line of research is to translate basic fibroblast growth factor (bFGF) treatment for vocal fold scarring into practical clinical use. In a previous canine investigation, we demonstrated that bFGF improves phonation threshold pressure, mucosal wave amplitude, and histologic measures in vocal folds treated after injury. In the present study, we studied the effects of bFGF on gene expression of the extracellular matrix and growth factors in rat vocal fold fibroblasts.

Methods

Fibroblasts harvested from the vocal folds of 5 rats were treated with 3 concentrations of bFGF (0, 10, and 100 ng/mL). The fibroblasts were collected at 24 hours and 72 hours after bFGF administration. Quantitative polymerase chain reaction was then used to investigate the gene expression of the investigated growth factors and extracellular matrices.

Results

The results revealed significantly down-regulated expression of procollagen I and significantly up-regulated expression of hyaluronic acid synthase (HAS) 2 and fibronectin in fibroblasts treated with bFGF. The administration of bFGF also resulted in the up-regulation of bFGF and hepatocyte growth factor (HGF). No changes in the expression of HAS-1, tropoelastin, or procollagen III were observed between the treatment and control conditions.

Conclusions

Treatment with bFGF induces the down-regulation of procollagen I and the up-regulation of HAS-2 in vocal fold fibroblast cell cultures. These gene expression alterations to key mediators of the wound healing process may translate into potential benefits in the remediation of vocal fold injury. The up-regulation of HGF, an antifibrotic effector molecule, may demonstrate additional benefits by optimizing the wound healing environment and by accelerating the wound repair cascade. These findings may provide fuel for additional discoveries into the development of growth factor therapy for the treatment of vocal fold scar.
Congenital Laryngeal Webs: Surgical Course and Outcomes
Authors: Goudy Steven , Bauman Nancy , Manaligod José , Smith Richard J. H.
Published: May 2017

Objectives

We compare the success of different surgical options in the treatment of laryngeal webs.

Methods

We performed a retrospective study spanning the years 1980 to 2005.

Results

Eighteen patients were identified. The average age at diagnosis was 6 months (range, 1 day to 2.5 years). The presenting symptoms included weak cry, stridor, airway obstruction, and difficulty breathing. Associated cardiac defects consistent with the diagnosis of 22q-syndrome were present in 7 patients. Webs were classified as grade I (5 patients), grade II (2 patients), grade III (10 patients), or grade IV (1 patient) according to the Cohen classification. In 5 patients, only endoscopic lysis was required. The remaining 13 patients underwent open procedures; 9 patients in this group required tracheotomy. An average of 1.3 open airway procedures was necessary to achieve a decannulation rate of 89%. After operation, 34% of patients had residual webbing and 20% had a weak or aphonic voice.

Conclusions

Management of laryngeal webs is dependent on the severity of airway obstruction. Grade I and II webs can be treated endoscopically; more severe laryngeal webs usually require tracheotomy and open airway reconstruction.
Integrated Surface-Enhanced Raman Spectroscopy (SERS) Chip Based on a Total Reflection Liquid Core Waveguide
Authors: Lai Chunhong , Chen Gang , Chen Li , Li Junhui , Liu Qinghao , Fang Shoumin
Published: May 2017

This study proposes a surface-enhanced Raman scattering (SERS) chip integrated with a liquid core waveguide. Due to the total reflection, the chip suppresses the leaky waveguide mode and enables a long propagation distance for SERS signal collection. A 10 nM rhodamine 6G Raman signal was obtained using a QE65000 portable microspectrometer at a low excitation power intensity of 14.5 W/cm2. The proposed SERS chip was also used to detect the SERS spectrum of a silkworm DNA solution, the structural information of which was clearly shown. In addition, due to the lower excitation power density, damage to the structure of the biomolecule was avoided.
Milling and Public Warnings
Authors: Wood Michele M. , Mileti Dennis S. , Bean Hamilton , Liu Brooke F. , Sutton Jeannette , Madden Stephanie
Published: May 2017

Given the potential of modern warning technology to save lives, discovering whether it is possible to craft mobile alerts for imminent events in a way that reduces people’s tendency to seek and confirm information before initiating protective action is essential. The purpose of this study was to examine the possibility of designing messages for mobile devices, such as Wireless Emergency Alert (WEA) messages, to minimize action delay. The impact of messages with varied amounts of information on respondents’ understanding, believing, personalizing, deciding, and intended milling was used to test Emergent Norm Theory, using quantitative and qualitative methods. Relative to shorter messages, longer public warning messages reduced people’s inclination to search for and confirm information, thereby shortening warning response delay. The Emergent Norm Theory used herein is broader in application than the context-specific models provided by leading warning scholars to date and yields deeper understanding about how people respond to warnings.
Probability Methods for Detecting Randomness in Small Sample Spatial Distributions
Authors: O'brien Frank
Published: May 2017

