bluuebunny/crossref_metadata_2025 huggingface dataset:
The effectiveness of national guidance in changing analgesic prescribing in primary care from 2002 to 2009: An observational database study
Authors: Bedson J. , Belcher J. , Martino O.I. , Ndlovu M. , Rathod T. , Walters K. , Dunn K.M. , Jordan K.P.
Published: July 2012

Background

Numerous national guidelines have been issued to assist general practitioners’ safe analgesic prescribing. Their effectiveness is unclear. The objective of this study was to examine trends in general practitioners’ prescribing behaviour in relation to national guidelines.

Methods

This was a retrospective observational database study of registered adult patients prescribed an analgesic (2002–2009) from the Consultations in Primary Care Archive – 12 North Staffordshire general practices. Prescribing guidance from the UK Medicines Regulatory Health Authority (MHRA) regarding non‐steroidal anti‐inflammatory drugs (NSAIDs) and co‐proxamol, and the National Institute for Health and Clinical Excellence (NICE) osteoarthritis (OA) management guidelines were considered. Analgesic prescribing rates were examined, arranged according to a classification of six equipotent medication groups: (1) basic analgesics; (2)–(5) increasingly potent opioids and (6) NSAIDs. In each quarter from 2002 to 2009, the number of patients per 10,000 registered population receiving a prescription for the first time from each group was determined. Quarters associated with significant changes in the underlying prescribing trend were determined using joinpoint regression.

Results

A significant decrease in incident co‐proxamol and Cox‐2 prescribing occurred around the time of the first MHRA advice to stop using them and were rarely prescribed thereafter. The new prescribing of weak analgesics (e.g., co‐codamol 8/500) increased at this same time. Initiating topical NSAIDs significantly increased around the time of the NICE OA guidelines.

Conclusions

Significant prescribing changes occurred when national advice and guidelines were issued. The effectiveness of this advice may vary depending upon the content and method of dissemination. Further evaluation of the optimal methods for delivering prescribing guidance is required.
Perfectly registered multiphoton and reflectance confocal video rate imaging of in vivo human skin
Authors: Wang Hequn , Lee Anthony M.D. , Frehlick Zack , Lui Harvey , McLean David I. , Tang Shuo , Zeng Haishan
Published: July 2012

We present a multimodal in vivo skin imaging instrument that is capable of simultaneously acquiring multiphoton and reflectance confocal images at up to 27 frames per second with 256 × 256 pixel resolution without the use of exogenous contrast agents. A single femtosecond laser excitation source is used for all channels ensuring perfect image registration between the two‐photon fluorescence (TPF), second harmonic generation (SHG), and reflectance confocal microscopy (RCM) images. Images and videos acquired with the system show that the three imaging channels provide complementary information in in vivo human skin measurements. In the epidermis, cell boundaries are clearly seen in the RCM channel, while cytoplasm is better seen in the TPF imaging channel, whereas in the dermis, SHG and TPF channels show collagen bundles and elastin fibers, respectively. The demonstrated fast imaging speed and multimodal imaging capabilities of this MPM/RCM instrument are essential features for future clinical application of this technique. (© 2013 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
The role of endothelial-mesenchymal transition in heterotopic ossification
Authors: Medici Damian , Olsen Bjorn R
Published: July 2012

Heterotopic ossification (HO) is a process by which bone forms in soft tissues, in response to injury, inflammation, or genetic disease. This usually occurs by initial cartilage formation, followed by endochondral ossification. A rare disease called fibrodysplasia ossificans progressiva (FOP) allows this mechanism to be induced by a combination of genetic mutation and acute inflammatory responses. FOP patients experience progressive HO throughout their lifetime and form an ectopic skeleton. Recent studies on FOP have suggested that heterotopic cartilage and bone is of endothelial origin. Vascular endothelial cells differentiate into skeletal cells through a mesenchymal stem cell intermediate that is generated by endothelial-mesenchymal transition (EndMT). Local inflammatory signals and/or other changes in the tissue microenvironment mediate the differentiation of endothelial-derived mesenchymal stem cells into chondrocytes and osteoblasts to induce HO. We discuss the current evidence for the endothelial contribution to heterotopic bone formation. © 2012 American Society for Bone and Mineral Research.
Overexpression of FABP3 promotes apoptosis through inducing mitochondrial impairment in embryonic cancer cells
Authors: Song Gui Xian , Shen Ya Hui , Liu Yao Qiu , Sun Wei , Miao Li Ping , Zhou Li Juan , Liu Hai Lang , Yang Rong , Kong Xiang Qing , Cao Ke Jiang , Qian Ling Mei , Sheng Yan Hui
Published: July 2012

Fatty acid‐binding protein 3 (FABP3) is a low‐molecular‐weight protein with a distinct tissue distribution that may play an important role in fatty acid transport, cell growth, cellular signaling, and gene transcription. Previously, we have found that FABP3 was involved in apoptosis‐associated congenital cardiac malformations, but the underlying mechanisms have not yet been described. In the present study, we investigated the characteristics of mitochondrial dysfunction in embryonic cancer cells (P19 cells) that overexpressed FABP3. We demonstrated that in FABP3‐overexpressing P19 cells a lower cellular ATP production was accompanied by a dramatic decrease in mitochondrial membrane potential (MMP), despite the lack of a substantial decrease in the mtDNA copy number. In addition, FABP3 overexpression also led to an imbalance in mitochondrial dynamics and to excess intracellular reactive oxygen species production. Collectively, our results indicated that overexpression of FABP3 in P19 cells caused mitochondrion dysfunction that might be responsible for the development of FABP3‐induced apoptosis. J. Cell. Biochem. 113: 3701–3708, 2012. © 2012 Wiley Periodicals, Inc.
High absorption of endocrine disruptors by Hytrel: towards the development of a two‐phase partitioning bioreactor
Authors: Ouellette Julianne , dos Santos Silvia Cristina Cunha , Lépine François , Juteau Pierre , Déziel Eric , Villemur Richard
Published: July 2012

