bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of cognitive reserve and lifestyle on cognition and dementia in Parkinson's disease—a longitudinal cohort study
Authors: Hindle John V. , Hurt Catherine S. , Burn David J. , Brown Richard G. , Samuel Mike , Wilson Kenneth C. , Clare Linda
Published: March 2015

Objective

Cognitive reserve theory seeks to explain the observed mismatch between the degree of brain pathology and clinical manifestations. Early‐life education, midlife social and occupational activities and later‐life cognitive and social interactions are associated with a more favourable cognitive trajectory in older people. Previous studies of Parkinson's disease (PD) have suggested a possible role for the effects of cognitive reserve, but further research into different proxies for cognitive reserve and longitudinal studies is required. This study examined the effects of cognitive lifestyle on cross‐sectional and longitudinal measures of cognition and dementia severity in people with PD.

Methods

Baseline assessments of cognition, and of clinical, social and demographic information, were completed by 525 participants with PD. Cognitive assessments were completed by 323 participants at 4‐year follow‐up. Cognition was assessed using the measures of global cognition dementia severity. Cross‐sectional and longitudinal serial analyses of covariance for cognition and binomial regression for dementia were performed.

Results

Higher educational level, socio‐economic status and recent social engagement were associated with better cross‐sectional global cognition. In those with normal cognition at baseline, higher educational level was associated with better global cognition after 4 years. Increasing age and low levels of a measure of recent social engagement were associated with an increased risk of dementia.

Conclusions

Higher cognitive reserve has a beneficial effect on performance on cognitive tests and a limited effect on cognitive decline and dementia risk in PD. Copyright © 2015 John Wiley & Sons, Ltd.
Safety and efficacy of concurrent neck dissection and transoral robotic surgery
Authors: Kucur Cuneyt , Durmus Kasim , Gun Ramazan , Old Matthew O. , Agrawal Amit , Teknos Theodoros N. , Ozer Enver
Published: March 2015

Background

The literature is scarce regarding transoral robotic surgery (TORS) with simultaneous neck dissection. This study evaluates the safety and efficacy of concurrent neck dissection in oropharyngeal squamous cell carcinoma (SCC) treated with TORS.

Methods

Analysis of 113 patients with oropharyngeal SCC treated with TORS and concurrent neck dissection.

Results

Six intraoperative communications between the pharynx and neck region were recognized. After pharyngeal mucosal flap advancement, 1 defect was closed primarily and another one was reinforced with acellular dermal matrix. In 1 case, submandibular gland was transposed posteriorly over the sutured defect as a support. One omohyoid and 2 digastric muscular pedicle rotation flaps were used in the remaining 3 patients for the reconstruction of pharyngeal communications. None of the patients developed postoperative pharyngocutaneous fistula.

Conclusion

The advantage of TORS oropharyngectomy, when compared with open approaches, is the avoidance of pharyngocutaneous fistula even in the presence of concurrent neck dissection © 2015 Wiley Periodicals, Inc. Head Neck 38: E519–E523, 2016
Orbital carcinomas treated with adjuvant intensity‐modulated radiation therapy
Authors: Tao Randa , Ma Dominic , Takiar Vinita , Frank Steven J. , Fuller Clifton D. , Gunn G. Brandon , Beadle Beth M. , Morrison William H. , Rosenthal David I. , Edson Mark A. , Esmaeli Bita , Kupferman Michael E. , Hanna Ehab Y. , Garden Adam S. , Phan Jack
Published: March 2015

Background

The purpose of this study was to assess outcomes of patients with orbital carcinomas treated with orbital exenteration and intensity‐modulated radiation therapy (IMRT).

Methods

Twenty‐nine patients were treated with orbital exenteration and postoperative IMRT between 2002 through 2011; their medical records were retrospectively reviewed.

Results

Adenoid cystic carcinoma represented the most common histology (41%) followed by squamous cell carcinoma (21%). Perineural invasion (PNI) was identified in 22 patients (76%). The median radiation dose was 60 Gy (range, 60–70). Seven patients (24%) received neck radiation. The median follow‐up was 43 months (range, 5–102 months). Five‐year local control, overall survival (OS), and disease‐free survival rates were 83%, 60%, and 55%, respectively. PNI (p = .01) and especially involvement of a named nerve (p = .001) significantly correlated with worse OS.

Conclusion

Favorable disease control rates for orbital carcinomas are achievable with IMRT after orbital exenteration even for patients with advanced disease. Toxicity for the contralateral eye was minimal. © 2015 Wiley Periodicals, Inc. Head Neck 38: E580–E587, 2016
Prospective, randomized controlled trial on use of ropivacaine after robotic thyroid surgery: Effects on postoperative pain
Authors: Bae Dong Sik , Kim Su‐jin , Koo Do Hoon , Paek Se‐Hyun , Kwon Hyungju , Chai Young Jun , Choi June Young , Lee Kyu Eun , Youn Yeo‐Kyu
Published: March 2015

Background

We evaluated the effects of ropivacaine for pain relief after robotic thyroid surgery.

Methods

One hundred eight patients scheduled for robotic thyroid surgery were randomized into ropivacaine (n = 54) or control (n = 54) groups. After surgery, 40 mL of 0.25% ropivacaine or 0.9% saline (control) was instilled into the skin flap. Postoperative pain intensity (visual analog scale [VAS]), analgesic requirements (fentanyl), and adverse events were assessed at 1, 2, 4, 8, 16, and 24 hours postoperatively.

