bluuebunny/crossref_metadata_2025 huggingface dataset:
Attraction between electrophilic caps: A counterintuitive case of noncovalent interactions
Authors: Wang Changwei , Danovich David , Shaik Sason , Wu Wei , Mo Yirong
Published: October 2018

Intermolecular attractive interaction between electrophilic sites is a counterintuitive phenomenon, as the electrostatic interaction therein is repulsive and destabilizing. Here, we confirm this phenomenon in four representative complexes, using state‐of‐the‐art quantum mechanical methods. By employing the block‐localized wavefunction (BLW) method, which can turn off intermolecular charge transfer interactions, we profoundly demonstrated the significance of charge transfer interactions in these seemingly counterintuitive complexes. Indeed, after being “turned off” the intermolecular charge transfer interaction in, for example, the FNSi···BrF complex, the originally attractive intermolecular interaction turns to be repulsive. The energy decomposition approach based on the BLW method (BLW‐ED) can partition the overall stability gained on the formation of intermolecular noncovalent interaction into several physically meaningful components. According to the BLW‐ED analysis, the electrostatic repulsion in these counterintuitive cases is overwhelmed by the stabilizing polarization, dispersion interaction, and most importantly, the charge transfer interaction, resulting in the eventual counterintuitive overall attraction. The present study suggests that, predicting bonding sites of noncovalent interactions using only the “hole” concept may be not universally sufficient, because other significant stabilizing factors will contribute to the stability and sometimes, play even bigger roles than the electrostatic interaction and consequently govern the complex structures. © 2018 Wiley Periodicals, Inc.
A Comprehensive Overview of the Clinical Pharmacokinetics of Clobazam
Authors: Tolbert Dwain , Larsen Frank
Published: October 2018

Clobazam (CLB) is a 1,5‐benzodiazepine that has been widely used as an anxiolytic and antiseizure drug (ASD) since it was first synthesized over 50 years ago. CLB was approved in the United States in 2011 as adjunctive therapy for seizures in patients ≥2 years old with Lennox‐Gastaut syndrome. CLB pharmacokinetics (PK) have been studied in single‐ and multiple‐dose administrations in healthy subjects. Salient features include high bioavailability, linear PK, and negligible effects from coadministration of other ASDs. CLB is highly and extensively absorbed, with little effect from food; time to maximum plasma concentration is 0.5 to 4 hours following the dose. After CLB doses of 20 to 40 mg/day, the volume of distribution is 99 to 120 L, with oral clearance ranging from 1.9 to 2.3 L/h. CLB is lipophilic and distributes throughout the body after oral administration. It is metabolized in the liver by cytochrome P450 (CYP) isoenzymes CYP3A, CYP2C19, and CYP2B6, and its main active metabolite isN‐desmethylclobazam. The half‐life of CLB after a single oral dose ranges from 36 to 42 hours; the half‐life ofN‐desmethylclobazam ranges from 59 to 74 hours. The metabolites of CLB are primarily excreted renally. Population PK modeling using data from healthy subjects and patients with Lennox‐Gastaut syndrome indicates that race, sex, age, weight, and renal function do not influence CLB PK. As CLB has been extensively studied since the 1970s, this review is meant to provide a consolidated and comprehensive resource on CLB PK for both prescribers and scientists alike.
Peritumoural adipose tissue pro‐inflammatory cytokines are associated with tumoural growth factors in cancer cachexia patients
Authors: Neto Nelson Inácio Pinto , Murari Ariene Soares de Pinho , Oyama Lila Missae , Otoch José Pinhata , Alcântara Paulo Sérgio Martins , Tokeshi Flavio , Figuerêdo Raquel Galvão , Alves Michele Joana , Lima Joanna Darck Carola Correia , Matos‐Neto Emídio Marques de , Seelaender Marilia , Oller do Nascimento Claudia Maria
Published: October 2018

Background

Cancer cachexia (CC) is a multifactorial syndrome, often irreversible, that affects patients with cancer influenced, in part, by the inflammatory condition. Peritumoural adipose tissue produces adipokines and angiogenic, apoptotic, and growth factors; given the possible crosstalk between the peritumoural adipose tissue and tumour, these may play an important role in cancer biology and carcinogenesis.

Methods

The aim of this study was to evaluate the factors produced by peritumoural adipose tissue in a cohort of 16 colorectal cancer patients with either weight‐stable cancer (WSC; n = 7) or CC (n = 9). The study was approved by the Ethics Research Committee (972.914). Samples of peritumoural adipose tissue were analysed for concentrations of TNF‐α, IL‐1β, STAT‐1, STAT‐3, RANTES, IL‐1Ra, IP‐10, IL‐15, MCP‐1, IFN‐α, GCSF, FADD, and TGF‐β. The cytokines and proteins were measured using Multiplex. Correlations between the proteins and cytokines were evaluated.

Results

TNF‐α, STAT‐1, and FADD, a factor involved in apoptosis, were significantly higher in CC group than in the WSC group. In the peritumoural adipose tissue of the CC group, RANTES showed a significant positive correlation with IL‐1Ra and IP‐10 and a negative correlation with IFN‐α; and GCSF showed significant negative correlations with IL‐1Ra, IP‐10, IL‐15, and MCP‐1 and a positive correlation with IFN‐α. In the peritumoural adipose tissue of the WSC group, no significant correlations were detected between RANTES, GCSF, IL‐3, FADD, and STAT‐1 and the cytokines/chemokines analysed.

