bluuebunny/crossref_metadata_2025 huggingface dataset:
Bioavailability study of a polyphenol‐enriched extract from Hibiscus sabdariffa in rats and associated antioxidant status
Authors: Fernández‐Arroyo Salvador , Herranz‐López María , Beltrán‐Debón Raúl , Borrás‐Linares Isabel , Barrajón‐Catalán Enrique , Joven Jorge , Fernández‐Gutiérrez Alberto , Segura‐Carretero Antonio , Micol Vicente
Published: August 2012

The aqueous extracts of Hibiscus sabdariffa have been commonly used in folk medicine. Nevertheless, the compounds or metabolites responsible for its healthy effects have not yet been identified. The major metabolites present in rat plasma after acute ingestion of a polyphenol‐enriched Hibiscus sabdariffa extract were characterized and quantified in order to study their bioavailability. The antioxidant status of the plasma samples was also measured through several complementary antioxidant techniques. High‐performance liquid chromatography coupled to time‐of‐flight mass spectrometry (HPLC‐ESI‐TOF‐MS) was used for the bioavailability study. The antioxidant status was measured by ferric reducing ability of plasma method, thiobarbituric acid reactive substances assay, and superoxide dismutase activity assay. Seventeen polyphenols and metabolites have been detected and quantified. Eleven of these compounds were metabolites. Although phenolic acids were found in plasma without any modification in their structures, most flavonols were found as quercetin or kaempferol glucuronide conjugates. Flavonol glucuronide conjugates, which show longer half‐life elimination values, are proposed to contribute to the observed lipid peroxidation inhibitory activity in the cellular membranes. By contrast, phenolic acids appear to exert their antioxidant activity through ferric ion reduction and superoxide scavenging at shorter times. We propose that flavonol‐conjugated forms (quercetin and kaempferol) may be the compounds responsible for the observed antioxidant effects and contribute to the healthy effects of H. sabdariffa polyphenolic extract.
Biologic drugs: properties and use in the treatment of RA
Authors: Chaplin Steve , Rakieh Chadi , Conaghan Philip
Published: August 2012

Steve Chaplin, Dr Chadi Rakieh and Professor Philip Conaghan provide an overview of the properties of biologics and their current recommended place in the treatment of RA. Copyright © 2012 Wiley Interface Ltd
Zizyphus jujuba and its Active Component Jujuboside B Inhibit Platelet Aggregation
Authors: Seo Eun Ji , Lee So Young , Kang Sam Sik , Jung Yi‐Sook
Published: August 2012

The seeds of Zizyphus jujuba (SZJ), a famous oriental traditional medicine, have been reported to exhibit diverse activities in biological systems including the cardiovascular system. However, little information is available on its antiplatelet activity. This study was undertaken to investigate the antiplatelet effects of the ethanolic extract of SZJ (ESZJ) and of its principal components jujuboside A and B. In the in vitro platelet aggregation study, ESZJ exhibited significant and concentration‐dependent inhibitory effects on collagen‐, thrombin‐, and AA‐induced platelet aggregation. In addition, ESZJ‐treated mice showed significantly the prolongation of bleeding times and the protection against thromboembolic attack. A comparison of the effects of jujuboside A and B on platelet aggregation revealed that only jujuboside B had potent inhibitory effects on collagen‐, thrombin‐, AA‐, and ADP‐induced aggregation. Jujuboside B also exhibited superior protection on thromboembolic model. Furthermore, jujuboside B had a significant inhibitory effect on collagen‐induced thromboxane A2 production in rat platelets. This study describes the antiplatelet effects of ESZJ and of its active component jujuboside B, and its findings suggest that these agents be considered as components of preventive and therapeutic herbal drugs targeting cardiovascular diseases associated with platelet hyperaggregation. Copyright © 2012 John Wiley & Sons, Ltd.
Bioactivity‐guided Isolation of Antiosteoporotic Compounds from Ligustrum lucidum
Authors: Chen Qianfeng , Yang Lijuan , Zhang Guolin , Wang Fei
Published: August 2012

The fruits of Ligustrum lucidum (FLL) has long been used for the treatment of osteoporosis in China, but the antiosteoporotic compounds in FLL are still poorly understood. In this study, the alkaline phosphatase (ALP) activity‐guided isolation of osteogenic components from FLL was carried out by using osteoblast‐like UMR‐106 cells. Eight compounds, namely tyrosol (1), tyrosyl acetate (2), hydroxytyrosol (3), salidroside (4), oleoside dimethyl ester (5), oleoside‐7‐ethyl‐11‐methyl ester (6), nuzhenide (7), and G13 (8), were isolated and identified. Further study showed that compounds 3, 4, 7, and 8 increased ALP activity in UMR‐106 cells. Compounds 5, 6, and 7 promoted the proliferation of UMR‐106 cells. The aqueous extract of FLL‐activated ERα/β‐mediated gene transcription, whereas the isolated compounds were inactive. All eight isolated compounds also exhibited antioxidative activity, with compounds 1, 2, and 3 being the most potent. These results indicate that the antiosteoporotic effect of FLL is derived from different compounds together with different mechanisms such as ER‐dependent or independent pathways and antioxidative effects. Salidroside (4) and nuzhenide (7) warrant further investigation as new pharmaceutical tools for the prevention and treatment of osteoporosis. Copyright © 2012 John Wiley & Sons, Ltd.
Open versus robot‐assisted sphincter‐saving operations in rectal cancer patients: techniques and comparison of outcomes between groups of 100 matched patients
Authors: Kim Jin C. , Yang Sung S. , Jang Tae Y. , Kwak Jae Y. , Yun Myung J. , Lim Seok B.
Published: August 2012

Background

Although open resection using a sphincter‐saving operation (SSO) remains the standard of care for rectal cancer, few studies have compared open and robot‐assisted (RA) SSOs. This study aimed to compare the operative features, functional outcomes, and oncological validity of open and RA SSO for rectal cancer.