Results

One hundred three patients completed the study protocol. VAS scores were lower in the ropivacaine group than the control group (p = .010); however, VAS scores were not significantly different after 8 hours postoperatively. Total analgesic consumption was higher in controls than ropivacaine‐treated patients (p = .01). Adverse events did not differ between the 2 groups.

Conclusion

Ropivacaine instillation after robotic thyroid surgery reduces acute postoperative pain and analgesic requirements without adverse events. © 2015 Wiley Periodicals, Inc. Head Neck 38: E–E, 2016
Impact of resection margin status on outcome after salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma
Authors: Chan Jimmy Yu Wai , Wei William Ignace
Published: March 2015

Background

The purpose of this study was to present the postoperative local tumor control and survival with regard to the different resection margin statuses during salvage nasopharyngectomy.

Methods

We conducted a whole‐organ study of nasopharyngectomy specimens.

Results

Between 2005 and 2010, 126 patients underwent maxillary swing nasopharyngectomy. The T classification of the recurrent tumor was: T1, 23.8%; T2, 41.3%; T3, 28.6%; and T4, 6.3%. The chance of clear, close, and involved resection margins at nasopharyngectomy was 44.4%, 31.0%, and 24.6%, respectively. At follow‐up, the corresponding risk of local tumor recurrence after surgery was 10.7%, 38.5%, and 67.7%, respectively. The local tumor control was significantly worse in patients with involved margins compared with those with close margins (p = .01), which was, in turn, significantly worse than those with clear margins (p = .04).

Conclusion

The primary objective of salvage nasopharyngectomy is to achieve clear resection margins. Close and involved margins result in significantly inferior local tumor control and overall survival. © 2015 Wiley Periodicals, Inc. Head Neck 38: E594–E599, 2016
Coordinating with the “Inner GPS”
Authors: Fenton André A.
Published: March 2015

The 2014 Nobel Prize for Physiology or Medicine was awarded for the discoveries that have elucidated the components of the internal positioning system that is centered on the hippocampus and entorhinal cortex. Here I provide a less than objective discussion of the importance of these accomplishments to systems neuroscience. By identifying positioning components like place, direction, distance, borders and the like, the field is given the opportunity to have a shot at piecing together how these components are integrated into the synthetic positioning sense. We are also given what is in my view, the most experimentally accessible and therefore potentially understandable, cognitive representation. Lest we feel too confident in the completeness of our understanding, and to inspire redoubled curiosity, I briefly describe a preliminary observation from our work with the psychosis‐inducing drug phencyclidine (PCP). While PCP does not disturb where individual place cells fire, it dramatically discoordinates how these cells discharge together in time. Trying to understand how the positioning component cells are coordinated to provide useful knowledge is an exciting and tenable problem to be working on. © 2015 Wiley Periodicals, Inc.
Life Cycle Energy and Greenhouse Gas Emission Analysis of Groundwater‐Based Irrigation Systems
Authors: Acharya Sharmila , George Biju , Aye Lu , Nair Sudeep , Nawarathna Bandara , Malano Hector
Published: March 2015

The reliance on groundwater for irrigation is increasing in Australia and India, which is causing concerns to policy makers about energy consumption and greenhouse gas (GHG) emissions. Therefore, it is important to quantify the GHG emissions of all components of the groundwater‐based irrigation systems, over the entire life cycle to develop more environmentally friendly groundwater management strategies. This study identified and analysed energy use and GHG emissions associated with different components in the supply chain of groundwater‐based irrigation systems. An existing GHG emissions and energy‐accounting framework was adapted to enhance its capabilities by considering drilling techniques, water distribution and irrigation application methods. The results of this study highlighted that embodied and direct GHG emissions from drilling tube wells were higher in the Musi catchment, India, compared to South Australia. The study also highlighted that GHG emissions associated with water conveyance were higher for concrete and plastic‐lined channels than unlined channels. Drip irrigation systems in both countries were found to have more GHG emissions than gravity‐fed systems. Centre pivot systems were found to be emitting more than the drip systems in South Australia. We conclude that different components of the system have an impact on total GHG emissions and energy consumption for both countries. Any change in the most commonly used methods of drilling bore wells, water distribution in channels, and the irrigation methods, will have distinct impacts on energy consumption rates and GHG emissions. The developed conceptual framework provided a systematic complete analysis of the energy‐consuming and GHG‐emitting components associated with groundwater‐based irrigation systems. Policy makers and decision makers may use the developed framework to compare different system components to develop strategies that have minimal impact on the environment. Copyright © 2015 John Wiley & Sons, Ltd.
Environmental Benefits of Improved Water and Nitrogen Management in Irrigated Sugar Cane: A Combined Crop Modelling and Life Cycle Assessment Approach
Authors: van der Laan M. , Jumman A. , Perret S. R.
Published: March 2015

