bluuebunny/crossref_metadata_2025 huggingface dataset:
Building staff capability, opportunity, and motivation to provide smoking cessation to people with cancer in Australian cancer treatment centres: development of an implementation intervention framework for the Care to Quit cluster randomised controlled trial
Authors: Ryan Annika , Young Alison Luk , Tait Jordan , McCarter Kristen , McEnallay Melissa , Day Fiona , McLennan James , Segan Catherine , Blanchard Gillian , Healey Laura , Avery Sandra , White Sarah , Vinod Shalini , Bradford Linda , Paul Christine L.
Published: September 2022

Few rigorous studies provide a clear description of the methodological approach of developing an evidence-based implementation intervention, prior to implementation at scale. This study describes the development, mapping, rating, and review of the implementation strategies for the Care to Quit smoking cessation trial, prior to application in nine cancer services across Australia. Key stakeholders were engaged in the process from conception through to rating, reviewing and refinement of strategies and principles. An initial scoping review identified 21 barriers to provision of evidence-based smoking cessation care to patients with cancer, which were mapped to the Theoretical Domains Framework and Behaviour Change Wheel (BCW) to identify relevant intervention functions. The mapping identified 26 relevant behaviour change techniques, summarised into 11 implementation strategies. The implementation strategies were rated and reviewed against the BCW Affordability, Practicality, Effectiveness and cost-effectiveness, Acceptability, Side-effects/safety, and Equity criteria by key stakeholders during two interactive workshops to facilitate a focus on feasible interventions likely to resonate with clinical staff. The implementation strategies and associated intervention tools were then collated by form and function to provide a practical guide for implementing the intervention. This study illustrates the rigorous use of theories and frameworks to arrive at a practical intervention guide, with potential to inform future replication and scalability of evidence-based implementation across a range of health service settings.
Sequence-aware news recommendations by combining intra- with inter-session user information
Authors: Symeonidis Panagiotis , Chaltsev Dmitry , Berbague Chemseddine , Zanker Markus
Published: September 2022

There exist many research works that strive to answer the question “what news article is a user going to click next given his profile”. These works take into account the time dimension to reveal users’ preferences over time. However, few works exploit adequately the information that is hidden inside user sessions. User sessions include a list of user interactions with items within a short period of time such as 30 min, and can reveal her very last intentions. In this paper, we combine intra- with inter-session item transition probabilities to reveal the short- and long-term intentions of individuals. Thus, we are able to better capture the similarities among items that are co-selected inside a user session but also within any two consecutive sessions. We have evaluated experimentally our method and compare it against state-of-the-art algorithms on three real-life datasets. We demonstrate the superiority of our method over its competitors.
Stability and Structure of Silver–l-methionine Complexes
Authors: Bottari Emilio , D’Ambrosio Antonietta , Festa Maria Rosa , Iuliano Mauro , Meschino Martina , De Tommaso Gaetano
Published: September 2022

Stability and structure of complexes between silver (I) and l-methionine (L) deduced from potentiometric and 1H NMR measurements allow to assume the prevailing of several protonated species. The experimental data are compatible with the formation of the following complexes: AgL, AgL2, AgH2L, AgH1L2, AgH2L2, AgH3L2 and AgH4L2. The coordination sites are obtained by 1H NMR spectra, showing that only the bond between the methylthioether sulfur atom and silver (I) is responsible of the complex stability. The system is studied potentiometrically with silver and glass electrodes at 25 °C and 1.00 mol·dm−3 NaClO4 as ionic medium. Amino acids containing sulfur are few and not extensively studied. In particular, l-methionine, even if it is the most important, enantiomer and their complexes with silver (I) present anticarcinogenic properties, is quite not investigated. In the same experimental conditions, l-methionine protonation constants are determined. The 1H NMR data allow one to assume that, in moderately alkaline solution, silver (I) is bond with six membered chelate rings with sulfur and amino nitrogen, while carboxylic groups are not involved. No polynuclear species are present. The high stability of the complex with ratio 1:2 (silver (I)/l-methionine), involving also two hydrogen ions, predominating in a wide range of hydrogen ion concentration suggests to propose a study for the preparation of an electrode to measure the deprotonated l-methionine concentration.
Conceptions of Professionalism in U.S. Research Universities: Evidence from the gradSERU Survey
Authors: Brint Steven , Ilhan Ali O.
Published: September 2022

Recent scholars of the professions have argued that a new hybrid form of professionalism is becoming dominant. This new form combines traditional commitments to ethics and community service with new commitments to managerial and entrepreneurial objectives. We analyze the perceptions of 4,300 U.S. graduate students in 21 fields concerning how well their programs have prepared them for leadership and management and for ethics and community service. These assessments allow us to examine the prevalence of this new conception of professionalism and to examine it in relation to two other conceptions: the “neo-classical” emphasis on ethics and community service as opposed to leadership and management, and another that emphasizes a divergence between business and technical professions on one side and social and cultural professions on the other. Hybridization was comparatively rare but occurred more frequently among students preparing for management, law, and medicine, and among men and students from more affluent families. We also find some support for the neo-classical thesis insofar as students tended to score higher on the ethics and community measure than on the leadership and management measure. However, the largest number of students took positions consistent with the divergence thesis.
Mapping the Oxford Shoulder Score onto the EQ-5D utility index
Authors: Valsamis Epaminondas M. , Beard David , Carr Andrew , Collins Gary S. , Brealey Stephen , Rangan Amar , Santos Rita , Corbacho Belen , Rees Jonathan L. , Pinedo-Villanueva Rafael
Published: September 2022