BACKGROUND

Endocrine disruptors (EDs) contribute to the endocrine disrupting potential of urban wastewater because most wastewater treatment plants only partially remove these compounds. Many EDs are present at very low concentrations in wastewater, which explains why most wastewater treatment plants can only partially remove them. The development of a two‐phase partitioning bioreactor (TPPB) could represent an alternative for the extraction of these compounds from water prior to their biodegradation. This study assesses the potential of using the polymer Hytrel used in TPPBs, to extract and concentrate estrone, estradiol, estriol, ethynylestradiol, nonylphenol and bisphenol A from aqueous solutions.

RESULTS

Hytrel demonstrated high capacity absorption for all these EDs. The Hytrel/water partition coefficient for the six EDs was determined. Finally, the capacity of Hytrel to extract a high proportion of these EDs from ED‐spiked, treated wastewater was demonstrated.

CONCLUSION

Our results showed that Hytrel has the potential to be used as an effective water‐immiscible phase in the development of a TPPB for the extraction and biodegradation of EDs. Copyright © 2012 Society of Chemical Industry
Circular‐Arc Bigraphs and Its Subclasses
Authors: Basu Asim , Das Sandip , Ghosh Shamik , Sen Malay
Published: July 2012

In this article, we obtain two new characterizations of circular‐arc bigraphs. One of them is the representation of a circular‐arc bigraph in terms of two two‐clique circular‐arc graphs while another one represents the same as a union of an interval bigraph and a Ferrers bigraph. Finally, we introduce the notions of proper and unit circular‐arc bigraphs, characterize them and show that, as in the case of circular‐arc graphs, unit circular‐arc bigraphs form a proper subclass of the class of proper circular‐arc bigraphs.
Physiological traits related to terminal drought resistance in common bean (Phaseolus vulgaris L.)
Authors: Rosales Miguel A , Cuellar‐Ortiz Sonia M , de la Paz Arrieta‐Montiel María , Acosta‐Gallegos Jorge , Covarrubias Alejandra A
Published: July 2012

BACKGROUND: A major problem in common bean (Phaseolus vulgaris L.) agriculture is the low yield due to terminal drought. Because common beans are grown over a broad variety of environments, the study of drought‐resistant genotypes might be useful to identify distinctive or common mechanisms needed for survival and seed production under drought.

RESULTS: In this study the relationship between terminal drought resistance and some physiological parameters was analysed using cultivars contrasting in their drought response from two different gene pools. Trials were performed in three environments. As expected, drought treatments induced a decrease in leaf relative humidity and an increase in leaf temperature; however, when these parameters were compared between susceptible and resistant cultivars under optimal irrigation and drought, no significant differences were detected. Similar results were obtained for chlorophyll content. In contrast, analysis of relative water content (RWC) and stomatal conductance values showed reproducible significant differences between susceptible and resistant cultivars grown under optimal irrigation and drought across the different environments.

CONCLUSIONS: The data indicate that drought‐resistant cultivars maximise carbon uptake and limit water loss upon drought by increasing stomatal closure during the day and attaining a higher RWC during the night as compared with susceptible cultivars, suggesting a water balance fine control to achieve enough yield under drought. Copyright © 2012 Society of Chemical Industry
Physical barriers to carotenoid bioaccessibility. Ultrastructure survey of chromoplast and cell wall morphology in nine carotenoid‐containing fruits and vegetables
Authors: Jeffery Jennifer , Holzenburg Andreas , King Stephen
Published: July 2012

BACKGROUND: The ultrastructural characterisation of cellular components is a key element in revealing the bases for differences in nutrient bioaccessibility among fruits and vegetables and their derived products. Together, cell walls and chromoplasts constitute the two major physical barriers to carotenoid release from the food matrix (structure) during digestion. In general, larger cells with thinner cell walls are most likely to fail under mechanical pressure. In relation to chromoplasts, the substructures plastoglobuli, crystals and membranes give decreasing rates of carotenoid solubilisation when exposed to digestive forces.

RESULTS: This paper describes cell wall and chromoplast structures in nine carotenoid‐storing raw fruits and vegetables. Watermelon and melon cells were shown to have the largest cells concomitant with thin, non‐fibrous cell walls, while carrot, hypodermal grapefruit and sweet potato cells were smallest with fibrous or dense cell walls. Mango fruit showed the highest proportion of globules to other substructures. Carrot, papaya and tomato contained many crystalline structures. Finally, watermelon, mango and butternut squash developed a high proportion of membranous structures.

CONCLUSION: A more precise description of the physical characteristics of foods that stand as barriers to bioaccessibility can help in understanding which are more or less inhibitory for particular foods. Copyright © 2012 Society of Chemical Industry
Proanthocyanidin‐rich grape seed extract reduces leg swelling in healthy women during prolonged sitting
Authors: Sano Atsushi , Tokutake Shoichi , Seo Akihiko
Published: July 2012

BACKGROUND: Leg swelling is a modern‐day affliction of sedentary working women. The aim of this study was to evaluate the effectiveness of the intake of grape seed extract (GSE) on leg swelling in healthy Japanese women while sitting.

