bluuebunny/crossref_metadata_2025 huggingface dataset:
Numerical analysis of concrete-filled circular steel tubes
Authors: Deng Yaohua , Norton Terri R. , Tuan Christopher Y.
Published: December 2012

Concrete-filled steel tubes have been widely used in building and bridge construction. In this paper, the flexural behaviour of concrete-filled steel tubes is investigated using finite-element analysis and theoretical sectional analysis. The numerical results from both analytical methods are validated against published experimental test results. It is shown that both methods are capable of predicting the elastic and the ultimate moment capacities of concrete-filled steel tubes. Due to its computational efficiency, theoretical sectional analysis is more suitable for the design of concrete-filled steel tubes than finite-element analysis.
Dynamic modelling of integrated water resources quality management
Authors: Azmi Mohammad , Heidarzadeh Nima
Published: December 2012

Basin-scale water resources decisions need to have a decision support system (DSS) that models all water quantity and quality elements. Common integrated water resources management (IWRM) models such as Weap and Modsim can quantitatively model a water system well. However, although certain insertions to such software have been incorporated to simulate quality parameters in rivers, none of these can model such parameters in reservoirs. To solve this issue, researchers have coupled IWRM models with water quality models of reservoirs (WQMRs). WQMRs such as Cequal-W2 usually require voluminous and various input and output information. They are not user friendly and have a high running time. Because of these shortcomings, coupled IWRM and WQMR models cannot be considered as a DSS to assess a variety of scenarios. This paper represents an attempt to introduce a DSS based on the system dynamics approach to utilise in basin-scale integrated water resources quantitative and qualitative management. The proposed model uses a one-dimensional water quality approach for the reservoir to overcome the quality modelling disadvantages of IWRM models. The final results of the proposed model for different scenarios are compared with Modsim and Cequal-W2.
Using simulation to compare methods for estimating density from capture–recapture data
Authors: Ivan Jacob S. , White Gary C. , Shenk Tanya M.
Published: December 2012

Estimation of animal density is fundamental to wildlife research and management, but estimation via mark–recapture is often complicated by lack of geographic closure of study sites. Contemporary methods for estimating density using mark–recapture data include (1) approximating the effective area sampled by an array of detectors based on the mean maximum distance moved (MMDM) by animals during the sampling session, (2) spatially explicit capture–recapture (SECR) methods that formulate the problem hierarchically with a process model for animal density and an observation model in which detection probability declines with distance from a detector, and (3) a telemetry estimator (TELEM) that uses auxiliary telemetry information to estimate the proportion of animals on the study site. We used simulation to compare relative performance (percent error) of these methods under all combinations of three levels of detection probability (0.2, 0.4, 0.6), three levels of occasions (5, 7, 10), and three levels of abundance (10, 20, 40 animals). We also tested each estimator using five different models for animal home ranges. TELEM performed best across most combinations of capture probabilities, sampling occasions, true densities, and home range configurations, and performance was unaffected by home range shape. SECR outperformed MMDM estimators in nearly all comparisons and may be preferable to TELEM at low capture probabilities, but performance varied with home range configuration. MMDM estimators exhibited substantial positive bias for most simulations, but performance improved for elongated or infinite home ranges.
Genetic diversity within a dominant plant outweighs plant species diversity in structuring an arthropod community
Authors: Crawford Kerri M. , Rudgers Jennifer A.
Published: December 2012

Plant biodiversity is being lost at a rapid rate. This has spurred much interest in elucidating the consequences of this loss for higher trophic levels. Experimental tests have shown that both plant species diversity and genetic diversity within a plant species can influence arthropod community structure. However, the majority of these studies have been conducted in separate systems, so their relative importance is currently unresolved. Furthermore, potential interactions between the two levels of diversity, which likely occur in natural systems, have not been investigated. To clarify these issues, we conducted three experiments in a freshwater sand dune ecosystem. We (1) independently manipulated plant species diversity, (2) independently manipulated genetic diversity within the dominant plant species, Ammophila breviligulata, and (3) jointly manipulated genetic diversity within the dominant plant and species diversity. We found that genetic diversity within the dominant plant species, Ammophila breviligulata, more strongly influenced arthropod communities than plant species diversity, but this effect was dependent on the presence of other species. In species mixtures, A. breviligulata genetic diversity altered overall arthropod community composition, and arthropod richness and abundance peaked at the highest level of genetic diversity. Positive nonadditive effects of diversity were detected, suggesting that arthropods respond to emergent properties of diverse plant communities. However, in the independent manipulations where A. breviligulata was alone, effects of genetic diversity were weaker, with only arthropod richness responding. In contrast, plant species diversity only influenced arthropods when A. breviligulata was absent, and then only influenced herbivore abundance. In addition to showing that genetic diversity within a dominant plant species can have large effects on arthropod community composition, these results suggest that understanding how species diversity and genetic diversity interact to influence community structure may be critically important for predicting the consequences of biodiversity loss.
Safety Planning With Children and Adolescents in Domestic Violence Shelters
Authors: Chanmugam Amy , Hall Kimberly
Published: December 2012