Purpose

In order to enable cost-utility analysis of shoulder pain conditions and treatments, this study aimed to develop and evaluate mapping algorithms to estimate the EQ-5D health index from the Oxford Shoulder Score (OSS) when health outcomes are only assessed with the OSS.

Methods

5437 paired OSS and EQ-5D questionnaire responses from four national multicentre randomised controlled trials investigating different shoulder pathologies and treatments were split into training and testing samples. Separate EQ-5D-3L and EQ-5D-5L analyses were undertaken. Transfer to utility (TTU) regression (univariate linear, polynomial, spline, multivariable linear, two-part logistic-linear, tobit and adjusted limited dependent variable mixture models) and response mapping (ordered logistic regression and seemingly unrelated regression (SUR)) models were developed on the training sample. These were internally validated, and their performance evaluated on the testing sample. Model performance was evaluated over 100-fold repeated training–testing sample splits.

Results

For the EQ-5D-3L analysis, the multivariable linear and splines models had the lowest mean square error (MSE) of 0.0415. The SUR model had the lowest mean absolute error (MAE) of 0.136. Model performance was greatest in the mid-range and best health states, and lowest in poor health states.

For the EQ-5D-5L analyses, the multivariable linear and splines models had the lowest MSE (0.0241–0.0278) while the SUR models had the lowest MAE (0.105–0.113).

Conclusion

The developed models now allow accurate estimation of the EQ-5D health index when only the OSS responses are available as a measure of patient-reported health outcome.
Resilient entrepreneurs? — revisiting the relationship between the Big Five and self-employment
Authors: Runst Petrik , Thomä Jörg
Published: September 2022

The Big Five personality traits and their influence on entrepreneurial action have been repeatedly studied using a trait-based approach. The present paper partly deviates from this perspective by analysing the role of personality prototypes in relation to entrepreneurship. This person-centred approach suggests that combinations of Big Five traits form individual personalities. By using data from the German Socio-Economic Panel (SOEP), we show that at least three prototypes can be identified, one of which — the resilient type — can be hypothesized to significantly increase the likelihood of entrepreneurial action. Our regression results provide evidence of a positive impact of this prototype on the likelihood of and transitioning into self-employment but not the likelihood of exit. We also show that the prototyping approach explains individual self-employment decisions over and above what can already be explained by the profiling approach, another person-centred Big Five approach. The paper concludes with implications for policy and research.
Automatic and controlled information processing in the context of students’ ethnic background and social status: An eye-tracking study
Authors: Tobisch Anita , Dresel Markus
Published: September 2022

Based on the continuum model of impression formation (Fiske & Neuberg, 1990), information processing can be more or less automated or controlled and thus relies more or less on stereotype-based or individual-based characteristics. Also, teachers’ impression formation can be influenced by social categories like students’ ethnic background or social status. However, when teachers form an impression of students’ abilities or performance social categories should not play a role. But a lot of empirical findings show that teachers make a difference depending on students’ backgrounds. Whether this can be explained by a more automated or controlled information processing depending on students’ backgrounds is still an open question. Accordingly, the purpose of this study was to investigate teacher students’ impression formation in dependence on students’ ethnic backgrounds and social status. In order to investigate whether information processing differs according to students’ ethnic backgrounds and social status, an experimental eye-tracking study with 45 teacher students was designed. As physiological processes are strongly connected to psychological processes, specific eye-movements can be interpreted as indicators for physiological arousal in first place, but might also allow conclusions about mental processes like information processing. Pupil diameter and blink rate were measured while participants read three case vignettes with manipulated student background. Analysis of variance with repeated measures showed differences in pupil diameter and blink rate according to students’ background. Results showed less arousal when forming an impression about students without immigrant background and with high social status compared to students with immigrant background and with low social status. This might indicate more automated information processing for non-immigrant students with high-status, and more controlled processing for students with immigrant background and low-status.
Frictionless vs. Frictional Contact in Numerical Wear Predictions of Conformal and Non-conformal Sliding Couplings
Authors: Mattei Lorenza , Di Puccio Francesca
Published: September 2022

The role of friction on wear evolution is manifold since it interplays with lubrication regime, nominal contact point, and contact pressure distribution. Nevertheless, in the literature many wear models simulate wear assuming frictionless contact conditions to simplify the analyses. That assumption, physically not realistic, often appears as a contradiction, permitted in numerical simulations where friction and wear can be considered independent phenomena.