Methods

A total of 200 rectal cancer patients undergoing curative SSO were enrolled prospectively. The open and RA groups (n = 100, respectively) were matched for clinical stage and operation type.

Results

The mean operation time was significantly longer in the RA group than in the open group (188 vs. 103 min, P < 0.001), but it was significantly reduced in the latter half of the RA patients compared with that in the first half (164 vs. 214 min, P < 0.001). The mean distal resection margin was significantly longer in the RA than in the open group (2.7 vs. 1.9 cm; P = 0.001), but only one patient in either group had positive circumferential resection margin. Bowel peristalsis returned one day earlier in the RA than in the open group (P < 0.001). Postoperative complication rates and anorectal functional outcomes were comparable between the two groups. The operator's physical discomfort, assessed on a visual analog scale, was significantly lower in the RA than in the open group (P < 0.001).

Conclusions

According to this short‐term study, the RA SSO showed equivalent oncological safety, functional outcome, and morbidities to open SSO. Although the operation takes longer, the robotic system enables a technically versatile SSO with fine dissection in a limited surgical field. Copyright © 2012 John Wiley & Sons, Ltd.
Personalized image‐based templates for iliosacral screw insertions: a pilot study
Authors: Chen Bin , Zhang Yuanzhi , Xiao Shengxiang , Gu Pengcheng , Lin Xiangjin
Published: August 2012

Background

Stabilization of rare unstable pelvic fractures in the case of sacral fractures and iliosacral joint dislocations can be tricky. 3D reconstruction and reverse engineering templates may be used to increase the accuracy of screw placement.

Methods

Computed tomography (CT) images were used to design the template for 16 consecutive patients with unstable pelvic ring fractures, which were used to guide the screw placement. Another 10 patients received screw placement under conventional fluoroscopy. The screw position, radiation exposure, and surgery time were compared between the two groups.

Results

Personalized image‐based templates had better correct screw positions (P < 0.05), reduced radiation exposure (P < 0.01), and shorter surgery time (P < 0.05) compared with the conventional group.

Conclusions

Personalized image‐based templates for iliosacral screw insertions can increase the sacral lag screw placement accuracy, reduce radiation exposure, and shorten surgery time compared with traditional fluoroscopic methods. Copyright © 2012 John Wiley & Sons, Ltd.
Studying of antifungal activity of functionalized multiwalled carbon nanotubes by microwave‐assisted technique
Authors: Zare‐Zardini Hadi , Amiri Ahmad , Shanbedi Mehdi , Memarpoor‐Yazdi Mina , Asoodeh Ahmad
Published: August 2012

In this paper, we reinforced the antifungal activity of multi‐walled carbon nanotubes (MWCNTs) using an effective technique. Covalent functionalization of MWCNTs was performed by lysine and arginine under microwave radiation. To prove functionalization phenomenon, the grafted chemical groups on the surfaces of MWCNTs were analyzed by Fourier transform infrared and Raman spectroscopy. Antifungal activities of functionalized MWCNTs as well as pristine MWCNTs were tested against different fungal species based on minimal inhibitory concentration (MIC) and radial diffusion assay. MIC results showed that the antifungal activity of MWCNTs‐lysine, in comparison to pristine MWCNTs against fungi, including Aspergillus niger, Aspergillus fumigatus, Candidate albicans, Penicillium chrysogenum, Saccharomyces cerevisiae, Fusarium culmorum, Microsporum canis, Trichophyton mentagrophytes, Trichophyton rubrum and Penicillium lilacinum were increased 1.92, 2.36, 2.35, 1.3, 1.5, 1.1, 2.54, 1.23, 1.42 and 2.1 times, respectively. Similarly, the antifungal activity of MWCNTs‐arginine was increased 1.98, 2.40, 2.55, 1.8, 1.9, 1.7, 2.64, 1.36, 2.1 and 2.55 times, respectively. On the basis of the results of this study, it is clearly indicated that covalent groups of lysine and arginine could improve the antifungal activity of MWCNTs. Copyright © 2012 John Wiley & Sons, Ltd.
Interplay of priors and skeletons in two‐stage continual reassessment method
Authors: Iasonos Alexia , O'Quigley John
Published: August 2012

Model‐based dose‐finding designs such as the continual reassessment method (CRM) rely on some basic working model. In the Bayesian setting, these take the form of ‘guess estimates’ of the probabilities of toxicity at each level. In the likelihood setting, these estimates simply take the form of a model as operational characteristics are unaffected by arbitrary positive power transformations. These initial estimates are often referred to as the model skeleton. The impact of any prior distribution on the model parameter that describes the dose–toxicity curve will itself depend on the skeleton being used.