Conclusions

These results indicated that inflammatory and tumorigenic pathways were altered in peritumoural adipose tissue in CC. Furthermore, inflammatory cytokines were correlated with growth factors in the peritumoural adipose tissue of cachectic patients, suggesting that inflammatory cytokines modulated the proliferative environment closely linked to the tumour.
Fundus image classification methods for the detection of glaucoma: A review
Authors: Saba Tanzila , Bokhari Syedia Tahseen Fatima , Sharif Muhammad , Yasmin Mussarat , Raza Mudassar
Published: October 2018

Glaucoma is a neurodegenerative illness and is considered as a standout amongst the most widely recognized reasons for visual impairment. Nerve's degeneration is an irretrievable procedure, so the diagnosis of the illness at an early stage is an absolute requirement to stay away from lasting loss of vision. Glaucoma effected mainly because of increased intraocular pressure, if it is not distinguished and looked early, it can result in visual impairment. There are not generally evident side effects of glaucoma; thus, patients attempt to get treatment just when the seriousness of malady is advanced altogether. Determination of glaucoma often comprises of review of the basic crumbling of the nerve in conjunction with the examination of visual function capacity. This article shows the persistent illustration of glaucoma, its side effects, and the potential people inclined to this malady. The essence of this article is on different classification methods being utilized and proposed by various scientists for the identification of glaucoma. This article audits a few division and segmentation methodologies that are exceptionally useful for recognizable proof, identification, and diagnosis of glaucoma. The research related to the findings and the treatment is likewise evaluated in this article.
Diagnosis of Hirschsprung's disease in children: Preliminary evaluation of a novel endoscopic technique for rectal biopsy
Authors: Nabi Zaheer , Shava Upender , Sekharan Anuradha , Nageshwar Reddy Duvvur
Published: October 2018

Background and Aim

The diagnosis of Hirschsprung's disease (HD) relies on anorectal manometry and rectal biopsy. The role of endoscopic biopsy is uncertain for the diagnosis of HD in children. In this study, we evaluated the adequacy of biopsies procured by endoscopic mucosal resection (EMR) for the diagnosis of HD.

Methods

Consecutive children with suspected HD from January 2013 to January 2018 were enrolled in the study. EMR was performed using the standard band ligation device at a distance of about 3 cm from dentate line in rectum. All samples were assessed macroscopically and microscopically. An adequate sample was defined as those measuring >3 mm and including adequate submucosa.

Results

A total of 132 children underwent evaluation for constipation in the study period. Of these, 10 children (median age, 4.25 years) underwent EMR using the band ligation device for the evaluation of HD. EMR was performed with and without submucosal lifting injection in four and six children, respectively. All the samples were adequate macroscopically (>3 mm). Absence of ganglion cells was noted in six children. Of these, three children underwent full‐thickness rectal biopsy followed by surgery. Three children did not undergo surgery. Ganglion cells were identified in four children, thereby excluding the diagnosis of HD.

Conclusion

Rectal biopsy using EMR with a band ligation device is feasible, safe, and provides adequate sample for the evaluation of HD in children.
Hamiltonicity of planar graphs with a forbidden minor
Authors: Ellingham M. N. , Marshall Emily A. , Ozeki Kenta , Tsuchiya Shoichi
Published: October 2018

Tutte showed that ‐connected planar graphs are Hamiltonian, but it is well known that ‐connected planar graphs need not be Hamiltonian. We show that ‐minor‐free ‐connected planar graphs are Hamiltonian. This does not extend to ‐minor‐free ‐connected graphs in general, as shown by the Petersen graph, and does not extend to ‐minor‐free ‐connected planar graphs, as we show by an infinite family of examples.
Inducible nitric oxide synthase: An asset to neutrophils
Authors: Saini Rashmi , Singh Sarika
Published: October 2018

Neutrophils play a key role in innate immune responses against foreign intrusion and influence the subsequent instigation of adaptive immune response. Nitric oxide (NO) synthesized by neutrophil nitric oxide synthase (NOS) profoundly modulates their diverse physiological responsibilities furthermore encompassing pathological implications. Neutrophils are the active participants in diverse inflammatory and cardiovascular disorders but neutrophil nitric oxide synthase (NOS) remains enigmatic on various aspects. This review focuses on inducible NOS (iNOS) and makes an attempt to address its potential impact in neutrophil pathophysiology, their differentiation, functionality, and survival. We described the scenario from its expressional modulation, by pro- and anti-inflammatory cytokines governing the extent and duration of neutrophil immune response, to iNOS catalysis, the intracellular compartmentalization, and protein–protein interactions determining its microenvironment, activity and its contribution as a potential signaling protein apart from its role as signal transducer. Further, the relevance of investigating the unexplored facets of iNOS biology in neutrophils and possible prototypes of iNOS regulation is also exemplified in related cellular systems.