The application of irrigation water and nitrogen (N) fertilizer in excess of crop demand reduces profitability and has multiple detrimental impacts on the environment. N dynamics in agro‐ecosystems are extremely complex, and mechanistic crop models are most often required to quantify the impact of improved management practices on reducing fertilizer N losses. In this study, life cycle assessment (LCA) methodology and mechanistic modelling were used to quantify the environmental benefits of improved management of water and fertilizer N by sugar cane farmers in a case study in Pongola, South Africa. A baseline scenario, representing farmer intuition‐based irrigation scheduling management, and two additional scenarios in which water, and water and N were more rationally managed, were compared. Results show that improved water and N management can lead to a 20% reduction in non‐renewable energy consumption per functional unit (FU), with sustained or even increased yields. Total greenhouse gas (GHG) emissions can potentially be reduced by 25% through more efficient water and N management. Limiting the rates of fertilizer N applied, made possible by decreasing N leaching through improved irrigation scheduling, resulted in the highest reductions for both impact categories. While total water consumption was very similar between the scenarios, more efficient use of rainfall was achieved through accurate scheduling, reducing blue water requirements. Through the simultaneous consideration of multiple environmental impacts, combining mechanistic crop modelling and LCA shows potential to identify improved management practices as well as to establish environmental stewardship incentives. Copyright © 2015 John Wiley & Sons, Ltd.
Fabrication of the Monolithic Fiber for the Solid Phase Micro‐extraction of Malachite Green
Authors: Hu Mei , Chen Jin , Yang Jing‐Hua , Zhang Yu‐Ping , Zhou Xiao‐Mao , Bai Lian‐Yang
Published: March 2015

A monolithic fiber of molecularly imprinted polymer (MIP) was prepared by in situ polymerization within the capillary with an inner diameter of 530 µm. It was carried out in 8 min by microwave irradiation using malachite green (MG) as a template molecule, α‐methacrylic acid (MAA) as a functional monomer, acetonitrile (ACN) as a porogenic solvent, ethylene dimethacrylate (EDMA) as a crosslinker, azodiiso‐butyronitrile (AIBN) as a thermal initiator. The resulted MIP fibers were pushed out from the capillary, eluted and inserted in the capillary again, which successfully used for the solid phase microextraction (SPME) procedure. The factors affecting the extraction of MG, such as the molar ratio of template/monomer (MG/MAA), concentration of NaCl, extraction and desorption time, and extraction and desorption solvents were investigated in detail. The selectivity of the MIP fibers was compared using MG analogues crystal violet (CV) and non‐analogue Sudan II. It was also employed for the pretreatment of trace MG in the fish feed followed by high‐performance liquid chromatography (HPLC) detection. Under the optimal conditions, the linear range of MG was 10‐600 μg/L, the detection limit (LOD) was 1.23 μg/L and the recovery of spiked fish feed sample was 88.7∼113.9%.
A Selective Colorimetric and Fluorescent Chemodosimeter for Fe(III) Ion Based on Hydrolysis of Schiff Base
Authors: Tsai Haw‐Tyng , Bhorge Yeshwant Ramchandra , Pape Albert J. , Janaki Sudhakar Narasimha , Yen Yao‐Pin
Published: March 2015

An efficient colorimetric and fluorescent chemodosimeter for Fe3+ ions has been developed. The visual and fluorescent behaviors of the receptor toward various metal ions were investigated. The receptor shows exclusive response toward Fe3+ ions and also distinguishes Fe3+ from other cations by color change and unusual fluorescence enhancement in aqueous solution (DMSO/H2O = 4/1, v/v). Thus, the receptor can be used as a colorimetric and fluorescent sensor for the determination of Fe3+ ion. The visual color detection limit and the fluorescence detection limit of the receptor towards Fe3+ are (1.42 ± 0.01) × 10‐6 M and (7.57 ± 0.04) × 10‐8 M, respectively. The fluorescence microscopy experiments showed that the receptor is efficient for detection of Fe3+ in vitro, developing a good image of the biological organelles. The sensing mechanism is proven to be a hydrolysis process
Choroidal thickness and retinal vascular caliber correlations with internal carotid artery Doppler variables
Authors: Agladioglu Kadir , Pekel Gökhan , Citisli Veli , Yagci Ramazan
Published: March 2015

Purpose

Decreased retinal arteriolar caliber and increased retinal venular caliber have been associated with increased cardiovascular mortality. This study aimed to evaluate correlations of choroidal thickness and retinal vascular caliber measurements with internal carotid artery (ICA) Doppler ultrasound variables.

Methods

In this cross‐sectional and observational study, 43 eyes and ICAs of 43 healthy volunteers were examined. Spectral domain optical coherence tomography was used to measure subfoveal choroidal thickness (SFCT) and retinal vascular caliber. The ICA Doppler ultrasonographic parameters were diameter, flow volume, peak‐systolic velocity, end‐diastolic velocity, resistance index (RI), and pulsatility index (PI).

Results

Negative correlations emerged between ICA RI and SFCT (p = 0.017, r = −0.36) as well as between ICA PI and retinal arteriolar caliber (p = 0.015, r = −0.37). A negative linear correlation appeared between ICA diameter and SFCT (p = 0.005, r = −0.42), although ICA diameter and flow volume showed no association with retinal vessel caliber (p > 0.05).

Conclusions

Choroidal thickness is negatively correlated with ICA diameter and ICA RI, while retinal arteriolar caliber is inversely related with ICA PI in normal volunteers. © 2015 Wiley Periodicals, Inc. J Clin Ultrasound 43:567–572, 2015
Intermittent Pringle maneuver is unlikely to induce bacterial translocation to the portal vein: a study using bacterium‐specific ribosomal RNA‐targeted reverse transcription‐polymerase chain reaction
Authors: Yamaguchi Naoya , Yokoyama Yukihiro , Ebata Tomoki , Igami Tsuyoshi , Sugawara Gen , Asahara Takashi , Nomoto Koji , Nagino Masato
Published: March 2015

Background

The occurrence of bacterial translocation (BT) to the mesenteric lymph nodes following the Pringle maneuver is well established; however, the incidence of BT to the portal circulation remains unclear.