We study the interplay between prior assumptions and skeleton choice in the context of two‐stage CRM designs. We consider the behavior of a two‐stage design at the point of transition from a 3 + 3 design to CRM. We study how use can be made of stage 1 data to construct a more efficient skeleton in conjunction with any prior information through an example of a clinical trial. We evaluate to what extent stage 1 data might be down weighted when the maximum tolerated dose (MTD) is far from the starting level and stage 1 data is strongly informative. The results show no improvement in accuracy; thus, weighting is not necessary unless the investigators feel strongly about the location of the MTD and wish to accelerate into the vicinity of the MTD. In general, because this information is not available, we recommend that the design of two‐stage trials utilize stage 1 data to establish a skeleton. Copyright © 2012 John Wiley & Sons, Ltd.
Lipid‐PEG‐Folate Encapsulated Nanoparticles with Aggregation Induced Emission Characteristics: Cellular Uptake Mechanism and Two‐Photon Fluorescence Imaging
Authors: Geng Junlong , Li Kai , Ding Dan , Zhang Xinhai , Qin Wei , Liu Jianzhao , Tang Ben Zhong , Liu Bin
Published: August 2012

Folate functionalized nanoparticles (NPs) that contain fluorogens with aggregation‐induced emission (AIE) characteristics are fabricated to show bright far‐red/near‐infrared fluorescence, a large two‐photon absorption cross section and low cytotoxicity, which are internalized into MCF‐7 cancer cells mainly through caveolae‐mediated endocytosis. One‐photon excited in vivo fluorescence imaging illustrates that these AIE NPs can accumulate in a tumor and two‐photon excited ex vivo tumor tissue imaging reveals that they can be easily detected in the tumor mass at a depth of 400 μm. These studies indicate that AIE NPs are promising alternatives to conventional TPA probes for biological imaging.
Novice‐Service Language Teacher Development: Bridging the Gap Between Preservice and In‐Service Education and Development
Authors: Farrell Thomas S. C.
Published: August 2012

One reason for teacher attrition is that a gap exists between pre‐service teacher preparation and in‐service teacher development, in that most novice teachers suddenly have no further contact with their teacher educators, and from the very first day on the job, must face the same challenges as their more experienced colleagues, often without much guidance from the new school/institution. These challenges include lesson planning, lesson delivery, classroom management, and identity development. In this introductory paper to introduce the special issue on Novice Professionals in TESOL, I also outline practical suggestions that can help bridge the gap between pre‐service and in‐service education, with the idea that novice teachers can experience the transition from teacher preparation to the first years of teaching, less like “hazing” and more like professional development. I call this bridging period novice‐service language teacher development.
TESOL Teacher Education: Novice Teachers' Perceptions of Their Preparedness and Efficacy in the Classroom
Authors: Faez Farahnaz , Valeo Antonella
Published: August 2012

This study examined the teacher education of novice teachers of English to speakers of other languages (ESOL). A survey and follow‐up interviews were employed to investigate novice teachers' perceptions about four aspects of their teacher preparation: (a) degree of preparedness to teach after graduating from a teaching English to speakers of other languages (TESOL) program, (b) preparedness after classroom experience (up to 3 years), (c) sense of efficacy to complete teaching practices in adult ESOL classrooms, and (d) perceptions of what was useful to them in the TESOL program. Accredited ESOL teachers with less than 3 years of experience (N = 115) completed a questionnaire that explored their perceptions of preparedness and efficacy to teach in adult ESOL programs in Ontario, Canada. Eight teachers participated in follow‐up semistructured interviews. Findings show that although, overall, novice teachers increased their perceptions of preparedness by gaining experience in the classroom, their sense of efficacy to perform within certain teaching expectations was task specific and highly situated. The practicum and “real” teaching experiences were found to be the most influential aspects of the induction programs. These findings have implications for teacher educators, TESOL institutions, and accreditation bodies that are committed to preparing qualified teachers for adult ESOL programs.
Novice ESOL Teachers' Perceptions of Social Support Networks
Authors: Brannan Debi , Bleistein Tasha
Published: August 2012

As new teachers navigate the challenging first years of work, they need positive support providers (Villani, 2002). The impact of support providers on novice educators' beliefs about teaching efficacy previously went unexplored. This study examined novice English to speakers of other languages (ESOL) teachers' perceptions of social support and teacher efficacy using integrated qualitative and quantitative methods (Morgan, 1998, 2011). In the initial qualitative component, novice teachers identified three categories of support: mentors, coworkers, family. The Teachers' Sense of Teacher Efficacy Scale (Tschannen‐Moran & Woolfolk Hoy, 2001) was administered to examine potential links between support providers and three areas of perceived teacher efficacy: instructional strategies, student engagement, classroom management. Support appraisals were examined for each support domain using a modified version of the Perceived Social Support Inventory (Procidano & Heller, 1983) to assess the degree to which novice teachers felt supported. Teachers reported coworkers and mentors as the most significant support providers, yet only family support was significantly associated with teacher efficacy beliefs in the quantitative portion of this study. Novice teachers were also asked to elaborate on the frequency, type, and quality of support offered by family, friends, and mentors.
Mitochondrial network energetics in the heart
Authors: Aon Miguel A. , Cortassa Sonia
Published: August 2012

