bluuebunny/crossref_metadata_2025 huggingface dataset:
Breast Milk–Acquired Cytomegalovirus Infection and Disease in VLBW and Premature Infants
Authors: Lanzieri Tatiana M. , Dollard Sheila C. , Josephson Cassandra D. , Schmid D. Scott , Bialek Stephanie R.
Published: May 2013

BACKGROUND:

Very low birth weight (VLBW) and premature infants are at risk for developing postnatal cytomegalovirus (CMV) disease, including CMV-related sepsis-like syndrome (CMV-SLS) for which in the United States are lacking.

METHODS:

We performed a systematic review and meta-analysis to estimate the pooled proportions (and 95% confidence intervals) of VLBW and premature infants born to CMV-seropositive women with breast milk–acquired CMV infection and CMV-SLS. We combined these proportions with population-based rates of CMV seropositivity, breast milk feeding, VLBW, and prematurity to estimate annual rates of breast milk–acquired CMV infection and CMV-SLS in the United States.

RESULTS:

In our meta-analysis, among 299 infants fed untreated breast milk, we estimated 19% (11%–32%) acquired CMV infection and 4% (2%–7%) developed CMV-SLS. Assuming these proportions, we estimated a rate of breast milk–acquired CMV infection among VLBW and premature infants in the United States of 6.5% (3.7%–10.9%) and 1.4% (0.7%–2.4%) of CMV-SLS, corresponding to 600 infants with CMV-SLS in 2008. Among 212 infants fed frozen breast milk, our meta-analysis proportions were 13% (7%–24%) for infection and 5% (2%–12%) for CMV-SLS, yielding slightly lower rates of breast milk–acquired CMV infection (4.4%; 2.4%–8.2%) but similar rates of CMV-SLS (1.7%; 0.7%–4.1%).

CONCLUSIONS:

Breast milk–acquired CMV infection presenting with CMV-SLS is relatively rare. Prospective studies to better define the burden of disease are needed to refine guidelines for feeding breast milk from CMV-seropositive mothers to VLBW and premature infants.
Scope of Practice Issues in the Delivery of Pediatric Health Care
Authors:   COMMITTEE ON PEDIATRIC WORKFORCE, Shugerman Richard P. , Rimsza Mary E. , Basco William T. , Hotaling Andrew J. , Sigrest Ted D. , Simon Frank A.
Published: May 2013

The American Academy of Pediatrics (AAP) believes that optimal pediatric health care depends on a team-based approach with supervision by a physician leader, preferably a pediatrician. The pediatrician, here defined to include not only pediatric generalists but all pediatric medical subspecialists, all surgical specialists, and internal medicine/pediatric physicians, is uniquely qualified to manage, coordinate, and supervise the entire spectrum of pediatric care, from diagnosis through all stages of treatment, in all practice settings. The AAP recognizes the valuable contributions of nonphysician clinicians, including nurse practitioners and physician assistants, in delivering optimal pediatric care. However, the expansion of the scope of practice of nonphysician pediatric clinicians raises critical public policy and child health advocacy concerns. Pediatricians should serve as advocates for optimal pediatric care in state legislatures, public policy forums, and the media and should pursue opportunities to resolve scope of practice conflicts outside state legislatures. The AAP affirms the importance of appropriate documentation and standards in pediatric education, training, skills, clinical competencies, examination, regulation, and patient care to ensure safety and quality health care for all infants, children, adolescents, and young adults.
Motor Delays: Early Identification and Evaluation
Authors: Noritz Garey H. , Murphy Nancy A. ,   NEUROMOTOR SCREENING EXPERT PANEL, Murphy Nancy A. , Hagan Joseph F. , Lipkin Paul H. , Macias Michelle M. , Navsaria Dipesh , Noritz Garey H. , Peacock Georgina , Rosenbaum Peter L. , Saal Howard M. , Sarwark John F. , Swanson Mark E. , Wiznitzer Max , Yeargin-Allsopp Marshalyn
Published: May 2013

This Clinical Report was reaffirmed May 2017 and November 2022.

Pediatricians often encounter children with delays of motor development in their clinical practices. Earlier identification of motor delays allows for timely referral for developmental interventions as well as diagnostic evaluations and treatment planning. A multidisciplinary expert panel developed an algorithm for the surveillance and screening of children for motor delays within the medical home, offering guidance for the initial workup and referral of the child with possible delays in motor development. Highlights of this clinical report include suggestions for formal developmental screening at the 9-, 18-, 30-, and 48-month well-child visits; approaches to the neurologic examination, with emphasis on the assessment of muscle tone; and initial diagnostic approaches for medical home providers. Use of diagnostic tests to evaluate children with motor delays are described, including brain MRI for children with high muscle tone, and measuring serum creatine kinase concentration of those with decreased muscle tone. The importance of pursuing diagnostic tests while concurrently referring patients to early intervention programs is emphasized.
Nanometer Resolution XANES Imaging of in situ switched individual PC-RAM devices
Authors: Richter Jan H. , Kolobov Alexander V. , Fons Paul , Wang Xiaomin , Mitrofanov Kirill V. , Tominaga Junji , Osawa Hitoshi , Suzuki Motohiro
Published: May 2013

