bluuebunny/crossref_metadata_2025 huggingface dataset:
Les congrès qui décidèrent de la fondation de la C.T.C.C.
Authors: Têtu Michel
Published: October 2017

La Confédération des travailleurs catholiques du Canada (CTCC) qui a changé son nom par la suite en celui de la Confédération des Syndicats Nationaux (CSN) a été fondée à Hull en 1921. Cependant les mêmes syndicats s'étaient réunis dans trois congrès précédents pour établir les bases de cette organisation. L'auteur retrace ici l'histoire de ces réunions.
L'Analyse des conventions collectives de travail
Authors: Quinet Félix
Published: October 2017

L'analyse des conventions collectives de travail effectuée soit par le Ministère fédéral du travail ou d'autres institutions privées est une tâche aussi difficile qu'importante. Elle soulève des problèmes de méthode qu'il est bon de connaître pour pouvoir évaluer les conclusions. M. Quinet explique ici les méthodes utilisées à la Division de l'économie et de recherches du Ministère fédéral du Travail. M. Jean-Réal Cardin commente le travail de M. Quinet.
Dans les terres sauvages à la recherche du sublime
Authors: BINIK Oriana
Published: October 2017

L’article traite de la question des motivations pour le tourisme sombre, du point de vue émotionnel. Il est supposé, en particulier, que le « sublime » représente l’expérience émotionnelle d’être placé au centre du processus de la fascination. L’analyse proposée ici crée un parallèle entre les notions de « sublime », de « awe » et de l’« inquiétante étrangeté ». Deux dimensions sont en outre identifiées pour orienter la recherche empirique et relever la présence de cet état émotionnel chez les dark tourists.
De la relégation à la participation : les avatars socioculturels d’un aménagement en station de montagne, les snowparks
Authors: PABION MOURIES Johanne , REYNIER Véronique , SOULÉ Bastien , BOURDEAU Philippe
Published: October 2017

Innovation emblématique de la fin des années 1990, l’aménagement desnowparksa largement participé du renouvellement de l’offre des sports d’hiver dans les années 2000. Rapidement généralisés, ces espaces « nouvelles glisses » représentent désormais un enjeu en termes d’attractivité des stations. Depuis leur création, ils ont connu de multiples transformations sur les plans physique, mais surtout organisationnel et social. Cet article, basé sur une enquête multisite mêlant ethnographie, entretiens et approche documentaire, s’attache à l’analyse des deux dernières dimensions. En dépassant une lecture purement technicienne dessnowparks, il s’agit de mettre en perspective la dynamique socioculturelle propre et le virage participatif inédit dans l’univers des sports d’hiver, qui sont à l’œuvre non sans contradictions dans la conception et la gestion de ces espaces de pratique.
Distinct cellular and molecular mechanisms for β3 adrenergic receptor-induced beige adipocyte formation
Authors: Jiang Yuwei , Berry Daniel C , Graff Jonathan M
Published: October 2017

Beige/brite adipocytes are induced within white adipose tissues (WAT) and, when activated, consume glucose and fatty acids to produce heat. Classically, two stimuli have been used to trigger a beiging response: cold temperatures and β3-adrenergic receptor (Adrb3) agonists. These two beiging triggers have been used interchangeably but whether these two stimuli may induce beiging differently at cellular and molecular levels remains unclear. Here, we found that cold-induced beige adipocyte formation requires Adrb1, not Adrb3, activation. Adrb1 activation stimulates WAT resident perivascular (Acta2+) cells to form cold-induced beige adipocytes. In contrast, Adrb3 activation stimulates mature white adipocytes to convert into beige adipocytes. Necessity tests, using mature adipocyte-specific Prdm16 deletion strategies, demonstrated that adipocytes are required and are predominant source to generate Adrb3-induced, but not cold-induced, beige adipocytes. Collectively, we identify that cold temperatures and Adrb3 agonists activate distinct cellular populations that express different β-adrenergic receptors to induce beige adipogenesis.
The effects of familiarity on escape responses in the Trinidadian guppy (Poecilia reticulata)
Authors: Wolcott Hayley L. , Ojanguren Alfredo F. , Barbosa Miguel
Published: October 2017

Predation is the main cause of mortality during early life stages. The ability to avoid and evade potential threats is, therefore, favoured to evolve during the early stages of life. It is also during these early stages that the process of familiarization occurs. It has long been recognized that associating with familiar individuals confers antipredator benefits. Yet gaps in our knowledge remain about how predator evasion is affected by social experience during early stages. In this study, we test the hypothesis that familiarization acquired during early life stages improves escape responses. Using the guppyPoecilia reticulata, we examine the effect of different recent social conditions in the three main components of predator evasion. Using high-speed motion analysis, we compared the number of individuals in each test group that responded to a visual stimulus, their reactive distance and magnitude of their response (maximum speed, maximum acceleration and distance) in groups composed either of familiar or non-familiar individuals. Contrary to the prediction, groups composed of familiar individuals were less responsive than groups of unfamiliar individuals. Reactive distance and magnitude of response were more dependent on individual size rather than on familiarity. Larger individuals reached higher maximum speeds and total distances in their escape response. Our result indicates that familiarity is likely to affect behaviour earlier in a predator-prey interaction, which then affects the behavioural component of the response. Taken together, our study contributes to previous ones by distinguishing which components of an escape response are modulated by familiarity.
Homozygous indel mutation in CDH11 as the probable cause of Elsahy–Waters syndrome
Authors: Taskiran Ekim Z. , Karaosmanoglu Beren , Koşukcu Can , Doğan Özlem A. , Taylan‐Şekeroğlu Hande , Şimşek‐Kiper Pelin Ö. , Utine Eda G. , Boduroğlu Koray , Alikaşifoğlu Mehmet
Published: October 2017