At the core of eukaryotic aerobic life, mitochondrial function like ‘hubs’ in the web of energetic and redox processes in cells. In the heart, these networks—extending beyond the complex connectivity of biochemical circuit diagrams and apparent morphology—exhibit collective dynamics spanning several spatiotemporal levels of organization, from the cell, to the tissue, and the organ. The network function of mitochondria, i.e., mitochondrial network energetics, represents an advantageous behavior. Its coordinated action, under normal physiology, provides robustness despite failure in a few nodes, and improves energy supply toward a swiftly changing demand. Extensive diffuse loops, encompassing mitochondrial–cytoplasmic reaction/transport networks, control and regulate energy supply and demand in the heart. Under severe energy crises, the network behavior of mitochondria and associated glycolytic and other metabolic networks collapse, thereby triggering fatal arrhythmias. WIREs Syst Biol Med 2012, 4:599–613. doi: 10.1002/wsbm.1188

This article is categorized under:

Analytical and Computational Methods > Analytical Methods

Models of Systems Properties and Processes > Cellular Models

Physiology > Mammalian Physiology in Health and Disease
“Adhesions after abdominal, pelvic and intra-uterine surgery and their prevention”
Authors: Wallwiener Markus , Brölmann Hans , Koninckx Philippe Robert , Lundorff Per , Lower Adrian M. , Wattiez Arnaud , Mara Michal , De Wilde Rudy Leon ,   The Anti-adhesions in Gynecology Expert Panel (ANGEL)
Published: August 2012

We here present the full text of a patient leaflet we have designed, and routinely use, to provide preoperative education about adhesions to patients undergoing open or laparoscopic gynaecological surgery. The leaflet presents appropriate, patient-orientated information on the nature of adhesions, their causes and the health risks they may involve as well as on adhesiolysis and modern methods of adhesion prevention. As adhesion formation is not specific to gynaecological surgery, the leaflet can also be adapted for the purposes of general abdominal surgery.
Dicer is essential for neuronal polarity
Authors: Li Zhi , He Xi , Feng Jiexiong
Published: August 2012

Dicer, an RNase III endonuclease, is the enzyme which cleaves microRNA (miRNA) and small interfering RNA (siRNA) precursors into 21–25 nucleotide species. This cleavage is an essential step in the biogenesis of these small noncoding RNA molecules. In their mature forms, siRNA and miRNAs function to regulate gene expression through different mechanisms (Bartel, 2004). To investigate the role of Dicer and microRNAs in neuronal polarity development, we used mice in which the RNase III domain of Dicer was conditionally floxed. To knockout Dicer gene, hippocampal neurons were electroporated with Cre together with pmaxGFP® plasmid by Amaxa® Mouse Neuron Nucleofector® Kit. Neuronal polarity was analyzed at 3 days in vitro (DIV). Neurons expressing pmaxGFP® showed normal polarity. In contrast, the majority of neurons transfected with Cre developed multiple axons. We found multiple axons were significantly increasing. Here we explore Dicer function in neuronal polarity by inactivating it in the hippocampal neuron using the Cre/loxP approach. Neurons which lack Dicer have multiple axons, demonstrating that Dicer is essential for neuron polarity, providing evidence that Dicer function is required to neuronal development.
The clinical significance of inflammatory cytokines in primary cell culture in endometrial carcinoma
Authors: Smith Harriet O. , Stephens Nicole D. , Qualls Clifford R. , Fligelman Tal , Wang Tao , Lin Chang-Yun , Burton Elizabeth , Griffith Jeffrey K. , Pollard Jeffrey W.
Published: August 2012

Endometrial cancer is the most common malignancy of the female genital tract, and the incidence and mortality rates from this disease are increasing. Although endometrial carcinoma has been regarded as a tissue‐specific disease mediated by female sex steroid pathways, considerable evidence implicates a role for an inflammatory response in the development and propagation of endometrial cancer. We hypothesized that if specific patterns of cytokine expression were found to be predictive of adverse outcome, then selective receptor targeting may be a therapeutic option. This study was therefore undertaken to determine the relationship between cytokine production in primary cell culture and clinical outcome in endometrial adenocarcinoma. Fresh endometrial tissues were fractionated into epithelial and stromal fractions and cultured. After 6–7 days, supernatants were collected and cells enumerated. Batched aliquots were assayed using ELISA kits specific for CSF‐1, GMCSF, G‐CSF, TNF‐α, IL‐6, IL‐8, and VEGF. Data were compared using ANOVA, Fisher's exact, and log rank tests. Increased epithelial VEGF production was observed more often in tumors with Type 2 variants (p = 0.039) and when GPR30 receptor expression was high (p = 0.038). Although increased stromal VEGF production was detected more often in grade 3 endometrioid tumors (p = 0.050), when EGFR expression was high (p = 0.003), and/or when ER/PR expression was low (p = 0.048), VEGF production did not correlated with overall survival (OS). Increased epithelial CSF‐1 and TNF‐α production, respectively, were observed more often in tumors with deep myometrial invasion (p = 0.014) and advanced stage (p = 0.018). Increased CSF‐1 (89.5% vs. 42.9%, p = 0.032), TNF‐α (88.9% vs. 42.9%, p = 0.032, and IL‐6 (92.3% vs. 61.5%, p = 0.052) also correlated with low OS. In Cox multivariate models, CSF‐1 was an independent predictor of low survival when stratified by grade (p = 0.046) and histology (p = 0.050), and TNF‐α, when stratified by histology (p = 0.037). In this study, high CSF‐1, TNF‐α, and IL‐6 production rates identified patients at greatest risk for death, and may signify patients likely to benefit from receptor‐specific therapy.
Dynamics of gravity–capillary solitary waves in deep water
Authors: Wang Zhan , Milewski Paul A.
Published: August 2012