Methods

Portal blood of patients with suspected hilar malignancy who underwent major hepatobiliary resection with cholangiojejunostomy was sampled three times during surgery: immediately after laparotomy (PV‐1); before liver transection and after skeletonization of the hepatoduodenal ligament (PV‐2); and after completion of the liver transection (PV‐3). The samples were analyzed for microbes with a bacterium‐specific ribosomal RNA‐targeted reverse transcription‐polymerase chain reaction method.

Results

Fifty patients were enrolled in the study, with a mean total Pringle time of 86 min. Microbes in the portal blood were detected in 11 (22%) of the 50 patients. The occurrence of microbes was not different among the PV‐1 samples (8% = 4/50), PV‐2 samples (14% = 7/50), and PV‐3 samples (14% = 7/50) (P = 0.567). Obligate anaerobes were predominantly detected. The positivity of the PV‐3 samples showed no correlation with the total Pringle time or with the occurrence of postoperative infectious complications. The total Pringle time did not affect the surgical outcomes, including infectious complications, liver failure, or mortality. The concentrations of aspartate aminotransferase and alanine aminotransferase on postoperative day 1 significantly correlated with the total Pringle time.

Conclusions

The intermittent Pringle maneuver is unlikely to induce BT to the portal circulation and is safe, even in difficult, complicated hepatobiliary resections requiring long clamping times.
Viral gastroenteritis in children in Colorado 2006–2009
Authors: Osborne Christina M. , Montano Aaron C. , Robinson Christine C. , Schultz‐Cherry Stacey , Dominguez Samuel R.
Published: March 2015

Acute gastroenteritis accounts for a significant burden of medically attended illness in children under the age of five. For this study, four multiplex reverse transcription PCR assays were used to determine the incidence of adenovirus, astrovirus, coronavirus, norovirus GI and GII, rotavirus, and sapovirus in stool samples submitted for viral electron microscopy (EM) to the Children's Hospital Colorado. Of 1105 stool samples available, viral RNA/DNA was detected in 247 (26.2%) of 941 pediatric samples (median age = 2.97 years, 54% male) with 28 (3.0%) positive for more than one virus. Adenovirus, astrovirus, norovirus GI, norovirus GII, rotavirus, and sapovirus were detected in 95 (10.0%), 33 (3.5%), 8 (0.9%), 90 (9.6%), 49 (5.2%), and 2 (0.2%) of the pediatric samples, respectively. No coronaviruses were identified. Sequencing of norovirus positive samples indicated an outbreak of norovirus strain GII.4 in 2006 with evidence of numerous circulating strains. Multiple samples from the same immunocompromised patients demonstrated symptomatic shedding of norovirus for up to 32 weeks and astrovirus for 12 weeks. RT‐PCR detected 99 of 111 (89%) adenovirus‐positive samples versus 12 (11%) by EM, and 186 of 192 (97%) sapovirus/astrovirus/norovirus‐positive samples versus 21 (11%) by EM. Noroviruses and adenoviruses are common causes of gastroenteritis in children. Immunocompromised patients can be infected with multiple viruses and shed viruses in their stools for prolonged periods. This data support the superiority of RT‐PCR compared to EM for diagnosis of viral gastroenteritis. J. Med. Virol. 87:931–939, 2015. © 2015 Wiley Periodicals, Inc.
A potential peptide pathway from viruses to oral lichen planus
Authors: Lucchese Alberta
Published: March 2015

Oral lichen planus is an idiopathic inflammatory disease of oral mucous membranes, characterized by an autoimmune epidermis attack by T cells. It remains unknown, however, how such aggressive T cells are activated in vivo to cause epidermal damage. This study analyzes the relationship at the peptide level between viruses and oral lichen planus disease. Four potentially immunogenic peptides (SSSSSSS, QEQLEKA, LLLLLLA, and MLSGNAG) are found to be shared between HCV, EBV, HHV‐7, HSV‐1, and CMV and three human proteins (namely pinin, desmoglein‐3, and plectin). The described peptide sharing might be of help in deciphering the still unexplained immunopathogenic pathway that leads to oral lichen planus. J. Med. Virol. 87:1060–1065, 2015. © 2015 Wiley Periodicals, Inc.
Norovirus genotype diversity in community‐based sporadic gastroenteritis incidents: A five‐year study
Authors: Bruggink Leesa D. , Dunbar Natalie L. , Marshall John A.
Published: March 2015

Although norovirus is a known cause of sporadic gastroenteritis, the incidence and genotypes of norovirus associated with sporadic community‐based gastroenteritis are poorly understood. The current study examined this issue by using material from alleged food poisoning incidents in the state of Victoria, Australia, for the period 2008–2012. Norovirus was identified, by either ORF (open reading frame) 1 or ORF 2 RT‐PCR methodology, in 159 of 379 (42.0%) sporadic gastroenteritis incidents, thereby showing that norovirus was an important cause of sporadic gastroenteritis. The number of sporadic norovirus incidents did not vary significantly from year to year, indicating that the pool of circulating norovirus remained constant. Norovirus ORF 1 genotypes identified included GI.1, GI.2, GI.3, GI.4, GI.b, GI.d, GII.2, GII.4 (including variants 2006a, 2006b, 2007, and 2009), GII.16, GII.22, GII.b, GII.e, and GII.g. Norovirus ORF 2 genotypes identified included GI.1, GI.2, GI.3, GI.4, GI.6, GII.2, GII.3, GII.4 (variants 2006b, 2009, 2009‐like, 2012, and “unknown”), GII.6, GII.7, GII.9, GII.12, and GII.13. Five ORF 1/ORF 2 norovirus recombinant forms were confirmed: GII.b/GII.3, GII.e/GII.4 (2012), GII.e/GII.4 (unknown), GII.g/GII.12 and GII.16/GII.2. Although the incidence of ORF 2 GI.3 was significantly higher in children than in adults, this was not the case for other major ORF 2 genotypes (GII.2, GII.4, and GII.6) which occurred equally in all age groups. The findings demonstrate the importance and diverse nature of norovirus in sporadic community‐based gastroenteritis incidents and indicate that the development of successful vaccine strategies may be difficult. J. Med. Virol. 87:961–969, 2015. © 2015 Wiley Periodicals, Inc.
Trends on epidemiological, virological, and clinical features among newly diagnosed HIV‐1 persons in Northwest Spain over the last 10 years
Authors: Pernas B. , Mena A. , Cañizares A. , Grandal M. , Castro‐Iglesias A. , Pértega S. , Pedreira J.D. , Poveda E.
Published: March 2015

