bluuebunny/crossref_metadata_2025 huggingface dataset:
Manual versus automated streaking system in clinical microbiology laboratory: Performance evaluation of Previ Isola for blood culture and body fluid samples
Authors: Choi Qute , Kim Hyun Jin , Kim Jong Wan , Kwon Gye Cheol , Koo Sun Hoe
Published: January 2018

Background

The process of plate streaking has been automated to improve routine workflow of clinical microbiology laboratories. Although there were many evaluation reports about the inoculation of various body fluid samples, few evaluations have been reported for blood. In this study, we evaluated the performance of automated inoculating system, Previ Isola for various routine clinical samples including blood.

Methods

Blood culture, body fluid, and urine samples were collected. All samples were inoculated on both sheep blood agar plate (BAP) and MacConkey agar plate (MCK) using Previ Isola and manual method. We compared two methods in aspect of quality and quantity of cultures, and sample processing time. To ensure objective colony counting, an enumeration reading reference was made through a preliminary experiment.

Results

A total of 377 nonduplicate samples (102 blood culture, 203 urine, 72 body fluid) were collected and inoculated. The concordance rate of quality was 100%, 97.0%, and 98.6% in blood, urine, and other body fluids, respectively. In quantitative aspect, it was 98.0%, 97.0%, and 95.8%, respectively. The Previ Isola took a little longer to inoculate the specimen than manual method, but the hands‐on time decreased dramatically. The shortened hands‐on time using Previ Isola was about 6 minutes per 10 samples.

Conclusion

We demonstrated that the Previ Isola showed high concordance with the manual method in the inoculation of various body fluids, especially in blood culture sample. The use of Previ Isola in clinical microbiology laboratories is expected to save considerable time and human resources.
New surface cross‐linking method to fabricate positively charged nanofiltration membranes for dye removal
Authors: Wang Xiao , Ju Xiaohui , Jia Tian‐Zhi , Xia Qian‐Cheng , Guo Jia‐Lin , Wang Chen , Cui Zhaoliang , Wang Yong , Xing Weihong , Sun Shi‐Peng
Published: January 2018

BACKGROUND

At present, most commercial nanofiltration (NF) membranes are negatively charged. An effective way to prepare a positively charged NF membrane is to cross‐link polyimide (PI) substrate with polyethyleneimine (PEI). However, the lack of an efficient process for selecting proper cross‐linking conditions is an important issue. Therefore, the major objective of this work is to develop an efficient method to cross‐link only the top surface of the membranes.

RESULTS

The optimum cross‐linking condition was found to be at a cross‐linking temperature of 70 °C, cross‐linking time of 80 minutes and stirring speed of 500 rpm. Comparing the membrane before and after cross‐linking, the molecular weight cut‐off changed from 17520 Da to 458 Da and the membrane surface changed from positive from negative. The cross‐linked membrane showed high rejection (>95%) for basic dyes with different molecular weights and relatively high antifouling properties to these dyes (flux recovery ratio > 92%, total flux decline ratio < 26.7%, irreversible flux decline ratio < 7.3%).

CONCLUSIONS

Stirring speed was found to greatly influence the membrane performance. It was found that there exists an optimum stirring speed at which the cross‐linker distributes evenly on the membrane surface for the most effective cross‐linking to take place. The newly developed surface cross‐linking method also may have the potential to modify other types of membrane surfaces. © 2018 Society of Chemical Industry
Preference, resistance to change, and the cumulative decision model
Authors: Grace Randolph C.
Published: January 2018

According to behavioral momentum theory (Nevin & Grace, 2000a), preference in concurrent chains and resistance to change in multiple schedules are independent measures of a common construct representing reinforcement history. Here I review the original studies on preference and resistance to change in which reinforcement variables were manipulated parametrically, conducted by Nevin, Grace and colleagues between 1997 and 2002, as well as more recent research. The cumulative decision model proposed by Grace and colleagues for concurrent chains is shown to provide a good account of both preference and resistance to change, and is able to predict the increased sensitivity to reinforcer rate and magnitude observed with constant‐duration components. Residuals from fits of the cumulative decision model to preference and resistance to change data were positively correlated, supporting the prediction of behavioral momentum theory. Although some questions remain, the learning process assumed by the cumulative decision model, in which outcomes are compared against a criterion that represents the average outcome value in the current context, may provide a plausible model for the acquisition of differential resistance to change.
Greater reinforcement rate during training increases spontaneous recovery
Authors: Thrailkill Eric A. , Kimball Ryan T. , Kelley Michael E. , Craig Andrew R. , Podlesnik Christopher A.
Published: January 2018