This exploratory mixed methods survey yielded a comprehensive picture of safety planning practices with children and adolescents in Texas emergency domestic violence shelters. Shelter personnel described safety planning goals, methods, timing, and contents and views of best practices, barriers, and risks. The study’s approach was guided by Proctor’s (2005) recommendations for developing the research base for an understudied intervention. Results indicate that the practice is widespread. Shelters consider developmental differences and use multiple methods and timing strategies. Views on goals and risks varied. Findings are contextualized with information on overall child/youth services. This article discusses implications for shelter practices and future research, such as outcome studies and the feasibility of children/youth implementing commonly recommended safety strategies.
Promising Practices in the Prevention of Intimate Partner Violence Among Adolescents
Authors: De Grace Alyssa , Clarke Angela
Published: December 2012

To inform practitioners and researchers interested in the prevention of intimate partner violence (IPV) among adolescents, 9 principles of effective prevention programs (Nation et al., 2003) were described and examples of how these principles have been incorporated into existing teen dating violence prevention programs were provided. An investigation of current prevention practices for adolescent IPV resulted in one noteworthy program that has successfully incorporated all 9 principles of effective prevention programming—Safe Dates (Substance Abuse and Mental Health Services Administration, National Registry of Evidence-based Programs and Practices [SAMHSA-NREPP], 2006). Although Safe Dates serves as a model teen dating violence prevention program, it may not be equally effective across contexts and diverse groups. Therefore, as researchers and practitioners continue to develop and refine programs to reduce adolescent IPV, the principles of effective prevention programs should serve as a guiding framework.
Evaluating Preschool Children’s Attitudes and Beliefs About Intimate Partner Violence
Authors: Howell Kathryn H. , Miller Laura E. , Graham-Bermann Sandra A.
Published: December 2012

Few studies have considered how intimate partner violence (IPV) impacts children’s overarching attitudes and beliefs about the prevalence and acceptability of aggression. This pilot study included 92 preschool children exposed to IPV who reported on attitudes and beliefs about violence using a new, theoretically driven measure. Findings illustrate that preschoolers were able to respond reliably on this measure, and that most report at least one maladaptive attitude or belief about violence. Maternal posttraumatic avoidance symptoms, increased child aggression, and decreased child self-blame were associated with maladaptive attitudes and beliefs. These findings, although preliminary, indicate that clinicians may need to address both children’s individual adjustment following violence exposure as well as their attitudes and beliefs concerning the acceptability of violence in interpersonal relationships.
A Comparison of Three Different Scoring Methods for Self-Report Measures of Psychological Aggression in a Sample of College Females
Authors: Shorey Ryan C. , Brasfield Hope , Febres Jeniimarie , Cornelius Tara L. , Stuart Gregory L.
Published: December 2012

Psychological aggression in females’ dating relationships has received increased empirical attention in recent years. However, researchers have used numerous measures of psychological aggression and various scoring methods with these measures, making it difficult to compare across studies on psychological aggression. In addition, research has yet to examine whether different scoring methods for psychological aggression measures may affect the psychometric properties of these instruments. This study examined three self-report measures of psychological aggression within a sample of female college students (N = 108), including their psychometric properties when scored using frequency, sum, and variety scores. Results showed that the Revised Conflict Tactics Scales (CTS2) had variable internal consistency depending on the scoring method used and good validity; the Multidimensional Measure of Emotional Abuse (MMEA) and the Follingstad Psychological Aggression Scale (FPAS) both had good internal consistency and validity across scoring methods. Implications of these findings for the assessment of psychological aggression and future research are discussed.
Care Management Role in End-of-Life Discussions
Authors: Meyer Star
Published: December 2012

How do we prepare our patients for decisions that will need to be made for end-of-life care? End-of-life care discussions should occur early on in the patient’s disease process and often requires a great deal of coordination between multiple caregivers. There are also ethical, cultural, social, and spiritual considerations during this very important time in the disease process. Research suggests that we are not doing an adequate job of addressing end-of-life care with our patients and that a great deal of money and resources are being spent in the last days of life when there may be no clinical indication to do so. Registered nurse case managers have a unique knowledge base to serve in the role of coordinating care and leading the multidisciplinary care team in an effort to use resources responsibly while providing patients and families with options for end-of-life care.
Intrinsic Properties of Mesemchymal Stem Cells from Human Bone Marrow, Umbilical Cord and Umbilical Cord Blood Comparing the Different Sources of MSC
Authors: Lv Fengjuan , Lu Minmin , MC Cheung Kenneth , YL Leung Victor , Zhou Guangqian
Published: December 2012

The past decade has witnessed numerous publications on mesenchymal stem cells (MSC), which have great potential
in regenerative medicine. MSC from various types of origins exhibit different characteristics, which may relate to
the maintenance role of MSC in that specific source. Reports have emerged that among the most widely investigated
sources, umbilical cord (UC) or umbilical cord blood (UCB) derived MSC throw advantages over bone marrow (BM) derived
MSC due to their close to fetal origin. Here the methodologies used to separate MSC from UC or UCB, and the intrinsic
properties, including proliferation capacity, multipotency, cytokine profile, cell surface protein expression and gene
expression, between UC, UCB and BM derived MSC, are discussed in details, though may not in a full picture, for the
first time.
Autologous Mesenchymal Stem Cell Therapy in Progressive Multiple Sclerosis: An Open Label Study
Authors: Mohyeddin Bonab Mandana , Ali Sahraian Mohammad , Aghsaie Aida , Ahmadi Karvigh Sanaz , Massoud Hosseinian Seyed , Nikbin Behrouz , Lotfi Jamshid , Khorramnia Saeideh , Reza Motamed Mohammad , Togha Mansoureh , Hossien Harirchian Mohammad , Beladi Moghadam Nahid , Alikhani Katayoun , Yadegari Samira , Jafarian Sirous , Reza Gheini Mohammad
Published: December 2012