Several probability and statistical methods are discussed for detecting spatial randomness in two dimensions. One method is derived and proposed for its ease of application. Monte Carlo simulation results are presented in support of the theoretical assumptions of the proposed method.
Attentional Style in Ratings of Perceived Exertion during Physical Exercise
Authors: Russell William D. , Weeks Douglas L.
Published: May 2017

This study assessed the effects of associative and dissociative psychological strategies of attention on heart rate and self-report ratings of perceived exertion (RPE) during cycling performance. Seven trained cyclists performed a control ride, a dissociation ride, and an association ride on a bicycle ergometer at a work rate corresponding to 75% of their maximal heart rate. For the dissociation ride, subjects watched a videotape unrelated to cycling and responded to a key word each time it occurred on tape. For the association ride, subjects focused attention on heart-rate feedback available throughout the ride. During the control ride, attentional focus was not intentionally manipulated. Analysis indicated that the deliberate application of an attentional strategy did not significantly affect heart rate or RPE scores; however, the dissociation condition yielded somewhat higher RPE scores. From a postexperimental interview, four subjects responded that the association ride was the easier to complete, while three subjects responded the control ride was the easier one, matching a possible trend in the data.
A Preliminary Study of the Bilingual Version of Khatena-Morse Multitalent Perception Inventory
Authors: Palaniappan Ananda Kumar
Published: May 2017

A bilingual version of the Khatena-Morse Multitalent Perception Inventory was designed to measure multitalent perception among Malaysian students. Forms A and B, each of 50 items, require the respondents to choose one of two alternatives. Test-retest reliability and criterion validity indexes for the Malaysian bilingual version suggested that it is suitable for assessing the multitalent perception as well as giftedness in various areas of talent. Replication with other groups is recommended.
The “Noble” Sports Fan: The Relationships between Team Identification, Self-Esteem, and Aggression
Authors: Wann Daniel L.
Published: May 2017

Authors have disagreed on whether sports spectating has positive or negative consequences for individuals and society. Based on Smith's 1988 discussion of “the noble sports fan,” the current research tested the prediction that identification with a sports team would be positively related to collective or group's self-esteem and not related to trait scores of aggression. The hypothesis was confirmed. Discussion centers on patterns of the observed correlations.
Gender and National Differences in Attitudes toward Same-Gender Touch
Authors: Willis Frank N. , Rawdon Vicki A.
Published: May 2017

Women have been reported to be more positive about same-gender touch, but cross-cultural information about this touch is limited. Male and female students from Chile (n = 26), Spain (n = 61), Malaysia (n = 32), and the US (n = 77) completed a same-gender touch scale. As in past studies, US women had more positive scores than US men. Malaysians had more negative scores than the other three groups. Spanish and US students had more positive scores than Chilean students. National differences in attitudes toward particular types of touch were also noted. The need for new methods for examining cross-cultural differences in touch was discussed.
Remembered and Perceived Size as a Function of Familiarity
Authors: Algom Daniel , Goshen Eyal
Published: May 2017

Subjects (42 girls 17 or 18 years old) overlearned to different criteria the associations between circles and the symbolic codes that stood for the circles when their areas were assessed from memory. Consistent with the prediction from the uncertainty theory but conflicting with the prediction from the reperception hypothesis, familiarity with the referent stimuli affected the memory-based magnitude judgments. Surprisingly, familiarity also affected perceptual judgments given to the referent circle stimuli. The possibility of discrete, linguistic influences on both perceptual and memory-based processing of sensory reactions is discussed.
Counting Kings (Revelation 17:10): A novel approach from Roman imperial coinage
Authors: May David M.
Published: May 2017

The identity of the seven kings in Revelation 17:9–10 has been a point of contention and confusion. The issue revolves around where to begin the count of Roman emperors who would correspond with the unnamed kings in Revelation. This article utilizes a special series of Roman imperial coins (called restoration coins) as evidence to identify the seven kings. The evidence suggests that the five kings “who have fallen” are the past emperors Augustus, Tiberius, Claudius, Galba, and Vespasian. The “one who is” represents the current emperor Titus, and the other “who has not yet come” is the anticipated reign of Domitian.
Galatians as Thesis
Authors: McConnell James R.
Published: May 2017