Review on expressional modulation, inducible catalysis, intracellular compartmentalization and protein-protein interactions of neutrophil NOS determining microenvironment, activity and its contribution as a potential signaling protein.
The myodural bridge in the common rock pigeon (Columbia livia): Morphology and possible physiological implications
Authors: Okoye Chukwuemeka Samuel , Zheng Nan , Yu Sheng‐Bo , Sui Hong‐Jin
Published: October 2018

The dense connective tissue that connects muscles to the cervical spinal dura mater is known as the myodural bridge in human anatomy and has been a subject of interest to anatomists and clinicians. The myodural bridge was originally discovered in humans, and also has been observed in other mammals and in reptilian sauropsids. We investigated the existence of the myodural bridge in a bird, that is, the Common Rock Pigeon Columba livia, to expand the understanding of the structure and function of the myodural bridge. Gross anatomical dissection of seven specimens and histological analyses of the suboccipital region of eight specimens were performed. The rectus capitis dorsalis minor muscle joins occipital periosteal extensions and inserts with several dense connective tissue cords on the dorsal side of the dura mater of the cervical spinal cord. The myodural bridge consists primarily of collagen Type I fibres, suggesting that the myodural bridge can transmit strong tensional forces generated by the contraction of M. rectus capitis dorsalis minor to the dura mater. The pull on the dura mater may affect the circulation of the cerebrospinal fluid in the subarachnoid space of the spine.
Effect of microscopic susceptibility gradients on chemical‐shift‐based fat fraction quantification in supraclavicular fat
Authors: McCallister Drew , Zhang Le , Burant Alex , Katz Laurence , Branca Rosa Tamara
Published: October 2018

Background

Susceptibility differences between fat and water can cause changes in the water‐fat frequency separation that can negatively affect the accuracy of fat fraction techniques. This may be especially relevant for brown adipose tissue, as MRI fat fraction techniques have been proposed for its detection.

Purpose

To assess the effect of microscopic magnetic susceptibility gradients on the water‐fat frequency separation and its impact on chemical‐shift‐based fat fraction quantification techniques in the supraclavicular fat, where brown adipose tissue is commonly found in humans.

Study Type

Prospective.

Population/Subjects/Phantom/Specimen/Animal Model

Subjects: 11 healthy volunteers, mean age of 26 and mean BMI of 23, three overweight volunteers, mean age of 38 and mean BMI of 33. Phantoms: bovine phantom and intralipid fat emulsion. Simulations: various water‐fat distributions.

Field Strength/Sequence

Six‐echo gradient echo chemical‐shift‐encoded sequence at 3T.

Assessment

Fat fraction values as obtained from a water‐fat spectral model accounting for susceptibility‐induced water‐fat frequency variations were directly compared to traditional spectral models that assume constant water‐fat frequency separation.

Statistical Tests

Two‐tail t‐tests were used for significance testing (p < 0.05.) A Bayesian Information Criterion difference of 6 between fits was taken as strong evidence of an improved model.

Results

Phantom experiments and simulation results showed variations of the water‐fat frequency separation up to 0.4 ppm and 0.6 ppm, respectively. In the supraclavicular area, the water‐fat frequency separation produced by magnetic susceptibility gradients varied by as much as ±0.4 ppm, with a mean of 0.08 ± 0.14 ppm, producing a mean difference in fat fraction of –1.26 ± 5.26%.

Data Conclusion

In the supraclavicular fat depot, microscopic susceptibility gradients that exist within a voxel between water and fat compartments can produce variations in the water‐fat frequency separation. These variations may produce fat fraction quantification errors of 5% when a spectral model with a fixed water‐fat frequency separation is applied, which could impact MR brown fat techniques.

Level of Evidence: 1

Technical Efficacy: Stage 1

J. Magn. Reson. Imaging 2019;49:141–151.
Magnetic Resonance Elastography in the Assessment of Acute Effects of Kinesio Taping on Lumbar Paraspinal Muscles
Authors: Wang Chien‐Kuo , Fang Yu‐Hua Dean , Lin Liang‐Ching , Lin Cheng‐Feng , Kuo Li‐Chieh , Chiu Feng‐Mao , Chen Chia‐Hui
Published: October 2018

Background

Kinesio tape (KT) is an elastic therapeutic tape used for treating sports‐related injuries and a number of other disorders. To date, the objective evidence to link pathophysiological effects and actual reactions triggered by KT is limited.

Purpose

To explore the effect of KT on the lumbar paraspinal muscles by magnetic resonance (MR) elastography.

Study Type

Prospective observational study.

Population

Sixty‐six asymptomatic volunteers with 31 women and 35 men.

Field Strength/Sequence

3.0T MRI and elastography with vibration frequency of 120 Hz.

Assessment

The 5‐cm‐width KT with full tension was placed on a single side of the lumbar paraspinal muscle. The taping side and adhering direction were randomly decided. Two rectangular regions of interest (ROIs) of 5‐ and 2.5‐cm‐width were positioned at the bilateral paraspinal regions from the L2 to L4 level on the confidence map of MR elastography before and after KT taping. The mean shear stiffness values of the ROIs at the superficial, middle, and deep depths were recorded; then the differences between the taping and reference sides were calculated.

Statistical Tests

Paired t‐test and Pearson correlations were used to evaluate the stiffness changes after KT application and intraoperator errors of the stiffness measures on the reference side, respectively.

Results

A significant decrease in the muscle stiffness value between taping and reference sides (–0.71 kPa ± 0.60 with KT and –0.25 kPa ± 0.78 without KT, P < 0.0001 for 5‐cm ROI; –0.67 kPa ± 1.12 with KT and –0.16 kPa ± 1.17 without KT, P = 0.0004 for 2.5‐cm ROI) was found in the superficial depth, but no significant differences in the middle and deep depths (P = 0.25 and P = 0.79 for 5‐cm ROI; P = 0.09 and P = 0.67 for 2.5‐cm ROI, respectively). There were no significant differences of muscle stiffness differences between gender (P = 0.11 for superficial, P = 0.37 for middle, P = 0.78 for deep) and taping direction (P = 0.18 for superficial, P = 0.13 for middle, P = 0.15 for deep).