Despite updating knowledge and a growing number of medications for multiple sclerosis (MS), no definite
treatment is available yet for patients suffering from progressive forms of the disease. Autologous bone marrow derived
mesenchymal stem cell (BM-MSC) transplantation is a promising method proposed as a therapy for MS. Although the
safety of these cells has been confirmed in hematological, cardiac and inflammatory diseases, its efficacy in MS treatment
is still under study.

Patients with progressive MS (expanded disability status scale score: 4.0 –6.50) unresponsive to conventional treatments
were recruited for this study.

Twenty-five patients [f/m: 19/6, mean age: 34.7±7] received a single intrathecal injection of ex-vivo expanded MSCs
(mean dose: 29.5×106 cells). We observed their therapeutic response for 12 months. Associated short-term adverse events
of injection consisted of transient low-grade fever, nausea /vomiting, weakness in the lower limbs and headache. No major
delayed adverse effect was reported. 3 patients left the study for personal reasons. The mean (SD) expanded disability
status scale (EDSS) score of 22 patients changed from 6.1 (0.6) to 6.3 (0.4). Clinical course of the disease (measured by
EDSS) improved in 4, deteriorated in 6 and had no change in 12 patients. In MRI evaluation, 15 patients showed no
change, whereas 6 patients showed new T2 or gadolinium enhanced lesions (1 lost to follow-up).

It seems that MSC therapy can improve/stabilize the course of the disease in progressive MS in the first year after injection
with no serious adverse effects. Repeating the study with a larger sample size, booster injections and longer follow-up
using a controlled study design is advised.
Advent and Maturation of Regenerative Medicine
Authors: M. Mhashilkar Abner , Atala Anthony
Published: December 2012

The field of regenerative medicine (RM), encompassing stem cell (SC) technologies, therapeutics, tissue engineering
(TE), biomaterials, scaffolds and other enabling technologies provides a wide gamut of tools and tracks to combat,
manage and hopefully cure serious human and animal injuries, dysfunctions and diseases. This review illustrates the
trends that are becoming the major platforms in this field. The last 10 years in itself has seen major definitive observations,
including multi-track directives of adult stem cell translational technologies, tissue and organ engineering protocols,
iPS cell applications and understanding of the role of cancer stem cells to develop effective anti-cancer regimens. With the
rapid advances of RM translational research, further advances are expected to be implemented for personalized repair and
curative outcomes. RM future is bright although laden with challenges of global fragmentation which needs coherent consolidation,
stringent cost and time effective regulation and long-term funding mechanisms, so clinical and diagnostic solutions
are realized and recognized to combat unmet medical needs.
Second Round of Studies on Advanced Power Generation Based on Combined Cycle Using a Single High-Pressure Fluidized Bed Boiler and Consuming Biomass
Authors: L. de Souza-Santos Marcio , Villanueva Chavez Juan
Published: December 2012

Following a preliminary study of power generation processes consuming sugar-cane bagasse; this second round indicates the possibility of almost doubling the current efficiency presently obtained in conventional mills. A combined cycle uses highly pressurized fluidized bed boiler to provide steam above critical temperature to drive steam-turbine cycle while the flue-gas is injected into gas turbines. The present round also shows that gains over usual BIG/GT (Biomass In-tegrated Gasification/Gas Turbine) are very likely mainly due to the practicality of feeding the biomass as slurry that can be pumped into the pressurized boiler chamber. Such would avoid the cumbersome cascade feeding of the fibrous bio-mass, usually required by other processes. The present stage assumes slurry with 50% added water. Future works will concentrate on thicker slurries, if those could be achieved. All studies apply a comprehensive simulator for boilers and gasifiers [CSFMB™ or CeSFaMB™] and a process simulator (IPES) to predict the main features of the steam and gas tur-bine branches.
Sacroiliac Joint Arthrodesis-MIS Technique with Titanium Implants: Report of the First 50 Patients and Outcomes
Authors: Rudolf Leonard
Published: December 2012

This retrospective study of 50 consecutive patients treated by a single orthopedic spine surgeon in private practice was conducted to evaluate the safety and efficacy of minimally invasive sacroiliac joint fusion using a series of triangular, porous plasma spray coated titanium implants.

Medical charts were reviewed for perioperative metrics, complications, pain, quality of life and satisfaction with surgery. All patients were contacted at a 24 months post-op to assess SI joint pain, satisfaction with surgery and work status.

An early and sustained statistically significant improvement in pain function was identified at all post-operative time points (ANOVA, p<0.000). A clinically significant improvement (>2 point change from baseline) was observed in 7 out of 9 domains of daily living. The complication rate was low and more than 80% of patients would have the same surgery again.