Previous research focusing on rhetorical criticism of Paul’s letter to the Galatians has failed to reach a consensus. Scholars are divided as to the genre of rhetoric Paul is employing. There is equally little agreement as to the structure of the letter and how it should be sub-divided into the categories for speeches as described by the rhetorical handbooks. This article seeks to simplify the approach to the structure of Galatians 1–4 by reading this portion of the letter in light of Theon’s description of the elementary exercise of thesis as found in the Progymnasmata. After demonstrating that Galatians can be read as a thesis, the article then examines proofs that Paul has employed in arguing his thesis, the most important of which is the proof from divine testimony. It is with this proof, which was considered to be of the highest value by the authors of the rhetorical handbooks, that Paul begins his argument; he then draws other arguments from authority and divine testimony that are based on this initial proof.
The elephant in the classroom: Ezekiel 1:28–3:3, 36:24–28
Authors: Cartledge Tony W.
Published: May 2017

An academic study of Scripture requires open, flexible, and discerning minds that recognize the sacredness of Scripture as a faithful human response to divine inspiration. With Ezekiel, we can learn that words from the Spirit may appear bitter and judgmental, but that God’s last word is one of grace.
Some assembly required
Authors: Bagby Daniel G.
Published: May 2017

The life experiences of Elijah, Paul, and Moses demonstrate that even for people of faith “some assembly is required.” Everyone, at some point in life, comes to the edge of our faith, a moment for unlearning things that have proven insufficient and for learning something new and more profound. The process takes time and we cannot rush it. God shows us just enough to take the next step.
Effect of moisture content on thermal protective performance of fabric assemblies by a stored energy approach under flash exposure
Authors: Zhang Hui , Song Guowen , Gu Yiming , Ren Haitao , Cao Juan
Published: May 2017

Firefighters wearing protective clothing perspire profusely in the process of performing their duties, and sweat increases moisture in the inner layers of multilayer protective clothing. Also, the outer shell fabrics inevitably become wet. In this study, two kinds of outer shell fabrics (aramid IIIA fabric and aramid 1313 and flame-retardant viscose-blended fabric) and three kinds of thermal liner fabrics with different thicknesses were selected. Two wetness conditions were investigated to simulate the sweating in thermal liner fabric with or without the wet outer shell fabric. A modified thermal protective performance (TPP) tester was employed to explore the effects of moisture and its distribution on stored thermal energy developed in six fabric systems and on TPP under flash exposure. Pearson correlations were established to analyze the relationships of the fabric systems’ thickness and second-degree burn time, and of absorbed energy and second-degree burn time in different configurations. The statistical analysis from these obtained data indicated that the thickness of fabric systems had no significant correlation for second-degree burn time ( p > 0.05), but the absorbed energy exhibited a strong relation (the lowest R2 value could reach 0.8070 and p-values were all much less than 0.05). Performance results for the wet thermal liner indicated that the negative impact on thermal protection reached the greatest degree in 15% wetness, but in some extreme situations (100% wetness), the performance was improved (the maximum increase can achieve 116.2% over performance in dry condition). However, the existing moisture in the outer shell showed a positive effect. These findings will enable the engineering of textile materials that achieve high performance protection from thermal hazards and give some guidance to firefighters during operations.
Hypertension management in general practice
Authors: Whitfield Michael , Hughes Anthony
Published: May 2017

The views of 542 general practitioners (GPs) and 64 consultant physicians about the management of patients with hypertension in general practice were sought by postal questionnaire. 325 (60%) of the GPs and 45 (70%) of the consultant physicians completed the questionnaire. For a 40-year-old man with no other cardiovascular risk factors most general practitioners would intervene with drugs at blood pressure levels specified in published guidelines, whereas many local consultants and older GPs would consider drug treatment at lower levels. About 75% of GPs, compared with 87% of consultants, would suggest drug treatment in a woman of 70 years with a BP of 180/ 100 mmHg. Although consultants tended to expect GPs to order more tests when investigating a patient with hypertension than the GPs actually did, both GPs and consultants would order similar types of investigations apart from imaging. Consultants had different expectations about the frequency with which general practitioners should record patients' blood pressure and the GPs' ability to prevent cardiovascular events in hypertensive patients. Many older GPs and consultants seem to have unrealistic expectations of the value of treating patients with hypertension.
Non-Invasive Cardiac Investigations in Patients Awaiting Renal Transplantation
Authors: Langford E J , De Belder A J , Cairns H , Hendry B M , Wainwright R J
Published: May 2017

Patients with chronic renal failure undergoing renal transplantation have a high prevalence of cardiovascular disease. Invasive investigation may identify those at risk of cardiac death during or after renal transplantation, but which patients should undergo cardiac catheterization is currently not clear. In 95 patients awaiting renal transplantation we assessed the ability of echocardiography and exercise electrocardiography to identify patients at risk of cardiac death.