RESULTS: Single intake trials and 14 day intake trials were held in a double‐blind, placebo‐controlled, crossover clinical study. A prolonged sedentary position was maintained for 6 h after GSE or placebo administration. Leg volume distension, increase in body extracellular fluid, and leg water were significantly suppressed in the GSE groups.

CONCLUSION: The intake of GSE is a contributing factor in the inhibition of leg swelling in healthy women during prolonged sitting. © 2012 Society of Chemical Industry
Hepatic artery infusional chemotherapy in patients with unresectable colorectal liver metastases and extrahepatic disease
Authors: Ammori John B. , D'Angelica Michael I. , Fong Yuman , Cercek Andrea , Dematteo Ronald P. , Allen Peter J. , Kingham T. Peter , Paty Philip B. , Jarnagin William R. , Kemeny Nancy E.
Published: July 2012

Background and Objectives

Hepatic arterial infusional (HAI) chemotherapy combined with systemic chemotherapy is effective palliative therapy for unresectable colorectal cancer liver metastases (CRLM). Some patients considered for HAI have evidence of minimal extrahepatic disease (EHD), and the role of HAI in these situations is unknown.

Methods

All patients with unresectable CRLM treated with HAI and systemic chemotherapy from 2000 to 2009 were included. Survival of patients who were ultimately proven to have low‐volume EHD was compared to those without EHD.

Results

Three hundred seventy‐three patients were included in this study. Seventy‐nine percent of patients were previously treated with chemotherapy. One hundred forty‐five patients (39%) ultimately proved to have EHD. Median overall survival from HAI pump placement in patients without EHD was 32 months compared to 16 months for patients with EHD, P < 0.001. Median overall survival from HAI pump placement in patients with a single site of EHD was 18 months compared to 9 months for those with multiple sites of EHD, P = 0.01.

Conclusions

In this study of heavily pre‐treated patients, overall survival was favorable in patients who proved to have EHD at one site. J. Surg. Oncol. 2012; 106: 953–958. © 2012 Wiley Periodicals, Inc.
Quality evaluation of Semen Cassiae (Cassia obtusifoliaL.) by using ultra‐high performance liquid chromatography coupled with mass spectrometry
Authors: Zhang Wei‐dong , Wang Ying , Wang Qing , Yang Wan‐jun , Gu Yi , Wang Rong , Song Xiao‐mei , Wang Xiao‐juan
Published: July 2012

A sensitive and reliable ultra‐high performance liquid chromatography–electrospray ionization–tandem mass spectrometry has been developed and partially validated to evaluate the quality of Semen Cassiae (Cassia obtusifolia L.) through simultaneous determination of 11 anthraquinones and two naphtha‐γ‐pyrone compounds. The analysis was achieved on a Poroshell 120 EC‐C18 column (100 mm × 2.1 mm, 2.7 μm; Agilent, Palo Alto, CA, USA) with gradient elution using a mobile phase that consisted of acetonitrile–water (30 mM ammonium acetate) at a flow rate of 0.4 mL/min. For quantitative analysis, all calibration curves showed perfect linear regression (r2 > 0.99) within the testing range. This method was also validated with respect to precision and accuracy, and was successfully applied to quantify the 13 components in nine batches of Semen Cassiae samples from different areas. The performance of developed method was compared with that of conventional high‐performance liquid chromatography method. The significant advantages of the former include high‐speed chromatographic separation, four times faster than high‐performance liquid chromatography with conventional columns, and great enhancement in sensitivity. This developed method provided a new basis for overall assessment on quality of Semen Cassiae.
Improvement in determination of isothiocyanates using high‐temperature reversed‐phase HPLC
Authors: Wilson Eli Adjélé , Ennahar Saïd , Marchioni Eric , Bergaentzlé Martine , Bindler Françoise
Published: July 2012

The largely adopted reversed‐phase HPLC analysis of the molecular species of isothiocyanates (ITCs) was performed and showed losses during the chromatographic run with eight ITCs. These losses, which obviously impact the accuracy of quantitative determinations, were due to precipitation in the chromatographic system. At 22°C, they ranged from 5.4% for sulforaphane (SFN) to 11.0% for benzyl‐ITC when ITCs were injected at 80 μg mL−1, but they were up to three times higher at 1 mg mL−1 reaching 31.9% for benzyl‐ITC. The water solubility of the ITCs was a key determinant of the extent of the measured loss. When the column was heated at 60°C, losses in injected ITCs were reduced, in comparison with 22, 40, and 50°C, by two to ten times depending on the ITCconsidered. A reversed‐phase HPLC method based on column heating was suggested and its quantitative performance was determined. It was then applied to the separation of methylene chloride extracts of various cruciferous vegetables. Ally‐ITC, SFN, and iberin in cabbage; SFN and iberin in cauliflower; and allyl‐ITC and phenylethyl‐ITC in horseradish could be identified and quantified. The obtained results cast doubt on quantitative determinations of ITCs that are carried out at room temperature using reversed‐phase HPLC.
Methods for determination of polybrominated diphenyl ethers in environmental samples – review
Authors: Fulara Izabela , Czaplicka Marianna
Published: July 2012