MIS SI joint fusion appears to be a safe and effective procedure for the treatment of sacroiliac joint disruption or degenerative sacroiliitis.
Comparison of Two Measures of Missing Cofactor in Cofactor-Dependent Enzymes: Proportion Versus Relative Increase
Authors: Hansson Tomas
Published: December 2012

The degree of missing cofactor in a cofactor-dependent enzyme is widely used as a biomarker of cofactor defi-ciency. The degree of missing cofactor can be expressed either as the proportion of enzyme without cofactor, or as the rel-ative increase in enzyme with cofactor after addition of excess cofactor to the sample. Especially for enzymes with thia-mine pyrophosphate (TPP) as a cofactor, the relative increase (TPP-effect) has been used in a majority of studies, and its use seems to prevail without consideration of the proportion (latency) as a better alternative. In this letter, the statistical properties of the two measures are compared in the context of a thiamine-dependent enzyme. Proportion is a more bal-anced and sensitive measure than relative increase, and simulation shows that proportion is associated with equal or high-er statistical power than relative increase. The power difference can be as high as 0.12.
Special Issue Introduction
Authors: Scott Bobby R. , Dobrzyński Ludwik
Published: December 2012

“At the early stages of evolution, increasingly complex organisms developed powerful defense mechanisms against such adverse radiation effects as mutation and malignant change. These effects originate in the cell nucleus, where the DNA is their primary target. That evolution has apparently proceeded for so long is proof, in part, of the effectiveness of living things’ defenses against radiation.” Zbigniew Jaworowski 1999

“Chernobyl was indeed an historic event; it is the only nuclear power station disaster that ever resulted in an occupational death toll, albeit a comparatively small one. A vast environmental dispersion of radioactivity occurred that did not cause any scientifically confirmed fatalities in the general population. The worst harm to the population was caused not by radiation, and not to flesh, but to minds.” Zbigniew Jaworowski 2010
Photocatalytic degradation of rose Bengal by semiconducting zinc sulphide used as a photocatalyst
Authors: Sharma Shweta , Ameta Rakshit , Malkani R.K. , Ameta Suresh
Published: December 2012

Various semiconductors have been used as photocatalysts for removal of
different dyes from their aqueous solutions. Zinc sulphide semiconductor is
used in the present investigation as a photocatalyst for the removal of rose
Bengal dye. Effect of different parameters, which affect the rate of
reaction; like pH, concentration of dye, amount of semiconductor and light
intensity have been studied. A mechanism has also been proposed in which
hydroxyl radicals are shown as an active oxidizing species.
Accounting Standards, Cost of Capital, Resource Allocation, and Welfare in a Large Economy
Authors: Zhang Guochang
Published: December 2012

In an extended capital asset pricing model (CAPM) setting, I examine how the quality of accounting standards affects real investment and welfare through its impact on investment hurdle rates. In this model, cash flow uncertainty arises from two fundamental sources relating, respectively, to economic performance and accounting measurement errors, but they combine into a single market factor for asset pricing. Accounting standards matter to real investment not only because information quality affects the required risk premiums on individual projects relative to a given market factor, but also because information quality affects the aggregate investment level and, hence, the market factor itself. I show that improving accounting standards causes both an expansion of the real economy and a shift in capital allocation across firms. While welfare increases as a result, firms in certain risk classes end up with higher costs of capital and lower values, some of which are crowded out from the economy. The study also lends insights into how the real and financial impacts of accounting standards depend on a firm's accounting and economic characteristics.
I/B/E/S Reported Actual EPS and Analysts' Inferred Actual EPS
Authors: Brown Lawrence D. , Larocque Stephannie
Published: December 2012

Users of I/B/E/S data generally act as if I/B/E/S reported actual earnings represent the earnings analysts were forecasting when they issued their earnings estimates. For example, when assessing analyst forecast accuracy, users of I/B/E/S data compare analysts' forecasts of EPS with I/B/E/S reported actual EPS. I/B/E/S states that it calculates actuals using a “majority rule,” indicating that its actuals often do not represent the earnings that all individual analysts were forecasting. We introduce a method for measuring analyst inferred actuals, and we assess how often I/B/E/S actuals do not represent analyst inferred actuals. We find that I/B/E/S reported Q1 actual EPS differs from analyst inferred actual Q1 EPS by at least one penny 39 percent of the time during our sample period, 36.5 percent of the time when only one analyst follows the firm (hence, this consensus forecast is based on the “majority rule”), and 50 percent of the time during the last three years of our sample period. We document two adverse consequences of this phenomenon. First, studies failing to recognize that I/B/E/S EPS actuals often differ from analyst inferred actuals are likely to obtain less accurate analyst earnings forecasts, smaller analyst earnings forecast revisions conditional on earnings surprises, greater analyst forecast dispersion, and smaller market reaction to earnings surprises than do studies adjusting for these differences. Second, studies failing to recognize that I/B/E/S EPS actuals often differ from analyst inferred actuals may make erroneous inferences.
A French Experience of an IFRS Transition
Authors: Bonnier Carole , Demerens Frédéric , Hossfeld Christopher , Le Manh Anne
Published: December 2012