Data Conclusion

Our results demonstrate that KT can reduce the MR elastography‐derived shear stiffness in the superficial depth of paraspinal muscles.

Level of Evidence: 2

Technical Efficacy: Stage 2

J. Magn. Reson. Imaging 2019;49:1039–1045.
Characterization of a novel bacteriophage specific to Exiguobacterium indicum isolated from a plateau eutrophic lake
Authors: Zhang Shiying , Fan Cong , Xia Yunsheng , Li Mengke , Wang Yongxia , Cui Xiaolong , Xiao Wei
Published: October 2018

Exiguobacterium is a versatile genus with potential in industry and agriculture. No bacteriophage that infects Exiguobacterium has been reported, despite its potential impacts on the utilization of Exiguobacterium. E. indicum EI9 was isolated from Dianchi Lake, a plateau eutrophic lake in China, which can significantly inhibit the growth of Microcystis aeruginosa. To isolate and characterize Exiguobacterium‐infecting bacteriophage, a virulent bacteriophage, DCEIV‐9 that specifically infects E. indicum EI9 was isolated from Dianchi lake water sample. DCEIV‐9 produced tiny, round, and clear plaques with 0.5–1 mm in diameter. Electron microscopy showed that DCEIV‐9 is a typical representative of the Siphoviridae, with an icosahedral head (56 nm in diameter) and a non‐contractile tail (163 nm in length). Based on a one‐step growth curve, latent period of 20 min and burst size of 51 PFU/infected cell were determined. DCEIV‐9 was sensitive to temperature over 50 °C and prefers acid environment. DCEIV‐9 was extremely sensitive to proteinase K, chloroform, ethanol, Triton X‐100 but not sensitive to SDS. Restriction endonucleases analysis indicated that DCEIV‐9 is a dsDNA virus. DCEIV‐9 can only infect E. indicum, indicates that it has a narrow host range. DCEIV‐9 is a potential new species.
Preserving the thyroidal isthmus during low tracheostomy with creation of a Björk flap
Authors: Janik Stefan , Kliman Jonathan , Hacker Philipp , Erovic Boban M.
Published: October 2018

Objectives/Hypothesis

Surgical tracheostomy (ST) with creation of an inferiorly based U‐shaped tracheal flap, known as the Björk flap, is the most commonly performed. The purpose of this study was to evaluate whether outcome was different in patients who underwent low ST with retraction and preservation of the thyroid isthmus compared to those who underwent high ST with ligation of the thyroid isthmus.

Study Design

Retrospective cohort study.

Methods

We included 1,143 patients who underwent ST with creation of a Björk flap between 2008 and 2015. Different outcome parameters, including complications, decannulation, inpatient mortality, and surgical characteristics, such as length of surgery and height of tracheal incision, were assessed comparing low and high ST.

Results

Complications occurred in 7.7% of patients, of which persistent stoma (4.1%) and hemorrhages (2.7%) were the most common. Low tracheostomy with retraction and preservation of thyroid isthmus was done in 31.4% of cases. Complications did not significantly differ between low and high tracheostomies (8.0% vs. 7.0%, P = .468). Moreover, decannulation rate and inpatient mortality were also not significantly different in low compared to high tracheostomies (P = .816 and P = .152, respectively). However, low tracheostomies were associated with significantly shorter operation times (33.0 ± 0.8 min vs. 38.7 ± 0.5 min, P < .001) and lower tracheal incisions for creation of a Björk flap (P < .001) compared to high tracheostomies.

Conclusions

Low tracheostomies are as safe as high tracheostomies regarding complications. Due to the fact that low tracheostomies are associated with shorter operation times and lower tracheal incisions, we recommend performong low tracheostomies whenever feasible.

Level of Evidence

4 Laryngoscope, 128:2783–2789, 2018
The Impact of Duty‐Hour Restrictions on Complication Rates Following Major Head and Neck Procedures
Authors: Crippen Meghan M. , Barinsky Gregory L. , Reddy Renuka K. , Elias Marcus L. , Eloy Jean Anderson , Baredes Soly , Park Richard Chan Woo
Published: October 2018

Objectives/Hypothesis

To assess the impact of resident duty‐hour restrictions (DHR) in otolaryngology via comparison of postoperative outcomes between otolaryngology teaching hospitals (Oto‐TH) and nonteaching hospitals (NTH) before and after complete implementation.

Study Design

Retrospective database review.

Methods

The Nationwide Inpatient Sample was queried for all major head and neck cases between 2000 and 2002 (n = 34,064) and 2008 and 2010 (n = 33,094). Cases were stratified into Oto‐TH (n = 28,771) and NTH (n = 38,387) and assessed for procedure type, patient comorbidities, and complications. A subpopulation matched by procedure type was generated for direct comparison of complication rates using χ2 and binary logistic regression analyses.

Results

In the years following DHR, total case volume and average case complexity increased at Oto‐TH only. Using a case‐matched subpopulation, regression analysis found Oto‐TH status to be protective for medical complications both before (odds ratio [OR]: 0.60, P < .001) and after (OR: 0.76, P = .001) DHR. In contrast, Oto‐TH cases had lower risk for surgical complications in 2000 to 2002 (OR: 0.77, P < .001) but not 2008 to 2010 (OR: 1.07, P = .275). When comparing time periods, the years following DHR were associated with a significant decrease in medical complications and mortality across hospital cohorts. For surgical complications, rates significantly improved at NTH only (OR: 0.82, P = .002), with no difference at Oto‐TH (OR: 0.95, P = .450).