We report on the study of single devices of phase-change (Ge2Sb2Te5) memory cells in line cell type devices. Devices were investigated employing an x-ray nanobeam of only about 150 nm diameter, which could be fully contained within the spatial extent of the active area within a single device cell. XANES spectra showing the device in the amorphous and crystalline state have been successfully collected after switching the device in situ at the synchrotron. By monitoring the fluorescence response of the sample constituent materials at a constant photon energy (corresponding to the Ge K-edge absorption edge) as a function of x-ray beam position on the sample 2D maps have been produced.
Histomorphometric Analysis of Bone Regeneration Using a Dual Layer of Membranes (dPTFE Placed Over Collagen) in Fresh Extraction Sites: A Canine Model
Authors: Al-Hezaimi Khalid , Iezzi Giovanna , Rudek Ivan , Al-Daafas Abdullah , Al-Hamdan Khalid , Al-Rasheed Abdulaziz , Javed Fawad , Piattelli Adriano , Wang Hom-Lay
Published: May 2013

In untreated extraction sockets, buccal bone remodeling compromises the alveolar ridge width. The aim of this study was to histologically assess the efficacy of using a dual layer of membranes (high-density polytetrafluoroethylene [dPTFE] placed over collagen) for ridge preservation in fresh extraction sites. Eight beagle dogs were used. After endodontic treatment of mandibular bilateral second (P2), third (P3), and fourth (P4) premolars, mandibular bilateral first premolars and distal roots of P2, P3, and P4 were extracted atraumatically. Animals were randomly divided into 4 treatment groups. group 1, the control group, received no treatment; in group 2, allograft was placed in the alveolum and the socket covered with dPTFE membrane; in group 3, allograft was placed in the alveolum, the buccal plate was overbuilt with allograft, and the socket was covered with dPTFE membrane; in group 4, allograft was placed in the alveolum and covered with dual layer of membranes (dPTFE placed over collagen). No intent of primary closure was performed for all groups. After 16 weeks, the animals were sacrificed and mandibular blocks were assessed histologically for buccolingual width of alveolar ridge, percentage of bone formation and bone marrow spaces, and the remaining bone particles. The buccolingual width of the alveolar ridge was significantly higher among sockets in group 4 than in group 1 (P < .05). the amount of newly formed bone in each socket was higher in extraction sockets in group 4 than in groups 1, 2, and 3 (P < .001). A significant difference was found in the percentage of bone marrow spaces among all groups (P < .001). No significant difference was found in the number of nonresorbed bone particles among the groups. Using a dual layer of membrane was more effective in ridge preservation than conventional socket augmentation protocols.
Implant Fixture Heat Transfer During Abutment Preparation
Authors: Aleisa Khalil , Alkeraidis Abdullah , Al-Dwairi Ziad Nawaf , Altahawi Hamdi , Lynch Edward
Published: May 2013

The purpose of the study was to evaluate the effect of water flow rate on the heat transmission in implants during abutment preparation using a diamond bur in a high-speed dental turbine. Titanium-alloy abutments (n = 32) were connected to a titanium-alloy implant embedded in an acrylic resin within a water bath at a controlled temperature of 37°C. The specimens were equally distributed into 2 groups (16 each) according to the water flow rate used during the preparation phase. Group 1 had a water flow rate of 24 mL/min, and group 2 had a water flow rate of 40 mL/min. Each abutment was prepared in the axial plane for 1 minute and in the occlusal plane for 1 minute with a coarse tapered diamond bur using a high-speed dental handpiece. Thermocouples embedded at the cervix of the implant surface were used to record the temperature of heat transmission from the abutment preparation. Heat generation was measured at 3 distinct times (immediately and 30 seconds and 60 seconds after the end of preparation). Statistical analyses were carried out using 2-way analysis of variance and the Student t test. Water flow rates (24 mL vs 40 mL) and time interval had no statistically significant effect on the implant's temperature change during the abutment preparation stage (P = .431 and P = .064, respectively). Increasing the water flow rate from 24 to 40 mL/min had no influence on the temperature of the implant fixture recorded during preparation of the abutment.
Leaf structure, microanalysis and characterization of the latex protein profile of Pachystroma longifolium (Nees) I.M. Jonhst. (Euphorbiaceae) in a seasonally dry Atlantic Forest
Authors: Rabelo Guilherme Rodrigues , Marques Jonas de Brito Campolina , Zottich Umberto , Dias Germana Bueno , Miguel Emílio Castro , Gomes Valdirene Moreira , Da Cunha Maura
Published: May 2013

Pachystroma longifolium is an evergreen species of Euphorbiaceae that occurs in tabuleiro forest, a type of lowland Atlantic Forest. The site chosen for this study was a fragment of tabuleiro forest that has a history of being selectively logged for timber. P. longifolium is very successful at colonizing disturbed areas in this forest fragment in comparison with preserved fragments. In the present work, which was based on using different microscopy (electron and light microscopy, X-ray analysis) and biochemistry techniques, we describe the leaf and latex traits of P. longifolium and their role as defense mechanisms against desiccation and herbivory. Our results suggest the richness of P. longifolium populations, in the disturbed forest area studied, is primarily a consequence of unpalatable leaves because of an abundance of calcium oxalate crystals in the subjacent epidermis; the presence of phenolic compounds in the adaxial surface; and a laticifer system that contains a complex mixture of proteins, which provides resistance to herbivores. In addition, this species is resistant to desiccation during dry periods because of an extensive amount of wax that occurs on the outer cell walls of the epidermis, and its ability to retain water because of a biseriate epidermis.
Non-adiabatic interactions in charge transfer collisions
Authors: Bacchus-Montabonel Marie-Christine , Rozsályi Emese , Bene Erika , Halász Gábor , Vibók Ágnes
Published: May 2013