In 2005, IFRS became mandatory for consolidated financial statements of French-listed companies. Our students had increasingly international backgrounds, internships, and jobs after graduation. Therefore, we felt the need to modify our French GAAP-based introductory accounting class to a course using IFRS. This article describes the challenges we faced and the solutions we adopted. Since French GAAP are rules-based and IFRS principles-based, the adoption of IFRS modified our learning goals, the learning strategy, and the assessment methods. We changed from a bookkeeping-oriented approach to one in which students have to define and analyze various transactions with respect to the conceptual framework using broader economic and financial concepts. We also had to modify student behavior from a learning attitude of repeating answers to one of finding answers, which meant further developing their analytical, synthesis, and judgment skills. Class material had to be adjusted to better reflect the complex reality and to allow students to make judgments, thus raising the question to what degree of detail certain topics are taught. This new approach also raised challenges in terms of providing feedback to students, grading, and student evaluation. By raising awareness about these issues, we want to contribute to a smoother transition when switching accounting classes from local GAAP to IFRS in other countries.
Glycemia, Insulin Resistance, Insulin Secretion, and Risk of Depressive Symptoms in Middle Age
Authors: Akbaraly Tasnime N. , Kumari Meena , Head Jenny , Ritchie Karen , Ancelin Marie-Laure , Tabák Adam G. , Brunner Eric , Chaudieu Isabelle , Marmot Michael G. , Ferrie Jane E. , Shipley Martin J. , Kivimäki Mika
Published: December 2012

OBJECTIVE

The extent to which abnormal glucose metabolism increases the risk of depression remains unclear. In this study, we investigated prospective associations of levels of fasting glucose and fasting insulin and indices of insulin resistance and secretion with subsequent new-onset depressive symptoms (DepS).

RESEARCH DESIGN AND METHODS

In this prospective cohort study of 3,145 adults from the Whitehall II Study (23.5% women, aged 60.6 ± 5.9 years), baseline examination included fasting glucose and insulin level, the homeostasis model assessment of insulin resistance (HOMA2-%IR), and the homeostasis model assessment of β-cell insulin secretion (HOMA2-%B). DepS (Center for Epidemiologic Studies Depression Scale ≥16 or use of antidepressive drugs) were assessed at baseline and at 5-year follow-up.

RESULTS

Over the 5-year follow-up, DepS developed in 142 men and 84 women. Women in the lowest quintile of insulin secretion (HOMA2-%B ≤55.3%) had 2.18 (95% CI 1.25–3.78) times higher odds of developing DepS than those with higher insulin secretion. This association was not accounted for by inflammatory markers, cortisol secretion, or menopausal status and hormone replacement therapy. Fasting insulin measures were not associated with DepS in men, and fasting glucose measures were not associated with new-onset DepS in either sex.

CONCLUSIONS

Low insulin secretion appears to be a risk factor for DepS in middle-aged women, although further work is required to confirm this finding.
Glycation of Apoprotein A-I Is Associated With Coronary Artery Plaque Progression in Type 2 Diabetic Patients
Authors: Pu Li Jin , Lu Lin , Zhang Rui Yan , Du Run , Shen Ying , Zhang Qi , Yang Zheng Kun , Chen Qiu Jing , Shen Wei Feng
Published: December 2012

OBJECTIVE

To investigate whether glycation level of apoprotein (apo)A-I is associated with coronary artery disease (CAD) and plaque progression in patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS

Among 375 consecutive type 2 diabetic patients undergoing quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS), 82 patients with nonsignificant stenosis (luminal diameter narrowing <30% [group I]) and 190 patients with significant CAD (luminal diameter stenosis ≥70% [group II]) were included for analysis of apoA-I glycation level and serum activity of lecithin: cholesterol acyltransferase (LCAT). The control group had 136 healthy subjects. At the 1-year follow-up, angiography and IVUS were repeated mainly in group II patients for plaque progression assessment.

RESULTS

Relative intensity of apoA-I glycation by densitometry was increased, and serum LCAT activity was decreased stepwise across groups control, I, and II. These two measurements were associated with the number of diseased coronary arteries and extent index in group II. During 1-year follow-up, QCA detected 45 patients with plaque progression in 159 subjects, and IVUS found 38 patients with plaque progression in 127 subjects. Baseline relative intensity of apoA-I glycation was significantly increased in patients with plaque progression compared with those without, with values associated with changes in QCA and IVUS measurements. Multivariable regression analysis revealed that baseline relative intensity of apoA-I glycation was an independent determinant of CAD and plaque progression in type 2 diabetic patients.

CONCLUSIONS

ApoA-I glycation level is associated with the severity of CAD and coronary artery plaque progression in type 2 diabetic patients.
A Novel Botulinum Neurotoxin Topical Gel: Treatment of Allergic Rhinitis in Rats and Comparative Safety Profile
Authors: Zhu Zhao , Stone Hongran F. , Thach Thai Q.D. , Garcia Luke , Ruegg Curtis L.
Published: December 2012

Background

Rhinitis affects a significant proportion of adults and children with typically seasonal or chronic symptoms. Botulinum neurotoxin type A (BoNTA) is a well-known cholinergic antagonist widely used in a number of approved neurological and esthetic indications. is study designed to assess the therapeutic effect of RT001, a novel topical gel formulation of BoNTA, in the treatment of allergic rhinitis using a rat model and to compare its safety profile with that of an aqueous formulation of BoNTA complex.