Polybrominated diphenyl ethers (PBDEs) are a group of persistent organic pollutants. They are used as flame retardants in plastics, paints, varnishes and textile materials. PBDEs pose great risk to the environment because of their high persistence and ability to get into the environment easily due to the lack of chemical bonds with the matrix of materials, to which they are added. Global research studies confirmed the occurrence of those compounds in the majority of elements of water and land environment. Analysis of PBDEs in environmental samples is one of the specific analytical methods of criteria that comprise low detection limits and high selectivity. The analysis of PBDEs in environmental samples is one of the specific analytical methods, in which the main criteria are low detection limits and high selectivity. In this article, a literature review of methods for environmental sample preparation and analysis of the PBDE content was presented. The article discusses the potential of modern extraction techniques such as: solid‐phase microextraction, single‐drop microextraction, dispersive liquid–liquid microextraction, microwave‐assisted extraction, cloud point extraction, hollow fibre–liquid phase microextraction and others for the separation of PBDEs from environmental samples with a complex matrix. Among the methods for qualitative and quantitative determination of PBDEs, a particular focus was put on gas chromatography/mass spectrometry with various injection techniques and different types of sample ionisation.
Direct dynamics study of the hydrogen abstraction reaction of CF3CH2Cl + Cl → CF3CHCl + HCl
Authors: Zhao Yuan , He Hongqing , Zhang Jinglai , Wang Li
Published: July 2012

The hydrogen abstraction reaction of Cl atoms with CF3CH2Cl (HCFC‐133a) is investigated by using density function theory and ab initio approach, and the rate constants are calculated by using the dual‐level direct dynamics method. Optimized geometries and frequencies of reactants, transition state, and products are computed at the B3LYP/6‐311+G(2d,2p) level. To refine the energetic information along the minimum energy path, single‐point energy calculations are carried out at the G3(MP2) level of theory. The interpolated single‐point energy method is employed to correct the energy profiles for the title reaction. The rate constants are evaluated by using the canonical variational transition state theory with a small‐curvature tunneling correction over a wide range of temperature, 200–2000 K. The variational effect for the reaction is moderate at low temperatures and very small at high temperatures. However, the tunneling correction has an important contribution in the lower temperature range. The agreement between calculated rate constants and available experimental values is good at lower temperatures but diverges significantly at higher temperatures. © 2012 Wiley Periodicals, Inc. Int J Chem Kinet 44: 661–667, 2012
Transoral robotic surgery: A multicenter study to assess feasibility, safety, and surgical margins
Authors: Weinstein Gregory S. , O'Malley Bert W. , Magnuson J. Scott , Carroll William R. , Olsen Kerry D. , Daio Lixia , Moore Eric J. , Holsinger F. Christopher
Published: July 2012

Objectives/Hypothesis:

Our objective was to determine the safety, feasibility, and the adequacy of surgical margins for transoral robotic surgery (TORS), by reviewing the early results from independent institutional review board‐approved clinical trials in three separate institutions.

Study Design:

Pooled Data from Independent Prospective Clinical Trials.

Methods:

One hundred ninety‐two patients were initially screened, but inadequate exposure did not permit TORS in 13 (6.7%). For two additional patients, TORS was begun but intraoperatively converted to an open procedure. Thus, the intent‐to‐treat population was 177 patients (average age, 59 years; 81% male), predominantly comprised of tumors arising in the oropharynx (139, 78%) and larynx (26, 15%). TORS was performed for 161 (91%) patients with malignant disease: 153 (95%) with squamous cell carcinoma (T1 [50, 32.7%], T2 [74, 48.4%], T3 [21, 13.7%], T4 [8, 5.2%]), six patients (3.72%) with salivary gland tumors, and two patients with carcinoma in situ. The average follow‐up was 345 days.

Results:

There was no intraoperative mortality or death in the immediate postoperative period. Average estimated blood loss was 83 mL; no patient required transfusion. The rate of positive margins was 4.3%. Twenty‐nine patients (16%) experienced 34 serious adverse events that required hospitalization or intervention (grade 3) or were considered life threatening (grade 4, 2.3%). Tracheostomy was performed in 12.4% of all patients (22/177), but only 2.3% had a tracheostomy at last follow‐up. For all patients undergoing TORS without previous therapy, the percutaneous endoscopic gastrostomy dependency rate was 5.0%. The average hospital stay was 4.2 days.

Conclusions:

Based on this multicenter study, TORS appears to be safe, feasible, and as such play an important role in the multidisciplinary management of head and neck cancer.
Systematic analysis of cephalometry in obstructive sleep apnea in Asian children
Authors: Ping‐Ying Chiang Rayleigh , Lin Chia‐Mo , Powell Nelson , Chiang Yuh‐Chyun , Tsai Yih‐Jeng
Published: July 2012

Objectives/Hypothesis:

This study was designed to systematically analyze the relationship between a cephalometric analysis and the apnea‐hypopnea index in a group of Asian children with obstructive sleep apnea.

Study Design:

Retrospective study.

Methods:

Data were collected from 56 children with obstructive sleep apnea who were between 3 and 13 years old. Each child underwent attended overnight polysomnography and cephalometry. We measured nine angles, 10 lines, and two ratios as well as adenoid size on each cephalometric film. Data included five segments of the upper airway: nasal cavity (segment 1), nasopharyngeal space (segment 2), retropalatal space (segment 3), retroglossal space and hyoid (segment 4), and oral cavity‐related space (segment 5).

Results:

Four cephalometric anthropomorphic findings (Gn‐Go‐H, MP‐H, MPH/GnGo, Ad/Na) were related to the apnea‐hypopnea index. Three of the four parameters belonged to segment 4, indicating the importance of hyoid position in pediatric obstructive sleep apnea.