An analysis of the charge transfer mechanism in the collision of multiply charged ions with molecular and biomolecular targets is performed, considering the non-adiabatic interactions between the molecular states involved. Collisions of doubly charged C 2+ ions on small molecular targets, CO and OH, have been investigated, together with the analysis of charge transfer between C 4+ ions on uracil and halouracil biomolecular targets. The process is studied theoretically by means of ab-initio molecular calculations followed by a semi-classical treatment of the collision dynamics. The influence of rotational couplings is discussed with regard to the collision energy. Strong anisotropic and vibration effects are pointed out.
Olfactory Function in Healthy Children: Normative Data for Odor Identification
Authors: van Spronsen Erik , Ebbens Fenna A. , Fokkens Wytske J.
Published: May 2013

Background

Olfactory disorders in children may be encountered frequently in the common ear, nose, and throat (ENT) practice. The need for objective measurements in the diagnosis, treatment, and evaluation of olfaction is present. However, for young children most olfactory tests need further normative data to be useful in clinical practice. Therefore, this study aimed to provide normative data in children and to determine possible parameters that influence odor identification test outcome.

Methods

In 201 healthy children reflecting the Dutch population, the Sniffin’ Sticks screening test was performed and possible outcome determinants (age, height, gender, weight, peak nasal inspiratory flow, previous ENT surgery, and parental smoking habits) were assessed.

Results

Age, gender, and previous ENT surgery seem to influence significantly the outcome of the olfactory test.

Conclusion

In a general population-based sample of children, normative data of the Sniffin’ Sticks screenings test are supplied as well as possible determinants of outcome.
Evaluation of Vascular Endothelial Growth Factor A and Endostatin Levels in Induced Sputum and Relationship to Bronchial Hyperreactivity in Patients with Seasonal Allergic Rhinitis
Authors: Yılmaz İnsu , Bayraktar Nilüfer , Ceyhan Koray , Seçil Derya , Yüksel Selcen , Mısırlıgil Zeynep , Bavbek Sevim
Published: May 2013

Background

Studies about the pathogenesis of bronchial hyperreactivity (BHR) in patients with allergic rhinitis (AR) and its relationship with lower airway remodeling are extremely limited. In this study, bronchial vascular remodeling and its relationship with BHR were evaluated by measurement of vascular endothelial growth factor A (VEGF-A) and endostatin in patients with seasonal AR (SAR).

Methods

The study group consisted of 30 patients with SAR (positive skin test to grass pollens) and 14 healthy controls. Induced sputum and bronchial provocation test (BPT) to methacholine (M) were performed in season. VEGF-A and endostatin levels were measured by ELISA in induced sputum supernatant.

Results

The percentages of eosinophils in induced sputum were significantly increased in BHR+ patients (n = 10) with SAR compared with BHR– patients (n = 20) with SAR (p < 0.001). There was no correlation between eosinophils and provocative concentration of M required to produce a 20% decrease in forced expiratory volume in 1 second. The levels of VEGF-A were significantly higher in SAR patients with BHR than in SAR patients without BHR and healthy controls (respectively, p = 0.014 and p = 0.04). The levels of endostatin were significantly lower in SAR patients with BHR than in SAR patients without BHR and healthy controls (respectively, p = 0.020 and p = 0.014). The ratio of VEGF-A/endostatin was significantly higher in SAR patients with BHR than in SAR patients without BHR and healthy controls (respectively, p = 0.009 and p = 0.019).

Conclusion

In this first study comparing the VEGF-A and endostatin levels of patients with SAR in sputum supernatant, the presence of BHR was shown to be associated with the vascular component of remodeling “angiogenesis.”
Incidental Sinonasal Findings Identified during Preoperative Evaluation for Endoscopic Transsphenoidal Approaches
Authors: Laury Adrienne M. , Oyesiku Nelson M. , Hadjipanayis Costas G. , DelGaudio John M. , Wise Sarah K.
Published: May 2013

Background

The endoscopic transsphenoidal approach (eTSA) to lesions of the sellar region is typically performed jointly by neurosurgeons and otolaryngologists. Occasionally, the approach is significantly altered by sinonasal disease, anatomic variants, or previous surgery. However, there are no current guidelines that describe which physical or radiological findings should prompt a change in the plan of care. The purpose of this study was to determine the incidence of sinonasal pathology or anatomic variants noted endoscopically or by imaging that altered preoperative or intraoperative management.

Methods

A retrospective review was performed of 355 consecutive patients who underwent combined neurosurgery–otolaryngology endoscopic sella approach from August 1, 2007 to April 1, 2011. Our practice in these patients involves preoperative otolaryngology clinical evaluation and MRI review. Intraoperative image guidance is not routinely used in uncomplicated eTSA.

Results

The most common management alteration was the addition of image guidance based on anatomic variants on MRI, which occurred in 81 patients (35.0%). Eight patients (2.9%) were preoperatively treated with antibiotics and surgery was postponed secondary to acute or chronic purulent rhinosinusitis; two (0.7%) required functional endoscopic sinus surgery for medically refractory disease before eTSA. Five patients (1.8%) required anterior septoplasty intraoperatively for severe nasal septal deviation. Two patients (0.7%) had inverted papilloma and one patient had esthesioneuroblastoma identified preoperatively during rigid nasal endoscopy.