Conclusions

In the years following DHR, rates of medical complications, surgical complications, and mortality have significantly improved at NTH. At Oto‐TH, there has been a lack of similar improvement in surgical complications, even after accounting for increasing case volume and complexity in more recent years. While the cause is likely multifactorial, DHR in otolaryngology residency may play a role.

Level of Evidence

4 Laryngoscope, 128:2804–2810, 2018
Incidence and Treatment Outcomes of Vocal Fold Movement Impairment After Total Arch Replacement
Authors: Fullmer Tanner , Wang David C. , Price Matt D. , LeMaire Scott A. , Coselli Joseph S. , Gregorio Casar J. , Donovan Donald T. , Eddie Liou N. , Ongkasuwan Julina
Published: October 2018

Background

Vocal fold movement impairment (VFMI) secondary to neuronal injury is a known risk after aortic surgery. Total arch replacement is technically challenging, and the incidence of vocal fold movement impairment secondary to neuronal injury after this surgery is unknown. This study examined the incidence of VFMI after total arch replacement and medialization treatment outcomes.

Study Design

Retrospective cohort study.

Methods

All patients who underwent total arch replacement at a tertiary care center over 11 years (2006–2017) were identified through an institutional database. End points included evidence of VFMI on flexible laryngoscopy, time to diagnosis, time to treatment, need for reintubation, and intensive care unit (ICU) and hospital length of stay.

Results

Of the 358 patients who underwent total arch replacement, 63 (20%) were diagnosed with VFMI during their initial inpatient stay. Fifty patients (79%) VFMIs were left‐sided, nine (14%) were right‐sided, and four (6%) were bilateral. Thirty‐nine patients (62%) underwent inpatient vocal fold medialization: 28 (72%) by injection laryngoplasty and 11 (28%) by type 1 thyroplasty. Those with unilateral VFMI had longer ICU (8.9 days) and hospital (19.4 days) than those with no VFMI (5.7 and 16.1 days). Among patients with unilateral VFMI, those who underwent inpatient vocal fold medialization trended toward shorter ICU (6.2 vs. 14.4 days, P = .03) and hospital stays (20.1 vs. 23.3 days, P = .4) than patients who did not have a medialization procedure.

Conclusion

The overall incidence of VFMI after total arch replacement in our series was 20%. Both the right and left vocal folds are potentially at risk from a total arch replacement; consequently, the distribution of injury in our cohort was more heterogeneous than in other series.

Level of Evidence

3 Laryngoscope, 129:699–703, 2019
Intratympanic Therapies in Ménière Disease: Evaluation of Outcomes and Early Vertigo Control
Authors: Naples James G. , Henry Laura , Brant Jason A. , Eliades Steven J. , Ruckenstein Michael J.
Published: October 2018

Objective

To evaluate outcomes of intratympanic (IT) dexamethasone and gentamicin in Ménière Disease (MD).

Methods

Charts of adult patients with unilateral definite MD receiving IT gentamicin or dexamethasone from 2005 to 2017 were retrospectively reviewed. All patients had at least 6 months follow‐up. Failure in each group was defined as the need for more aggressive therapy.

Prior to 2011, all patient received IT gentamicin, administered as primary therapy after failure of conservative treatment measures. Gentamicin was administered every 2 weeks, up to three injections, until vertigo control was achieved. Beginning in 2011, the treatment protocol shifted to IT dexamethasone as initial treatment, with gentamicin used for dexamethasone failures. Dexamethasone was administered weekly for up to three injections. Treatments could be repeated if symptoms recurred.

Results

Thirty‐three patients received IT dexamethasone, and 70 patients received IT gentamicin. Dexamethasone patients received a mean of 3.3 injections compared to 2.7 in the gentamicin group (P = 0.011). There were 12 (38%) failures in the dexamethasone group and only seven (10%) gentamicin failures (P = 0.025). No patients failed both treatments. The mean time to failure in the dexamethasone group was 5 months, whereas in the gentamicin group it was 27 months. Change in pure tone audiometry from baseline was not different between treatment groups (P = 0.30).

Conclusion

Subjects receiving IT gentamicin required fewer injections and had a significantly longer time to failure than IT dexamethasone. Audiometric outcomes were similar between the groups. The use of IT gentamicin as initial therapy for early and long‐term control of MD is safe and effective.

Level of Evidence

3 Laryngoscope, 129:216–221, 2019
Comparison of Modern Rigid Fixation Plating Outcomes for Segmental Mandibular Microvascular Reconstruction
Authors: McCann Adam C. , Shnayder Yelizaveta , Przylecki Wojciech H. , Kakarala Kiran , Nazir Niaman , Girod Douglas A. , Andrews Brian T.
Published: October 2018

Objectives/Hypothesis

New advances in osseous microvascular mandibular rigid fixation are being employed at many institutions. These include standardized prebent/preformed reconstruction plates as well as computer‐aided design/computer‐aided manufacturing (CAD/CAM) custom plates that are patient specific. Our goal was to assess and compare the outcomes of both of these new technologies when utilized for mandibular microvascular reconstruction.

Study Design

Retrospective chart review.

Methods

Subjects were categorized into two groups according to their mandibular rigid fixation technique: group 1 = prebent/preformed plates and group 2 = CAD/CAM custom plates. Primary outcome measures were 1) perioperative complications (defined as deep tissue infection, wound dehiscence resulting in bone exposure, and/or plate exposure) and 2) reoperation rates for mandibular hardware failure/explantation. Statistical analysis consisted of χ2, Fisher exact test, and multivariable regression models.

