bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of Positive Rule Estimator in the Ill-Conditioned Gaussian Regression Model
Authors: Kibria B. M. Golam , Saleh A. K. MD. E.
Published: July 2017

Ridge regression is a widely used method to estimate the regression parameters for an ill-conditioned model. This paper describes the estimation of the regression parameters for the Gaussian linear regression model with ill-conditioned explanatory variables. We propose some improved estimators, namely, the unrestricted ridge regression estimator, restricted ridge regression estimator, preliminary test ridge regression estimator, shrinkage ridge regression estimator and positive rule ridge regression estimators in this paper. The performances of the proposed estimators are compared based on the quadratic bias and risk functions under both null and alternative hypotheses, which specify certain restrictions on the regression parameters. The conditions of superiority of the proposed estimators for departure and ridge parameters are given. It is demonstrated that unlike the positive rule shrinkage (PR) estimator which dominates both unrestricted and shrinkage estimators, the positive rule ridge regression estimator (PRRRE) utilizes both sample and non-sample information but does not outperform the unrestricted and shrinkage ridge regression estimators for an ill-conditioned data. Some graphical representations have been presented which support the findings of the paper.
On Logistic and Generalized Logistic Distributions
Authors: Gupta R. P. , Jayakumar K. , Mathew Thomas
Published: July 2017

Characterizations of logistic and generalized logistic distributions are obtained. A result related to mixed generalized logistic distribution is proved. Applications of these results in time series modeling are discussed.
Healthy alliances between health promotion and education: the results of a national audit
Authors: Scriven Angela
Published: July 2017

The first phase of a three-year research project was undertaken in 1994. This involved a national survey of NHS health promotion units to determine the healthy alliances they had in place with the education sector. Questionnaires were sent to all specialist NHS health promotion units in England and a 64 per cent response rate was achieved. The aim of the survey was to discover the specialist health promoters' perceptions of the extent, purpose and nature of healthy alliances between the two sectors, and the factors they felt had facilitated and/or constrained the establishment of such alliances. Variables included the size and type of unit, the existence of coterminous boundaries and the health promotion approaches adopted. The results demonstrate that health promotion specialists are extremely active in both the initiation and management of collaborative initiatives, with 98 per cent of health promotion units having alliances in place with the education sector. The most common type of alliance is one established with a single LEA, although the majority of units had more than one type of alliance in place with education at the time of the audit. The education sector was said to play a less active role in alliance maintenance. Health promoters were concerned about the substantial change to educational funding. This was seen as a major setback for alliance working, particularly the impact this change has had on the role of local authority advisory staff. These results will be used to establish the second phase of the study, which will involve a national survey of health education advisors.
Influence of lifestyle behaviours on obesity among Chinese adolescents in Singapore
Authors: Wong Mee Lian , Koh David , Lee James , Lee Moh Hoon , Fong Yoke Tien
Published: July 2017

A case-control study was carried out in 1992 on 178 obese and 536 normal weight Chinese Singaporean adolescents to identify lifestyle behaviours associated with obesity. An inverse dose-response gradient of physical exercise to obesity was found in both genders. For females, obesity risk was statistically associated with those whose parents were food vendors, and for males, it was statistically associated with the practice of eating supper out regularly. Among the obese students, girls were statistically more likely than boys to eat in response to depression, stress and boredom.
Evaluating health promotion projects in primary care: recent experiences in Scotland
Authors: Shiroyama Cora , McKee Lorna , McKie Linda
Published: July 2017

The evaluation of health promotion in primary health care has been brought to the forefront of debates in Scotland with the introduction of an evaluation component in every project funded under the Development of Health Care Fund scheme. The level of skills and empathy with evaluation approaches and research methods varies considerably between primary health care team members, and consequently academic researchers are increasingly being drawn into NHS debates on evaluation and health promotion in primary health care. In this article the authors draw upon their respective experiences as evaluators to highlight specific issues and concerns in the evaluation of health promotion in a primary health care setting.
Does Alcohol Matter? Public Health in Russia and the Baltic Countries Before, During, and after the Transition
Authors: Reitan Therese C.
Published: July 2017

Since the mid-1980s public health in Russia and the Baltic countries has shown vast fluctuations. After a notable improvement during the second half of the 1980s, the early 1990s saw a dramatic deterioration with soaring mortality rates. This article describes some particularities of this rise and fall in public health, primarily concerning age, gender and cause of death, which have been remarkably similar in all four countries. The article identifies three phases in the development in alcohol policy and alcohol consumption, and in public health as such, during the past 15 years. There are many questions and few definite answers concerning the driving forces behind the recent public health turbulence, but developments are frequently related to two important events: the anti-alcohol campaign during the 1980s, and the economic and political transition following the breakup of the Soviet Union. Although the public health crisis is a result of unique historical experiences, there are general lessons to be learned, and the similarity in trends is noteworthy. Moreover, internationalization will enhance a certain convergence in consumption patterns and policy responses in the future, although local provisions will ensure a certain diversity in policies.
Alcohol in the Countries in Transition: The Polish Experience and the Wider Context
Authors: Moskalewicz Jacek
Published: July 2017

The Eastern European transitions of the 1990s from centrally planned economy toward market economy and from monoparty political system to multiparty democracy strongly affected the alcohol field. Rapid reduction of the State's powers and weak or nonexistent civil society led to domination of the market in both economy and social life. The alcohol supply from licit and illicit sources increased dramatically, its consumption soared, and problems related to alcohol contributed remarkably to the health crisis present in a majority of countries in transition.