Two sisters from a consanguineous couple were seen in genetics department for facial dysmorphic features and glaucoma. They both had broad foreheads, hypertelorism, megalocorneas, thick eyebrows with synophrys, flat malar regions, broad and bulbous noses, and mild prognathism. Both had glaucoma, younger one also had cataracts and phthisis bulbi. Other findings included bilateral partial cutaneous syndactyly of 2nd and 3rd fingers, history of impacted teeth with dentigerous cyst in the elder one, and intellectual disability (mild and borderline). The sisters were considered to have Elsahy–Waters syndrome. In order to elucidate the underlying molecular cause, sisters and their healthy parents were genotyped by SNP arrays, followed by homozygosity mapping. Homozygous regions were further analyzed by exome sequencing in one affected individual. A homozygous indel variant segregating with the condition was detected in CDH11 (c.1116_1117delinsGATCATCAG, p.(Ile372MetfsTer9)), which was then validated by using Sanger sequencing. CDH11 encodes cadherin 11 (osteo‐cadherin) that regulates cell–cell adhesion, cell polarization and migration, as well as osteogenic differentiation. Further experiments revealed that CDH11 expression was decreased in patient‐derived fibroblasts as compared to the heterozygous parent and another healthy donor. Immunostaining showed absence of the protein expression in patient fibroblasts. In addition, cell proliferation rate was slow and osteogenic differentiation potential was delayed. We consider that this study reveals loss‐of‐function mutations in CDH11 as a probable cause of this phenotype. Next generation sequencing in further patients would both prove this gene as causative, and finely delineate this clinical spectrum further contributing in identification of other possibly involved gene(s).
The influence of private primary schooling on children's learning: Evidence from three generations of children living in the UK
Authors: Parsons Samantha , Green Francis , Ploubidis George B. , Sullivan Alice , Wiggins R. D.
Published: October 2017

Much has been made of the academic success of children who have attended private secondary schools in Britain, but far less attention has been directed to whether there are similar benefits from attending a private primary school. Using data from three British birth cohorts—born in 1958, 1970 and 2000/1—this paper profiles the family background and personal characteristics of children at state‐funded and private fee‐paying schools and then investigates the effect of the type of primary school attended on academic progress made during the primary‐school years. Applying ‘value‐added’ linear regression and propensity score‐matching techniques, we find evidence of a positive association between private primary‐school attendance and a child's cognitive progress in all three cohorts. This effect remains after accounting for a wide range of individual and family characteristics, despite the very different times and socio‐economic circumstances experienced by the children and their families in the three studies. Findings are discussed and compared against contrasting international findings.
Self‐apposing stent‐assisted coil embolization for the treatment of coronary artery aneurysm
Authors: Gasparini Gabriele L. , Oreglia Jacopo A. , Reimers Bernhard
Published: October 2017

Coronary artery aneurysms (CAA) represent an uncommon disease with yet unclear standards of treatment. Clinical and anatomic characteristics determine choice of treatment. Stent‐assisted coil embolization has been described as a valuable option for management of patients with wide‐neck coronary aneurysms. Choice of appropriate stent sizing can be challenging particularly when there is a large difference between proximal and distal diameters. We report a case of stent‐assisted coil embolization of a coronary aneurysm using a self‐expandable stent. This type of stent can be helpful to treat CAA involving coronary sites where marked tapering of vessel diameter is often present.
Feasibility of coronary angiography and percutaneous coronary intervention after transcatheter aortic valve replacement using a Medtronic™ self‐expandable bioprosthetic valve
Authors: Htun Wah Wah , Grines Cindy , Schreiber Theodore
Published: October 2017

Background and Objective

With aging, the progression of atherosclerosis in the coronary arteries is expected. The Medtronic™ self‐expandable aortic bioprosthetic valve is deployed in the supra‐annular position, and it has been challenging to selectively engage coronary arteries post‐transcatheter aortic valve replacement (TAVR) even though there are diamond‐shaped spaces in the mesh frame within the valve. Given the scarcity of data, we analyzed angiographic and clinical data from all patients requiring coronary angiography (CA) or intervention post‐TAVR.

Methods

From January 2012 to December 2016, 403 patients were treated for severe aortic stenosis with TAVR at our center using the Medtronic™ self‐expandable valve. This study included patients who underwent CA with or without percutaneous coronary intervention (PCI) after TAVR.

Results

Twenty‐eight patients underwent 43 CAs after TAVR at our institution. Eleven patients (39%) were women. More than 90% of the procedures were performed for acute coronary syndrome. Thirty‐six cases were performed using the transfemoral approach (83%). Forty‐two of 43 (97%) left coronary arteries were selectively engaged, and 29 of 32 (90%) right coronary arteries were selectively engaged. We were able to engage 11 saphenous vein grafts and two left internal mammary artery grafts selectively (100%). The mean fluoroscopy time for diagnostic CA was 11.5 min, and for PCI, instantaneous wave‐free ratio, or intravascular ultrasound (IVUS) interrogation, it was 19 minutes. The mean amount of contrast used for diagnostic CA was 102 cc per case, and for PCI, iFR, or IVUS, it was 146 cc per case. No periprocedural complication was noted.