Results

A total of 142 subjects underwent microvascular mandibular reconstruction in a 6‐year period. Eighty‐nine subjects utilized prebent/preformed plates, and 53 employed CAD/CAM custom plates. Perioperative complications occurred in 32 of 89 (35.9%) subjects with prebent/preformed plates and 11 of 53 (20.7%) subjects using CAD/CAM custom plates. Reoperation requiring hardware explantation occurred in 18 of 89 (20.2%) subjects and three of 53 (5.6%) using CAD/CAM custom plates. Statistical comparison of perioperative complications between the two groups approached significance (P = .0556), and the rate of reoperation was significant favoring CAD/CAM implants (P = .0180).

Conclusions

In our experience, CAD/CAM custom plates utilized for rigid fixation during microvascular mandibular reconstruction demonstrated fewer complications and statistically lower reoperation rates when compared with prebent/preformed plates.

Level of Evidence

2c Laryngoscope, 129:1081–1086, 2019
Appropriateness Criteria for Surgery in the Management of Adult Recurrent Acute Rhinosinusitis
Authors: Rudmik Luke , Beswick Daniel M. , Alt Jeremiah A. , Bhattacharyya Neil , Chester Alexander C. , Gray Stacey T. , Poetker David M. , Stewart Michael G. , Smith Timothy L.
Published: October 2018

Objectives/Hypothesis

Endoscopic sinus surgery (ESS) is frequently performed for recurrent acute rhinosinusitis (RARS). Appropriate indications for surgery among patients with RARS have not yet been rigorously determined. The objective of this study was to define appropriateness criteria for ESS in the management of adult RARS.

Study Design

Application of RAND‐UCLA appropriateness methodology.

Methods

A panel of nine multidisciplinary experts in RARS was formed to evaluate RARS scenarios generated from current evidence. The panel completed two rounds of a modified Delphi‐ranking process and a teleconference.

Results

A total of 32 clinical scenarios were ranked in each round. For adult patients with RARS, ESS can appropriately be offered as a treatment option when patients experience ≥ four annual episodes, and there is confirmation of at least one episode via computed tomography or nasal endoscopy, and the patient and clinician jointly participate in shared decision making, and the patient has either failed a trial of topical nasal steroids or experienced RARS‐related productivity loss.

Conclusions

This study has defined appropriateness criteria for ESS as a management option for adult patients with RARS. These criteria are intended to represent a minimum threshold for which ESS should be considered in the treatment of RARS and do not suggest that all patients who meet these criteria should undergo surgery. These criteria may serve as a baseline set of indications for ESS in patients with RARS.

Level of Evidence

NA Laryngoscope, 129:37–44, 2019
Long‐Term Outcome of Hearing Rehabilitation With An Active Middle Ear Implant
Authors: Brkic Faris F. , Riss Dominik , Auinger Alice , Zoerner Barbara , Arnoldner Christoph , Baumgartner Wolf‐Dieter , Gstoettner Wolfgang , Vyskocil Erich
Published: October 2018

Objective

To assess the audiological and long‐term medical and technical follow‐up outcomes of an active middle ear implant.

Methods

This was a retrospective medical chart analysis of all patients provided with an active middle ear implant in a tertiary academic medical referral center between September 1, 1998, and July 31, 2015. Main outcome measures were medical and technical complications, revisions, reimplantations, explantations, coupling approaches, mean time of use, pre‐ and postoperative hearing thresholds, functional hearing gain across frequencies (250–4,000 Hz), and Freiburg monosyllablic word test at 65 dB.

Results

One hundred and three patients were identified. Fifteen were implanted bilaterally (n = 118 Vibrant Soundbridge devices [MED‐EL, Innsbruck, Austria]). Seventy‐seven devices were implanted for sensorineural and 41 for mixed and conductive hearing loss. Patients used the implant for 6.7 years (range 0.7 months–17.9 years) on average. Ninety‐one patients (77.12%) were using the device at the end of the observation period. An overall complication rate of 16.1% was observed. The revision and explantation rates were higher for devices implanted between 2004 and 2006. The device failure rate was 3.4%. Audiological evaluation showed significant hearing gains for both hearing loss patient groups.

Conclusion

This long‐term follow‐up reveals the reliability of the active middle ear implant in a single center. Overall complication rate and device failure rate are acceptable. The complication rate was higher during implementation of alternative coupling approaches. The audiological benefit was satisfactory in patients with all hearing loss types. The majority of implanted patients used the implant at the end of the observation period.

Level of Evidence

4 Laryngoscope, 129:477–481, 2019
Tobacco carcinogen research to aid understanding of cancer risk and influence policy
Authors: Singhavi Hitesh , Ahluwalia Jasjit S. , Stepanov Irina , Gupta Prakash C. , Gota Vikram , Chaturvedi Pankaj , Khariwala Samir S.
Published: October 2018

Education regarding the health effects associated with tobacco use has made important progress worldwide over the last few decades. Still, tobacco remains a significant cause of cancer and other diseases. As a result, significant worldwide morbidity and mortality is still attributable to tobacco use in modern times. Research into tobacco products, the carcinogens they contain, and how users metabolize them is an important benefit to the advancement of research aimed at reducing harm associated with tobacco use. This review summarizes the use of this type of research to study tobacco users’ risk of developing cancer, especially head and neck cancer. In addition, we discuss the use of tobacco research to provide support for increasing levels of federal regulation of tobacco products.