Conclusion

This is one of the larger reviews of patients undergoing eTSA for sellar lesions and the only study that describes how intraoperative management may be altered by preoperative sinonasal evaluation. We found a significant incidence of sinonasal pathology and anatomic variants that altered routine operative planning; therefore, a thorough sinonasal evaluation is warranted in these cases.
Surfactants in the Management of Rhinopathologies
Authors: Rosen Philip L. , Palmer James N. , O'Malley Bert W. , Cohen Noam A.
Published: May 2013

Background

Surfactants are a class of amphiphilic surface active compounds that show several unique physical properties at liquid–liquid or liquid–solid surface interfaces including the ability to increase the solubility of substances, lower the surface tension of a liquid, and decrease friction between two mediums. Because of these unique physical properties several in vitro, ex vivo, and human trials have examined the role of surfactants as stand-alone or adjunct therapy in recalcitrant chronic rhinosinusitis (CRS).

Methods

A review of the literature was performed.

Results

The data from three different surfactants have been examined in this review: citric acid zwitterionic surfactant (CAZS; Medtronic ENT, Jacksonville FL), Johnson's Baby Shampoo (Johnson & Johnson, New Brunswick NJ), and SinuSurf (NeilMed Pharmaceuticals, Santa Rosa, CA). Dilute surfactant therapy shows in vitro antimicrobial effects with modest inhibition of bacterial biofilm formation. In patients with CRS, surfactants may improve symptoms, most likely through its mucolytic effects. In addition, surfactants have several distinct potential benefits including their ability to improve an irrigant's penetration of the nonoperated sinus and their synergistic effects with antibiotics. However, surfactants potential for nasal irritation and possible transient ciliotoxicity may limit their use.

Conclusion

Recent data suggest a possible therapeutic role of surfactants in treating rhinopathologies associated with mucostasis. Further investigation, including a standardization of surfactant formulations, is warranted to further elucidate the potential benefits and drawbacks of this therapy.
Olfactory Sensitivity and Sexual Desire in Young Adult and Elderly Men: An Introductory Investigation
Authors: Ottaviano Giancarlo , Zuccarello Daniela , Frasson Giuliana , Scarpa Bruno , Nardello Ennio , Foresta Carlo , Marioni Gino , Staffieri Alberto
Published: May 2013

Background

It has been suggested that olfaction could influence human sexual behavior. Age is negatively associated with many aspects of sexuality and, with increasing age, people tend to show a declining sexual desire. The present pilot study investigated the relationship between sexual desire and olfactory sensitivity in healthy men of two age groups, young adult and elderly (≥65 years old), to ascertain whether their sense of smell could determine sexual desire and whether an age-related weaker olfactory sensitivity could correlate with the decline in sexual appetite in elderly patients.

Methods

Sixty-three volunteers were recruited and divided into two groups, one consisting of 48 healthy young adult men, the other of 15 healthy elderly men. All participants were tested to ascertain their odor threshold for n-butanol (Sniffin’ Sticks) and their sexual desire using the International Index of Erectile Function (IIEF), presenting only the questions relating to frequency (IIEF1) and level (IIEF2) of sexual desire.

Results

Sexual desire and mean olfactory thresholds were higher in the younger adults than in the elderly men (p = 0.001 and p = 0.02, respectively). There was a significant association between butanol threshold and sexual desire for the young adult group (p = 0.02), but not for the elderly group (p = 0.35).

Conclusion

This study found a preliminary association between olfaction and sexual behavior, in young adults at least. More studies are needed to improve our knowledge in this intriguing field, possibly using electrophysiological olfactory methods.
Immunohistochemical Dissimilarity between Allergic Fungal and Nonfungal Chronic Rhinosinusitis
Authors: Ragab Ahmed , Samaka Rehab Monir
Published: May 2013

Backgrounds

Diagnosis of allergic fungal rhinosinusitis (AFRS) is complicated because of the presence of fungi on mucosal surfaces of sinonasal passages. The objectives of this study were to define, using immunohistochemistry, lymphocyte populations associated with noninvasive fungal-related chronic rhinosinusitis (CRS; AFRS and FBs [FB]) relative to CRS with nasal polyposis (CRSwNP) and CRS without nasal polyposis (CRSsNP) as a means of diagnosing different forms of CRS.

Methods

Sinus CT scans, nasal endoscopy scores, and the presence of eosinophilic fungal mucin or FBs were used to prospectively define patient groups with CRS who had failed medical treatment and were undergoing endoscopic sinus surgery. Four patient groups were identified: AFRS, FB, CRSwNP, and CRSsNP. Tissue specimens were studied and graded for histopathological changes. Immunophenotyping of mucosal lymphocytes was performed using anti-CD3, -CD20, -CD4, -CD8, -CD56, and -perforin antibodies.