Conclusions

CA with or without PCI after TAVR is feasible with supra‐annular self‐expandable valves. With the proper technique in experienced hands, it can be conducted safely.
Impact of flow, gradient, and left ventricular function on outcomes after transcatheter aortic valve replacement
Authors: Carreras Edward T. , Kaneko Tsuyoshi , Ramirez‐Del Val Fernando , Pelletier Marc P. , Sobieszczyk Piotr S. , Bhatt Deepak L. , Shah Pinak B.
Published: October 2017

Objectives

To assess the impact of low flow with and without preserved left ventricular ejection fraction (LVEF) on outcomes after transcatheter aortic valve replacement (TAVR).

Background

Prior studies have shown that patients with low flow, AVG, and LVEF have worse outcomes after TAVR. It is unclear whether low AVG and LVEF remain prognostic after adjusting for flow, and how the outcomes of patients with low flow with and without preserved LVEF compare after TAVR. The goal of this study was to provide insight into these open questions.

Methods

Data from 340 TAVR patients at Brigham and Women's Hospital from 2011 through 2015 were analyzed. Low flow was defined as stroke volume index (SVI) ≤35 mL/m2, low AVG as mean gradient < 40 mmHg, and reduced LVEF as < 50%.

Results

Low flow was present in 96 (28.2%) patients, 48 (50.0%) of whom also had reduced LVEF. At 1 year, low flow was associated with increased mortality (21.9 vs 7.4%; P = 0.0002) and heart failure (HF) (20.8 vs 5.3%; P = 0.0113). Among patients with low flow, those with preserved LVEF had increased mortality (HR 5.17, 95% CI 2.73‐9.80; P < 0.001) and HF (HR 7.69, 95% CI 3.86‐15.31; P < 0.001). After adjusting for clinical factors, patients with low flow had increased mortality (HR 6.51, 95% CI 2.98‐14.22; P < 0.001) and HF (HR 5.52, 95% CI 2.34‐12.98; P < 0.001), while neither low AVG nor low LVEF were associated with increases in mortality or HF.

Conclusions

In patients undergoing TAVR, low flow was an independent predictor of 1‐year mortality and HF, and a stronger predictor than either low AVG or LVEF. Patients with low flow and preserved EF had increased mortality and HF at 1‐year, while those with low flow and reduced EF had outcomes similar to patients with normal flow.
Likelihood of changes in forest species suitability, distribution, and diversity under future climate: The case of Southern Europe
Authors: Noce Sergio , Collalti Alessio , Santini Monia
Published: October 2017

Forest conservation strategies and plans can be unsuccessful if the new habitat conditions determined by climate change are not considered. Our work aims at investigating the likelihood of future suitability, distribution and diversity for some common European forest species under the projected changes in climate, focusing on Southern Europe. We combine an Ensemble Platform for Species Distribution Models (SDMs) to five Global Circulation Models (GCMs) driven by two Representative Concentration Pathways (RCPs), to produce maps of future climate‐driven habitat suitability for ten categories of forest species and two time horizons. For each forest category and time horizon, ten maps of future distribution (5 GCMs by 2 RCPs) are thus combined in a single suitability map supplied with information about the “likelihood” adopting the IPCC terminology based on consensus among projections. Then, the statistical significance of spatially aggregated changes in forest composition at local and regional level is analyzed. Finally, we discuss the importance, among SDMs, that environmental predictors seem to have in influencing forest distribution. Future impacts of climate change appear to be diversified across forest categories. A strong change in forest regional distribution and local diversity is projected to take place, as some forest categories will find more suitable conditions in previously unsuitable locations, while for other categories the same new conditions will become less suited. A decrease in species diversity is projected in most of the area, with Alpine region showing the potentiality to become a refuge for species migration.
Development and evaluation of microwave‐assisted and ultrasound‐assisted methods based on a quick, easy, cheap, effective, rugged, and safe sample preparation approach for the determination of bisphenol analogues in serum and sediments
Authors: Song Shanjun , Shao Mingwu , Wang Weihua , He Yajuan , Dai Xinhua , Wang Huiyu , Liu Liliang , Guo Feng
Published: October 2017

Microwave‐ and ultrasound‐assisted methods based on a quick, easy, cheap, effective, rugged, and safe sample preparation approach followed by high‐performance liquid chromatography with tandem mass spectrometry were developed for the simultaneous determination of eight bisphenol analogues in serum and sediment. The developed methods provided satisfactory extraction efficiency for the energy provided by microwaves and ultrasound. Compositions of commercial sorbents (primary secondary amine, MgSO4, octadecyl‐modified silica, and graphitized carbon black) were evaluated. The ultrasound‐assisted method was suited for serum using primary secondary amine, MgSO4, and octadecyl‐modified silica as sorbents and a mixture of hexane and ethyl acetate as extraction solvent. The microwave‐assisted method worked better for sediment with tetrahydrofuran and methanol as solvents and primary secondary amine, MgSO4, octadecyl‐modified silica, and graphitized carbon black as sorbents. Other experimental parameters, such as extraction temperature and time, were also optimized. The inter‐ and intraday relative standard deviations ranged from 2.7 to 5.5%. The limits of detection were between 0.1 and 1.0 ng/mL for serum and between 0.1 and 0.5 ng/g dry weight for sediment. The proposed methods were successfully applied to seven sediment and 20 human serum samples. The results showed that the developed methods were practical for the analysis and biomonitoring of bisphenols in sera and sediment.
One‐pot synthesis of magnetic zeolitic imidazolate framework/grapheme oxide composites for the extraction of neonicotinoid insecticides from environmental water samples
Authors: Cao Xiaolin , Jiang Zejun , Wang Shanshan , Hong Sihui , Li Hui , Shao Yong , She Yongxin , Wang Jing , Jin Fen , Jin Maojun
Published: October 2017