Level of Evidence

4.
A remark on the Schrödinger propagator on Wiener amalgam spaces
Authors: Kato Tomoya , Tomita Naohito
Published: October 2018

In this paper, we study the boundedness of the Schrödinger propagator on Wiener amalgam spaces. In particular, we determine the necessary and sufficient conditions for the propagator to be bounded from to .
Phenoconversion from Idiopathic Rapid Eye Movement Sleep Behavior Disorder to Lewy Body Disease
Authors: Miyamoto Tomoyuki , Miyamoto Masayuki
Published: October 2018

Background

The conversion rate and estimated risk of neurodegenerative diseases vary with idiopathic rapid eye movement sleep behavior disorder (IRBD).

Methods

This retrospective cohort study examined 273 patients (213 men, 60 women) with polysomnographic‐confirmed IRBD (192 and 81 patients in the Sleep Center [SC] cohort and Neurological Center [NC] cohort, respectively) who were followed longitudinally. The date of diagnosis was determined as the onset of an overt neurological syndrome. The conversion rate was calculated; the risk of developing an overt neurological syndrome was estimated using the Kaplan‐Meier method.

Results

The estimated onset risk for a neurodegenerative syndrome from the time of IRBD diagnosis when the SC and NC cohorts were combined was 11.9%, 20.3%, 33.2%, and 51.4% at three, five, seven, and ten years, respectively. The phenoconversion rate (21.7% with a mean follow‐up period from the time of IRBD diagnosis of 3.9 ± 3.0 years) was lower than in prior studies, but the conversion risk increased progressively as the follow‐up period increased. The majority of patients developed Lewy body disease, while multiple system atrophy was rare. The risk of developing Lewy body disease differed significantly between the SC and NC cohorts (P = 0.02).

Conclusions

In this first study of a large Asian IRBD population, the estimated conversion risk leading to diagnosis differed between the two cohorts, which could be attributed to different evaluation results depending on the observed population due to a referral bias and follow‐up duration. Researchers should be aware of potential selection bias in their clinical studies.
How Do I Evaluate and Inject for Writer's Cramp?
Authors: Catania Santiago
Published: October 2018

Writer's cramp is a disabling focal dystonia, often accompanied by tremor, for which botulinum toxin injections are now the therapy of choice. However, the success of this treatment relies on the correct clinical selection of muscles responsible for the dystonic movements and the subsequent accurate administration of botulinum toxin into what are often very small and difficult to palpate muscles. In order to obtain the best possible outcomes, and to minimize side effects, it is necessary to use guidance from ultrasound or electromyography (EMG). In this video, we will explain how we evaluate patients with writer's cramp and demonstrate how we treat them with EMG guidance.
Circadian Rest‐Activity Rhythms Predict Cognitive Function in Early Parkinson's Disease Independently of Sleep
Authors: Wu Jade Q. , Li Peng , Stavitsky Gilbert Karina , Hu Kun , Cronin‐Golomb Alice
Published: October 2018

Background

Cognitive impairment is a common and debilitating symptom of Parkinson's disease (PD), and its etiology is likely multifactorial. One candidate mechanism is circadian disruption. Although there is evidence of circadian abnormalities in PD, no studies have directly assessed their association with cognitive impairment.

Objectives

Investigate whether circadian rest‐activity rhythm is associated with cognitive function in PD independently of sleep.

Methods

Thirty‐five participants with PD wore wrist actigraph monitors and completed sleep diaries for 7 to 10 days, then underwent neuropsychological testing. Rest‐activity rhythm was characterized using nonparametric circadian rhythm analysis of actigraphy data. Objective sleep parameters were also estimated using actigraphy data. Hierarchical regression models assessed the independent contributions of sleep and rest‐activity rhythm to cognitive performance.

Results

Less stable day‐to‐day rest‐activity rhythm was associated with poorer executive, visuospatial, and psychomotor functioning, but not with memory. Hierarchical regressions showed that interdaily stability's contribution to cognitive performance was independent of sleep's contributions. Whereas sleep contributed to executive function, but not psychomotor or visuospatial performance, rest‐activity rhythm stability significantly contributed to variance in all three of these domains, uniquely accounting for 14.4% to 17.6% of their performance variance.

Conclusions

Our findings indicate that circadian rest‐activity rhythm is associated with cognitive impairment independently of sleep. This suggests the possible utility of rest‐activity rhythm as a biomarker for circadian function in PD. Future research should explore interventions to stabilize behavioral rhythms in order to strengthen circadian function, which, in turn, may reduce cognitive impairment in PD.
Frequency and circular‐polarization switchable microstrip antenna for dynamic spectrum allocation
Authors: Pyo Seongmin , Jo Han‐Shin , Park Sung‐Ho , Park Jong‐Sung , Lee Hyungjoo
Published: October 2018

This article presents a novel frequency‐reconfigurable microstrip antenna supported with an opposite circular polarization sense for dynamic spectrum allocation. The degenerate TM10 and TM01 frequencies are designed by using the distinctly separated electrical delay depending on the H‐shaped slot along the feeding positions for generating circularly polarized waves. In addition, the circularly polarization sense is controlled by changing the status of the pin diode because the switched vertical path affects only TM10 frequency without changing horizontal TM01 frequency. To verify the feasibility of the proposed antenna, the conceptual equivalent circuit is established and the experimental validation is carried out. The implemented antenna successfully demonstrates frequency‐reconfigurable capability with opposite circular polarizations and shows a good agreement with the simulation results.
Dynamic per slice shimming for simultaneous brain and spinal cord fMRI
Authors: Islam Haisam , Law Christine S. W. , Weber Kenneth A. , Mackey Sean C. , Glover Gary H.
Published: October 2018

Purpose

Simultaneous brain and spinal cord functional MRI is emerging as a new tool to study the central nervous system but is challenging. Poor B0 homogeneity and small size of the spinal cord are principal obstacles to this nascent technology. Here we extend a dynamic shimming approach, first posed by Finsterbusch, by shimming per slice for both the brain and spinal cord.