Results

Nasal polyposis scores were similar between AFRS and CRSwNP. Radiological changes associated with AFRS can also be present in CRSwNP, e.g., heterogenicity in 9/30 (30%), expansion in 25/30 (83%), and bony attenuation of the ethmoid trabeculae in 19/30 (63%). Different grades of basement membrane thickness, edema, and fibrosis were observed. In both types of noninvasive fungal rhinosinusitis, CD3+ T lymphocytes were most commonly identified. In cases of AFRS, most T cells were CD8+ (p < 0.001). In FB cases, CD4+ lymphocytes were dominant (p < 0.001). In nonfungal CRS cases, CD20+ lymphocytes (B lymphocytes) predominated (p < 0.001).

Conclusion

Although CT scans and histological examination can assist the diagnosis of rhinosinusitis, tissue immunophenotyping can be used in defining different types of fungal and nonfungal CRS cases.
The Characteristics and New Treatment Paradigm of Dental Implant–related Chronic Rhinosinusitis
Authors: Chen Yi-Wei , Huang Chi-Che , Chang Po-Hung , Chen Chiang-Wen , Wu Chia-Chen , Fu Chia-Hsiang , Lee Ta-Jen
Published: May 2013

Background

Because dental implantation and sinus augmentation are widely performed in recent years, one of their possible complications, maxillary sinusitis, has become a major concern for both dentists and otolaryngologists. This study evaluates the characteristics of dental implant–related chronic rhinosinusitis (DIrCRS) and the outcome of endoscopic sinus surgery (ESS) for these patients.

Methods

Eighteen patients diagnosed with DIrCRS from 2007 to 2012 and who were recommended for operation were included. ESS served as the first surgical choice. Dental implants were not routinely removed unless there was severe periimplantitis. All data, including CT and surgical findings, were collected and analyzed.

Results

All 18 patients had findings of maxillary sinus floor perforation or penetration by dental implants on CT. Fifteen of the 18 patients underwent ESS. Two patients had the dental implants removed before ESS and did not experience recurrence. Four patients had recurrence and the dental implants were removed before revised ESS. They did not experience recurrence again after the revised operation. The other nine patients had their dental implants preserved and did not experience recurrence during follow-up. None of the 15 patients required a Caldwell-Luc operation.

Conclusion

In patients with DIrCRS, ESS can be used as the first surgical choice with good prognosis and low morbidity. Although most cases of DIrCRS are caused by dental implants penetrating into the maxillary sinus, the dental implants can be preserved unless there is severe periimplantitis or recurrence of sinusitis. Nonetheless, the sinus mucosa above the dental implants must be kept intact during ESS.
Nasal Obstruction
Authors: Osborn Jodi L. , Sacks Raymond
Published: May 2013

Nasal obstruction is one of the most common presenting symptoms requiring medical attention at both the primary care physician and the otorhinolaryngologists’ level. Nasal obstruction may be caused by anatomic, physiological, or neurologic factors. Complexity is added to this situation because, often, the causation may be multifactorial. Nasal obstruction is the primary symptom of persistent allergic rhinitis (AR) and affects up to 40% of the population. AR must be treated throughout the year; thus, treatment choices and patient compliance must be considered. It is interesting to note that AR directly affects an individual's quality of life, quality of sleep, and workplace efficiency. Therefore, the magnitude of costs to both the individual and the society must be recognized. Various medical therapies and surgical techniques will be described for the treatment of nasal obstruction.
Allergic Fungal Rhinosinusitis
Authors: Laury Adrienne M. , Wise Sarah K.
Published: May 2013

Allergic fungal rhinosinusitis (AFRS) is a type of chronic rhinosinusitis in which patients classically exhibit nasal polyps, type I IgE-mediated hypersensitivity, characteristic findings on computed tomography scans, eosinophilic mucin, and positive fungal stain. New research has sought to further understand the pathophysiology of AFRS. However, this has also led to debate about the classification and predominance of this interesting disease process. Historically, patients with AFRS are immunocompetent. The disease is most prevalent in the southeast and south central United States and typically presents with sinus pressure, hyposmia, and congestion. Radiographically, cases of AFRS have a distinct appearance, often exhibiting unilateral heterogeneously dense material, which may erode and expand the paranasal sinus bony walls. Treatment typically consists of surgery, sinonasal irrigations, and topical and systemic steroids, all with the effort to decrease the fungal load and antigenic response. Immunotherapy is also often included in the treatment regimen for AFRS.
Pediatric Rhinosinusitis: Definitions, Diagnosis and Management—An Overview
Authors: Chandran Swapna K. , Higgins Thomas S.
Published: May 2013

Rhinosinusitis is common in the pediatric population; however, diagnostic and management techniques often differ when compared with adult rhinosinusitis. Multidisciplinary guidelines have outlined the diagnostic criteria for pediatric rhinosinusitis. Although acute rhinosinusitis is a more infectious phenomenon, chronic sinusitis involves a more multifactorial etiology. This article outlines some of the definitions of rhinosinusitis, diagnosis and management of pediatric sinusitis, and the complications of rhinosinusitis seen in the pediatric population.
Analyzing Serum Eosinophil Cationic Protein in the Clinical Assessment of Chronic Rhinosinusitis
Authors: Kim Kyung Soo , Won Ho-Ryun , Park Chong Yoon , Hong Joon Hyeong , Lee Jae Heon , Lee Kyu Eun , Cho Hyun Sang , Kim Hyun Jik
Published: May 2013

Background

Eosinophil cationic protein (ECP) is a major granule–derived protein with cytotoxic activity found in eosinophils and has been known as a useful marker of allergic inflammation. In this study, we assessed the clinical significance of ECP in chronic inflammation of the nasal mucosa by evaluating the relationship between eosinophil activity and serum ECP concentration in a cohort of subjects with or without chronic rhinosinusitis (CRS) and allergic rhinitis (AR).