To describe temporal trend and characteristics of newly HIV‐diagnosed patients in a medical care area in Northwest Spain over the last 10 years. All newly diagnosed patients for HIV‐infection from 2004 to 2013 at a reference medical care area in Northwest of Spain were identified. Epidemiological, virological, immunological, and clinical data, as well as HIV genotype and drug resistance information were recorded. A total of 565 newly HIV‐diagnosed patients were identified. The number of new cases increased in the last 5 years (66 cases/year). Overall, 53.1% had a median CD4 counts < 350 cells/µl and 33.6% had an AIDS defining criteria. Non‐B variants were found in 34.4% of patients being subtype F (25.8%) the most common non‐B subtype. The rate of transmitted drug resistance (TDR) over the study period was 3.7%, but a decreased to 2.6% was observed in the last 5 years. The most prevalent TDR mutations were: T215 revertants (1.5%), K219QENR (1.2%), for NRTIs; K103N (1.9%), for NNRTIs; L90M (0.3%), for PIs. Overall, 73.2% of patients started antiretroviral treatment and 9.9% of patients died during follow‐up. The number of newly HIV diagnosed patients increased since year 2009. There is a high prevalence of late diagnosis (53%) and 33% had an AIDS defining criteria. Interestingly, the most prevalent non‐B subtype in our population was F (25.8%). These findings support the need to facilitate the access for HIV testing to reduce the rate of late HIV diagnosis, improve the clinical outcome and prevent HIV transmission. J. Med. Virol. 87:1319–1326, 2015. © 2015 Wiley Periodicals, Inc.
Lack of evidence that adherence to standard of care therapy improves survival in subjects with hepatocellular carcinoma in clinical practice
Authors: Guarino Maria , Stroffolini Tommaso , Lombardo Flavia Lucia , Loperto Ilaria , Auriemma Francesco , Gentile Ivan , Caporaso Nicola , Morisco Filomena
Published: March 2015

Currently, the BCLC classification, which links tumor stage with treatment option, is the standard system for clinical management of HCC. Thus far, this approach has been considered the standard of care worldwide. This study aimed to evaluate the survival of patients with HCC according to the BCLC Stage, surveillance, and adherence to standards of care. A 3‐year prospective study enrolled 92 consecutive patients with HCC in the Gastroenterology Unit of the University of Naples “Federico II”. Predictors of the likelihood of death were evaluated by the multivariate Cox model. Forty out of 92 (43%) subjects died during three years of follow up. The overall mortality rate per 100 person–years was 16.7, while the mortality rate for hepatic causes was only 14.2; it was lower in subjects under surveillance (11.4 vs. 28.2), in subjects adherent to standards of care (12.0 vs. 21.1), and in those who were in a better BCLC stage (10.6 vs. 45.8). The multivariate Cox model showed that advanced BCLC stage (HR 4.1, 95%C.I. = 1.8–9.4) was the sole independent predictor of the likelihood of mortality. In this regard, we observed lack of evidence that the adherence to the BCLC recommendations reduces the mortality of patients with HCC; and that the BCLC system cannot be accepted as a “commandment” to be invariably followed in everyday practice. Strategies to help improve adherence to international guidelines for HCC in clinical practice are required. J. Med. Virol. 87:1368–1376, 2015. © 2015 Wiley Periodicals, Inc.
Spatio‐temporal characteristics of the recent rainfall recovery in West Africa
Authors: Sanogo Souleymane , Fink Andreas H. , Omotosho Jerome A. , Ba Abdramane , Redl Robert , Ermert Volker
Published: March 2015