In countries where civil society reemerged relatively soon and the State regained its regulatory power over the market, the mortality crisis was less severe and much shorter. Partial reintroduction of State control over the alcohol market and revival of the temperance movements reduced illicit supply and led to either stabilization or decline of alcohol consumption, which, however, still exceeds the pretransition levels. Appropriation of the alcohol sector by multinational companies diminished again the influence of the State and civil society and may lead to a new high in consumption and related problems.
Knowledge, Embodiment and Neo-Liberal Drug Policy
Authors: Bunton Robin
Published: July 2017

Contemporary social policy on drugs is centrally concerned with ensuring the orderly reproduction of the social life in the face of rapid social transformation. This paper examines some recent changes in the relationships of weljare and makes observations about the principles underlying contemporary European drug policy, with a particular concern for the governability of drug users. Expert knowledge is argued to play an important role in reconstructing the late-modern human agency through a focus on the intoxicated body. Contemporary drug policy is viewed as part of a set of discourses, norms, social practices and techniques that regulate the quality of the social life of a population, its health and security. These discourses and practices are related to a particular form of rationality specific to neo-liberalismfound in the UK, in Europe and in other Western societies. While subject to new forms of governance, it is argued that contemporary intoxicated subjectivity also falls under the influence of non-specialist, everyday knowledge, often contradicting the rationale of neo-liberal governance of drug use.
The Treatment of Drug Addiction: The Individual Caught between Public Welfare and Private Capitalism
Authors: Laursen Lau , Storgaard Anette
Published: July 2017

This article analyzes and discusses the important changes in the Danish drug-treatment sector that took place from the middle of the 1990s. The background is a general review of the drug situation put forward by the Danish government in 1994, which changed the priority between control and treatment efforts. From 1995–1996 treatment of drug addiction was given more money and more awareness from society. One of the most interesting changes was an acceptance of the use of private treatment centers as a tolerated part of the treatment system. Since 1997 the Danish counties, as responsible authorities for drug treatment, have contracted out most of their residential treatment. The private treatment institutions have supplementary financial motives besides helping and offering treatment. This has raised new problems for the individual drug user and society as to the quality and effects of drug treatment.
Intoxication and Rite of Passage to Adulthood in Norway
Authors: Sande Allan
Published: July 2017

The author describes young Norwegians' use of alcohol in “russefeiring,” a special rite of passage to adulthood in the form of prolonged graduation parties. In this ritual, the young people wear special clothes, celebrate, and drink beer and spirits from the 1st through the 17th of May. The article argues that young people have invented rites of passage in which expressive individualism is stressed as a value. The article discusses the use of symbolic anthropology and sociology and field methods in research relating to this kind of ritual alcohol use and intoxication. Theoretically, the focus is on studying alcohol use as a ritual practice. Use of alcohol can be defined as a key symbol in these ritual processes, offering an opportunity to communicate meaning between members of the society and culture concerned.
Alcohol Consumption and the Experience of Adverse Consequences—A Comparison of Six European Countries
Authors: Ramstedt Mats
Published: July 2017

This paper describes prevalence rates of self-reported experiences of alcohol-related problems in six Western European countries and examines how self-reported consumption of alcohol is associated with the likelihood of experiencing these problems. Of particular interest is to assess whether alcohol is more strongly associated with the likelihood of experiencing adverse consequences in Northern Europe than in countries in Central and Southern Europe. Data on self-reported volume of drinking and binge drinking and of experiences of various alcohol-related problems from a general population survey undertaken in Finland, Sweden, Germany, the UK, France and Italy during the spring of 2000 were analyzed. The number of respondents was about 1,000 men and women (ages 18–64) in each country. In the assessment of the link between drinking and harm, results showed that the overall prevalence of alcohol-related harm was highest in Finland and the UK and lowest in Southern Europe. A general positive association was found between volume of drinking and problems, although some country differences were observed. The risk curve analysis also revealed that problems occurred at fairly low drinking levels. In the multivariate logistic regression analyses, the volume of drinking and a measure of binge drinking were both statistically significant predictors of most problems in most countries. A major conclusion is that both volume of drinking and binge drinking are important determinants of the risk of experiencing adverse consequences from drinking in all six European countries.
Drug Use within the Finnish Club Culture as Marks of Distinction
Authors: Salasuo Mikko , Seppälä Pauliina
Published: July 2017