This study aims to validate the frictionless assumption in wear models with steady nominal contact point, such as in many common configurations, e.g. pin on plate/pin on disc. Wear was simulated according to the Archard wear law for both non-conformal and conformal pin-on-plate contact pairs in reciprocating motion, assuming frictionless and frictional contact conditions, varying the coefficient of friction f in the range 0–0.4. Finite Element wear models were developed in Ansys® both with implicit and explicit kinematics. Results demonstrate that the effect of friction on contact pressure distribution and worn profiles and on their evolution is negligible (differences lower than 0.05%). Thus, wear can be predicted using models in frictionless conditions which allow to extremely reduce the computational costs that represent a limit of FE wear simulations. Additionally, a procedure with implicit kinematics was compared to the explicit one resulting valid and computationally convenient, especially in case of non-conformal contact.
Microstructural and Mechanical Properties of Al2O3 and Al2O3/TiB2 Ceramics Consolidated by Plasma Pressure Compaction
Authors: Rubino F. , Rotella G. , Perrella M. , Carlone P. , Sudarshan T. S.
Published: September 2022

Alumina oxide ceramics were produced by plasma pressure compaction (P2C) sintering process. Two types of pure α-alumina (Al2O3) and a mixture of alumina and titanium diboride (TiB2) powders were used as starting materials. Microstructure and mechanical properties, namely hardness, elastic modulus, and fracture toughness, were analyzed and correlated to the type of the sintered powders and the adopted manufacturing route. The microstructural development and the chemical composition variation induced by the sintering process were assessed by using scanning electron microscopy and x-ray diffraction. Nano-indentation and Chevron notch beam techniques were adopted to estimate the mechanical properties of the sintered ceramics. The conducted analyses show the capability of P2C technique to produce sound alumina ceramics. Pure alumina bulks exhibit a good level of compaction and mechanical properties close to those achievable with conventional sintering processes, such as hot isostatic pressing or spark plasma sintering. No significant alterations in the chemical composition of the ceramics were observed. The addition of the titanium diboride in the alumina powders caused a moderate increase in the grain size lowering the hardness and Young’s modulus of the sintered alumina and, at the same time, increased its fracture toughness to the occurrence of toughening mechanisms, like crack bridging and crack deflection.
Clinical feasibility of combining intraoperative electron radiation therapy with minimally invasive surgery: a potential for electron-FLASH clinical development
Authors: Calvo Manuel Felipe Ángel , Serrano Javier , Solé Claudio , Cambeiro Mauricio , Palma Jacobo , Aristu Javier , Garcia-Sabrido Jose Luis , Cuesta Miguel Angel , del Valle Emilio , Lapuente Fernando , Miñana Bernardino , Morcillo Miguel Ángel , Asencio Jose Manuel , Pascau Javier
Published: September 2022

Background

Local cancer therapy by combining real-time surgical exploration and resection with delivery of a single dose of high-energy electron irradiation entails a very precise and effective local therapeutic approach. Integrating the benefits from minimally invasive surgical techniques with the very precise delivery of intraoperative electron irradiation results in an efficient combined modality therapy.

Methods

Patients with locally advanced disease, who are candidates for laparoscopic and/or thoracoscopic surgery, received an integrated multimodal management. Preoperative treatment included induction chemotherapy and/or chemoradiation, followed by laparoscopic surgery and intraoperative electron radiation therapy.

Results

In a period of 5 consecutive years, 125 rectal cancer patients were treated, of which 35% underwent a laparoscopic approach. We found no differences in cancer outcomes and tolerance between the open and laparoscopic groups. Two esophageal cancer patients were treated with IOeRT during thoracoscopic resection, with the resection specimens showing intense downstaging effects. Two oligo-recurrent prostatic cancer patients (isolated nodal progression) had a robotic-assisted surgical resection and post-lymphadenectomy electron boost on the vascular and lateral pelvic wall.

Conclusions

Minimally invasive and robotic-assisted surgery is feasible to combine with intraoperative electron radiation therapy and offers a new model explored with electron-FLASH beams.
Overeducation as moderator for the link between job change and job satisfaction among immigrants and natives in Germany
Authors: Khalil Samir , Lietz Almuth , Mayer Sabrina J.
Published: September 2022

Job satisfaction is a major driver of an individual’s subjective well-being and thus affects public health, societal prosperity, and organisations, as dissatisfied employees are less productive and more likely to change jobs. However, changing jobs does not necessarily lead to higher job satisfaction in the long run. Previous studies have shown, instead, that changing jobs only increases job satisfaction for a short period of time before it gradually falls back to similar levels as before. This phenomenon is known as the ’honeymoon–hangover’ pattern. In our study, we identify an important new moderator of the relation between job change and job satisfaction: the job–education match of job changes. Based on relative deprivation theory, we argue that job changes from being overeducated in a job lowers the likelihood of negative comparisons and thus increases the honeymoon period, lessens the hangover period, and increases long-term job satisfaction. We use data from the Socio-Economic Panel ranging from 1994–2018 and focus specifically on individual periods of employees before and after job changes (n = 134,404). Our results confirm that a change to a job that requires a matched education has a stronger and longer-lasting effect on job satisfaction, and that this effect is slightly lower for respondents born abroad.
A Cross-Cultural Comparison on Implicit and Explicit Attitudes Towards Artificial Agents
Authors: Diana Fabiola , Kawahara Misako , Saccardi Isabella , Hortensius Ruud , Tanaka Akihiro , Kret Mariska E.
Published: September 2022