Magnetic zeolitic imidazolate framework 67/graphene oxide composites were synthesized by one‐pot method at room temperature for the first time. Electrostatic interactions between positively charged metal ions and both negatively charged graphene oxide and Fe3O4 nanoparticles were expected to chemically stabilize magnetic composites to generate homogeneous magnetic products. The additional amount of graphene oxide and stirring time of graphene oxide, Co2+, and Fe3O4 solution were investigated. The zeolitic imidazolate framework 67 and Fe3O4 nanoparticles were uniformly attached on the surface of graphene oxide. The composites were applied to magnetic solid‐phase extraction of five neonicotinoid insecticides in environmental water samples. The main experimental parameters such as amount of added magnetic composites, extraction pH, ionic strength, and desorption solvent were optimized to increase the capacity of adsorbing neonicotinoid insecticides. The results show limits of detection at signal‐to‐noise ratio of 3 were 0.06–1.0 ng/mL under optimal conditions. All analytes exhibited good linearity with correlation coefficients of higher than 0.9915. The relative standard deviations for five neonicotinoid insecticides in environmental samples ranged from 1.8 to 16.5%, and good recoveries from 83.5 to 117.0% were obtained, indicating that magnetic zeolitic imidazolate framework 67/graphene oxide composites were feasible for analysis of trace analytes in environmental water samples.
Number of theoretical plates achievable by a toroidal capillary electrophoresis system
Authors: Kist Tarso B. Ledur
Published: October 2017

The ability of a method and instrument to separate very similar compounds is related to the “plate number,” a number indicating performance. The resolution between two neighboring peaks is proportional to the square root of the plate number. Currently available commercial capillary electrophoresis instruments easily reach plate numbers of a few million. In the present work, a capillary electrophoresis system with a toroidal platform is proposed and theoretically studied with the goal of extending the achievable plate number. In this new system, electrophoresis occurs in a nonstop continuous circulating mode within a closed loop capillary (toroid). Plate numbers upwards of one billion are theoretically predicted. This could resolve hundreds of unseparated mixtures of stereoisomers and other analytes that remain without a method for their analysis.
Poly(norepinephrine)‐coated open tubular column for the separation of proteins and recombination human erythropoietin by capillary electrochromatography
Authors: Xiao Xue , Zhang Yamin , Wu Jia , Jia Li
Published: October 2017

Recombinant human erythropoietin is an important therapeutic protein with high economic interest due to the benefits provided by its clinical use for the treatment of anemias associated with chronic renal failure and chemotherapy. In this work, a poly(norepinephrine)‐coated open tubular column was successfully prepared based on the self‐polymerization of norepinephrine under mild alkaline condition, the favorable film forming and easy adhesive properties of poly(norepinephrine). The poly(norepinephrine) coating was characterized by scanning electron microscopy and measurement of the electro‐osmotic flow. The thickness of the coating was about 431 nm. The electrochromatographic performance of the poly(norepinephrine)‐coated open tubular column was evaluated by separation of proteins. Some basic and acidic proteins including two variants of bovine serum albumin and two variants of β‐lactoglobulin achieved separation in the poly(norepinephrine)‐coated open tubular column. More importantly, the column demonstrated separation ability for the glycoforms of recombinant human erythropoietin. In addition, the column demonstrated good repeatability with the run‐to‐run, day‐to‐day, and column‐to‐column relative standard deviations of migration times of proteins less than 3.40%.
Recent advances in methods for the analysis of protein o‐glycosylation at proteome level
Authors: You Xin , Qin Hongqiang , Ye Mingliang
Published: October 2017

O‐Glycosylation, which refers to the glycosylation of the hydroxyl group of side chains of Serine/Threonine/Tyrosine residues, is one of the most common post‐translational modifications. Compared with N‐linked glycosylation, O‐glycosylation is less explored because of its complex structure and relatively low abundance. Recently, O‐glycosylation has drawn more and more attention for its various functions in many sophisticated biological processes. To obtain a deep understanding of O‐glycosylation, many efforts have been devoted to develop effective strategies to analyze the two most abundant types of O‐glycosylation, i.e. O‐N‐acetylgalactosamine and O‐N‐acetylglucosamine glycosylation. In this review, we summarize the proteomics workflows to analyze these two types of O‐glycosylation. For the large‐scale analysis of mucin‐type glycosylation, the glycan simplification strategies including the ‘‘SimpleCell’’ technology were introduced. A variety of enrichment methods including lectin affinity chromatography, hydrophilic interaction chromatography, hydrazide chemistry, and chemoenzymatic method were introduced for the proteomics analysis of O‐N‐acetylgalactosamine and O‐N‐acetylglucosamine glycosylation.
Immobilized‐enzyme reactors integrated with capillary electrophoresis for pharmaceutical research
Authors: Schejbal Jan , Glatz Zdeněk
Published: October 2017