Drug use in the context of dance clubs and “raves” has established a permanent position in Western youth cultures during the past two decades. Although the phenomenon is global, the prevalence and local cultural forms vary significantly among countries. In this article we analyze how the Finnish drug users in the context of club culture distinguish themselves from other night-life subcultures and from mainstream popular culture. We also try to categorize the distinctions of this group into more general discursive structures that define their group identity. Drug use in the club cultural context is analyzed as modern symbolically significant consumption as a way to create and maintain social categories and distinctions. We conclude that Finnish club culture is quite a hidden context. Club cultural distinctions differ greatly from values of Finnish society. Even though the club culture expanded and interlocked with mainstream popular culture in the late 1990s, club culture and related drug use are still quite a marginal phenomenon.
Characteristics of Former Heavy Drinkers: Results from a Natural History of Drinking General Population Survey
Authors: Cunningham John A. , Blomqvist Jan , Koski-Jännes Anja , Cordingley Joanne , Callaghan Russell
Published: July 2017

This study explored the factors associated with reduction from heavy drinking among three groups: current abstinent, moderate, and reduced drinkers. A random-digit-dialing telephone survey was conducted of 3,006 respondents in Ontario, Canada. Of these, 470 respondents (46% female) met criteria as former heavy drinkers (99 abstinent; 237 moderate; 134 reduced but not moderate drinkers). Quantitative and qualitative questions were used to explore current and past drinking, use of treatment, and reasons for change. Qualitative items were tape-recorded and transcribed. Respondents in the abstinent group had more severe problems prior to resolution as compared with those in the moderate group. Reduced drinkers displayed a prior alcohol severity at a level between these two other groups. The most common reasons for change in all groups were new responsibilities, maturation, and health concerns. This study serves as a useful adjunct to other natural-history research, exploring the reasons for change in a representative sample of former heavy drinkers.
Alcohol Advertising Policies in the United States: National Promotion and Control initiatives
Authors: Giesbrecht Norman , Johnson Suzanne , Anglin Lise , Greenfield Thomas K. , Kavanagh Lynn
Published: July 2017

This article describes policy developments in alcohol advertising and counter-advertising at the U.S. national level, including federally mandated warning labels on alcoholic beverage containers, the campaign for health warnings on broadcast advertising, the end of the voluntary ban on advertising of distilled spirits on television and radio, and the debate concerning a health-benefits label on wine products. Federal legislative documents and media accounts provided the context for 64 key-informant interviews with persons working for the federal government, the alcohol industry, public health, and research and media organizations. A decline in per capita alcohol consumption in the 1980s and 1990s and concurrent demographic shifts in the U.S. population have given impetus to controversial advertising campaigns and their opposition. The policy case studies show disagreement among key players about the impact of advertising on consumption and problems, need for controls, benefits of regulation and counter-advertising, and need for federal-level legislation.
Social Organization in Bars: Implications for Tobacco Control Policy
Authors: Lee Juliet P. , Antin Tamar M. J. , Moore Roland S.
Published: July 2017

This article considers social roles and relationships of the patrons, staff and owners of bars as critical factors determining adherence to public health policies, and specifically California's smokefree workplace law. Specific elements of social organization in bars affecting health policy include the community within which the bar is set, the unique identity the bar creates, the bar staff and patrons who enact this identity, and their bar society. These elements were found to contribute to the development of power relations within the bar and solidarity against the outside world, resulting in either resistance to or compliance with smoke-free workplace policy.
Psychoactive Substance Use among Young People: Core Findings of a Multi-Center Study in the Republic of Belarus and the Russian Federation
Authors: Nkowane Mwansa , Silva Lee Da Rocha , Saxena Shekhar , Poznyak Vladimir , Koshkina Eugenia , Rostovtsev Vladimir , Kalinina Tatiana
Published: July 2017

This article presents core findings of a pre-intervention survey of psychoactive substance use in two communities in the Republic of Belarus and three communities in the Russian Federation between December 2000 and March 2001. The survey was part of the Global Initiative for the primary prevention of psychoactive substance use among young people in eight countries, initiated by the United Nations International Drug Control Program and the World Health Organization. The survey found that young people (10–21 year olds) fairly commonly reported the use of psychoactive substances, especially the use of malt beer and cigarettes. The young people also tended to report such use among significant others (e.g. (step)fathers, (step)mothers, older siblings, and close friends) in their lives. The young people in the Russian Federation sites tended to approve of various forms of psychoactive substance use among their peers.
Patterns of drinking and harm
Authors: Rehm Jürgen
Published: July 2017