Methods

A rat model of allergic rhinitis was used involving induction of classic rhinitis signs (sneezing and nasal itch) in addition to nasal inflammatory pathology to assess the degree of therapeutic effect of RT001. Comparative safety of RT001 and BoNTA complex was assessed in guinea pigs based on lethality and body weight gain.

Results

Clinical signs of rhinitis were significantly (p < 0.01) relieved after a single intranasal administration of RT001 and resolved to normal baseline levels within 5 days after treatment. Mucosal inflammation characterized by edema, congestion, and vascular dilatation along with increased expression of vasoactive intestinal peptide was noted in control animals after allergy induction, whereas 001 treatment resolved inflammation to essentially normal baseline levels. Safety studies in guinea pigs via intranasal dosing revealed ~31-fold greater safety factor for RT001 when compared with BoNTA complex.

Conclusion

These results suggest that topical intranasal application of RT001 is effective in relief of clinical signs and inflammatory pathology associated with allergic rhinitis in a rodent model and may provide a safe treatment for rhinitis.
Use of Advanced Imaging Technology and Endoscopy for Chronic Rhinosinusitis Varies by Physician Specialty
Authors: Pynnonen Melissa A. , Lin Giant , Dunn Rodney L. , Hollenbeck Brent K.
Published: December 2012

Background

Patients with chronic rhinosinusitis are cared for by multiple specialties. Endoscopy and imaging are important diagnostic tools. However, because physicians vary in their access to imaging and endoscopy, testing may vary across specialties. The purpose of this study is to characterize differences in use of imaging and endoscopy between physician specialties.

Methods

Using data from the National Ambulatory Medical Care Survey, we identified adult visits with primary, secondary, and tertiary diagnoses of chronic rhinosinusitis from 2005 through 2008. We measured rates of advanced radiographic imaging (CT, MRI, and PET) and office procedures. Logistic regression models were used to assess the bivariate and independent effects of patient, physician, and practice-level factors on use of advanced imaging and office procedures.

Results

There were nearly 51 million visits for diagnoses coded as chronic rhinosinusitis, representing an average of 12.7 million visits annually. Primary care providers saw the majority of these patients. Otolaryngologists used advanced radiographic imaging at a rate higher n primary care physicians per outpatient visit (16.0% versus 1.93%; p < 0.001). Office procedures, performed almost exclusively (99.2%) by otolaryngologists, were performed at 24.5% of otolaryngology visits. Private insurance was significantly associated with a lower use of advanced radiographic imaging (odds ratio, 0.54; 95% CI, 0.31–0.94) among otolaryngology visits, but no patient or provider-level variables were associated with office procedure use.

Conclusion

Radiographic imaging and office procedures are used at a higher rate per outpatient visit by otolaryngologists than by primary care providers. Additional studies are needed to identify and characterize factors that contribute to these different rates of use.
Does Oral Prednisolone Increase the Efficacy of Subsequent Nasal Steroids in Treating Nasal Polyposis?
Authors: Kirtsreesakul Virat , Wongsritrang Krongthong , Ruttanaphol Suwalee
Published: December 2012

Background

Although combined oral and nasal steroid therapy is widely used in nasal polyposis, a subset of patients show an unfavorable therapeutic outcome. This study aimed to evaluate whether oral prednisolone produces any additive effects on subsequent nasal steroid therapy and to evaluate if any clinical variables can predict therapeutic outcome.

Methods

Using a 3:2 randomization ratio, 67 patients with nasal polyposis received 50 mg of prednisolone and 47 patients received placebo daily for 2 weeks, followed by mometasone furoate nasal spray (MFNS) at 200 micrograms twice daily for 10 weeks. Clinical response was evaluated by nasal symptom score (NSS), peak expiratory flow index (PEFI), and total nasal polyps score (TNPS). Potential predictor variables were assessed by clinical history, nasal endoscopy, allergy skin test, and sinus radiography.

Results

At the end of the 2-week oral steroid phase, the prednisolone group showed significantly greater improvements in all nasal symptoms, nasal airflow, and polyp size than the placebo group. In the nasal steroid phase, while the MFNS maintained the outcome improvements in the prednisolone group, all outcome variables in the placebo group showed continuing improvements. At the end of the nasal steroid phase, there re no significant differences of most outcome improvements between the two groups, except in hyposmia, PEFI, and TNPS (p = 0.049, p = 0.029, and p = 0.005, respectively). In the prednisolone group, patients with polyps grade 3 and endoscopic signs of meatal discharge showed significantly less improvement in total NSS, PEFI, and TNPS than patients with grade 1–2 size and negative metal discharge.