Enzymes play an essential role in many aspects of pharmaceutical research as drug targets, drug metabolizers, enzyme drugs and more. In this specific field, enzyme assays are required to meet a number of specific requirements, such as low cost, easy automation, and high reliability. The integration of an immobilized‐enzyme reactor to capillary electrophoresis represents a unique approach to fulfilling these criteria by combining the benefits of enzyme immobilization, that is, increased stability and repeated use, as well as the minute sample consumption, short analysis time, and efficient analysis provided by capillary electrophoresis. In this review, we summarize, analyze, and discuss published works where pharmaceutically relevant enzymes were used to prepare capillary electrophoresis‐integrated immobilized‐enzyme reactors in an online manner. The presented assays are divided into three distinct groups based on the drug–enzyme relationship. The first, more extensively studied group employs enzymes that are considered to be therapeutic targets, the second group of assays present tools to assess drug metabolism and the third group assesses enzyme drugs. Furthermore, we examine various methods of enzyme immobilization and their implications for assay properties.
Effect of cochlear implantation on middle ear function: A three‐month prospective study
Authors: Wasson Joseph D. , Campbell Luke , Chambers Scott , Hampson Amy , Briggs Robert J. S. , O'Leary Stephen J.
Published: October 2017

Objectives/Hypothesis

To determine if cochlear implantation has a delayed effect on the middle ear conductive hearing mechanism by measuring laser Doppler vibrometry (LDV) of the tympanic membrane (TM) in both implanted and contralateral control ears preoperatively and 3 months postoperatively, and then comparing the relative change in LDV outcome measures between implanted and control ears.

Study Design

Prospective cohort study.

Methods

Eleven preoperative adult unilateral cochlear implant recipients in previously unoperated ears with normal anatomy and aerated temporal bones were included in this study. The magnitude and phase angle of umbo velocity transfer function in response to air‐ conduction (AC) stimulus, and the magnitude of umbo velocity in response to bone‐ conduction (BC) stimulus were measured in the implant ear and the contralateral control ear preoperatively and 3 months postoperatively and compared.

Results

No significant changes in the magnitude or phase angle of TM velocity in response to either AC or BC stimulus were observed in the implanted ear relative to the contralateral control ear 3 months following cochlear implantation.

Conclusions

From the results of LDV measurements, it can be said that cochlear implantation has no significant delayed effect on the middle ear conductive mechanism.

Level of Evidence

4. Laryngoscope, 128:1207–1212, 2018
Effects of supramaximal balloon dilatation pressures on adult cricoid and tracheal cartilage: A cadaveric study
Authors: Durvasula Venkata S. P. B. , Shalin Sara C. , Tulunay‐Ugur Ozlem E. , Suen James Y. , Richter Gresham T.
Published: October 2017

Objectives/Hypothesis

Cricoid fracture is a serious concern for balloon dilatation in airway stenosis. Furthermore, there are no studies examining tracheal rupture in balloon dilatation of stenotic segments. The aim of this study was to evaluate the effect of supramaximal pressures of balloons on the cricoid and tracheal rings.

Study Design

Prospective cadaveric study.

Methods

Seven cadaveric laryngotracheal complexes of normal adults with intact cricothyroid membranes were acquired. Noncompliant vascular angioplasty balloons (BARD‐VIDA) were used for dilatation. The subglottis and trachea were subjected to supramaximal dilatation pressures graduated to nominal burst pressure (NBP) and, if necessary, rated burst pressure (RBP). Larger‐diameter balloons, starting from 18 mm size to 24 mm, were used. Dilatations were maintained for 3 minutes.

Results

The cricoid ring was disrupted by larger‐diameter balloons (22 mm and 24 mm) even at lower pressures (less than NBP) in six cases. Tracheal cartilages were very distensible, and external examination after supramaximal dilatation (24 mm close to RBP) revealed no obvious cartilage fractures or trachealis tears. Histopathological examination revealed sloughing of mucosa in the areas corresponding to balloon placement, but no microfractures or disruption of the perichondrium of tracheal ring cartilages.

Conclusions

These results indicate that the cricoid is vulnerable to injury from larger balloons even at lower dilatation pressures. The tracheal cartilages and the membranous wall of the trachea remained resilient to supramaximal dilatation and larger balloons.

Level of Evidence

NA. Laryngoscope, 128:1304–1309, 2018
Awake serial intralesional steroid injections without surgery as a novel targeted treatment for idiopathic subglottic stenosis
Authors: Franco Ramon A. , Husain Inna , Reder Lindsay , Paddle Paul
Published: October 2017

Objectives/Hypothesis

The fibrotic/erythematous appearance of the subglottis in idiopathic subglottic stenosis (iSGS) hints that it might respond to repeated intralesional steroid treatment similar to keloids.

Study Design

Retrospective cohort study.

Methods

Thirteen iSGS subjects (six treated in‐office with serial intralesional steroid injections [SILSI] versus seven treated endoscopically in the operating room [OR] followed by awake SILSI) between October 2011 and April 2017. Forced spirometry was performed before injections and at each follow‐up visit (peak expiratory flow [%PEF] and peak inspiratory flow). Steroids were injected via transcricothyroid or transnasal routes. Injections were grouped into rounds of four to six injections separated by 3 to 5 weeks.