Based on exemplary papers presented at the “International Conference on Social and Health Effects of Different Drinking Patterns,” characteristics of current research on patterns of drinking and harm are presented. These characteristics include a new focus on such outcomes as social harms, benefits and casualties, and better conceptualization and measurement of patterns. A conceptual scheme for future research is proposed to integrate the various elements of current patterns of research. Areas for future investigation are identified.
More than consumption: moderating and independent effects of workplace factors on alcohol problems
Authors: Wild T. Cameron , Macdonald Scott , Wells Samantha
Published: July 2017

In a household survey, 882 respondents provided information on (1) weekly alcohol consumption, (2) perceptions of job security, pressures exerted by co-workers and friends to use alcohol and other drugs, social isolation on the job, and (3) alcohol-related problems. At a bivariate level, consumption was positively related to alcohol problems (r = .45, p < .001). However, perceived pressure to use alcohol and other drugs exacerbated the effects of consumption on social and legal problems among drinkers reporting low (three or fewer drinks per week) and high (nine or more drinks per week) levels of alcohol use. In addition, workplace variables improved the predictability of alcohol problems, after effects of alcohol consumption were controlled. These results suggest that future work should examine perceived characteristics of the workplace as moderators of consumption effects, and as direct effects on alcohol-related problems, independently of consumption levels.
Patterns of alcohol consumption and psychiatric disorders among Ontario adults
Authors: Ross Helen , Rehm Jürgen , Walsh Gordon
Published: July 2017

This study examined the relationship between patterns of alcohol consumption, including problem drinking, and psychiatric disorders in the general population. The paper utilizes data on 8,116 adults age 15–64 living in households who were interviewed for the Ontario Health Survey and the Mental Health Supplement. The University of Michigan Composite International Diagnostic Interview (UM-CIDI) was administered by trained lay interviewers to generate lifetime DSM-III-R diagnoses. Unlike previous studies, the results of this study provided no evidence of a U-shaped or J-shaped curve or relationship between alcohol use and mental health. Lifetime abstainers had the lowest risks for all mental disorders examined, while former at-risk drinkers (those who had not had a drink in the previous year but at one time regularly drank more than 12 drinks a week) had the highest risks, even after adjustment for age and gender.
Keep Coming Back! Narcotics Anonymous Narrative and Recovering-Addict Identity
Authors: Rafalovich Adam
Published: July 2017

The following study is a qualitative analysis of the 12-step fellowship Narcotics Anonymous. Over a two-year period, ethnographic data were collected from over 150 NA meetings and codified using the principles of the research methodology grounded theory. Through an analysis of testimonials presented at the meeting level, a theory of the process of identity, specifically that of becoming a “recovering addict,” has been posited. The foundation for these testimonials lay within the presentation of “the story,” or typical NA testimony, found at every NA meeting this researcher attended. The story, it will be argued, constructs the narrative environment of NA and works in a reflexive relationship with identity. That is, addict identity is articulated through the language of the story, and the story itself cultivates this identity in the NA member. The components of the story are examined at considerable length, followed by a conceptual model that seeks to explain some of the dynamics of this identity phenomenon.
Drugs at School: How the School Community Addresses the Problem within an Interactional Framework
Authors: Jaatinen Jaana
Published: July 2017

In autumn 1996, articles appeared in the Finnish newspapers about a vocational school where the sale and use of drugs were discovered; this was the beginning of the social construction of the school drug problem. This paper describes one part of the process that has taken place in the community since the public framing of the problem. The study set out to look at how the problem is constructed among the school staff members. The data consist of interviews with 24 staff members of the school in spring 1997. The analysis of the interview material revealed three discursive themes that the interviewees used to construct the drug problem: The first theme had to do with the invisibility of drugs; the second had to do with what the school could (not) do to address the challenge presented by its students; and the third concerned the tension between wanting to help transgressors and the requirement to punish them. The paper argues that the drug problem is closely linked with many of the interactional practices in the school community that have become taken for granted.
The Forgotten Origins of Cannabis Prohibition in California
Authors: Gieringer Dale H.
Published: July 2017

Long before being banned by federal law in 1937, cannabis was prohibited by California in 1913. The law was sponsored by the state Board of Pharmacy as part of a wider, aggressive anti-narcotics campaign originally aimed at opiates. There was no broader public concern about cannabis at the time. Prior to 1913, evidence for the use of “hashish” in California is exceedingly slim. Mexican “marihuana” was not familiar to the public until after the law was passed. The law was originally proposed by board member Henry Finger, supposedly to prevent the spread of cannabis use by “Hindoo” immigrants. The board began staging raids against marihuana in the Mexican district of Los Angeles in 1914. Despite increasing penalties, use gradually spread during the 1920s and after. California's law was not caused by “reefer madness,” anti-Mexican prejudice, or any publicly perceived problem, but by a preemptive bureaucratic initiative.
Worker Drug Use and Workplace Drug-Testing Programs: Results from the 1994 National Household Survey on Drug Abuse
Authors: Hoffmann John P. , Larison Cindy L.
Published: July 2017