The dynamics of solitary gravity–capillary water waves propagating on the surface of a three-dimensional fluid domain is studied numerically. In order to accurately compute complex time-dependent solutions, we simplify the full potential flow problem by using surface variables and taking a particular cubic truncation possessing a Hamiltonian with desirable properties. This approximation agrees remarkably well with the full equations for the bifurcation curves, wave profiles and the dynamics of solitary waves for a two-dimensional fluid domain, and with higher-order truncations in three dimensions. Fully localized solitary waves are then computed in the three-dimensional problem and the stability and interaction of both line and localized solitary waves are investigated via numerical time integration of the equations. There are many solitary wave branches, indexed by their finite energy as their amplitude tends to zero. The dynamics of the solitary waves is complex, involving nonlinear focusing of wavepackets, quasi-elastic collisions, and the generation of propagating, spatially localized, time-periodic structures akin to breathers.
Early Medieval Ecclesiastical Sites in South-western Britain: their dates, characters and significance
Authors: Pearce Susan
Published: August 2012

This paper considers the historical, topographical, and morphological characteristics of burial sites in south-western Britain betweenad400 and 1000, looking for evidence of patterns of Christian development across the region. The study concludes that there is no one simple set of characteristics that exclusively identifies sites of this period. It demonstrates the very considerable complexity of the long, slow cultural shift that turned a pagan society into a Christian one, and it draws attention to the range of place names, morphologies, dedications and traditions that mark the surviving evidence.
Is Côte d'Ivoire a Test Case for R2P? Democratization as Fulfilment of the International Community's Responsibility to Prevent
Authors: Ipinyomi Foluke
Published: August 2012

After the election deadlock in Côte d'Ivoire, the international community recognized Ouattara as the winner of the elections, while the incumbent president, Gbagbo, also claimed victory. When they were both sworn in, violence ensued. UN Secretary General Ban Ki-Moon stated that the international community had a responsibility to protect citizens. Thereafter, the UN, African Union and ECOWAS attempted to quell the violence through mediation and the threat of force. Gbagbo was eventually ousted by Ouattara's forces. This article examines the international community's responsibility to prevent and its actions in that regard. If democratization is a means to prevent mass atrocities, what was the nature of the international community's responsibility to Ivoirians to prevent conflict? What should be the international community's reaction to internal agitations for democracy? Some answers to these questions lie in the framework for the international community's responsibility to prevent the four crimes related to R2P.
GENETIC AND ENVIRONMENTAL INFLUENCES ON BLOOD PRESSURE IN AN URBAN INDIAN POPULATION
Authors: GUPTA SHILPI , KAPOOR SATWANTI
Published: August 2012

Aggarwal Baniyas were found to have a high prevalence of high blood pressure. Genetic and environmental influences may be implicated for this risk factor of cardiovascular disease. The aim of this study was to investigate the potential for common genetic and environmental influences on blood pressure measures (systolic and diastolic blood pressure (SBP, DBP)). The population-based sample was comprised of 309 Aggarwal Baniya families, including 1214 individuals (271 fathers, 307 mothers, 311 sons and 325 daughters) from New Delhi, India. The prevalence of obesity in this community was found to be high (BMI: fathers, 26.1 kg/m2; mothers, 29.4 kg/m2; sons, 16.9–22.4 kg/m2; and daughters, 16.3–22.7 kg/m2). Correlation and heritability were estimated. Most sibling–sibling correlations were larger than the parent–offspring correlations, and all parent–offspring and sibling–sibling correlations were larger than the corresponding spouse correlation (SBP=0.026; DBP=0.029). The maximum heritability was estimated as 44.6% for SBP and 62.8% for DBP. The lack of a significant spouse correlation is consistent with little or no influence of the common familial environment. However, the high heritability estimate for both SBP and DBPs reinforces the importance of the non-shared environmental effect.
An unusual foreign body in the nostril
Authors: Nathan K , Nagala V , Farhat S , Shah A
Published: August 2012

Background:

Intranasal teeth are uncommon. Causes include trauma, infection, anatomical malformations and genetic factors. They present mainly in children, and many are asymptomatic.

Methods:

This report describes the finding of a tooth that had been displaced into the nasal cavity in a six-year-old girl. The history, clinical examination, findings and operative treatment are described.

Results:

The child presented with nasal symptoms. Examination revealed a tooth in the right nasal cavity, confirmed by a lateral cephalogram radiograph. It was extracted under general anaesthesia. At follow up, the child was asymptomatic.

Conclusion:

This is an unusual case of a child presenting with an intranasal tooth and nasal symptoms following trauma a number of years earlier. The child underwent extraction of the tooth, and recovered well without any complications.
Facial palsy in individuals with thalidomide embryopathy: frequency and characteristics
Authors: Sjögreen L , Kiliaridis S
Published: August 2012

Background:

Earlier studies have shown that individuals with thalidomide embryopathy can have skeletal deformities, ear and eye aberrations, and facial palsy. This study aimed to survey the frequency and characteristics of facial palsy in this group of individuals.

Participants:

Thirty-one individuals with thalidomide embryopathy (age range, 45–47 years) and 25 healthy adults (age range, 41–56 years; mean age ± standard deviation, 49 ± 4.2 years).