Results

Thirteen subjects with a mean follow‐up of 3 years (3.3 years for SILSI and 2.7 years for OR). Awake‐only SILSI subjects had a mean improvement/round of 23.1% %PEF (range, 65.4%–88.6%), whereas the OR‐treated subjects had a mean %PEF improvement/round of 25.1% (range, 57.4%–82.5%). Both groups had improved breathing, and the improvements were statistically equal (P = .569). SILSI subjects underwent 5.3 injections/round in 1.3 rounds, whereas OR subjects had 5.9 injections/round over 2.1 rounds. Statistically significant improvement was seen in %PEF for both groups (SILSI P = .007, OR P = .002). Overall, SILSI achieved sustained %PEF above 80% in 83% (5/6) and OR + SILSI 86% (6/7).

Conclusions

SILSI in the awake outpatient setting can improve the airway caliber in iSGS and is equivalent to endoscopic OR treatment. We believe iSGS can be viewed as a chronic scarring/inflammatory condition that can benefit from steroid scar‐modification therapy.

Level of Evidence

4. Laryngoscope, 128:610–617, 2018
Treatment, survival, and costs of oropharyngeal cancer care in the elderly
Authors: Gourin Christine G. , Fakhry Carole , Quon Harry , Kang Hyunseok , Kiess Ana P. , Herbert Robert J. , Eisele David W. , Frick Kevin D.
Published: October 2017

Objectives/Hypothesis

To examine associations between treatment, survival, and costs in elderly patients with oropharyngeal squamous cell cancer (OPSCC).

Study Design

Retrospective cross‐sectional analysis of Surveillance, Epidemiology, and End Results–Medicare data.

Methods

We evaluated 666 patients diagnosed with OPSCC from 2004 to 2007 using cross‐tabulations, multivariate logistic and generalized linear regression modeling, and survival analysis.

Results

The majority of patients were nonsmokers (79%), had advanced‐stage disease (59%), and received chemoradiation (38%) or radiation (28%). Surgery with postoperative radiation (hazard ratio [HR]: 0.33 [95% CI: 0.20‐0.53]) and chemoradiation (HR: 0.45 [95% CI: 0.29‐0.71]) were associated with improved survival, whereas stage IV disease was associated with poorer survival (HR: 1.95 [95% CI: 1.13‐3.38]). Additional cancer‐directed treatment after primary treatment was more likely following chemoradiation (odds ratio [OR]: 3.44 [95% CI: 1.78‐6.63]). Salvage surgery was performed in 25% of patients undergoing subsequent additional cancer‐directed treatment, and was associated with high‐volume hospitals (OR: 2.81 [95% CI: 1.07‐7.74]). Additional radiation (HR: 0.47 [95% CI: 0.31‐0.72]) and salvage surgery (HR: 0.61 [95% CI: 0.38‐0.99]) were associated with improved overall survival when performed >6 months following initial treatment, whereas salvage neck dissection alone was not significantly associated with survival after controlling for time to salvage (HR: 0.38 [95% CI: 0.05‐2.78]). Treatment and 5‐year overall costs were highest for chemoradiation, surgery with postoperative radiation, and additional cancer‐directed treatment.

Conclusions

Multimodality treatment in elderly OPSCC patients was associated with improved survival and increased costs. Chemoradiation was associated with an increased likelihood of additional cancer‐directed treatment. Salvage surgery was centralized at high‐volume hospitals, and was associated with improved survival when performed >6 months after last initial treatment date, but was performed in <20% of patients undergoing additional treatment.

Level of Evidence

2c. Laryngoscope, 128:1103–1112, 2018
Positive fresh frozen section margins as an adverse independent prognostic factor for local recurrence in oral cancer patients
Authors: Szewczyk Mateusz , Golusinski Wojciech , Pazdrowski Jakub , Masternak Michal , Sharma Neil , Golusinski Pawel
Published: October 2017

Objectives

To access 1) the value of further surgical resection (completion surgery) in cases with a positive intraoperative margin analysis, and 2) whether cancers that undergo completion surgery following positive intraoperative margin analysis with subsequent negative margins should be considered true margin‐negative (R0) resections in terms of adjuvant treatment planning.

Study Design

Retrospective analysis of patients with primary oral cancer.

Methods

One hundred and fifty‐one patients underwent primary surgical resection of oral squamous cell carcinoma with intraoperative margin examination. In all cases for which frozen section margin analysis was positive, an extended resection was performed. Only patients with clear final margins were included in the study.

Results

The intraoperative analysis of surgical margins revealed that cancer‐free margins were achieved in 123 cases (81.5%). In 28 specimens (18.5%), the surgical margins were positive. Local recurrence was observed in 28 (18.5%) patients, whereas regional recurrence developed in 30 (19.9%) patients. Factors significantly (P < 0.05) increased the risk of local recurrence: advanced stage of the disease (III/IV), node N‐positive status, lymphovascular invasion and positive fresh frozen surgical margins. On multivariate analysis, only positive fresh frozen surgical margins remained significant independent adverse factors.

Conclusion

Our study demonstrates that positive fresh frozen margins, regardless of re‐resection to R0 status, could be a powerful adverse factor that determines an aggressive nature of the tumor. This feature should be taken into consideration in adjuvant treatment planning. The greatest impact this could have is in borderline clinical situations for which the indication for adjuvant treatment may be questionable.