Historically, there has been a great deal of confusion in the literature regarding cross-cultural differences in attitudes towards artificial agents and preferences for their physical appearance. Previous studies have almost exclusively assessed attitudes using self-report measures (i.e., questionnaires). In the present study, we sought to expand our knowledge on the influence of cultural background on explicit and implicit attitudes towards robots and avatars. Using the Negative Attitudes Towards Robots Scale and the Implicit Association Test in a Japanese and Dutch sample, we investigated the effect of culture and robots’ body types on explicit and implicit attitudes across two experiments (total n = 669). Partly overlapping with our hypothesis, we found that Japanese individuals had a more positive explicit attitude towards robots compared to Dutch individuals, but no evidence of such a difference was found at the implicit level. As predicted, the implicit preference towards humans was moderate in both cultural groups, but in contrast to what we expected, neither culture nor robot embodiment influenced this preference. These results suggest that only at the explicit but not implicit level, cultural differences appear in attitudes towards robots.
In vitro evaluation of fissure sealants’ wear under erosive, abrasive and erosive/abrasive conditions
Authors: Hamza B. , Sekularac M. , Attin T. , Wegehaupt F. J.
Published: September 2022

Purpose

To evaluate and compare the wear of selected resin-based fissure sealants with different compositions properties under erosive, abrasive, and erosive/abrasive conditions.

Methods

Forty-five samples of the following resin-based fissure sealants were prepared: Fissurit (fluoride free), Fissurit F (with fluoride), Fissurit FX (55 wt.% filler content), Grandio Seal (70 wt.% nano-filler content) and bovine enamel. Fifteen samples from each material were randomly allocated into three groups according to the wear condition they would be subjected to as follows: erosive condition (citric acid, 1 min, pH 2.3), abrasive condition (120 brushing strokes at 2 N, toothpaste slurry RDA value = 69), and erosive/abrasive condition (combination of both). The wear challenges were repeated six times each day for 10 days. The material wear was measured using a stylus profilometer. Kruskal–Wallis and Conover’s test was applied to compare the resulting material wear between the groups.

Results

Under erosive conditions, Grandio Seal and Fissurit FX showed statistically significantly the least material wear. Under abrasive and erosive/abrasive conditions, Grandio Seal showed statistically significantly the least material wear. Fissurit F showed statistically significantly the highest material wear under abrasive and erosive/abrasive conditions, after dental enamel (p < 0.05).

Conclusion

Higher filler content in sealants leads to better wear resistance. Incorporating fluoride into sealants seems to reduce their wear resistance at similar filler contents.
Intergenerational income distribution before and after the great recession: winners and losers
Authors: Chybalski Filip
Published: September 2022

Ageing process may affect intergenerational relations in different ways, including income distribution. Simultaneously, the global economy has undergone various crises. An important question is whether these crises impact the nexus between ageing and intergenerational income distribution. Finding an answer to this question is difficult in the literature; although the crisis-income inequality nexus is quite often investigated, this is not in the intergenerational context. This paper attempts to solve such puzzles using data covering 13 OECD countries in the period 1995–2018. The findings show that the relationship between the age structure of the population and intergenerational income distribution before and after the Great Recession of 2007–2009 was quite different. Actually, the Great Recession seems to have triggered this nexus in such a way that the elderly won the intergenerational income game in the aftermath of the crisis; however, the working-age and younger cohorts took a rematch later. The results obtained may support the political decision-making how to cope with economic crises, including the present COVID-19 pandemic and its impact on the economy and society, so as to treat different generations fair.
Influence of Structural Types of CRTS I Plate-Type Ballastless Track on Aerodynamic Characteristics of High-Speed Train
Authors: Du Liming , Bian Chenjie , Zhang Peng
Published: September 2022