Using daily (monthly) rainfall data from 167 (254) stations across West Africa with at least 80% data availability for the 31‐year period 1980–2010 and the gridded African Rainfall Climatology Version 2 (ARC2) for the period 1983–2010, linear trends in yearly and monthly rainfall totals were investigated. Measures of the Expert Team on Climate Change Detection and Indices (ETCCDI) and two rainy season onset and retreat definitions were employed to assess the corresponding trends in frequency and intensity of daily rainfall and changes to monsoon season length. A rotated Empirical Orthogonal Function analysis yielded two homogeneous rainfall regions, the Sahel and Guinea Coast, in terms of interannual to decadal rainfall variability, and this led to analysis of station data and Standardised Precipitation Index for the two regions. Results show that the majority of stations in the Sahel between the West Coast and 15°E shows a statistically significant positive rainfall trend for annual totals. The August–October period exhibits the largest rainfall recovery in the Sahel and the date of the retreat of the rainy season significantly moved later into the year by 2 days decade−1. The recovery is reflected both in more rainy days associated with longer wet spell duration and more extreme rainfall events. Trends along the Guinea Coast are weak and non‐significant except for extreme rainfall related indices. This missing significance is partly related to the hiatus in rainfall increase in the 1990s, but also to the larger interannual rainfall variability. However, the tendency towards a more intense second rainy season suggests a later withdrawal of rains from the West African subcontinent. ARC2 trends are broadly consistent where ground calibration was undertaken, but are dubious for Nigeria and Ghana, and especially for the Guinea, Jos and Cameroon Line highlands due to missing gauge data.
Baroque glass mosaics from the Capela de São João Baptista (Chapel of Saint John the Baptist, Lisbon): unveiling the glassmaking records
Authors: Muralha Vânia S. F. , Canaveira Sara , Mirão José , Coentro Susana , Morna Teresa , Salerno Carlo Stefano
Published: March 2015

For the first time, 18th‐century glass mosaics from the Capela de São João Baptista (Chapel of St. John the Baptist, Lisbon) were analysed by Raman microscopy (RM). This masterpiece in baroque mosaic art had one of its major contributors the most famous glassmaker in Rome, Alessio Mattioli. Mattioli was celebrated because of the opacity of his mosaics and the astonishing number of hues he was able to produce for mosaic decorating Saint Peter's Basilica in Rome. This study had two goals in mind: (1) characterising the materials involved in the manufacture of these glass mosaics and (2) lengthening the understanding of what was left of Mattioli's glassmaking records. As expected the mosaics presented a high ratio of crystalline phases, making RM the ideal technique for non‐destructive analysis. The mosaics contained a white ‘background’ or opacifier added identified as Ca2Sb2O7. The yellow tesserae are opacified with lead antimonate (Pb2Sb2O7) and ternary oxides, structures related to lead antimonate but with other ions entering the position of Sb4+ (namely Sn4+). Those ternary oxides are pervasive in most colours, admixed with other colorants. The red, orange, pink and brown colours were accomplished with cuprous oxide (Cu2O) and admixed with a ternary oxide to create the latter three colours. The red copper‐based colours were made according to the procedure to make a ruby copper glass and with the exception of the red colour; all mosaics exhibited a dark layer on each side of the mosaic, named scorzetta. This layer is the outcome of an oxidation reaction because of a quick cooling process and is composed of CuO. Finally the blue and green colours are accomplished with cobalt oxide and copper oxide, respectively, and the purple/black colour with manganese oxide. Copyright © 2015 John Wiley & Sons, Ltd.
Identification and quantification of 34 drugs and toxic compounds in blood, urine, and gastric content using liquid chromatography with tandem mass spectrometry
Authors: Liang Chen , Ye Haiying , Wang Rong , Ni Chunfang , Rao Yulan , Zhang Yurong
Published: March 2015

A liquid chromatography with tandem mass spectrometry method was developed for the simultaneous screening of 34 drugs and poisons in forensic cases. Blood (0.5 mL, diluted 1:1 with water) or 1.0 mL of urine was purified by solid‐phase extraction. Gastric contents (diluted 1:1 with water) were treated with acetonitrile, centrifuged, and supernatant injected. Detection was achieved using a Waters Alliance 2695/Quattro Premier XE liquid chromatography tandem mass spectrometry system equipped with electrospray ionization, operated in the multiple reaction monitoring modes. The method was validated for accuracy, precision, linearity, and recovery. The absolute recovery of drugs and toxic compounds in blood was greater than 51% with the limit of detection in the range of 0.02–20 ng/mL. The absolute recovery of drugs and toxic compounds in urine was greater than 61% with limit of detection in the range of 0.01–10 ng/mL. The matrix effect of drugs and toxic compounds in urine was 65–117% and 67–121% in blood. The limit of detection of drugs and toxic compounds in gastric content samples were in the range of 0.05–20 ng/mL. This method was applied to the routine analysis of drugs and toxic compounds in postmortem blood, urine, and gastric content samples. The method was applied to actual forensic cases with examples given.
Direct parasagittal magnetic resonance imaging of the internal auditory canal to determine cochlear or auditory brainstem implant candidacy in children
Authors: Noij Kimberley S. , Remenschneider Aaron K. , Kozin Elliott D. , Puram Sidharth , Herrmann Barbara , Cohen Michael , Cunnane Mary Beth , Lee Daniel J.
Published: March 2015

Laryngoscope, 125:2382–2385, 2015
Effects of honey on oral mucositis in patients with head and neck Cancer: A meta‐analysis
Authors: Cho Hye Kyung , Jeong Yeon Min , Lee Ho Seok , Lee Yeon Ji , Hwang Se Hwan
Published: March 2015

Objectives/Hypothesis

The objective of this study was to perform a meta‐analysis of the efficacy of honey in the management of oral mucositis during radiotherapy in patients with head and neck cancer.

Study Design

Meta‐analysis using MEDLINE, Scopus, and the Cochrane Library as data sources.

Methods

Two authors independently searched the databases for relevant studies from inception to June 2014. Included in the meta‐analysis were randomized controlled studies published in English comparing the oral administration of honey (honey group) with placebo or no treatment (control group) in patients with head and neck cancer who were undergoing radiotherapy or chemoradiotherapy. Excluded studies failed to report quantifiable outcome measures regarding oral mucositis. Outcomes of interest included the degree and incidence of mucositis, incidence of microbial colonization, and weight loss.