Workplace drug-testing programs in the United States have proliferated over the past 10–15 years. It appears that many companies see drug-testing programs as an effective policy for deterring illicit drug use among their employees. However, there is little empirical research that has examined the relationship between drug-testing programs and worker drug use. Using data from the 1994 National Household Survey on Drug Abuse (NHSDA), this paper examines the associations among drug use, drug-testing programs, and perceptions of programs. The results suggest that weekly users of marijuana or cocaine are less likely than others to work for companies that have drug-testing programs. In general, users of marijuana and cocaine are also less likely to want to work for such companies. These findings suggest a deterrent effect of drug-testing programs, although the mechanisms underlying this deterrent effect remain unknown.
Magnetic Resonance Imaging in the Search for Retrocochlear Pathology
Authors: Sedwick Jack D. , Gajewski Byron J. , Prevatt Angela R. , Antonelli Patrick J.
Published: July 2017

OBJECTIVES:

The purpose of this study is to evaluate the incidence of retrocochlear pathologic conditions that may be seen with full, contrast‐enhanced magnetic resonance imaging of the brain, relative to more limited studies of the internal auditory canals (IACs) in patients with unilateral hearing loss or tinnitus with or without dizziness.

METHODS:

A retrospective study was performed on all patients who had a magnetic resonance imaging of the brain and otologic symptoms over a 7‐year period.

RESULTS:

Abnormalities were found in 11 of 128 patients with only auditory symptoms and in 63 of 282 patients with auditory symptoms and/or dizziness (P = 0.005). Treatable lesions may not have been identified with a limited IAC study in 3 of 128 patients with only unilateral auditory symptoms, and 21 of 282 patients with dizziness (P = 0.045).

CONCLUSIONS:

Limited MRI of the IACs may serve as an adequate screening test for retrocochlear pathologic conditions in patients with unilateral auditory symptoms and no dizziness.
Reflections on the Management of Adenoid Cystic Carcinoma of the Nasal Cavity and Paranasal Sinuses
Authors: Howard David J. , Lund Valerie J.
Published: July 2017

Adenoid cystic carcinoma of the nasal cavity and paranasal sinuses has a unique natural history. It has a propensity for frequent local recurrence and early perineural and hematogenous spread. These factors, together with a complex anatomic situation, make adequate oncologic surgery extremely difficult. The incidence of local recurrence is lower in those patients receiving more radical primary surgery, but the choice between conservative and radical management may not alter prognosis. Indeed, it is doubtful if any patients are cured of this disease.
Human Papillomavirus in Various Lesions of the Head and Neck
Authors: Strauss Melvin , Jenson A. Bennett
Published: July 2017

The association of human papillomavirus with benign and malignant epithelial lesions of the head and neck has been studied by a peroxidase‐antiperoxidase technique having immunospecificity against genus‐specific structural antigens of the papillomaviruses. More than 360 specimen blocks from 144 patients were evaluated. There was evidence of human papillomavirus antigen in three out of eight patients with childhood‐onset laryngeal papillomas (37.5%) and in four out of eight patients with adult‐onset papillomas (50%). A patient with an unusual flat, wartlike lesion appearing as an oral cavity leukoplakia had detectable papillomavirus antigen in it. None of the 13 cases of inverting papilloma or any of the malignant lesions studied showed evidence for the presence of papillomavirus antigen. There is currently only suggestive evidence for the oncogenic potential of human papillomavirus in the head and neck.
Histologic Changes in Skin Implanted into the Larynx and Trachea by Myocutaneous Flap Reconstruction
Authors: Eliachar Isaac , Sebek Bruce A. , Levine Samuel , Tucker Harvey M.
Published: July 2017

Skin is the tissue most readily available for relining the walls of the reconstructed larynx or trachea. Its use has been condemned In the past because of potential contracture, scaling, crust formation, and collapse into the lumen. Most of these complications have occurred when free, split‐thickness grafts were used. We studied the changes that develop within skin that is transferred into the lumen of the airway as part of a vascularized sternohyoid myocutaneous flap. Twenty‐one dogs underwent reconstruction of laryngotracheal defects by a vascularized myocutaneous flap. The closely shaved and chemically depilated skin included in this reconstruction was ultimately found to be well healed to the adjacent mucosa. Flaps as large as 8 cm2 survived with no evidence of scaling, crusting, or contracture. The cutaneous appendages in the flaps were compared with those found in adjacent skin near the donor site. After proper depilation there was involution of cutaneous appendages. Scarring of the dermis appeared to add support to the grafts. Our findings demonstrate that the rotary door sternohyoid myocutaneous flap is a reliable, well‐vascularized flap that can have extensive application in laryngotracheal reconstruction.
Anterior Facial Nerve Decompression
Authors: Farrior Jay B.
Published: July 2017