In order to improve the running quality of trains on a ballastless track, the influence of the CRTS I ballastless track with different structures (flat-type and frame-type tracks) is investigated with respect to the aerodynamic characteristics of high-speed trains. In the present paper, the aerodynamic force changes on the head, middle, tail, and whole car of the high-speed train were studied under two conditions, with crosswind and without crosswind, and the influence of different crosswind speeds (10, 15, 20, 25, 30 m/s) on the aerodynamic force of the train was analyzed. The pressure and flow field distribution characteristics were also studied, and the reasons for the different aerodynamic characteristics of different track structures and trains running in different wind environments were analyzed, respectively. The results indicate that the ballastless track structure obviously influences the aerodynamic characteristics of the high-speed train. When there is no natural wind, compared with the flat track, the frame track reduces the drag and lateral forces of the train but increases the lift force. The frame track causes the drag force of the whole vehicle to decrease slightly (the maximum ratio is 2.15%), the lift force increases significantly (the maximum ratio is 12.55%), and the lateral force obviously decreases (the maximum ratio is 52.43%). The lift and lateral forces of the middle car are most affected, which is because the frame structure changes the vortex motion state of the middle car. Compared with the flat track, the drag force of each car on the frame track is reduced under the crosswind; the lift force of each car is increased, and the maximum increase in the lift force of the head, middle, and tail cars is 5.60%, 2.55%, and 3.63%, respectively; the lateral force of the tail car increases greatly at a wind speed of 15 m/s, reaching 6.84%. Due to the existence of the frame structure, the space under the vehicle increases, resulting in a decrease in the airflow rate and an increase in local pressure, which leads to changes in the train’s aerodynamic force. Meanwhile, the train’s aerodynamic change under the crosswind is smaller than that when there is no wind.
High-dimensional randomization-based inference capitalizing on classical design and modern computing
Authors: Bind Marie-Abele C. , Rubin D. B.
Published: September 2022

A common complication that can arise with analyses of high-dimensional data is the repeated use of hypothesis tests. A second complication, especially with small samples, is the reliance on asymptoticp-values. Our proposed approach for addressing both complications uses a scientifically motivated scalar summary statistic, and although not entirely novel, seems rarely used. The method is illustrated using a crossover study of seventeen participants examining the effect of exposure to ozone versus clean air on the DNA methylome, where the multivariate outcome involved 484,531 genomic locations. Our proposed test yields a single null randomization distribution, and thus a single Fisher-exactp-value that is statistically valid whatever the structure of the data. However, the relevance and power of the resultant test requires the careful a priori selection of a single test statistic. The common practice using asymptoticp-values or meaningless thresholds for “significance” is inapposite in general.
A sequential explanatory mixed-methods study of UK higher education teacher experiences when building rapport with international students online
Authors: Peacock Gemma
Published: September 2022

Effective, interpersonal teacher–student relationships and positive rapport are widely known to positively impact student attainment and learning experiences. Establishing and maintaining these have been particularly challenging, however, since the Covid-19 pandemic forced higher education (HE) teaching online in 2020. This study, therefore, aimed to explore English for Academic Purposes (EAP) teachers’ experiences of building rapport with international students in online learning environments in UK HE institutions during emergency remote teaching via sequential explanatory mixed methods and three research questions. Study Phase 1 comprised a structured, online, quantitative and qualitative questionnaire completed by 36 participants of the target population from 19 UK HE institutions, while Phase 2 employed in-depth qualitative interviews with three selected participants from Phase 1. Three themes emerged as most significant when considering teacher experiences of building rapport with students online: online communication in online sessions; teacher–student communication outside online sessions; and teacher availability and accessibility. The findings suggest that if online sessions could primarily be used as opportunities to meet learning outcomes, then the necessary and conscious task of building teacher–student rapport might be more effective in frequent 1–1 tutorials with students or during any available pre- and post-online session time.
Successful Nonextracorporeal Life Support Resuscitation and Rewarming of a Patient with Hypothermia in Cardiac Arrest
Authors: Bhatnagar Anshul , Mackman Sean
Published: September 2022

We report full recovery of a patient with hypothermia in cardiac arrest following continuous and prolonged cardiopulmonary resuscitation (CPR) and conventional, nonextracorporeal life support (non-ECLS) methods. A 57-y-old man presented with unwitnessed cardiac arrest and a core temperature of 23°C (73°F). The presenting cardiac rhythm was ventricular fibrillation. The team administered epinephrine and performed defibrillation and CPR. Because ECLS was unavailable at the facility, the medical team externally and internally rewarmed the patient using heated blankets, forced warmed air, thoracic lavage, and warmed IV fluids. The patient achieved return of spontaneous circulation after 4 h 56 min of continuous CPR and rewarming. The medical team admitted the patient to the intensive care unit. He achieved full neurologic recovery the following day. When ECLS is not available and transfer is not appropriate because of patient instability or hospital location, conventional rewarming methods and continuous, prolonged CPR can lead to successful outcomes in patients with hypothermia in cardiac arrest. This case demonstrates that CPR in patients with hypothermia-associated cardiac arrest can lead to full recovery.
Relation of Biochemical, Cytologic, and Morphologic Parameters to the Result of Gammagraphy with Technetium 99m Sestamibi in Primary Hyperparathyroidism
Authors: Piñero Antonio , Rodriguez José M. , Ortiz Sergio , Soria Teresa , Bermejo Juan , Claver Maria A. , Canteras Manuel , Parrilla Pascual
Published: September 2022