Methods

We retrospectively reviewed the medical records of 492 subjects and analyzed eosinophil percentage in nasal smears, serum eosinophil counts, serum ECP concentrations, symptom scores, CT scores, the size of nasal polyp, and recurrence of CRS at follow-up.

Results

Elevated serum ECP concentration was closely related with higher eosinophil expression in all subject's nasal smears and sera. CRS subjects without AR had a higher percentage of immune cells that were eosinophils compared with control subjects and it was similar to subjects’ with AR only or with both CRS and AR. CRS subjects without AR also had significantly higher serum ECP concentrations and eosinophil counts compared with control subjects. Additionally, serum ECP concentration was significantly correlated with CT scores, symptom scores, polyp size, and recurrence rate in CRS subjects without AR.

Conclusion

Serum ECP concentration can be used as a marker of local and systemic eosinophil expression. We conjecture that although serum ECP elevation may not be specific in AR, analysis of serum ECP concentration could be particularly useful in estimating the progression and prognosis of CRS.
Determining the Role of Allergy in Sinonasal Disease
Authors: Settipane Russell A. , Borish Larry , Peters Anju T.
Published: May 2013

The contributing role of specific IgE sensitization in the pathophysiology of sinonasal diseases including rhinitis, chronic rhinosinusitis (CRS), and nasal polyps is explored. Although it is estimated that sensitization to environmental allergens is present in 75% of patients with rhinitis, the role of allergy in CRS and nasal polyps is less certain. However, when atopy is present in the setting of nasal polyps, it is associated with worse quality of life and a higher incidence of asthma. Several theories have been put forth whereby inhalant aeroallergen exposure could drive the inflammatory response that occurs both in the nose and in the sinuses. Tools available to determine the presence of allergic sensitization include skin tests for immediate hypersensitivity, in vitro testing for allergen-specific IgE, and nasal allergen provocation testing. Whether by skin testing or in vitro testing, the identification of specific IgE requires clinical correlation with the history and physical exam.
Immunomodulation of Allergic Sinonasal Disease
Authors: Settipane Russell A. , Peters Anju T. , Borish Larry
Published: May 2013

IgE hypersensitivity is important to the pathogenesis of allergic diseases and the development and persistence of airway inflammation. Allergic immunomodulation encompasses various therapies that attempt to suppress or modify the immune mechanisms responsible for IgE-mediated disease. These include allergy immunotherapy (AIT) in the forms of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT), as well as the emergence of biological agents, such as anti-IgE, for allergic respiratory disease. Clinical evidence strongly supports the efficacy and safety of AIT for the treatment of allergic rhinitis, allergic conjunctivitis, and allergic asthma, but for chronic rhinosinusitis evidence is lacking. In allergic rhinitis, the decision to initiate AIT depends on the degree to which symptoms can be reduced by avoidance and medication, the amount and type of medication required to control symptoms, the adverse effects of medication, the severity and duration of symptoms, and their effect on quality of life. AIT has the potential to produce sustained long-lasting immune modulation and possibly avoid or reduce lifelong requirements for medical therapy. Although SLIT is currently being evaluated, SCIT remains the preferred form of AIT in the United States because of robust efficacy data, availability of allergen extracts, and current Food and Drug Administration approval. However, SLIT holds the potential for greater patient safety and convenience. Other immunomodulators such as anti-IgE also hold promise, but require further investigation.
Mechanical Behaviour of Adhesive Joint under Tensile and Shear Loading
Authors: Jiang Xu , Kolstein M. H. , Bijlaard F. S. K.
Published: May 2013

Due to various advantages of Fibre-Reinforced Polymer (FRP) decks, the FRP to steel composite bridge system is being increasingly used in new bridge structures as well as rehabilitation projects for old bridges. This paper focuses on the mechanical behaviours and failure modes of the adhesively-bonded joins between FRP sandwich decks and steel girders. The adhesively-bonded joints were experimentally investigated under tensile and shear loading. Further comparison on failure modes confirmed that the surface pretreatment can improve the bonding quality between FRP composites and adhesive layer, and correspondingly increase the load-carrying capacity of adhesive joints.
Shear Behavior Of Existing RC T-Beams Strengthened With CFRP
Authors: Imperatore Stefania , Lavorato Davide , Nuti Camillo , Santini Silvia , Sguerri Lorena
Published: May 2013

This paper presents the experimental behaviour of two reinforced concrete T-beams strengthened in shear with CFRP. The beams are extracted from an important building of the mid-'30s in Rome. The goal of this research is to evaluate the shear strength of the retrofitted beams with the simultaneous occurrence of a negative bending moment. The tests are performed at the Experimental Laboratory of the Structural Department of the University “Roma Tre”. In the meantime the two beams are modelled with the software ATENA in order to perform numerical simulations of the tests. The numerical results seem to be in good agreement with the experimental data in terms of load– displacement response, strain state, crack pattern and failure mode.
Feasibility and Life Cycle considerations of Fiber Reinforced Polymer (FRP) deck solutions for renovation of steel highway bridges
Authors: Tromp Liesbeth , Schipper Koen
Published: May 2013