Level of Evidence

4. Laryngoscope, 128:1093–1098, 2018
Survival of renal cell carcinoma metastatic to nonthyroid head and neck region: A systematic review
Authors: Liou Tzyy‐Nong , Scott‐Wittenborn Nicholas R. , Kallogjeri Dorina , Lieu Judith E. , Pipkorn Patrik
Published: October 2017

Objective

Metastasis of renal cell carcinoma to nonthyroid head and neck region is rare. Survival benefit for complete metastasectomy of more common renal cell foci has been reported in the literature. It is uncertain whether metastasectomy in nonthyroid head and neck region would provide a similar benefit.

Data Sources

We conducted a retrospective review of all renal cell metastases to the head and neck region treated in the past 15 years at an academic hospital, and a systematic review of all relevant reports with survival data in the literature between 1960 and 2016.

Review Methods

An analysis of pooled data was performed to estimate overall survival.

Results

Six cases from our institution and 260 independent cases reported in the literature were included in the survival analyses (n = 266). The median follow‐up time was 12 months (range 0–180 months). The overall median survival was 36 months (95% confidence interval [CI] 23.7–48.3). The median survival for those who underwent complete metastasectomy in the head and neck was significantly higher at 60 months (95% CI 41.1–78.9) than those who had incomplete or no metastasectomy (12 months, 95% CI 9.5–14.5). Multivariable Cox proportional hazards model estimated that, after controlling for potential confounders, complete metastasectomy remained associated with reduced risk of death (hazard ratio 0.44, 95% CI 0.29–0.69).

Conclusion

Complete metastasectomy was associated with 4‐year longer median overall survival than incomplete metastasectomy or no metastasectomy. Laryngoscope, 128:889–895, 2018
Upper esophageal sphincter augmentation reduces pharyngeal reflux in nasogastric tube–fed patients
Authors: Jiao Hongmei , Mei Ling , Liang Chenyang , Dai Yun , Fu Zhifang , Wu Lihong , Sanvanson Patrick , Shaker Reza
Published: October 2017

Objectives/Hypothesis

Aspiration of gastric refluxate is one of the most commonly observed complications among long‐term nasogastric tube (NGT) fed patients. The upper esophageal sphincter (UES) pressure barrier is the main defense mechanism against pharyngeal reflux of gastric contents. Our objective was to investigate the efficacy and safety of the UES assist device (UES‐AD) in preventing gastric reflux through the UES in long‐term NGT‐fed patients.

Study Design

Self‐Controlled Case series.

Methods

We studied 10 patients (mean age = 90.6 ± 3.4 years, four females) with dysphagia caused by stroke or dementia who were fed for 0.5 to 5 years (median = 3 years) by NGT. External pressures of 20 to 30 mm Hg were applied by using a handmade UES‐AD, which was started 2 hours after the beginning of NGT infusion and was alternated between periods of 2 hours on and 2 hours off, for a total of 12 hours. Placement of the impedance sensors within the UES was guided by high‐resolution manometry. Trans‐UES and intraesophageal reflux events were recorded by using 24‐hour combined pH‐impedance measurements.

Results

No aspiration pneumonia events were noted in the period 1 month before or during the study in any of the cohort. Baseline UES pressure averaged 17.5 ± 9.4 mm Hg and was increased to 38.9 ± 11.9mm Hg after application of the UES‐AD. Overall frequency of trans‐UES reflux decreased significantly with the UES‐AD compared to without (0.8 ± 0.9 vs. 3.3 ± 2.8, P < .05 for the 12‐hour study period). There was no effect of the UES‐AD on esophageal reflux events (7.4 ± 4.4 vs. 6.4 ± 3.0, P > .05).

Conclusions

UES‐AD significantly decreases the number of trans‐UES reflux events and can potentially reduce the aspiration risk associated with NGT feeding.

Level of Evidence

4. Laryngoscope, 128:1310–1315, 2018
Clinical outcomes and prognostic factors of sialendoscopy in salivary duct stenosis
Authors: Choi Jeong‐Seok , Choi Yoon‐Gi , Kim Young‐Mo , Lim Jae‐Yol
Published: October 2017

Objectives/Hypothesis

This study aimed to analyze the clinical outcomes of sialendoscopy in patients with salivary duct stenosis and to investigate factors associated therewith.

Study Design

Retrospective case series.

Methods

This study included 47 patients with salivary stenosis who underwent sialendoscopy between January 2014 and December 2015. Subjective symptom, salivary flow rate, salivary scintigraphy, and radiologic evaluation using magnetic resonance (MR) sialography were performed preoperatively; direct ductal findings were evaluated during sialendoscopy. Univariate and multivariate analyses of factors influencing the patient‐reported outcomes (complete, partial, or no improvement at 3 months after sialendoscopy) were conducted.

Results

Stenosis severity was graded according to sialendoscopic findings. Seventeen patients were classified with grade I stenosis, 18 patients with grade II stenosis, and 12 patients with grade III stenosis. Symptoms completely disappeared in 21 patients (44.7%) after sialendoscopic procedures. In 19 patients (40.4%), symptoms were partially improved. Seven patients (14.9%) showed no improvement or worsening of symptoms. In univariate analysis, symptom score, stimulatory salivary flow rate, Tmin (time interval from stimulation to minimal count on salivary scintigraphy), type of stenosis on MR sialography, and sialendoscopic grade were found to be significantly associated with treatment outcomes. In multivariate analysis, Tmin, stenosis type of MR sialography, and sialendoscopic grade remained significantly associated with outcomes after sialendoscopy.