Conclusion

In the 12-week treatment evaluation of nasal polyposis, pretreatment with oral steroids had no significant advantage for most nasal symptoms other than earlier relief; however, combined oral and nasal steroid therapy more effectively improved hyposmia, polyps size, and nasal airflow. Polyps size grade 3 and/or endoscopic signs of meatal discharge predisposed to a poorer treatment outcome.
The Novel Dry Extract BNO 1011 Stimulates Chloride Transport and Ciliary Beat Frequency in Human Respiratory Epithelial Cultures
Authors: Kreindler James L. , Chen Bei , Kreitman Yael , Kofonow Jennifer , Adams Kelly M. , Cohen Noam A.
Published: December 2012

Background

Herbal remedies predate written history and continue to be used more frequently than conventional pharmaceutical medications. The novel dry extract BNO 1011 is based on a combination of five herbs that is used to treat acute and chronic rhinosinusitis. We evaluated the pharmacologic effects of the novel dry extract BNO 1011 on human respiratory epithelial cultures specifically addressing electrolyte transport and cilia beat frequency (CBF).

Methods

Well-differentiated human bronchial epithelial cultures grown at an air–liquid interface were treated on the apical or basolateral surface with varying concentrations of dry extract BNO 1011. Changes in transepithelial sodium and chloride transport were determined in Ussing chambers under voltage-clamped conditions. Changes in CBF were determined using the Sissons-Ammons Video Analysis system (Ammons Engineering, Mt. Morris, MI).

Results

When applied to the apical surface, dry extract BNO 1011 activated forskolin-stimulated chloride secretion and ciliary beat in a dose-dependent fashion. Basolateral application of dry extract BNO 1011 did not alter the measured physiological properties.

Conclusion

Apical application of dry extract BNO 1011 stimulates both chloride secretion and CBF and therefore may augment mucociliary clearance.
Identifying Intracellular Staphylococcus Aureus in Chronic Rhinosinusitis: A Direct Comparison of Techniques
Authors: Tan Neil C.-W. , Tran Hai Bac , Foreman Andrew , Jardeleza Camille , Vreugde Sarah , Wormald Peter John
Published: December 2012

Background

The emerging concept of intracellular pathogens such as Staphylococcus aureus playing a role in chronic rhinosinusitis (CRS) has led to the development of numerous imaging techniques for their identification. Traditional methods of bacterial culture are not effective at localizing bacteria to the surface or within tissue samples. The aim of this study was to develop and validate a novel imaging technique using confocal scanning laser microscopy (CSLM) coupled with a fluorescence in situ hybridization (FISH) probe and nucleic acid counterstain (propidium iodide [PI]) that allows for simultaneous analysis of S. aureus intracellular status and surface biofilm within whole mucosal samples.

Methods

A prospective study was performed including 17 patients undergoing endoscopic sinus surgery for CRS. Tissue samples were analyzed with both CSLM-FISH/PI and immunohistochemistry (IHC) for intracellular S. aureus status.

Results

Using CSLM-FISH/PI intracellular S. aureus was identified in 9/17 (47%) patients and in 7/17 (39%) using IHC. Surface biofilm can be identified with CSLM-FISH/PI in the same piece of tissue; however, deeper imaging to the submucosa is impossible. IHC showed submucosal bacteria in three patients.

Conclusion

Both CSLM-FISH/PI and IHC are complementary techniques that can be used to identify intracellular S. aureus. CSLM-FISH/PI allows for the simultaneous detection of intracellular status and surface biofilm within the tissue analyzed. IHC has a role in the identification of intracellular and submucosal S. aureus within these tissues. Additional investigation is required to identify the true pathogenic nature of intracellular organisms as well as any relationship to surface biofilm status.
A Time Course Study on the Development of Allergen-induced Nasal Airway Remodeling in a Rat Model
Authors: Chung Young-Jun , Kim Hyo Yeol , Chung Seung-Kyu , Dhong Hun-Jong
Published: December 2012

Background

Only a few studies have investigated the airway remodeling process in allergic rhinitis (AR), and the results reported are conflicting. We established an allergen-induced nasal remodeling model for AR using brown Norway rats and investigated time-dependent histological changes and the reversibility of the epithelial and subepithelial changes.

Methods

Ovalbumin (OVA)-sensitized rats were exposed to OVA daily and then assigned to one of five groups depending on the duration of the challenge. Groups I, II, III, and IV rats were exposed for 1, 4, 8, and 12 weeks, respectively. Group V rats were exposed for 12 weeks and then protected from challenge for 4 weeks. Matched control rats were exposed to saline. Histological parameters of the nasal mucosa such as epithelial and subepithelial thickness, goblet cell hyperplasia, eosinophil infiltration, submucosal gland hypertrophy, and expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) were compared between groups.

Results

Repeated challenges for 12 weeks resulted in the characteristic features of nasal airway remodeling. All parameters except epithelial thickness increased markedly. Goblet cell hyperplasia and eosinophil infiltration decreased to control group levels after cessation of challenge for 4 weeks. Subepithelial changes such as subepithelial thickening, submucosal gland hypertrophy, and increased expression of MMP-9 and TIMP-1 were still observed after 4 weeks without challenge.