This paper describes the feasibility of FRP deck solutions for refurbishment and reinforcement of steel orthotropic bridges. Several Dutch steel bridges suffer from fatigue damage, because of the increased traffic intensity. The currently solution in the Netherlands is reinforcing the steel deck with a High Performance Concrete (HPC) layer. The main disadvantage is the relatively high dead weight it adds to the bridge structure. Fiber Reinforced Polymer (FRP) deck structures are strong, lightweight and fatigue resistant. FRP does not corrode and requires hardly any maintenance. Different solutions for both deck materials and configurations are evaluated for various types of steel bridges, over a realistic extended life time period of 30 years. Life Cycle considerations are included to show the value and opportunities for the FRP alternatives.
Applying Seismic Isolation Technologies to Buildings Above tracks
Authors: Yamataka Madoka , Hoshikawa Tsutomu , Iwasaki Kazuaki , Hayashi Atsushi , Igarashi Shinya , Suzuki Yosuke
Published: May 2013

Applying seismic isolation technologies to over-track buildings enables a reduction of lower structures accompanying reduced seismic response. That reduction of structures will likely allow cuts in construction time and costs of those buildings that face severe constraints in terms of design and construction. Using seismic isolation to control the area where damage occurs can also enable earlier recovery after a disaster.

There were, however, technical issues faced in achieving seismic isolation of over-track buildings. To overcome those, we came up with a new seismic isolation frame form. Using a model that simulates a over-track building, we verified safety of the building at earthquakes through test design and analysis of seismic isolation by the conceived frame form.
Seismic retrofitting of bridges based on indirect strategies
Authors: Mitoulis Stergios A. , Tegos Ioannis A.
Published: May 2013

An indirect retrofitting scheme for bridges is analytically studied and evaluated. The scheme is based on the reduction in seismic actions of the bridge, namely the displacements of the deck and the bending moments of the piers by utilizing external key walls (barrettes) that participate in the earthquake resisting system (ERS) of the bridge as external supports. Simultaneously, the deck of the bridge is made partially continuous by replacing part of the existing sidewalks by new connecting slabs that are fixed on the existing ones. No strengthening of the existing members of the ERS of the bridge was attempted. The new sidewalk slabs respond as RC structural struts connecting the subsequent simply supported spans of the deck, while sliding on the rest of their lengths. The end spans of the deck are connected with the new key walls (barrettes) constructed behind the abutment. During the bridge service, the part of the RC struts, which are supported by the existing sidewalks, i.e. the unrestraint part of the struts, respond as concrete struts (during expansion of the deck) or ties (during the contraction of the deck). The role of these structural struts is to receive safely the deck constraint movements through their constraint shortening (struts) or lengthening (ties). During an earthquake the movements of the deck are effectively restrained by the external supports namely the key walls. Hence, the displacements of the deck and the resulting loading of the existing piers, bearings and foundations are reduced. The effectiveness of the above retrofitting scheme has been assessed on an existing bridge of Aliakmon River, actually built in the early ‘90s. The study revealed that this low cost retrofitting scheme can effectively reduce the seismic demand of the bridge.
Effect of Skewness on Bridges Subjected to Seismic Loading
Authors: Ayoub Essam , Malek Charles , Helmy Gamal
Published: May 2013

Skew bridges are basically required in highway and railway engineering. Unlike straight bridges, the behavior of skew bridges under seismic loading is not quite simple due to the interaction which exists between longitudinal and transversal bridge directions when subjected to in-plane loading such as earthquake forces. The aim of the present paper is to study the behavior of skew bridges when subjected to longitudinal and transversal earthquake loading. The response spectrum analysis as presented by AASHTO LRFD is considered in the present study. Straight, moderate and sharp skew bridges are included. The effect of pier stiffness is also discussed. The present study is based on two span skew bridges resting on pot bearings. Two types of finite element models are adopted for the seismic analysis of the skew bridges. In both models shell elements are used to represent the bridge superstructure; while, frame and shell elements are considered for the pier representation of model 1 and model 2 above, respectively.
Vibration Behaviour and Seismic Performance of an Existing Bridge Retrofitted by Ground Anchor
Authors: An Tongxiang , Kiyomiya Osamu
Published: May 2013

The vibration behaviour and seismic performance of an existing girder bridge with laminated rubber bearings is being discussed. The bridge was retrofitted by ground anchors and was verified by nonlinear dynamic analysis. As a result, ground anchors had a significant effect on improving the vibration behaviour and seismic performance of the whole bridge.
Partially-Repaired Reinforced Concrete Beams with Exposed Reinforcement
Authors: Scott Trevor , Bartlett Michael
Published: May 2013

Deteriorated reinforced concrete highway bridge girders are regularly repaired by replacing existing concrete with new concrete, temporarily exposing the reinforcement. At this stage the capacity of the girder is uncertain because, while plane sections remain plane at each cross section, the requirement of compatible strains in the reinforcement and the adjacent concrete no longer holds.