The aim of this study was to analyze the possible relation of biochemical, cytologic, and morphologic parameters to the results of parathyroid gammagraphy with Tc 99m sestamibi in primary hyperparathyroidism. We studied 46 consecutive patients with primary hyperparathyroidism who were undergoing surgery. All the patients were given a preoperative parathyroid gammagraphy with Tc 99m sestamibi and a complete preoperative biochemical study. During the surgical intervention we recorded the weight and size of the pathologic glands to calculate the volume of each. We also determined the percentage of the chief and oxyphil cells in the pathologic glands. Tc 99m sestamibi sensitivity is higher in adenomas (91%) than in hyperplasia (67%) or double adenomas (50%). No relation was found between biochemical or cytologic parameters and gammagraphic results. Weight and gland volume were significantly greater for adenomas than for hyperplasia (P < 0.0014 and P < 0.0004, respectively), and statistically significant differences in both of them were observed between the glands with positive and negative sestamibi.
Accuracy of Fine‐Needle Aspiration Biopsy of the Thyroid Combined with an Evaluation of Clinical and Radiologic Factors
Authors: Carrillo José F. , Frias‐Mendivil Mauricio , Ochoa‐Carrillo Francisco J. , Ibarra Margarita
Published: September 2022

Fine‐needle aspiration biopsy (FNAB) of thyroid nodules is an operator‐interpreter‐dependent procedure whose diagnostic accuracy has deficiencies, especially concerning indeterminate and negative results. There are reports in the literature of up to a 15% definitive diagnosis of carcinoma in the first category of cytology and an 11% false‐negative rate in the second category. With these facts in mind, a prospective study was done at the Instituto Nacional de Cancerología, Mexico City, to determine whether one or several clinicoradiologic factors were associated with a final pathologic diagnosis of carcinoma, thereby increasing the diagnostic accuracy of thyroid FNAB. In total, 200 cases were reviewed, and 159 patients underwent surgery. Our study group comprises these 159 patients. The only clinical factor associated with false‐negative results was size ≥ 4 cm, with no statistical significance for the other factors analyzed. A comparison was done between clinical factors of patients who had indeterminate results in the aspirate and those of patients who had a definitive diagnosis by permanent section of the thyroid carcinoma, where an association was found between malignancy and tumor size ≥ 4 cm, irregular borders, fixed lesions, and heterogeneity on ultrasound. We conclude that in the presence of a negative cytology result, with tumor size ≥ 4 cm, close follow‐up is indicated, and a new thyroid FNAB should be performed in 6 months. If the nodule persists or grows, a surgical procedure should be considered. In the case of an indeterminate cytology result and in the absence of those factors associated more frequently with a pathologic result of carcinoma, a conservative approach could be indicated with clinical follow‐up and repeat thyroid FNAB in 6 months to 1 year.
Topical Nasal Anesthesia for Transnasal Fiberoptic Laryngoscopy: A Prospective, Double‐Blind, Cross‐Over Study
Authors: Johnson Paul E. , Belafsky Peter C. , Postma Gregory N.
Published: September 2022

BACKGROUND

Transnasal fiberoptic laryngoscopy (TFL) is frequently performed by otolaryngologists, speech language pathologists, and various other health care providers. Historically, topical sprays have been administered to patients to decongest and anesthetize the nasal mucosa, thus minimizing the discomfort of the procedure. Recently, it was reported that patients undergoing TFL with topical anesthesia experienced no improvement in comfort compared with those who received oxymetazoline or saline. This observation is in direct opposition to our clinical experience that patients tolerate the procedure better with topical anesthesia. PURPOSE: We sought to compare patient comfort levels during TFL after the administration of cocaine, oxymetazoline, or saline.

METHODS

Fifteen subjects undergoing TFL were prospectively evaluated. Each had TFL performed on 3 separate occasions. Before TFL, each patient received either 4% cocaine, 0.05% oxymetazoline, or saline topically administered via an atomizer to both nasal cavities (1 spray of 2‐second duration). By the conclusion of the study, each patient had undergone TFL with each of the test agents. The subjects rated the discomfort they experienced on a scale ranging from 1 (minimal discomfort) to 5 (severe discomfort). Both patient and examiner were blinded to the test agent used.

RESULTS

The mean nasal discomfort score for saline was 2.8 ± 1.1. The scores for oxymetazoline and cocaine were 3.4 ± 0.9 and 2.0 ± 0.9, respectively. Compared with saline and oxymetazoline independently, TFL with topical cocaine appeared to provide more comfort (P < 0.05 and P < 0.005). CONCLUSION: The continued routine use of topical anesthetics such as cocaine before the performance of TFL is justified because it significantly decreases the patient's discomfort.
The Effectiveness of Neuromuscular Facial Retraining Combined with Electromyography in Facial Paralysis Rehabilitation
Authors: Cronin Gaye W. , Steenerson Ronald Leif
Published: September 2022

OBJECTIVE

The study goal was to present the effectiveness of neuromuscular facial retraining techniques used in combination with electromyography for improving facial function even in cases of longstanding paralysis.

STUDY DESIGN AND SETTING

We conducted a retrospective case review in a tertiary neurotology clinic. PATIENTS: Twenty‐four patients with facial paralysis received neuromuscular facial retraining between April 1999 and April 2001. The patient sample included 6 males and 18 females, with an average age of 44 years. A control group consisted of 6 patients (4 females and 2 males).