With the current interest in skull base surgery and the resurgence of cavity surgery in the management of cholesteatoma, the otologic surgeon should be able to approach the facial nerve anteriorly as well as posteriorly. The anatomy and identification of the facial nerve are traditionally taught from a transmastoid perspective. In many cases of skull base and chronic ear surgery, it would often be more efficacious if the facial nerve were identified by a transcanal or anterior approach. An anterior approach to the facial nerve expedites surgery in a small sclerotic mastoid process and gives maximum exposure of disease In the hypotympanum and tympanic recess.
Preoperative Nursing Planning in Pediatric Tracheotomy
Authors: Hennessy Patricia A.
Published: July 2017

Tracheotomy may be necessary in the treatment of severe, prolonged illness or airway obstruction. The preoperative nursing care plan is developed to meet the physical needs of the child as well as provide essential information and emotional support to the child and family. Comprehensive attention to all aspects of care needs in the preoperative period assists in the provision of optimum nursing care during the hospital stay and after discharge
Does the Vestibulo‐Ocular Reflex (VOR) Merit Redefinition?
Authors: Katsarkas Athanasios , Galiana Henrietta , Smith Heather
Published: July 2017

The VOR has historically been described by parameters of the slow phase of nystagmus while fast phases have been systematically ignored. However, ample neurophysiologic and theoretical evidence suggests that fast phases are an integral part of the VOR and are not to be discarded in evaluation of vestibular function. In a series of experiments, normal subjects and compensated patients with total or partial loss of unilateral peripheral vestibular function were tested. They were exposed to sinusoidal oscillations (20, 60, and 120/second at 1/6 Hz and 25/second at 1 Hz) with no actual or imaginary visual targets (doing mental arithmetic) and the usual slow‐phase parameters (gain, phase, etc.) were computed. The gaze (total eye position, slow and fast phase of nystagmus vs. head + head position in space) was also plotted vs. head position in space. It was found that in patients, fast phases of nystagmus are unequally (right vs. left) produced, extending the linear range of VOR function. It was also found that in normal subjects and patients, gaze essentially tracks the head in the absence of visual targets. It is concluded that fast phases of nystagmus contribute to gaze control during head rotations in darkness and that the definition and the testing of the VOR have to be modified to accommodate these observations.
Midline Nasal Destruction in Cocaine Abusers
Authors: Sercarz Joel A. , Strasnick Barry , Newman Anita , Dodd Leslie G.
Published: July 2017

Idiopathic midline destructive disease (IMDD) is a diagnosis of exclusion in patients who manifest midline nasal necrosis with no specific etiology such as infection, tumor, or Wegener's granulomatosis. Recently, a group of cocaine abusers has been identified that manifests a syndrome that mimics IMDD, but is less fulminant in its course. To better define the natural history of this syndrome, we reviewed the medical records, radio‐graphs, and pathologic material from five such patients treated at the University of California, Los Angeles. Other causes of midline nasal destruction were excluded in each patient on the basis of histopathology, cultures, and laboratory tests. Biopsy material, available in four patients, demonstrated inflammation and necrosis without vasculitis. Treatment was conservative in four of the five patients, using antibiotics, local care, debridement, and cessation of cocaine use. During the follow‐up period, progressive disease developed in one of the five patients, requiring radiation and steroid therapy. We conclude that the treatment of midline nasal destruction in cocaine abusers should initially be conservative, once other etiologies have been systematically excluded.
An Evaluation of the Head‐Shaking Nystagmus Test
Authors: Burgio Don L. , Blakley Brian W. , Myers Steven F.
Published: July 2017

Head‐shaking nystagmus can be observed in some patients with vestibular lesions. This nystagmus is transient and appears after 15 to 20 cycles of rapid head‐shaking. Horizontal head‐shaking may be associated with a low‐amplitude reversal phase, which follows the primary response. Several previous studies using active head movement have indicated that head‐shaking nystagmus is a sensitive indicator of vestibular loss. In this study, the head‐shaking nystagmus test using passive head movement was evaluated in 115 patients and 17 control subjects, using three examiners. The data indicate that using passive head movement, the head‐shaking nystagmus test is neither sensitive nor specific enough for use as a screening test for vestibular loss.
Dynamic Rehabilitation of the Paralyzed Face: III: Balanced Coupling of Oral and Ocular Musculature from the Intact Side in the Canine
Authors: Broniatowski Michael , Grundfest‐Broniatowski Sharon , Davies Sbee, MD. Charles R. , Jacobs Gordon B. , Tucker Harvey M. , Nose Yukihiko
Published: July 2017