Methods

We shim dynamically by a simple and fast optimization of linear field gradients and frequency offset separately for each slice in order to minimize off‐resonance for both the brain and spinal cord. Simultaneous acquisition of brain and spinal cord fMRI is achieved with high spatial resolution in the spinal cord by means of an echo‐planar RF pulse for reduced FOV. Brain slice acquisition is full FOV.

Results

T2*‐weighted images of brain and spinal cord are acquired with high clarity and minimal observable image artifacts. Fist‐clenching fMRI experiments reveal task‐consistent activation in motor cortices, cerebellum, and C6‐T1 spinal segments.

Conclusions

High quality functional results are obtained for a sensory‐motor task. Consistent activation in both the brain and spinal cord is observed at individual levels, not only at group level. Because reduced FOV excitation is applicable to any spinal cord section, future continuation of these methods holds great potential.
Maternal and Postnatal Supplementation of Fish Oil Improves Metabolic Health of Mouse Male Offspring
Authors: Ramalingam Latha , Menikdiwela Kalhara R. , Clevenger Stephani , Eboh Tochi , Allen London , Koboziev Iurii , Scoggin Shane , Rashid Al Maqsudur , Moussa Hanna , Moustaid‐Moussa Naima
Published: October 2018

Objective

Over half of American women of childbearing age have either obesity or overweight. Hence, maternal programming through diet is critical for prevention of diseases in the offspring. Clinical trials with fish oil (FO) report various health benefits; however, it remains unclear whether maternal and postnatal consumption of FO protects offspring from adverse effects of consuming a high‐fat (HF) diet.

Methods

Female mice were fed HF diets supplemented without (HF) or with FO from 8 weeks before pregnancy through lactation. A low‐fat (LF) diet was included as a control diet. After weaning, male offspring from HF or FO dams were either continued on their respective diet (HF‐HF and FO‐FO) or switched to the other diet (HF‐FO and FO‐HF) and compared with LF. Phenotypic and mechanistic studies were performed.

Results

FO‐FO offspring demonstrated significantly higher glucose clearance and insulin sensitivity compared with other pups fed the HF diet (P < 0.05). Furthermore, FO‐FO pups had lower adiposity, inflammation, and fat deposition in the liver, consistent with reduced markers of hepatic lipogenesis and increased hepatic lipid oxidation.

Conclusions

Supplementation of FO during pregnancy and early life is more beneficial than treating with FO either during pregnancy or in pups.
Well‐Defined Thermoresponsive Polymethacrylamide Copolymers with Ester Pendent Groups through One‐Pot Statistical Postpolymerization Modification of Poly(2‐Isopropenyl‐2‐Oxazoline) with Multiple Carboxylic Acids
Authors: Jerca Florica Adriana , Jerca Valentin Victor , Hoogenboom Richard
Published: October 2018

Thermoresponsive polymers that undergo a solubility phase transition in water are important as basis for the development for a wide variety of responsive and smart materials. In this study, the synthesis of thermoresponsive copolymers is demonstrated by the straightforward one‐pot statistical postpolymerization modification of well‐defined poly(2‐isopropenyl‐2‐oxazoline) (PiPOx) by ring‐opening reaction with multiple carboxylic acids. The reactions are carried out using dual, triple, and quadruple mixtures of up to four different aliphatic carboxylic acids. The cloud point temperatures of the resulting polymethacrylamide copolymers with ester pendent groups can be finely tuned by adjusting the feed ratio and the hydrophilic–hydrophobic balance of the acids that are used for the ring‐opening modification of PiPOx. © 2018 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2019, 57, 360–366
A Novel Strategy to Investigate Tissue‐Secreted Tumor Microenvironmental Proteins in Serum toward Development of Breast Cancer Early Diagnosis Biomarker Signature
Authors: Pendharkar Namita , Dhali Snigdha , Abhang Subodhini
Published: October 2018

Purpose

The study aims to discover and identify early grade diagnosis markers in tumor microenvironment and investigates their expression in serum.

Experimental design

2D fluorescence difference gel electrophoresis (2D‐DIGE), a gel‐based proteomics platform is used for tissue profiling and identifies deregulated proteins by matrix‐assisted laser desorption/ionization‐time‐of‐flight mass spectrometry. Western blot validation for statistically significant six different proteins is performed in an independent cohort of participant serum.

Results

Total 67 nonredundant tissue proteins are identified out of 230 protein spots obtained through Marker selection tool of EDA. GELS, DAPLE, IQCC, CATD, A1AT, and HS90B are selected for validation and found to be upregulated in early grade serum samples. Pathway analysis performed through PANTHER and DAVID indicates that apoptosis, CCKR, EGF, FAS, FGF, Wnt, p13 kinase, and p53 signaling pathways are expressed specifically during or early onset of grade I cancer lesions.

Conclusions and clinical relevance

GELS, DAPLE, HS90B, A1AT, IQCC, and CATD may be promising potential serum biomarker signature for diagnosis of early grade breast cancer. This panel also contributes to better understanding of molecular mechanisms involved in inceptive stage of breast cancer.