Results

Nine studies comprising 476 patients were included in the meta‐analysis. The incidence of moderate to severe mucositis and the mean mucositis grade during the first 3 weeks of therapy were significantly lower in the honey group than the control group. Additionally, the onset of mucositis was significantly later in the honey group than the control. Although there were no significant differences in the incidences of microbial colonization and pain experienced between the two groups, the incidence of weight loss was significantly lower in the honey group than control group.

Conclusions

Oral administration of honey after radiotherapy could prevent moderate to severe mucositis and associated weight loss. However, because our results were based on an analysis of a small number of trials, further trials are required to confirm these results.

Level of Evidence

NA Laryngoscope, 125:2085–2092, 2015
Long‐term in vivo electromechanical reshaping for auricular reconstruction in the New Zealand white rabbit model
Authors: Badran Karam W. , Manuel Cyrus T. , Loy Anthony Chin , Conderman Christian , Yau Yuk Yee , Lin Jennifer , Tjoa Tjoson , Su Erica , Protsenko Dmitriy , Wong Brian J. F.
Published: March 2015

Objectives/Hypothesis

To demonstrate the dosimetry effect of electromechanical reshaping (EMR) on cartilage shape change, structural integrity, cellular viability, and remodeling of grafts in an in vivo long‐term animal model.

Study Design

Animal study.

Methods

A subperichondrial cartilaginous defect was created within the base of the pinna of 31 New Zealand white rabbits. Autologous costal cartilage grafts were electromechanically reshaped to resemble the rabbit auricular base framework and mechanically secured into the pinna base defect. Forty‐nine costal cartilage specimens (four control and 45 experimental) successfully underwent EMR using a paired set of voltage‐time combinations and survived for 6 or 12 weeks. Shape change was measured, and specimens were analyzed using digital imaging, tissue histology, and confocal microscopy with LIVE‐DEAD viability assays.

Results

Shape change was proportional to charge transfer in all experimental specimens (P < .01) and increased with voltage. All experimental specimens contoured to the auricular base. Focal cartilage degeneration and fibrosis was observed where needle electrodes were inserted, ranging from 2.2 to 3.9 mm. The response to injury increased with increasing charge transfer and survival duration.

Conclusions

EMR results in appropriate shape change in cartilage grafts with chondrocyte injury highly localized. These studies suggest that elements of auricular reconstruction may be feasible using EMR. Extended survival periods and further optimization of voltage‐time pairs are necessary to evaluate the long‐term effects and shape‐change potential of EMR.

Levels of Evidence

NA Laryngoscope, 125:2058–2066, 2015
Impact of educational intervention on the interrater agreement of nasal endoscopy interpretation
Authors: Colley Patrick , Mace Jess C. , Schaberg Madeleine R. , Smith Timothy L. , Tabaee Abtin
Published: March 2015

Objective

Nasal endoscopy is integral to the evaluation of sinonasal disorders. However, prior studies have shown significant variability in the interrater agreement of nasal endoscopy interpretation among practicing rhinologists. The objective of the current study is to evaluate the interrater agreement of nasal endoscopy among otolaryngology residents from a single training program at baseline and following an educational intervention.

Methods

Eleven otolaryngology residents completed nasal endoscopy grading forms for eight digitally recorded nasal endoscopic examinations. An instructional lecture reviewing nasal endoscopy interpretation was subsequently provided. The residents then completed grading forms for eight different nasal endoscopic examinations. Interrater agreement among residents for the pre‐ and postlecture videos was calculated using the unweighted Fleiss' kappa (Kf) statistic and intraclass correlation agreement (ICC).

Results

Interrater agreement improved from a baseline level of fair (Kf range 0.268–0.383) to a posteducational level of moderate (Kf range 0.401–0.547) for nasal endoscopy findings of middle meatus mucosa, middle turbinate mucosa, middle meatus discharge, sphenoethmoid recess mucosa, sphenoethmoid recess discharge, and atypical lesions (ICC, P < 0.001). The baseline level of agreement for evaluation of nasal septum deviation was poor/fair and did not improve following educational intervention.

Conclusions

This study demonstrates a limited baseline level of interrater agreement of nasal endoscopy interpretation among otolaryngology residents. The interrater agreement for the majority of the characteristics that were evaluated improved after educational intervention. Further study is needed to improve nasal endoscopy interpretation.

Level of Evidence

N/A. Laryngoscope, 125:2259–2265, 2015
Gene expression demonstrates an immunological capacity of the human endolymphatic sac
Authors: Møller Martin Nue , Kirkeby Svend , Vikeså Jonas , Nielsen Finn Cilius , Cayé‐Thomasen Per
Published: March 2015

Objectives/Hypothesis

The purpose of the present study is to explore, demonstrate, and describe the expression of genes related to the innate immune system in the human endolymphatic sac. It is hypothesized that the endolymphatic sac has a significant immunological function in the human inner ear.

Study Design

DNA microarrays and immunohistochemistry were used for analyses of fresh human endolymphatic‐sac tissue samples.

Methods

Twelve tissue samples from the human endolymphatic sac were obtained during translabyrinthine surgery for vestibular schwannoma. Microarray technology was used to investigate tissue sample gene expression using adjacent dura mater as control. The expression of genes specific for the innate immune system was determined and results for selected key molecules verified by immunohistochemistry.