Conclusions:

This study showed that segment 4 was the most important segment affecting the apnea‐hypopnea index. Most of the cephalometric parameters in segment 4 did not show a difference from the results of Caucasian groups, except that mandibular length and position appeared to have more positive findings in the Caucasian results. In segment 2, the apnea‐hypopnea index was less affected by the skull base‐related parameters in our data. The reason why the other segments appeared to play a lesser role in pediatric obstructive sleep apnea might due to the limitations of two‐dimensional imaging. Further cephalometric studies with anterior‐posterior view and on the differences between Caucasian and Asian children are mandatory.
Customization of the voice prosthesis to prevent leakage from the enlarged tracheoesophageal puncture: Results of a prospective trial
Authors: Lewin Jan S. , Hutcheson Katherine A. , Barringer Denise A. , Croegaert Lindsay E. , Lisec Asher , Chambers Mark S.
Published: July 2012

Objectives/Hypothesis:

Customization of the tracheoesophageal (TE) voice prosthesis (VP) is often preferred over surgical closure to prevent aspiration around the VP in laryngectomized patients with an enlarged tracheoesophageal puncture (TEP), but it has not been thoroughly evaluated.

Study Design:

Single‐institution prospective trial.

Methods:

A prospective trial was conducted to evaluate the effectiveness of a customized VP with the addition of an enlarged tracheal and/or esophageal collar in patients with leakage around an enlarged TEP. Absence of leakage around the VP after placement defined immediate effectiveness. Long‐term success was defined by the prevention of adverse events related to leakage during the study period. Events that defined failure included: permanent gastrostomy dependence, aspiration pneumonia, and/or surgical TEP closure.

Results:

Twenty‐one patients with enlarged TEP were enrolled (2003–2006). Insertion of a customized VP was unsuccessful in one patient; 145 customizations were performed in the remaining 20 patients (median, 3.5 customizations) during the trial period. Of the customizations, 77% (112/145) prevented leakage immediately after VP insertion. The most common adverse event was dislodgement of the prosthesis (11%) or the collar alone (7%) in 18% (26/145) of customized VP placements. Six patients who died of disease were not evaluable for long‐term outcomes. Long‐term success was achieved in 80% (12/15) of evaluable patients who avoided permanent gastrostomy, aspiration pneumonia, and surgical TEP closure.

Conclusions:

Prosthetic customization offers an effective method to prevent leakage around the VP in many patients with an enlarged TEP, thereby preserving TE voice while avoiding surgical closure in this high‐risk population.
Sentinel node biopsy in early oral squamous cell carcinomas: A 10‐year experience
Authors: Melkane Antoine E. , Mamelle Gérard , Wycisk Gregory , Temam Stéphane , Janot François , Casiraghi Odile , Lumbroso Jean
Published: July 2012

Objectives/Hypothesis:

To evaluate the reliability of the sentinel node (SN) biopsy in early oral squamous cell carcinomas.

Study Design:

Prospective cohort study.

Methods:

We conducted a primary prospective study on 53 consecutive patients presenting T1, T2 N0 squamous cell carcinomas of the oral cavity between January 2000 and June 2003. Primary results demonstrated a negative predictive value of 100%. The series was then extended until June 2010, with a total number of 166 successful procedures.

Results:

The cohort accounted for 118 males and 48 females with a mean age of 56 years. The median follow‐up period was 36 months. There were 42 patients (25%) with positive SNs, 14 of them (33%) only harboring micrometastasis. The negative predictive value of the sentinel node biopsy was 95.2%. The SN involvement was strongly correlated with the tumor location (34% of SN+ for the tongue vs. 13% for the floor of mouth, P = .003), tumor stage (18% of SN+ for T1 vs. 40% for T2, P = .002), depth of invasion (median depth for SN+ lesions was 6.5 mm vs. 4 mm for SN− lesions, P = .028), and lymphovascular involvement (P = .002). The false‐negative rate of frozen section examination was 42%.

Conclusions:

The sentinel node biopsy appears to be an excellent staging method in early oral cancers. This study also provides evidence that routinely undiagnosed micrometastasis may have clinical significance.
Paranasal sinus exostoses: An unusual complication of topical drug delivery using cold nasal irrigations
Authors: Haffey Timothy , Woodard Troy , Sindwani Raj
Published: July 2012

Objectives/Hypothesis:

The use of topical drug delivery through nasal irrigations can minimize systemic side effects and deliver higher concentrations of drugs directly to diseased sinus mucosa. Complications related to this popular method of treatment are not well described. We present our experience with paranasal sinus exostosis (PSE), a new diagnostic entity that appears to be a complication of cold nasal irrigations.

Study Design:

Retrospective chart review.

Methods:

Retrospective chart reviews were performed on patients within the Cleveland Clinic Foundation from 2005 to 2011. Six patients were identified with sinus exostoses. A literature review for “sinonasal exostoses” and “paranasal sinus exostoses” was performed using PubMed.

Results:

Six patients with PSE were identified at the Cleveland Clinic Foundation between 2005 and 2011. All patients had undergone sinus surgery, and none had documented evidence of PSE prior to surgery. There was no evidence of worsening PSE once the cold irrigations were stopped. No patients showed any resolution of PSE over time. None of our patients has progressed to have disease burden significant enough to require intervention.