Main outcome measures:

Voluntary facial movements, lip force and three-dimensional lip motion analysis.

Results and conclusion:

Four of the thalidomide embryopathy individuals (13 per cent) had congenital facial palsy. All four had eye aberrations, three had ear anomalies and one had a limb anomaly. Individuals with thalidomide embryopathy without a clinical diagnosis of facial impairment had significantly weaker lips and more restricted lip mobility than healthy controls. This study contributes to the overall knowledge of thalidomide embryopathy by adding a description of how facial expression can be affected in this condition.
Rhabdomyosarcoma of the trachea: first reported case treated with proton beam therapy
Authors: Exley R , Bernstein J M , Brennan B , Rothera M P
Published: August 2012

Objective:

We report a case of rhabdomyosarcoma of the trachea in a 14-month-old child, and we present the first reported use of proton beam therapy for this tumour.

Case report:

A 14-month-old girl presented acutely with a seven-day history of biphasic stridor. Emergency endoscopic debulking of a posterior tracheal mass was undertaken. Histological examination revealed an embryonal rhabdomyosarcoma with anaplasia. Multimodality therapy with surgery and chemotherapy was administered in the UK, and proton beam therapy in the USA.

Conclusion:

Only three cases of rhabdomyosarcoma of the trachea have previously been reported in the world literature. This is the first reported case of treatment of this tumour with proton beam therapy. Compared with conventional radiotherapy, proton beam therapy may confer improved long-term outcome in children, with benefits including reduced irradiation of the spinal cord.
Antiplatelet drugs in elective ENT surgery
Authors: Savage J R , Parmar A , Robinson P J
Published: August 2012

Introduction:

Oral antiplatelet drugs are increasingly being encountered in patients scheduled for elective ENT surgery. Their pre-operative cessation can have potentially serious complications in some patients, particularly those with intracoronary stents.

Methods:

In order to gain an impression of current peri-operative management of patients taking antiplatelet drugs, an online survey was distributed to the Expert Panel of ENT UK, the British Association of Otolaryngologists Head and Neck Surgeons, between 13 January and 15 February 2011.

Results:

Three hundred and three members were contacted. The response rate was 55 per cent (167 replies); 78 per cent of respondents were consultants. Results are presented in the main text.

Conclusion and recommendations:

Patients can be categorised as high or low risk, depending on their indication for taking antiplatelet drugs. Recommendations taken from the literature are given on how best to manage these two groups.
Surgical treatment of posterior semicircular canal dehiscence syndrome caused by jugular diverticulum
Authors: Lim H W , Park H J , Jung J H , Chung J W
Published: August 2012

Objective:

We report a rare case of posterior semicircular canal dehiscence caused by a jugular diverticulum, and we describe its surgical treatment using a dehiscence resurfacing manoeuvre.

Method:

The clinical findings, surgical procedure and outcomes are presented.

Results:

A 66-year-old man presented with disequilibrium, sound-induced vertigo, a reduced ocular vestibular evoked myogenic potential threshold, and pressure-induced vertical and torsional nystagmus. Computed tomography revealed a right posterior semicircular canal dehiscence caused by a diverticulum of the jugular bulb. The defect in the posterior semicircular canal was localised and resurfaced with bone paté, temporalis muscle fascia and conchal cartilage, under direct visualisation. Post-operatively, the patient's symptoms disappeared and his ocular vestibular evoked myogenic potential threshold normalised.

Conclusion:

This case illustrates that posterior semicircular canal dehiscence can be surgically managed by resurfacing the defect site via a transmastoid approach.
Achieving flying colours in surgical safety: audit of World Health Organization ‘Surgical Safety Checklist’ compliance
Authors: Sheena Y , Fishman J M , Nortcliff C , Mawby T , Jefferis A F , Bleach N R
Published: August 2012

Objective:

The World Health Organization ‘Surgical Safety Checklist’ has been adopted by UK surgical units following National Patient Safety Agency guidance. Our aim was to assess compliance with our local version of this Checklist.

Methods:

Otolaryngology trainee doctors prospectively assessed compliance with the local Checklist over a six-week period. A staff educational intervention was implemented and the audit was repeated 12 months later.

Results:

A total of 72 cases were assessed. The initial audit found that: 44 per cent of procedures were undocumented at ‘Sign in’; ‘Time out’ was inappropriately interrupted in 39 per cent of cases; the procedure started before Checklist completion in 33 per cent of cases; and the ‘Sign out’ was not read out in 94 per cent of cases and was not fully documented in 42 per cent of cases. Following education, re-audit indicated that overall compliance had improved from 63.7 per cent (±8.9 per cent standard error of the mean) to 90.4 per cent (±2.7 per cent standard error of the mean).

Conclusion:

Our completed audit cycle demonstrated a significant improvement in Checklist compliance following educational intervention. We discuss barriers to compliance, as well as strategies for quality improvement, and we call for other surgeons to similarly publish their Checklist experience and assess its impact on surgical outcomes.
Utilising silk fibroin membranes as scaffolds for the growth of tympanic membrane keratinocytes, and application to myringoplasty surgery
Authors: Levin B , Redmond S L , Rajkhowa R , Eikelboom R H , Atlas M D , Marano R J
Published: August 2012

Background:

Chronic tympanic membrane perforations can cause significant morbidity. The term myringoplasty describes the operation used to close such perforations. A variety of graft materials are available for use in myringoplasty, but all have limitations and few studies report post-operative hearing outcomes. Recently, the biomedical applications of silk fibroin protein have been studied. This material's biocompatibility, biodegradability and ability to act as a scaffold to support cell growth prompted an investigation of its interaction with human tympanic membrane keratinocytes.