We have recently demonstrated the feasibility of artificial agonist/antagonist coupling between intact facial and reinnervated strap muscles in the rabbit. The present study broadens this principle to involve bi‐level cross‐facial innervation. After severing the facial innervation unilaterally in four dogs, a nerve pedicle from a cervical motor nerve was implanted into the orbicularis oris and from the deep temporal nerve into the orbicularis oculi. After neurotization (5.6 months), the pedicles were electrically stimulated to verify muscular response. Graded contraction on the intact side was induced by stimulating the ipsilateral facial nerve with currents of various pulse widths. The resulting compression of a strain gauge on the intact face triggered a two‐channel, opto‐isolated, pulse width‐modulated stimulator to produce agonistic graded contraction at one level of the reinnervated side (e.g., oral) and reciprocal relaxation in its reinnervated counterpart (e.g., ocular). The sophistication of the present model—s as compared to the original pilot study—sbrings us one step closer to dynamic human facial rehabilitation.
First Place — Resident Basic Science Award 1994: α‐Difluoromethylornithine Delays Behavioral Recovery and Induces Decompensation after Unilateral Labyrinthectomy
Authors: Backous Douglas D. , Henley Charles M. , Dunn J. Kay , Jenkins Herman A.
Published: July 2017

Biochemical and pharmacologic studies suggest a role for the ornithine decarboxylase—polyamine system as a modulator of behavioral changes during vestibular compensation. α‐Difluoromethylornithine specifically blocks the rate‐limiting step of polyamine biosynthesis. To assess the effects of α‐difluoromethylornithine on the acute phase of postural compensation, guinea pigs were divided into groups subjected to either unilateral labyrinthectomy only (n = 7), α‐difluoromethylornithine (500 mg/kg/day) for 4 days before labyrinthectomy (n = 10), equivalent volumes of saline for 4 days before labyrinthectomy (n = 8), and sham operations (n = 5). Yaw head tilt and roll head tilt, trunk curvature, and air‐righting reflex were measured at baseline and at regular intervals up to 4 weeks. α‐Difluoromethylornithine significantly delayed recovery of normal air‐righting but had no effect on yaw head tilt, roll head tilt, and trunk curvature. We also evaluated effects of α‐difluoromethylornithine in compensated guinea pigs. Fully compensated animals from phase 1 were randomly assigned to receive α‐difluoromethylornithine (500 mg/kg/day) or saline once daily for 4 days. Only 33% of α‐difluoromethylornithine animals maintained air‐righting, compared with 100% of saline‐treated animals (p = 0.003). Maximum trunk curvature was greater in the α‐difluoromethylornithine group (p = 0.02). Thus α‐difluoromethylornithine not only delayed the time course for postural recovery after unilateral labyrinthectomy, it also transiently disrupted the maintenance of the compensated state.
Blast Injuries to the Facial Nerve
Authors: Telischi Fred F. , Patete Michael L.
Published: July 2017

The recommended treatment of penetrating traumatic facial nerve injuries associated with Immediate, total paralysis of the ipsilateral facial muscles generally includes facial nerve exploration and repair. We reviewed our experience with bullet injuries to the extratemporal facial nerve to determine the efficacy of this approach. Five patients with immediate, total facial nerve paralysis caused by bullet wounds near the extratemporal facial nerve were seen between July 1990 and December 1992. Of four patients who underwent surgical exploration, only one demonstrated complete transection of the facial nerve. Two of these four were followed up with serial electroneuronography, which demonstrated complete degeneration within the first week after injury. The fifth patient was followed up with serial electroneuronography without complete degeneration, and partial recovery was observed. We conclude that penetrating bullet injuries with immediate, total facial paralysis may not necessarily be associated with transection of the facial nerve. We propose a method of treating patients with these Injuries using electroneuronography.
Preoperative Parathyroid Localization: Prospective Evaluation of Technetium 99m Sestamibi
Authors: Khan Anjum , Samtani Sameer , Varma Vijay M. , Frost Andra , Cohen Joshua
Published: July 2017

The utility of preoperative parathyroid localization remains controversial. The gold standard for Identification of abnormal parathyroid glands is exploration of the neck by an experienced surgeon. However, both for the experienced and less experienced surgeon. It may be desirable to localize the abnormality before surgery. Such a study would not only direct the surgeon to the site of the lesion but also would help reduce unnecessary dissection, the number of negative explorations, and operative anesthesia time. Unfortunately, currently used noninvasive techniques including ultrasonography, thalllum‐technetium subtraction, computed tomography scan, and magnetic resonance Imaging have had only limited success (35% to 78%) In demonstrating abnormal parathyroid glands. Thirty patients with proven hyperparathyroidism were enrolled to compare a new imaging agent, technetium 99m sestamibi, as an alternative to thallium 201 for subtraction scintigraphy with technetium 99m pertechnetate. Only 14 of 30 patients operated on at George Washington University underwent an identical surgical approach (exploration of all four glands) and had complete preoperative calcium and parathormone levels, postoperative calcium levels, and total time of surgical procedures to formulate the basis of this report. The remaining 16 had their surgeries at other Institutions. A surgical approach different from that used at George Washington University and unavailability of postoperative calcium levels and times of surgical procedures from these Institutions necessitated deletion of these 16 patients from this report. Technetium 99m sestamibl—technetium 99m subtraction scans accurately localized the abnormal parathyroid gland in 13 of 14 patients, as compared with only 9 of 14 thallium 201–technetium 99m pertechnetate subtraction scans. These results support technetium 99m sestamibl scanning as the superior modality for preoperative parathyroid localization.
Nonlinearity of the Jongkees Difference Equation for Vestibular Hypofunction
Authors: Wexler David B.
Published: July 2017