Conclusions:

PSE is a rare condition that mirrors a well‐described otologic process; exostoses of the external auditory canal. PSE appears to be a complication of cold nasal irrigations. It does not resolve with the halting of cold irrigations, but does not appear to progress further after intervention. PSE only affects postoperative patients. With the evolving trend to treat postoperative sinus disease topically, the clinician should be aware of the dangers of cold irrigations, and patients should be counseled accordingly.
Extracapsular dissection for benign parotid tumors: A meta‐analysis
Authors: Albergotti W. Greer , Nguyen Shaun A. , Zenk Johannes , Gillespie M. Boyd
Published: July 2012

Objectives/Hypothesis:

Recent studies suggest that extracapsular dissection (ECD) is an option for the resection of certain benign parotid tumors. This study investigates complication rates and effectiveness of ECD versus superficial parotidectomy (SP) for the treatment of primary benign parotid neoplasms.

Study Design:

Systematic literature review with meta‐analysis.

Methods:

Studies available for inclusion evaluated the complications and effectiveness of ECD and SP as surgical techniques for the treatment of solitary, benign parotid tumors. An Ovid/Medline search revealed nine articles that met inclusion criteria. A critical review and meta‐analysis of these articles was performed.

Results:

The included studies evaluated a total of 1,882 patients. There was no observed difference in tumor recurrence between the ECD and SP groups (odds ratio [OR], 0.557; 95% confidence interval [CI], 0.271‐1.147). There was a significantly lower rate of transient facial nerve paresis (OR, 0.256; 95% CI, 0.174‐0.377) in the ECD group (59 of 741; 8.0%) compared to the SP group (81 of 397; 20.4%); however, there was no observed difference in permanent facial paralysis between the ECD and SP groups (OR, 0.878; 95% CI, 0.282‐2.730). Frey's syndrome was less often observed (OR, 0.117; 95% CI, 0.071‐0.191) after ECD (27 of 602; 4.5%) compared to SP (75 of 287; 26.1%).

Conclusions:

This systematic review with meta‐analysis suggests that ECD has a similar recurrence rate as SP with fewer postoperative complications. ECD may be considered an alternative surgical modality for select benign parotid neoplasms.
Hearing aid satisfaction and use in the advanced digital era
Authors: Kaplan‐Neeman Ricky , Muchnik Chava , Hildesheimer Minka , Henkin Yael
Published: July 2012

Objectives/Hypothesis:

To evaluate satisfaction ratings and use patterns of advanced digital hearing aids (HAs) in a group of hearing‐impaired adults by means of self‐report questionnaires.

Study Design:

A self report questionnaire study.

Methods:

One hundred seventy‐seven hearing‐impaired adults who were fitted with advanced digital HAs at the Speech and Hearing Center at Sheba Medical Center were asked to participate in a structured telephone interview regarding HA satisfaction and use by means of the Satisfaction With Amplification in Daily Life (SADL) questionnaire. Patients who were not using their HAs completed a nonuse questionnaire.

Results:

One hundred thirty‐one patients participated in the survey, yielding a response rate of 74%. Eighty‐three percent used their HAs regularly, whereas 17% were nonusers. Of the users, 92% were satisfied to some degree with their HAs. The global SADL score was 5.12 on a scale of 1 to 7. Background variables that were significantly associated with satisfaction ratings were hours of HA use per day, fitting mode (binaural vs. monaural), age, and degree of hearing loss. Although nonuse was not significantly associated with background variables, the main reasons for nonuse were excessive amplification in background noise and minimal functional benefit.

Conclusions:

High satisfaction and use rates were characteristic of adults fitted with advanced digital HAs. Patients should be advised that longer use of HAs per day may lead to higher satisfaction and that binaural amplification is advantageous, especially while communicating in noise. Finally, expectation from HA functionality in challenging listening situations should be realistic, as additional research and technology development is still needed.
Occult middle ear and mastoid fluid in acute otitis externa
Authors: Brennan Tara E. , Saadia‐Redleaf Miriam I.
Published: July 2012

Objectives/Hypothesis:

Presence of fluid in the middle ear (ME) or mastoid air cells in acute otitis externa (OE) has not been reported. We hypothesize that in patients with OE there is often otitis media (occult middle ear and mastoid fluid) and secondary fluid in the mastoid air cell system, which is not seen during a clinical examination because of edema in the external canal skin.

Study Design:

Retrospective chart review.

Methods:

We reviewed the medical records of 209 patients who presented to our ear, nose, and throat (ENT) clinic with acute OE that was resolved with oral and/or topical antibiotics.

Results:

Twenty‐seven of the 209 patients presented with unilateral or bilateral acute OE (29 ears) and received a computed tomography (CT) scan of their temporal bones, which was ordered by the Emergency Department or ENT services. Twenty‐three of 29 ears (79%) showed fluid in the ME, mastoid, or both. Nine of the 10 patients (82%), who obtained their CT scan within 1 week of symptom onset, were found to have fluid.

Conclusions:

These findings support our hypothesis and serve to inform the medical community (both ENT and primary care) that fluid is often present in the ME or mastoid in patients with acute OE whose symptoms will resolve with oral and/or topical antibiotics.
The growing geriatric otolaryngology patient population: A study of 131,700 new patient encounters
Authors: Creighton Francis X. , Poliashenko Stanislav M. , Statham Melissa M. , Abramson Peter , Johns Michael M.
Published: July 2012

Objectives/Hypothesis:

To establish the effects the changing population demographics in the United States are having on the general practice otolaryngologists.