Methods and materials:

Silk fibroin membranes were prepared and human tympanic membrane keratinocytes cultured. Keratinocytes were seeded onto the membranes and immunostained for a number of relevant protein markers relating to cell proliferation, adhesion and specific epithelial differentiation.

Results:

The silk fibroin scaffolds successfully supported the growth and adhesion of keratinocytes, whilst also maintaining their cell lineage.

Conclusion:

The properties of silk fibroin make it an attractive option for further research, as a potential alternative graft in myringoplasty.
Protective effect of klotho protein against cisplatin ototoxicity in an auditory cell line
Authors: Park Se Jin , Park So Hyun , Chang Ji Won , Choi June , Jung Hak Hyun , Im Gi Jung
Published: August 2012

Objectives:

Klotho protein is involved in insulin-signalling and ageing. Klotho mutation causes premature ageing and significantly shortens the lifespan. The anti-neoplastic drug cisplatin promotes ototoxicity at higher doses by inducing apoptosis. This study aimed to clarify the effect of klotho expression on cisplatin ototoxicity, using an auditory cell line.

Materials and methods:

Expressions of klotho messenger RNA and protein were analysed by reverse-transcription polymerase chain reaction and western blotting. Auditory cells (HEI-OC1 line) were pretreated with 2 nM klotho protein for 2 hours; 15 µM cisplatin was then applied. After 48 hours incubation, assessment of cell viability (via 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide assay), apoptosis (via Hoechst 33258 staining) and reactive oxygen species was performed.

Results:

Klotho protein expression increased in cisplatin-treated auditory cells. Cells treated with both klotho protein and cisplatin showed a viability of 67.7 per cent, versus 59.4 per cent in cisplatin-treated cells. Klotho significantly attenuated the cisplatin-induced increase in reactive oxygen species, and increased the viability of cells with cisplatin-induced cytotoxicity.

Conclusion:

Klotho protein is protective against cisplatin-induced auditory cell cytotoxicity; inhibition of reactive oxygen species may be the main mechanism.
Cohabitation patterns among patients with severe psychiatric disorders in the entire Danish population
Authors: Thomsen A. F. , Olsbjerg M. , Andersen P. K. , Kessing L. V.
Published: August 2012

Background

Assortative mating has been demonstrated in mental disorders but the extent of cohabitation between patients with clinically diagnosed psychiatric disease has been poorly explored.

Method

We conducted a register-based study of all Danes between 18 and 70 years of age in a 13-year observational period, linking data on individuals' contacts with psychiatric services with data on individuals' cohabitation status. Two different Poisson regression analyses were performed: the first comparing the rates of commencing cohabitation with a psychiatric patient between individuals, depending on whether the individuals themselves had, or did not have, a psychiatric diagnosis; the second comparing the incidence rates of psychiatric diagnoses for individuals cohabitating with psychiatric patients with the similar rates for individuals living with unaffected cohabitants.

Results

In total, 159 929 (5.0%) out of 3 204 633 individuals were given a psychiatric diagnosis during the study period. Diagnosed individuals had an overall rate ratio (RR) of commencing cohabitation with a psychiatric patient of 1.95 [95% confidence interval (CI) 1.90–2.00] for women and 1.65 (95% CI 1.61–1.69) for men, when compared with unaffected individuals. The overall RR of receiving a psychiatric diagnosis while cohabitating with a psychiatric patient was 2.40 (95% CI 2.31–2.49) for women and 2.91 (95% CI 2.81–3.01) for men, when compared with those cohabitating with unaffected individuals. Individuals with schizophrenia and men with bipolar disorder had the highest RR of commencing cohabitation with a cohabitant with a similar diagnosis.

Conclusions

Cohabitation among individuals with severe psychiatric disorders is increased. This has implications for research and for the clinical management of patients.
Diffusion along transition chains of invariant tori and Aubry–Mather sets
Authors: GIDEA MARIAN , ROBINSON CLARK
Published: August 2012

We describe a topological mechanism for the existence of diffusing orbits in a dynamical system satisfying the following assumptions: (i) the phase space contains a normally hyperbolic invariant manifold diffeomorphic to a two-dimensional annulus; (ii) the restriction of the dynamics to the annulus is an area preserving monotone twist map; (iii) the annulus contains sequences of invariant one-dimensional tori that form transition chains (i.e., the unstable manifold of each torus has a topologically transverse intersection with the stable manifold of the next torus in the sequence); (iv) the transition chains of tori are interspersed with gaps created by resonances; (v) within each gap there is prescribed a finite collection of Aubry–Mather sets. Under these assumptions, there exist trajectories that follow the transition chains, cross over the gaps, and follow the Aubry–Mather sets within each gap, in any specified order. This mechanism is related to the Arnold diffusion problem in Hamiltonian systems. In particular, we prove the existence of diffusing trajectories in the large gap problem of Hamiltonian systems. The argument is topological and constructive.
Rural dementia carers: formal and informal sources of support
Authors: ORPIN PETER , STIRLING CHRISTINE , HETHERINGTON SHARON , ROBINSON ANDREW
Published: August 2012