Conclusion

Our results indicate that prolonged OVA challenge can induce nasal remodeling. Epithelial changes were minimal or absent after cessation of the challenge, but subepithelial changes were resistant to reversal.
Diagnostic Value of Biopsies in Identifying Cytoplasmic Antineutrophil Cytoplasmic Antibody–negative Localized Wegener's Granulomatosis Presenting Primarily with Sinonasal Disease
Authors: Borner Urs , Landis Basile Nicolas , Banz Yara , Villiger Peter , Ballinari Piero , Caversaccio Marco , Dubach Patrick
Published: December 2012

Background

A substantial proportion of Wegener's disease (WG) patients present with localized disease of the upper airways, i.e., sinonasal and other ear/nose/throat (ENT) symptoms. Because of the oligosymptomatic presentation a timely diagnosis of this potentially fatal disease is challenging. This study evaluates diagnostic peculiarities between WG in its localized and generalized form of the disease.

Methods

Retrospective analysis was performed of 82 patients with suspected WG manifesting in the ENT region between 1989 and 2009. Comparison was performed of the clinical and laboratory results between patients with localized (n = 15) and generalized stage (n = 16) as well as non-WG patients (n = 50).

Results

ENT signs and symptoms were subtle, especially in the population presenting with localized disease. Therapy refractory rhinosinusitis or serous otitis media were the most frequent presentations of WG. In testing for localized WG, mucosal biopsy had the highest sensitivity (53%) compared with cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCAs) with a lower sensitivity (47%) but highest specificity (96%) and highest positive predictive value (PPV; 78% versus 73%). Patients with generalized WG typically revealed a pathological urine sediment, hemoptysis, or rheumatological symptoms. In the generalized stage, c-ANCA had the highest sensitivity (81%), specificity (96% versus 95%), and highest PPV (87%).

Conclusion

Timely diagnosis and treatment of localized WG limited to the ENT region remains problematic. Even with adequate therapy, nearly one-half of patients with sinonasal localization suffer from relapse, at least 1 in 10 will progress to generalized disease, and up to two-thirds may develop permanent tissue damage. Unfortunately, the diagnostic usefulness of c-ANCA is significantly reduced at this early stage compared with cases with generalized disease (p = 0.04). Hence, the relative diagnostic value of mucosal biopsy increases especially for the significant proportion of c-ANCA– localized WG patients (47%). Sinonasal tissue sampling represents a cornerstone for diagnosis, which unlike c-ANCA testing can be repeated in short intervals and is associated with low morbidity.
Efficacy Study of Nasal Irrigation after Radiofrequency Tissue Volume Reduction for Inferior Turbinate Hypertrophy: An Equivalence Randomized Controlled Trial
Authors: Hirunwiwatkul Prakobkiat , Udomchotphruet Panya
Published: December 2012

Background

To determine the benefits of nasal irrigation after radiofrequency tissue volume reduction (RFTVR) for inferior turbinate hypertrophy (ITH) in terms of nasal obstructive symptoms, endoscopic nasal findings, and acoustic rhinometry. An equivalence randomized controlled trial was performed at the Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.

Methods

Seventy-nine subjects with ITH planned for RFTVR were enrolled consecutively. The intervention was randomized into two groups: with and without nasal saline irrigation. Primary outcome was visual analog scale (VAS; 0–10) of postoperative nasal obstructive symptoms. Rhinorrhea, pain, nasal itching and sneezing, foul odor, bleeding, crusting and discharge, and patient satisfaction were self-assessed by the patients. Findings from endoscopic nasal examination and acoustic rhinometry (total nasal volume and cross-sectional area 2 [CSA2]) were performed before and after the intervention by blinded assessors.

Results

The study revealed no difference of nasal obstruction and other symptoms between the saline group and the control group on the 1st postoperative week, except nasal itching and sneezing. The saline group had itching and sneezing symptoms lower than the control group on the 5th–7th postoperative day. All patients had minimal or no postoperative nasal bleeding. There were also no differences of satisfaction and acoustic rhinometry findings between both groups.

Conclusion

The nasal irrigation with normal saline had no additional benefits after RFTVR for ITH in terms of nasal obstructive symptoms, endoscopic nasal findings, and acoustic rhinometry except nasal itching and sneezing symptoms.
The "Moving" Image
Authors: Simine Silke Arnold-de
Published: December 2012

The moving image has become ubiquitous in museums that deal with traumatic, violent, and difficult histories and could be described as "memorial museums." This article investigates exhibition practices in the International Slavery Museum, Liverpool, in which large-scale video installations provide evocative recreations of traumatic experiences that are designed to unsettle and disturb visitors, providing them with a visceral and vicarious experience that calls for witnessing and "empathic unsettlement." It also queries the assumption that the capacity for empathy forms the basis for responsible moral agency, and whether museums aiming to encourage social responsibility should rely on such technologies.
Showcasing Dictatorship
Authors: Andermann Jens
Published: December 2012

This article compares two recently inaugurated museums dedicated to the period of dictatorial terror and repression in the Southern Cone: the Museum of Memory and Human Rights at Santiago, Chile (opened in 2009), and the Museum of Memory at Rosario, Argentina (2010). Both museums invoke in their very names the "memorial museum" as a new mode of exhibitionary remembrance of traumatic events from the past. They seek to sidestep the detachment and "objectivity" that has traditionally characterized historical museum displays in favor of soliciting active, performative empathy from visitors. Neither of the two institutions, however, complies entirely with the memorial museum's formal characteristics; rather, they reintroduce modern museographical languages of history and art, thus also challenging the emergent "global canon" of memorial museum aesthetics.