Study Design:

Retrospective analysis of 131,070 consecutive new patient visits at a large private practice otolaryngology group from 2004 to 2010.

Methods:

Billing records for new patient visits from 2004 to 2010 were reviewed. Analysis of patient age, diagnosis, and year of presentation was completed to determine changes in patient demographics and frequencies of diagnoses stratified by age groups. Predictive analysis was performed to determine future trends in patient demographics.

Results:

Geriatric patients showed a statistically significant increase from 14.3% of the patient population in 2004 to 17.9% in 2010. Predictive analysis shows that at the current rate, almost 30% of all patients seen by 2030 would be over the age of 65 years. The most common pathologies seen in geriatric patients were also different than that of other age groups, with the five most common geriatric diagnoses being otologic in nature. Geriatric patients also have an overall increased proportion of otologic diagnoses, with 73% of all geriatric diagnoses being otologic, compared to just 32% of those aged 18 to 45 years.

Conclusions:

Our data show that the changing population is causing the frequency and type of disease seen by general otolaryngologists to change. This information may be useful in structuring both residency training curricula as well as licensing and recertification exams to ensure otolaryngologists are properly prepared to care for their future patient population. Laryngoscope, 2013
Polyelectrolytes with Main‐Chain Perylene Units
Authors: Dolfen Daniel , Schottler Kristina J. , Scherf Ullrich
Published: July 2012

A new soluble polyamine with main chain perylene units is synthesized and subsequently converted into cationic or zwitterionic polyelectrolytes. The optical properties of the monomer 1,6,7,12‐tetrakis(4‐tert‐butylphenoxy)‐3,4,9,10‐tetra(bromomethyl)perylene and the resulting polymers have been studied with special attention to ongoing de/aggregation processes. UV–Vis and PL spectra of the polymers show a distinct concentration and solvent dependency of the optical properties. In contrast to the corresponding monomer complete deaggregation did not occur for the polymers. The environment‐sensitive optical properties should allow applications as sensor materials. The perylene‐containing polyelectrolytes may be applied in orthogonal processing schemes toward multilayer electronic devices.
Tunable Fabrication of Two‐Dimensional Arrays of Polymer Nanobowls for Biomimic Growth of Amorphous Calcium Carbonate
Authors: Ding Tao , Song Kai , Yang Guoqiang , Tung Chen‐Ho
Published: July 2012

Two‐dimensional arrays of polymer nanobowls can be fabricated by an oxygen plasma etching technique. The 2D colloidal crystals made of SiO2@PMMA particles are fabricated by a convective self‐assembly method. The oxygen plasma treatment is applied to the colloidal crystals to selectively etch the PMMA shells. Because the oxygen plasma etching proceeds in a layer‐by‐layer manner from top to bottom, the top parts of the PMMA shells are etched first, and the silica cores are exposed to the atmosphere, which can be removed with HF, leaving the bowl‐shaped PMMA shells to form 2D arrays of polymer nanobowls. The size and packing density of the nanobowl arrays can be tuned with tightly controlled etching time. The polymer nanobowl arrays can also serve as a template to direct the growth of calcium carbonate within the interstice of the nanobowls.
The clinical characteristics of spinocerebellar ataxia 36: A study of 2121 Japanese ataxia patients
Authors: Sugihara Katsunobu , Maruyama Hirofumi , Morino Hiroyuki , Miyamoto Ryosuke , Ueno Hiroki , Matsumoto Masayasu , Kaji Ryuji , Kitaguchi Hiroshi , Yukitake Motohiro , Higashi Yasuto , Nishinaka Kazuto , Oda Masaya , Izumi Yuishin , Kawakami Hideshi
Published: July 2012

Spinocerebellar ataxia 36 is caused by the expansion of the intronic GGCCTG hexanucleotide repeat in NOP56. The original article describing this condition demonstrated that patients with spinocerebellar ataxia 36 present with tongue atrophy, a finding that had not been seen in previous types of spinocerebellar ataxias. A total of 2121 patients with clinically diagnosed spinocerebellar ataxia participated in the study. We screened our patient samples for spinocerebellar ataxia 36 using the repeat‐primed polymerase chain reaction method and also determined the clinical features of spinocerebellar ataxia 36. Of the ataxia cases examined, 12 were identified as spinocerebellar ataxia 36. Of these, 7 cases (6 families) were autosomal dominant, 4 cases (three families) had a positive family history but were not autosomal dominant, and 1 case was sporadic. The average age of onset was 51.7 years, and disease progression was slow. The main symptoms and signs of disease included ataxia, dysarthria, and hyperreflexia. Approximately half the affected patients demonstrated nystagmus, bulging eyes, and a positive pathological reflex, although dysphagia, tongue atrophy, and hearing loss were rare. Moreover, the observed atrophy of the cerebellum and brain stem was not severe. The patients identified in this study were concentrated in western Japan. The frequency of spinocerebellar ataxia 36 was approximately 1.2% in the autosomal dominant group, and the age of onset for this condition was later in comparison with other spinocerebellar ataxia subtypes. © 2012 Movement Disorder Society
Multiplicity of nontrivial solutions to a biharmonic equation via Lusternik–Schnirelman theory
Authors: Alves Claudianor O. , Figueiredo Giovany M.
Published: July 2012

In this paper, we are concerned with the multiplicity of nontrivial solutions for the following class of biharmonic problem
urn:x-wiley:01704214:media:mma2618:mma2618-math-0001
where is a bounded domain with smooth boundary. Using the Lusternik–Schnirelman theory, we relate the number of solutions with the topology of Ω. Copyright © 2012 John Wiley & Sons, Ltd.
Epigallocatechin gallate reduces vascular inflammation in db/db mice possibly through an NF‐κB‐mediated mechanism
Authors: Babu Pon V. Anandh , Si Hongwei , Liu Dongmin
Published: July 2012

Scope

Hyperglycemia‐induced vascular inflammation resulting in the adhesion of monocytes to endothelium is a key event in the pathogenesis of atherosclerosis in diabetes. We investigated whether epigallocatechin gallate (EGCG), a major catechin found in green tea, reduces vascular inflammation in diabetes.