Primary carers provide much of the day-to-day care for community-dwelling people living with dementia (PWD). Maintaining that contribution will require a more in-depth understanding of the primary carer role and the support needs that flow from that role. This study explored patterns of formal and informal support utilisation by people caring for a PWD in a rural-regional context. In-depth semi-structured interviews were conducted with 18 rural primary carers of a PWD and thematically analysed. Participant primary carers' almost total commitment to, and absorption in their role and their assumption of ultimate responsibility for the PWD's wellbeing meant that external social context, such as rurality, became less relevant. Carer networks effectively contracted to those key individuals who were central to supporting them in their caring task. External sources of support were tightly managed with strong boundaries around the provision of direct care to the PWD largely excluding all but professional providers. Primary carers are generally categorised along with other family and friends as informal care. However, in assumingprimaryresponsible for the care and wellbeing for the PWD they effectively become the key care provider, suggesting that it would be productive in both research and practice to treat primary carers as key members of a care partnership alongside professional carers, rather than as adjuncts to formal care and/or another client.
The influence of high-rise residence on physical activity and quality of life among older people with leprosy in a retirement community
Authors: CHENG SHUN PING , WANG TZE FANG , TANG FU IN , CHU NGOK KIU , CHEN I JU
Published: August 2012

The significant time older people typically spend at home affects both their level of physical activity and quality of life. This prospective cohort study was designed to identify the effects that living in a high-rise residence retirement community has on physical activity and quality of life in older people with leprosy. The relocation group was comprised of study participants who had relocated voluntarily to a high-rise apartment building. The comparison group was comprised of study participants who had chosen not to relocate to that building. Data were collected using a personal information survey, Modified Baecke's Questionnaire, and the brief version of the World Health Organization Quality of Life assessment (WHOQOL-BREF). The groups were significantly similar in terms of household activities, leisure time activities, total physical activity score, and quality of life physical and social aspects, and significantly different in terms of quality of life overall (F=7.864,p=0.006), psychological (F=5.403,p=0.021) and environmental (F=23.099,p=0.000) aspects. This study indicates that living in a high-rise apartment environment does not decrease physical activity and may promote overall quality of life, and psychological and environmental aspects, in retirement community residents. The findings enhance understanding of the effect of different living environments on physical activity and quality of life. Greater health professional participation in retirement community design to ensure such designs facilitate residents’ health and quality of life is recommended.
CORRECTIVE FEEDBACK AND WORKING MEMORY CAPACITY IN INTERACTION-DRIVEN L2 LEARNING
Authors: Goo Jaemyung
Published: August 2012

The present study explores the relative efficacy of recasts over metalinguistic feedback on the learning of the Englishthat-trace filter and how working memory capacity (WMC) is related to the extent to which learners can benefit from recasts and metalinguistic feedback. Fifty-four Korean English as a foreign language (EFL) learners from six intact classes at a university formed two experimental groups (recasts and metalinguistic feedback) and one control group and carried out two first language (L1) working memory (WM) span tasks (reading span and operation span tasks). The two experimental groups participated in two information gap activities over two treatment sessions, during which they were required to ask questions involving thethat-trace filter and received corrective feedback (either recasts or metalinguistic feedback) on their erroneous utterances. Two dependent variable measures (a written production test and a grammaticality judgment test) were administered in each test session (pretest and immediate posttest). Results showed that recasts were as effective as metalinguistic feedback in facilitating the acquisition of the target construction. This may, to some extent, be attributable to the blocking of modified output opportunities specifically designed in this study to prevent modified output from playing a potential role as a confound. Also, individual differences in WMC significantly predicted, and thus mediated the effects of, recasts but not metalinguistic feedback, on the acquisition of thethat-trace filter. This suggests that executive attention or attention control (considered as a critical component of WMC) is involved in the noticing of recasts, but not in the noticing of metalinguistic feedback.
DECONSTRUCTING COMPREHENSIBILITY
Authors: Isaacs Talia , Trofimovich Pavel
Published: August 2012

Comprehensibility, a major concept in second language (L2) pronunciation research that denotes listeners’ perceptions of how easily they understand L2 speech, is central to interlocutors’ communicative success in real-world contexts. Although comprehensibility has been modeled in several L2 oral proficiency scales—for example, the Test of English as a Foreign Language (TOEFL) or the International English Language Testing System (IELTS)—shortcomings of existing scales (e.g., vague descriptors) reflect limited empirical evidence as to which linguistic aspects influence listeners’ judgments of L2 comprehensibility at different ability levels. To address this gap, a mixed-methods approach was used in the present study to gain a deeper understanding of the linguistic aspects underlying listeners’ L2 comprehensibility ratings. First, speech samples of 40 native French learners of English were analyzed using 19 quantitative speech measures, including segmental, suprasegmental, fluency, lexical, grammatical, and discourse-level variables. These measures were then correlated with 60 native English listeners’ scalar judgments of the speakers’ comprehensibility. Next, three English as a second language (ESL) teachers provided introspective reports on the linguistic aspects of speech that they attended to when judging L2 comprehensibility. Following data triangulation, five speech measures were identified that clearly distinguished between L2 learners at different comprehensibility levels. Lexical richness and fluency measures differentiated between low-level learners; grammatical and discourse-level measures differentiated between high-level learners; and word stress errors discriminated between learners of all levels.