This paper presents an experimental study of five 4-metre concrete T-section specimens with exposed reinforcement loaded with a simulated uniformly distributed load and a concurrent single- point load to realistically simulate the loading applied to a typical girder. These results are used to validate an analytical approach developed to assist practicing engineers in checking the safety of girders with exposed reinforcement during rehabilitation.
Reconstruction of old quay walls in the Port of Rotterdam
Authors: Voogt Henk
Published: May 2013

The Port of Rotterdam dealt with the question how to preserve the old fashioned look of quay wall from the last century and meanwhile guarantee the structural integrity.
Aged Deterioration Inspection Results of Suspender Ropes by Main Flux Method
Authors: Sakai Kazuyoshi , Kishi Yuki , Ogihara Katsuya
Published: May 2013

Two types of suspender ropes, Center Fit Rope Core (CFRC) ropes and Parallel Wire Strand (PWS) ropes are used in the Honshu-Shikoku suspension bridges. CFRC ropes are painted and supposed to be replaced periodically. Since conventional visual inspection cannot catch the internal corrosion state, Honshu-Shikoku Bridge Expressway Co., Ltd. (HSBE) developed a non-destructive inspection system using an electromagnetic method (main flux method) in order to know the internal corrosion state accurately. The corroded CFRC ropes of the Innoshima Bridge and the Ohshima Bridge, inspected in the past, were inspected again. It has been nine years and five years since the last inspection of the Innoshima Bridge and the Ohshima Bridge respectively. As a result, it was found that the sectional area reduction rates of the ropes were measured to be at most about 2.3% and at most about 1.0% respectively.
Halftime – an ambitious goal !
Authors: Ruijtenbeek Richard , Buijs Cees , Kolet Flip , van Atten Jelle , Stolwijk Henny
Published: May 2013

In recent years the Dutch building and construction industry has produced much knowledge related to renewal of the construction sector. All studies conducted by the Dutch building industry allegedly discovered that the benefits of renewal of the construction sector are numerous. The outcomes did not automatically ensure success in practice.

Each of the results of every study performed have their merit. When it came to practical implementation in projects, the insights did not lead to improvements needed within the supply chain. The improvements achieved mostly are related to individual partners in the supply chain, and also related to a single task.

In new construction and refurbishment an accelerating change is required, allowing for more innovation, sustainability, licence to operate from client and user etc. Since none of these improvements that have been achieved were satisfactory, the Rotterdam municipality together with CURNET adopted the idea of Catalyst management (ref Jim Collins). Where most of the time money is considered the criterion to optimise, Halftime adopts time to optimise against, keeping quality for routine procurement at least on the same level.

Earlier, Halftime has been successfully adopted as in company improvement programme for a large construction company [1] assisted by TNO.

The Halftime approach adopted by Rotterdam municipality focuses on routine procurement of infrastructural services and objects. In routine projects of several companies a waste of between 30 and 50 % has been proved. Waste is caused by institutions, miscommunication and habits related to routine work. ‘This is how we normally do our work …..”. Routine prevents also the application of innovation related to material use, work processes, new arrangements of supply chain cooperation etc. As a

consequence of applying the Halftime-catalyst, the City of Rotterdam will improve on accessibility. In addition it will decrease nuisance from refurbishment and construction. In that way Halftime claims to contribute to sustainable management of infrastructure.
Radar Simulation and Radar Improvement of the Galecopperbridge
Authors: Cook Steven , Mitchell Kevin , Den-Blanken Sander , Tuinstra Dimitri , Nagtegaal Gerland
Published: May 2013

Galecopperbrug is a 3 span cable-stayed bridge with a main span of 180m over the canal.

During strengthening of the Galecopper bridge, the design team was tasked to solve problems caused to ships radar when using the canal caused by multiple reflections of radar waves amongst the bridge beams. Alternative solutions were considered and a computer simulation was undertaken to determine a solution. Work is completed and the solution that involves fixing radar absorbing material to the bridge will be implemented with the works to strengthen the bridge.
Biggest hybrid lightweight bridge in the world
Authors: van der Ven Jurre
Published: May 2013

A program has been initiated to utilize the advanced composite materials in structural applications. The goal is to offer distinctive solutions for clients. One of these solutions was a hybrid bridge of 142 m long and 6.5 m wide for heavy traffic made of steel trusses and a composite deck. It concerned a project for a client who wanted both low life cycle costs and low weight. Special techniques and high-tech materials were used to make the connections between the steel trusses and composite deck. The special techniques and materials used for this project are now used for maintenance, repair and upgrading of structures.
Combined portal frames for signalling and overhead contact line
Authors: Kadiri Karim , Roks Anne-Cécile , Touat Tayeb , Lecluse Yannick
Published: May 2013

Technical equipment for the renewal and upgrading of railway lines is generally complex, because the supporting structures for various electrical devices are independent. Overhead lines are fixed to steel frames or individual columns, separated from the fixed signals. During the upgrading of the suburban railway network around Brussels, the idea of combined portal frames for all rail equipment was implemented. The frames can be adapted to the total width of the track area and consist of 3 steel tubes joined by welded connecting plates to a spatial truss.

Since the frame span varies, for larger portals the deformation criterion for overhead line alignment is more important than strength. The frames are fixed to the foundations by threadbars and earthed. The type of foundations varies with soil conditions and can be diaphragm walls, as well as concrete blocks cast on site. In a few particular cases the frames are supported by steel corbels fixed to bridges or earth retaining walls.

As the signalling is also installed on the vertical and horizontal members of the frames, simulations have been used to verify sufficient visibility for train conductors, both in straight alignment and bends. The system allows better view of the railway line than classical equipment. The frames also continue functioning in the event of train car derailment. At present 70 of these adaptable frames have been installed and the experience has been positive.