RESULTS

All patient groups made significant improvements in function with improved symmetry in dual‐channel electromyographic readings and increased facial movement percentages. Some of the percentages of posttreatment facial function were as follows: acoustic neuromas, 93%; Bell's palsy/Ramsay Hunt syndrome, 80%; and facial nerve anastomosis, 71%. Synkinesis was reduced by at least 2 levels in patients who initially demonstrated synkinesis.

CONCLUSIONS

Neuromuscular facial retraining exercises and electromyography are effective for improving facial movements.

SIGNIFICANCE

Facial retraining is an excellent example of the plasticity of the central nervous system to reorganize, even in cases of longstanding paralysis.
The Larynx and Neonatal Apneas
Authors: Dorion Dominique , Praud Jean‐Paul
Published: September 2022

OBJECTIVE

We sought to review the current literature on the role of the larynx in neonatal apneas. STUDY DESIGN: We conducted a literature search and analysis of the published and other available information on the topic.

RESULTS

Publications on this topic in otolaryngology journals are rare, although more basic sciences‐oriented journals have published interesting results from animal studies during the past 20 years. The scarce data on human neonates are also presented.

CONCLUSIONS

The authors follow the phylogenetic and oncogenetic pathways to explain the active role of the larynx in neonatal apneas. Although most of these results are derived from animal studies, they certainly improve our understanding of human neonatal apneas.
Gene Polymorphisms in Detoxification Enzymes as Susceptibility Factor for Head and Neck Cancer?
Authors: Gronau S. , Koenig‐Greger D. , Jerg M. , Riechelmann H.
Published: September 2022

OBJECTIVE

Impaired detoxification of carcinogens found in tobacco smoke appears to increase the risk for tobacco associated cancer. The objective of this study was to investigate concomitant polymorphisms in genes encoding for various detoxification enzymes in patients with head and neck squamous cell carcinoma (HNSCC).

METHODS

In 187 patients with HNSCC and in 139 healthy control subjects, the polymorphisms of cytochrome P450 1A1 (CYP1A1), cytochrome P450 2D6 (CYP2D6), and glutathione S‐transferase μ1 and θ (GSTM1, GSTT1) were detected by polymerase chain reaction.

RESULTS

No significant association were identified between CYP1A1 and CYP2D6 gene polymorphisms and HNSCC. Patients with laryngeal cancer revealed the GSTM1 null genotype more frequently than did the control subjects (P < 0.05). The coincidence of GSTM1 and GSTT1 null genotype was found twice as great in patients as in control subjects (P < 0.05).

CONCLUSIONS

It is assumed that detoxification enzymes are functionally redundant and only the simultaneous deficiency of several detoxification enzymes increase the risk for HNSCC in alcohol‐ and tobacco‐exposed individuals.
Acoustic Assessment of the Voice Quality before and after Medialization Thyroplasty Using the Titanium Vocal Fold Medialization Implant (TVFMI)
Authors: Schneider Berit , Denk Doris‐Maria , Bigenzahn Wolfgang
Published: September 2022

OBJECTIVE

This study was designed to objectify the vocal outcome in patients with unilateral vocal fold paralysis. Acoustic parameters were evaluated and compared to perceptual voice sound assessments before and after medialization thyroplasty using the titanium vocal fold medialization implant (TVFMI®).

STUDY DESIGN AND SETTING

Twenty‐eight patients underwent external medialization thyroplasty using TVFMI®. Prior to and after surgery videostroboscopy, perceptual voice evaluation and acoustic analysis based on the computerized “hoarseness diagram” were performed.

RESULTS

In videostroboscopy, most patients showed an almost complete glottal closure after thyroplasty. The statistical analysis revealed a significant improvement in the perceptual voice parameters (p<0.001). The acoustic measurements could objectify the positive impact on the voice after thyroplasty (p≤0.001).

CONCLUSION

The results confirm that the TVFMI® is an excellent and individually adjustable device for medialization thyroplasty. The “hoarseness diagram” allows the vocal outcome after surgery to be documented and objectified in an easy and reliable manner.
Evaluation of Middle Meatal Stenting after Minimally Invasive Sinus Techniques (MIST)
Authors: Catalano Peter J. , Roffman Eric J.
Published: September 2022

OBJECTIVES

In this study, we compared postoperative synechia rates and morbidity for different middle meatal (MM) stents after minimally invasive sinus techniques(MIST).

STUDY DESIGN

In a prospective study, we included 100 patients with bilateral chronic sinusitis undergoing MIST at a tertiary care facility with a single surgeon.

METHODS

For all patients, MeroGel stents were placed in the right MM, Gelfilm stents were placed in the left MM. Follow‐up consisted of 3 postoperative visits between weeks 1 and 12 with endoscopic evaluation for synechia, granulation tissue, stent retention, nasal obstruction, headache, and infection.