Methods and results

Human aortic endothelial cells (HAEC) were pretreated with green tea catechins before the addition of high glucose (25 mM) for 72 h. EGCG at physiologically achievable concentration (1 μM) significantly inhibited high glucose induced adhesion of monocytes to HAEC both in static and under flow conditions. EGCG also reduced nuclear factor κB (NF‐κB) regulated transcriptional activity in ECs. Six‐week‐old diabetic db/db mice were fed a diet containing 0% or 0.1% EGCG for 8 weeks. ECs were isolated from aortic vessels of db/db, db/db‐EGCG, and control db/+ mice. EGCG supplementation greatly suppressed diabetes‐increased monocytes adhesion to ECs, which is associated with reduced circulating levels of chemokines, and reduced secretions of chemokines and adhesion molecules by aortic ECs from db/db‐EGCG mice. EGCG treatment reduced nuclear translocation of NF‐κB p65 in aortic vessels, decreased blood pressure and serum concentrations of cholesterol and triglycerides in db/db‐EGCG mice.

Conclusion

EGCG may have a direct protective effect against vascular inflammation in diabetes.
In vitro fermentation of potential prebiotic flours from natural sources: Impact on the human colonic microbiota and metabolome
Authors: Maccaferri Simone , Klinder Annett , Cacciatore Stefano , Chitarrari Roberto , Honda Harue , Luchinat Claudio , Bertini Ivano , Carnevali Paola , Gibson Glenn R. , Brigidi Patrizia , Costabile Adele
Published: July 2012

Scope

Fibers and prebiotics represent a useful dietary approach for modulating the human gut microbiome. Therefore, aim of the present study was to investigate the impact of four flours (wholegrain rye, wholegrain wheat, chickpeas and lentils 50:50, and barley milled grains), characterized by a naturally high content in dietary fibers, on the intestinal microbiota composition and metabolomic output.

Methods and results

A validated three‐stage continuous fermentative system simulating the human colon was used to resemble the complexity and diversity of the intestinal microbiota. Fluorescence in situ hybridization was used to evaluate the impact of the flours on the composition of the microbiota, while small‐molecule metabolome was assessed by NMR analysis followed by multivariate pattern recognition techniques. HT29 cell‐growth curve assay was used to evaluate the modulatory properties of the bacterial metabolites on the growth of intestinal epithelial cells. All the four flours showed positive modulations of the microbiota composition and metabolic activity. Furthermore, none of the flours influenced the growth‐modulatory potential of the metabolites toward HT29 cells.

Conclusion

Our findings support the utilization of the tested ingredients in the development of a variety of potentially prebiotic food products aimed at improving gastrointestinal health.
Hybrid reduced order modeling applied to nonlinear models
Authors: Bang Youngsuk , Abdel‐Khalik Hany S. , Hite Jason M.
Published: July 2012

Reduced order modeling plays an indispensible role for most real‐world complex models. The objective of this manuscript is to hybridize local and global sensitivity analysis methods to enable the application of reduced order modeling to complex nonlinear models, often encountered in real system design and analysis calculations, for example, nuclear reactors. This is achieved by first employing local variational methods to identify important nonlinear features of the original model that are required to reach a user‐defined accuracy for the reduced model. This information is obtained by sampling local first‐order derivatives of a pseudoresponse utilizing a modified representation of an infinite series expansion around some reference point. The resulting derivative information is aggregated in a subspace of dimension much less than the dimension of the input parameter space. The accuracy of the reduced model can be mathematically quantified using a bounding norm. Next, global sensitivity methods are employed to exhaustively search the reduced subspace for sensitivity information. The theory and implementation details of the proposed method are exposed in this manuscript. Numerical tests based on prototype nonlinear functions and radiation transport models with many input parameters and many responses are conducted as proof of principle. Copyright © 2012 John Wiley & Sons, Ltd.
Healthcare providers' perceptions of breastfeeding peer counselors in the neonatal intensive care unit
Authors: Rossman Beverly , Engstrom Janet L. , Meier Paula P.
Published: July 2012

In this qualitative descriptive study we examined the perceptions of 17 neonatal intensive care unit (NICU) healthcare providers (nurses, neonatologists, lactation consultants, and dietitians) about the role of breastfeeding peer counselors who were mothers of former NICU infants and who provided primary lactation care in the NICU. Findings revealed that the healthcare providers respected the peer counselors' lactation expertise and identified three critical elements that contributed to the effectiveness of the peer counseling program: having a champion for the program, counselors being mothers of former NICU infants, and a NICU culture supportive of using human milk. Healthcare providers thought the peer counselors enhanced care of the infant by empowering mothers to provide milk and by facilitating and modeling positive patterns of maternal–infant interactions. © 2012 Wiley Periodicals, Inc. Res Nurs Health 35:460–474, 2012