Echocardiography identified impaired left ventricular (LV) systolic function in 20%, severe in 8%. Of the patients with severe LV dysfunction, 25% died before transplantation. Of those undergoing exercise electrocardiography, 44% did not achieve 85% of maximum predicted heart rate. No coronary artery disease requiring intervention was identified by exercise testing.

These findings indicate that echocardiography, but not exercise electrocardiography, should be part of the assessment for renal transplantation.
Occipital Seizures Imitating Migraine Aura
Authors: Panayiotopoulos C P , Sharoqi I Ahmed , Agathonikou A
Published: May 2017

Three cases are reported in which symptoms of occipital seizures resembled the visual aura of migraine. Careful recording of the characteristics and timing of such visual effects will often resolve the diagnostic dilemma.
Risk Factors for Basal Cell Carcinoma in the UK: Case-Control Study in 806 Patients
Authors: Lear J T , Tan B B , Smith A G , Bowers W , Jones P W , Heagerty A H , Strange R C , Fryer A A
Published: May 2017

Basal cell carcinoma (BCC) is the commonest malignant neoplasm in white people. We present a large UK case-control study in which conditional logistic regression analysis of age-matched and gender-matched data sets was used to compare, first, cases with controls (n=403) and second, patients having multiple BCC with those having a single BCC (n=278). Eye/hair colour, occupation, skin type, social class, tumour site at presentation and smoking history were assessed.

Social class 1/2, skin type 1, red/blonde hair and blue/green eyes were all related to BCC risk, social class most strongly (odds ratio 2.36, P=0.007). Truncal site at presentation was a risk factor for the development of multiple BCC (odds ratio 4.03, P=0.002).

These data support the view that genetically mediated differences in ultraviolet responsiveness are important in BCC, though the scale of their effect is small. They may be exploitable in primary and secondary prevention as well as giving insights into pathogenesis. In particular, the fact that patients presenting with a truncal tumour are at increased risk of further BCC suggests that intermittent exposure in genetically predisposed individuals may contribute to a cancer susceptibility syndrome.
Longitudinal Intestinal Lengthening and Tailoring: Results in 20 Children
Authors: Bianchi A
Published: May 2017

Longitudinal intestinal lengthening and tailoring (LILT) is increasingly favoured as a treatment for short-bowel syndrome. In a personal series, 20 children underwent LILT between 1982 and 1997.

There was negligible morbidity (hemiloop anastomotic stenosis in 2) and no operative mortality. At a mean follow-up of 6.4 years overall survival was 45%, and certain features were clearly related to outcome. Survivors had >40cm of residual small bowel (commonly jejunum) and had little hepatic dysfunction despite parenteral nutrition of similar time and nature as non-survivors. Children who did not survive had < 40 cm of residual small bowel and developed early lethal hepatic dysfunction of unclear aetiology. Outcome did not seem to be influenced by the presence of the ileocaecal valve or the length of residual colon.

Children born with short-bowel should be offered LILT at an early stage when still in good physical condition, so as to avoid liver-damaging intraluminal stasis and bacterial translocation and to enhance intestinal adaptation and hepatoprotective factors.
Illness doesn't belong to us
Authors: Mckevitt C , Morgan M
Published: May 2017

There has been little research in Britain into the experiences of doctors who are ill. We conducted in-depth interviews with 64 doctors of all grades with a recent illness lasting one month or more. Whether the illness was physical or psychiatric, many expressed the idea that illness is inappropriate for doctors. This idea is a cultural value among doctors which is reinforced by the organization of medical work. It discourages doctors from seeking and obtaining appropriate help when they are ill.
Does an Increase in the Sensitivity of Serum Thyrotropin Assays Reduce Diagnostic Costs for Thyroid Disease in the Community?
Authors: Vanderpump M P J , Neary R H , Manning K , Clayton R N
Published: May 2017

Many authorities now advocate that the first-line assessment of thyroid function should be measurement of thyrotropin (TSH). The latest serum TSH assays (third generation) are more sensitive than the second generation but the reagents are more costly. We have examined whether overall assay reagent costs would be higher or lower with a third-generation assay, in a laboratory that serves a population of almost 500 000. In a prospective study over six weeks, 505 samples with a second-generation serum TSH less than 0.5 mU/L (303 for screening and 202 for monitoring thyroxine therapy) had an additional third-generation TSH analysis.