Results

A comprehensive overview of expressed genes of the innate immune system was obtained. Multiple key elements of both the cellular and humoral innate immune system were expressed, including Toll‐like receptors 4 and 7, as well as beta‐defensin and lactoferrin.

Conclusions

The present data provides the first direct evidence of an immunological capacity of the human endolymphatic sac. At the molecular level, the endolymphatic sac is capable of antigen recognition and processing for initiation of an immune response. In addition, potent molecules directly toxic to invading pathogens are expressed by the sac epithelium.

This evidence strongly supports the endolymphatic sac as a significant immunological entity of the inner ear.

Level of Evidence

N/A.Laryngoscope, 125:E269–E275, 2015
Using google glass to solve communication and surgical education challenges in the operating room
Authors: Moshtaghi Omid , Kelley Kanwar S. , Armstrong William B. , Ghavami Yaser , Gu Jeffery , Djalilian Hamid R.
Published: March 2015

Laryngoscope, 125:2295–2297, 2015
The effects of alterations in the osseous external auditory canal on perceived sound quality
Authors: van Spronsen Erik , Brienesse Patrick , Ebbens Fenna A. , Waterval Jerome J. , Dreschler Wouter A.
Published: March 2015

Objectives/Hypothesis

To evaluate the perceptual effect of the altered shape of the osseous external auditory canal (OEAC) on sound quality.

Study Design

Prospective study.

Methods

Twenty subjects with normal hearing were presented with six simulated sound conditions representing the acoustic properties of six different ear canals (three normal ears and three cavities). The six different real ear unaided responses of these ear canals were used to filter Dutch sentences, resulting in six simulated sound conditions. A seventh unfiltered reference condition was used for comparison. Sound quality was evaluated using paired comparison ratings and a visual analog scale (VAS).

Results

Significant differences in sound quality were found between the normal and cavity conditions (all P < .001) using both the seven‐point paired comparison rating and the VAS. No significant differences were found between the reference and normal conditions. Sound quality deteriorates when the OEAC is altered into a cavity.

Conclusions

This proof of concept study shows that the altered acoustic quality of the OEAC after radical cavity surgery may lead to a clearly perceived deterioration in sound quality. Nevertheless, some questions remain about the extent to which these changes are affected by habituation and by other changes in middle ear anatomy and functionality.

Level of Evidence

4 Laryngoscope, 125:2362–2365, 2015
Surveillance direct laryngoscopy and bronchoscopy in children with tracheostomies
Authors: Richter Amy , Chen Diane Wenhua , Ongkasuwan Julina
Published: March 2015

Objectives/Hypothesis

To determine utility of surveillance direct laryngoscopy and bronchoscopy (DLB) in children with chronic tracheostomies by examining the frequency of operative intervention in children undergoing an annual DLB.

Study Design

Retrospective medical record review and analysis of operative findings and interventions.

Methods

A retrospective chart review was conducted of all children with tracheostomies who underwent surveillance DLB between 2003 and 2012 at a tertiary children's hospital. Charts were reviewed for demographics, indication for tracheotomy, symptoms prior to DLB, dates of DLB, and operative findings and interventions.

Results

A total of 489 patients underwent 1,094 DLBs. Two hundred fifty‐three DLBs (23%) were accompanied by preprocedural symptoms including bleeding; increased secretions; infection; and changes in ventilation requirement, swallow, or voice. Six hundred nineteen procedures (58%) required 817 interventions. Common interventions performed included debridement of granulation tissue (41%), tracheostomy tube exchange (27%), and subglottic dilation (10%). The presence of preprocedural symptoms and indication for tracheostomy did not predict need for intervention during DLB (P > .05).

Conclusions

In pediatric tracheostomy patients undergoing surveillance DLB, most procedures (58%) required operative intervention for airway optimization. These data support our current practice of yearly surveillance DLB in asymptomatic pediatric tracheostomy patients and aim to facilitate the development of clinical practice guidelines regarding chronic tracheostomy care in pediatric patients.

Level of Evidence

4 Laryngoscope, 125:2393–2397, 2015
Decision support for organ offers in liver transplantation
Authors: Volk Michael L. , Goodrich Nathan , Lai Jennifer C. , Sonnenday Christopher , Shedden Kerby
Published: March 2015

Organ offers in liver transplantation are high‐risk medical decisions with a low certainty of whether a better liver offer will come along before death. We hypothesized that decision support could improve the decision to accept or decline. With data from the Scientific Registry of Transplant Recipients, survival models were constructed for 42,857 waiting‐list patients and 28,653 posttransplant patients from 2002 to 2008. Daily covariate‐adjusted survival probabilities from these 2 models were combined into a 5‐year area under the curve to create an individualized prediction of whether an organ offer should be accepted for a given patient. Among 650,832 organ offers from 2008 to 2013, patient survival was compared by whether the clinical decision was concordant or discordant with model predictions. The acceptance benefit (AB)—the predicted gain or loss of life by accepting a given organ versus waiting for the next organ—ranged from 3 to −2 years (harm) and varied geographically; for example, the average benefit of accepting a donation after cardiac death organ ranged from 0.47 to −0.71 years by donation service area. Among organ offers, even when AB was >1 year, the offer was only accepted 10% of the time. Patient survival from the time of the organ offer was better if the model recommendations and the clinical decision were concordant: for offers with AB > 0, the 3‐year survival was 80% if the offer was accepted and 66% if it was declined (P < 0.001). In conclusion, augmenting clinical judgment with decision support may improve patient survival in liver transplantation. Liver Transpl 21:784–791, 2015. © 2015 AASLD.