RESULTS

Synechia developed in 4 patients on the left and in none on the right (P= 0.04). There were no significant side‐specific differences regarding postoperative nasal congestion, headache, or sinusitis. Mean stent retention time was 7.9 days for MeroGel and 5.6 days for Gelfilm (P= 0.0004).

CONCLUSION

Compared with Gelfilm, Merogel MM stents produced less synechia; Merogel retains its position in the MM longer than Gelfilm; and the incidence of postoperative MM synechia can be reduced when absorbable MM stents are used in conjunction with MIST.
Microvascular flap reconstruction of the mandible: A comparison of bone grafts and bridging plates for restoration of mandibular continuity
Authors: Head Christian , Alam Daniel , Sercarz Joel A. , Lee Jivianne T. , Rawnsley Jeffrey D. , Berke Gerald S. , Blackwell Keith E.
Published: September 2022

OBJECTIVE

To compare the efficacy of vascularized bone grafts and bridging mandibular reconstruction plates for restoration of mandibular continuity in patients who undergo free flap reconstruction after segmental mandibulectomy.

STUDY DESIGN AND SETTING. A total of 210 patients underwent microvascular flap reconstruction after segmental mandibulectomy. The rate of successful restoration of mandibular continuity in 151 patients with vascularized bone grafts was compared to 59 patients with soft tissue free flaps combined with bridging plates.

RESULTS

Mandibular continuity was restored successfully for the duration of the follow‐up period in 94% of patients who received bone grafts compared with 92% of patients with bridging mandibular reconstruction plates. This difference was not statistically significant. In patients who received bone grafts, most cases of reconstructive failure occurred during the perioperative period and were due to patient death or free flap thrombosis. In patients who received bridging plates, all instances of reconstructive failure were delayed for several months and were due to hardware extrusion or plate fracture.

CONCLUSIONS

Vascularized bone‐containing free flaps are preferred for reconstruction of most segmental mandibulectomy defects in patients undergoing microvascular flap reconstruction. However, use of a soft tissue flap with a bridging mandibular reconstruction plate is a reasonable alternative in patients with lateral oromandibular defects when the nature of the defect favors use of a soft tissue free flap.

SIGNIFICANCE

Both bone grafts and bridging plates represent effective methods of restoring mandibular continuity following segmental mandibulectomy, with the former being the preferred technique for patients undergoing microvascular reconstruction.
p21, p53, andp27Kip1 alterations in benign and malignant tumors of sinonasal epithelium
Authors: Keles Nesil , Erdamar Burak , Kaur Ahmet , DeĞEr Kemal
Published: September 2022

OBJECTIVE

The goal of this study was to investigate alterations of cell cycle‐related molecules, includingp27, p21, andp53, in inverted papillomas (IPs) and squamous cell carcinomas (SCCs) of the sinonasal epithelium.

STUDY DESIGN

Sixteen IPs and 6 SCCs of the sinonasal epithelium, surgically resected at Istanbul Faculty of Medicine, Department of Otorhinolaryngology, from 1992 to 2000 were immunohistochemically investigated (p27, p21, andp53).

RESULTS

A significant decrease inp27nuclear staining was observed for SCCs of paranasal sinus compared with inverted papillomas (P= 0.0072). In SCCs there was no association betweenp27expression and the presence of keratinization and tumor grade.p21andp53expressions were not associated with IPs (dysplastic and nondysplastic) and SCCs.

CONCLUSION

Reduced levels ofp27expression correlate with increased cell proliferation in tumors of sinonasal region. Our findings indicate thatp27immunohistochemistry can be recommended to analyze the dysregulation of cell kinetics in these tumors.
The Efficacy of Anatomically Based Multilevel Surgery for Obstructive Sleep Apnea
Authors: Kao Yi H. , Shnayder Yelizaveta , Lee Kelvin C.
Published: September 2022

OBJECTIVE

Most reports in the literature focus on the efficacy of a single procedure for obstructive sleep apnea (OSA). We review the overall efficacy of a surgical methodology based on localizing the level of anatomic obstruction for each patient and surgical correction of the nasal, oropharyngeal, or hypopharyngeal obstruction.

STUDY DESIGN AND SETTING

Retrospective review of cases performed by a single practitioner using a systematic approach to surgery for OSA with pre‐operative and postoperative sleep studies.

RESULTS

Forty‐two patients with a respiratory disturbance index (RDI) greater than 15 were included in the study. Surgery involved at least 2 levels of obstruction usually performed in 2 stages. All patients reported symptomatic improvement. Overall, 83.3% (35 of 42) of patients were cured according to the accepted RDI criteria of more than 50% reduction and final RDI of less than 20. All 21 patients with mild OSA (RDI, <29), 73% of patients with moderate OSA (RDI, 30 to 49), and 50% of patients with severe OSA (RDI, >50) were cured.

CONCLUSION

The use of an anatomically based methodology in approaching patients with OSA seems to offer a higher efficacy than a single procedure as reported in the literature. (Otolaryngol Head Neck Surg 2003;129:327–35.)