With a second-generation assay for screening, 11% more free thyroxine (FT4) measurements were required to exclude thyrotoxicosis but there was a 42% saving on the reagent budget compared with a third-generation assay. In patients taking thyroxine, 33% more FT4 measurements were required to exclude over-replacement but the calculated saving in reagent costs was 53%. The costs of all other aspects of the two methods were similar.

In this community-based sample, the improvement in sensitivity yielded by the third-generation assay at the lower end of the normal range reduced the number of confirmatory FT4 levels required to exclude thyrotoxicosis or over-replacement with thyroxine, but reagent costs were nevertheless higher than for second-generation assays. In financial terms, there is little justification for use of assays with sensitivity greater than the second generation (0.1 mU/L).
Qualitative Medical Sociology: What are its Crowning Achievements?
Authors: Chard J A , Lilford R J , Court B V
Published: May 2017

Doctors and epidemiologists seldom read or cite qualitative medical sociology; it is little published in medical journals. A large number of articles bewail this lack and provide arguments explaining and justifying the subject. Any examples used in such articles are selected ad hoc.

We made a systematic search for the literature and used citation analysis to select the world's top 100 articles. We analysed this trawl and provide resumes of a selection from the ‘classics’.

Mental health and the organization of medicine are the themes within medical sociology with highest impact. Much highly cited work consists of historical and theoretical analysis done ‘at the desk’ rather than observation or interview ‘in the field’. Citation rates, even for the most famous works in medical sociology, are a small fraction of those for high impact biomedical research.
Are Randomized Controlled Trials Controlled? Patient Preferences and Unblind Trials
Authors: Mcpherson Klim , Britton Annie R , Wennberg John E
Published: May 2017

The most reliable information about treatment effects comes from randomized controlled trials (RCTs). However, the possibility of subtle interactions—for example, between treatment preferences and treatment effects—is generally subordinated in the quest for evidence about main treatment effects. If patient preferences can influence the effectiveness of treatments through poorly understood (psychological) pathways, then RCTs, particularly when unblinded, may wrongly attribute effects solely to a treatment's physiological/pharmacological properties. To interpret the RCT evidence base it is important to know whether any preference effects exist and, if so, by how much they affect outcome. Reliable measurement of these effects is difficult and will require new approaches to the conduct of trials. In view of the fanciful image with which such effects are portrayed and the uncertainties about their true nature and biological mechanisms, existing evidence is unlikely to provide sufficient justification for investment in trials. This is a Catch 22. Until an escape is found we might never know, even approximately, how much of modern medicine is attributable to psychological processes.
A Theory of Postoperative Fatigue
Authors: Salmon Peter , Hall George M
Published: May 2017

The concept of fatigue has entered medicine from other disciplines in which the term refers to weakening of a material by demands put upon it. Its application to the behavioural and subjective changes that characterize postoperative convalescence has led to the assumption that these changes reflect the physiological and metabolic consequences of surgery. Because evidence does not support this view, we outline a new theory in which postoperative fatigue is the product of physiological, psychological and cultural factors. This theory leads to novel predictions that can be tested in future clinical research. Of particular interest will be the evaluation of systematic attempts to change patient and staff expectations about postoperative convalescence.
The positive relationship between alcohol and heart disease in eastern Europe: potential physiological mechanisms
Authors: Mckee Martin , Britton Annie
Published: May 2017

Research into the effect of alcohol on cardiovascular disease has indicated protective effects from moderate consumption. These observations, made in industrialized countries, have influenced policies on alcohol in countries where the situation may be quite different—specifically, where consumption is substantially higher or patterns of drinking are different. In central and eastern Europe and the former Soviet Union, a growing body of epidemiological research indicates a positive rather than negative association between alcohol consumption and cardiovascular deaths, especially sudden cardiac deaths. By means of a systematic review of published work, we examine whether there is a physiological basis for the observed association between alcohol and heart disease seen in eastern Europe, focusing on the effects of high levels of consumption and of irregular or binge drinking.

In binge drinkers, cardioprotective changes in high-density lipoproteins are not seen, and adverse changes in low-density lipoproteins are acquired. Irregular drinking is associated with an increased risk of thrombosis, occurring after cessation of drinking. It predisposes both to histological changes in the myocardium and conducting system and to a reduction in the threshold for ventricular fibrillation.

Measures of frequency as well as quantity of consumption should be included in epidemiological studies. Taken with the epidemiological evidence emerging from eastern Europe, these observations have important implications for estimates of the burden of disease attributable to alcohol.