Conclusions

Sialendoscopic procedures were found to be clinically satisfactory for relieving the symptoms of patients with salivary stenosis. Factors related to the severity of ductal stenosis such as Tmin, stenosis type of MR sialography, and sialendoscopic grade were significantly associated with the success of sialendoscopic treatment for salivary duct stenosis.

Level of Evidence

4. Laryngoscope, 128:878–884, 2018
Hearing loss on social media: Who is winning hearts and minds?
Authors: Crowson Matthew G. , Tucci Debara L. , Kaylie David
Published: October 2017

Objectives/Hypothesis

To analyze specific patterns of Twitter usage using common references to hearing loss, and characterize the virtual public that comprises the hearing loss community to inform hearing loss stakeholders for opportunities for engagement and outreach.

Study Design

Social media network analysis.

Methods

Twitter tweets were sampled from July 2016 to September 2016 using #hearing, #hearingloss, #deaf, #hearingimpairment, #hardofhearing, #deafness, #hearingmatters, #hearinghealth, and #hearingimpaired tags. User and Twitter social community metrics were examined including temporal trends, tweet content, user activity, tweet reach, and an analysis of the tweets' social network.

Results

We identified and analyzed 49,208 tweets from July 2016 to September 2016 with tags relevant to hearing loss. Of the 100 most active Twitter accounts, organizations owned 67% compared to 33% owned by individuals. Commercial/for profit and informational organizations were the most common organization account owners (26% and 16%, respectively). Five unique tweets were identified as each having a reach of over 100,000 Twitter users, with the greatest reach exceeding 250,000 users. Temporal analysis identified marked retweet outliers (>300 retweets per hour) that corresponded with a widely publicized event involving the dismissal of a deaf employee from a fast‐food chain store.

Conclusions

Twitter accounts owned by organizations outnumbered individual accounts, and commercial/for profit user accounts were the most frequently active organization account type. Tweets pertaining to hearing loss may have a broad reach to a large community base. Analyses of social media use can be helpful in discovering issues of interest to the hearing loss community, as well as determining which users and organizations are dominating social network conversations.

Level of Evidence

NA. Laryngoscope, 128:1453–1461, 2018
Primary surgery versus primary radiation‐based treatment for locally advanced oropharyngeal cancer
Authors: Kamran Sophia C. , Qureshi Muhammad M. , Jalisi Scharukh , Salama Andrew , Grillone Gregory , Truong Minh Tam
Published: October 2017

Objective

Randomized data comparing surgery to radiation for locally advanced oropharyngeal cancer (OPC) are lacking. This study evaluated practice patterns and overall survival outcomes from the National Cancer Database.

Methods

A total of 22,676 patients with stage III to IV, locally advanced OPC were treated between 2004 to 2013 with primary chemoradiation (CRT) or surgery with adjuvant radiotherapy with or without chemotherapy (aRT ± CT). Survival rates were estimated using the Kaplan‐Meier method. Crude and adjusted hazard ratios (HR) were computed using Cox regression modeling.

Results

Median follow‐up was 40.7 months; 8,555 and 14,121 patients received surgery with aRT ± CT and CRT, respectively. Corresponding 3‐year survival was 85.4% and 72.6% (P < 0.0001). On multivariate analysis, adjusting for age, gender, race insurance status, median income, percentage with no high‐school degree, Charlson‐Deyo score, clinical tumor and node stage, tumor grade, facility type, treatment at > 1 facility, and human papillomavirus (HPV) status, surgery with aRT ± CT had a reduced hazard of death, HR, 0.79 (95% confidence interval 0.69–0.91), P = 0.001.

Conclusion

Primary surgery with aRT ± CT for locally advanced OPC has an improved survival compared to primary radiation‐based treatment even when stratified by HPV status.

Level of Evidence

2c. Laryngoscope, 128:1353–1364, 2018
Malignant fibrous histiocytoma: Database review suggests a favorable prognosis in the head and neck
Authors: Borucki Robert B. , Neskey David M. , Lentsch Eric J.
Published: October 2017

Objective

The malignant fibrous histiocytoma (MFH) is the most common soft tissue sarcoma of the head and neck. Currently, most of the data on this tumor relies on small retrospective studies. The objective of this study is to use the Surveillance, Epidemiology, and End Results (SEER) database to compare characteristics of this tumor based on location to better understand its prognosis in the head and neck region. This article represents the largest study analyzing prognosis of this tumor in the head and neck to date.

Study Design

Retrospective analysis of SEER database.

Methods

Using the SEER database, 395 patients with MFH of the head and neck were compared with 3,968 patients with MFH of the trunk and extremities. Disease‐specific survival was carried out comparing these two cohorts, as well as univariate and multivariate analysis to determine hazard ratios.

Results

Head and neck MFH had a significantly higher disease‐specific survival compared with trunk and extremity disease. However, head and neck tumors were more frequently a smaller size (P < .0001) and lower grade (P < .0001). Larger tumors and grade III and IV tumors conferred a worse prognosis (P < .0001).

Conclusion

Head and neck malignant fibrous histiocytoma presents at a smaller size and lower grade, likely due to earlier presentation in this region. Because of this, head and neck malignant fibrous histiocytoma represents a more favorable survival prognosis compared with trunk and extremity disease.

Level of Evidence

4. Laryngoscope, 128:885–888, 2018