The Jongkees formulation for vestibular paresis normalizes the difference between total left and right caloric responses to the sum of responses. When studied over the full paresis range of 0% to 100% hypofunction, the Jongkees formula is found to be a nonlinear index that does not accurately indicate the percentage of vestibular paresis. A linear paresis formula is described that more directly conveys the magnitude of relative vestibular hypofunction.
Evaluation and Treatment of the Unilateral Paralyzed Vocal Fold
Authors: Benninger Michael S. , Crumley Roger L. , Ford Charles N. , Gould Wilbur J. , Hanson David G. , Ossoff Robert H. , Sataloff Robert T.
Published: July 2017

The evaluation and treatment of patients with unilateral vocal fold paralysis have evolved as improvements in objective measurements of phonatory function and new modalities for treatment have developed. A thorough history, physical examination, subjective voice evaluation, objective voice analysis, and electromyography are used to make a diagnosis, determine the cause, and plan treatment. The goal of treatment of the patient with a unilateral vocal fold paralysis is to restore normal phonatory function without aspiration. Multiple modalities have developed to allow for restoration of nearly normal phonatory function, and these include voice therapy alone or in combination with injection medlalization, laryngoplastic phonosurgery, or laryngeal reinnervation. Otolaryngologists should be familiar with the incidence, cause, evaluation, and state‐of‐the‐art treatment of unilateral vocal fold paralysis to optimize patient care and avoid suboptimal results often seen with antiquated or Inappropriate treatment.
Penetrating Injuries of the Face
Authors: Chen Amy Y. , Stewart Michael G. , Raup Glenn
Published: July 2017

We reviewed 78 consecutive cases of penetrating facial injuries treated at Ben Taub General Hospital in Houston, Texas, between 1992 and 1994, and we analyzed injury patterns on the basis of (1) the mechanism of injury, and (2) the entry zone of the wounds. We found that gunshot wounds were more likely to require emergent airway establishment than shotgun wounds or stab wounds (p = 0.03). We noted a higher prevalence of globe injury among shotgun wounds than among gunshot wounds (p = 0.02). Nine (12%) patients had intracranial penetration of a bullet or shotgun pellet. Patients with gunshot wounds required open reduction and internal fixation of facial bone fractures more frequently than patients with shotgun wounds (p = 0.01). Thirty patients underwent arteriograms, and 10 demonstrated positive findings. Although there were only 3 deaths in our series, 29 (37%) patients overall had some complication caused by their penetrating facial trauma, including blindness in 12 patients. There was no significant difference in the prevalence of complications between gunshot, shotgun, and stab wounds (p = 0.18). With these injury patterns in mind, we describe an algorithm for evaluation and management of penetrating injuries of the face.
Color Doppler Ultrasound Findings in Patellar Tendinopathy (Jumper's Knee)
Authors: Hoksrud Aasne , Öhberg Lars , Alfredson Håkan , Bahr Roald
Published: July 2017

Background

Recent studies have revealed structural changes with neovessels in patients with jumper's knee and Achilles tendinopathy, and treatment with sclerosing injections has shown promising clinical results.

Purpose

To study the prevalence of neovascularization and structural tendon changes on color Doppler ultrasound examination in elite athletes with clinical symptoms of jumper's knee and to examine the ultrasound characteristics of the tendon after sclerosing injection treatment with polidocanol.

Study Design

Cohort study; Level of evidence, 3.

Methods

The authors recruited patients among elite athletes with a clinical diagnosis of jumper's knee who participated in a previous randomized clinical trial. The patients recorded knee function using the Victorian Institute of Sport Assessment score. Patients were examined by color Doppler ultrasound at baseline and, for patients with structural changes and neovascularization who received sclerosing treatment, after treatment.

Results

Sixty-three patients (11 women and 52 men) with 79 symptomatic tendons were studied. The ultrasound examination revealed that neovascularization was present in 48 of the 79 tendons (60%). Of 33 patients (43 tendons) who received sclerosing injections, 29 patients (37 tendons, 86%) were examined 37 (19 to 53) weeks after their final sclerosing injections. Of these, 7 tendons (18.9%) had no change in neovascularization after treatment, 21 tendons (56.8%) had less neovascularization, and 9 tendons (24.3%) had more visible neovascularization. There were no significant differences in the change in Victorian Institute of Sport Assessment score between patients who had less, more, or unchanged neovascularization after treatment (analysis of variance, P = .9).

Conclusion

About two thirds of patients with jumper's knee can be expected to have structural tendon changes with neovascularization. There was no relationship between changes in ultrasound characteristic and knee function after sclerosing treatment.