Spontaneous recovery occurs when a previously reinforced and recently extinguished response reemerges over the course of time, often at the beginning of a new session of extinction. Spontaneous recovery could underlie instances of treatment relapse that threaten otherwise effective behavioral interventions for problem behavior. In two experiments, we arranged multiple schedules with pigeons and a human child to assess the effects of different training reinforcer rates on spontaneous recovery. In both experiments, responding was both more resistant to extinction and more likely to relapse following training with greater reinforcement rates upon returning to extinction after time off from extinction testing. A quantitative model based on behavioral momentum theory accounted well for the data, which suggests reexposure to the extinction context following time off during extinction resulted in (1) the failure of extinction learning to generalize, and (2) greater generalization of original learning during training. The present model attempts to quantify theories attributing spontaneous recovery to changes in temporal context.
Chronic repeated exposure to weather‐related stimuli elicits few symptoms of chronic stress in captive molting and non‐molting European starlings (Sturnus vulgaris)
Authors: de Bruijn Robert , Reed J. Michael , Romero L. Michael
Published: January 2018

Repeated exposure to acute stressors causes dramatic changes in an animal's stress physiology and the cumulative effects are often called chronic stress. Recently we showed that short‐term exposure to weather‐related stimuli, such as temperature change, artificial precipitation, and food restriction, cause acute responses in captive European starlings (Sturnus vulgaris). Here, we examined the effect of repeated exposure to weather‐related stressors on heart rate and corticosterone (CORT) of captive non‐molting and molting European starlings. Four times every day for 3 weeks, birds were exposed to either 30 min of a subtle (3°C) decrease in temperature, a short bout of simulated rain, or 2 hr of food removal. The order and time of presentation were randomly assigned on each day. We found no differences in heart rate or heart rate variability. Furthermore, there were no changes in baseline CORT levels, CORT negative feedback efficacy, or maximal adrenal capacity. Mass increased across the experimental period only in molting birds. CORT responses to restraint were decreased in both groups following treatment, suggesting the birds had downregulated their responses to acute stress. Molting birds showed evidence of suppression of the HPA axis compared with non‐molting birds, which is consistent with previous research. Overall, our data show that repeated exposure to weather‐related stressors does not elicit most of the symptoms normally associated with chronic stress.
LncRNA CDKN2BAS rs2157719 genetic variant contributes to medulloblastoma predisposition
Authors: Chen Yi‐Dong , Zhang Nasha , Qiu Xiao‐Guang , Yuan Jupeng , Yang Ming
Published: January 2018

Background

How germline single nucleotide polymorphisms are involved in the etiology of medulloblastoma remans poorly understood. We hypothesized that CCDKN2A/B rs1063192 and rs4977756 and also the long noncoding RNA (lncRNA) CDKN2BAS rs2157719 glioma susceptibility polymorphisms identified by genome‐wide association studies may contribute to medulloblastoma predisposition.

Methods

To test this hypothesis, we genotyped these genetic variants among 160 medulloblastoma patients and 443 health controls in a Chinese population. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by logistic regression.

Results

We found that only the lncRNA CDKN2BAS rs2157719 T>C genetic polymorphism was significantly associated with an increased medulloblastoma risk (C allele: OR = 1.85, 95% CI = 1.32–2.58; p = 2.7 × 10–4). The stratified analyses showed an elevated risk of pediatric medulloblastoma associated with CDKN2BAS rs2157719 CC or TC genotype (both p < 0.05). Moreover, the association between the CDKN2BAS rs2157719 polymorphism and medulloblastoma risk is more pronounced in males (OR = 2.22, 95% CI = 1.36–3.62; p = 0.001).

Conclusions

The findings of the present study provide important insights into the genetic complexities and predisposition of medulloblastoma in Chinese, especially at the lncRNA germline variation level.
Chiral detection of entecavir stereoisomeric impurities through coordination with R‐besivance and ZnII using mass spectrometry
Authors: Wang Yali , Wang Lu , Chen Xiaolei , Sun Cuirong , Zhu Yixin , Kang Yu , Zeng Su
Published: January 2018

In this study, a mass spectrometry (MS)‐based kinetic method (KM) is shown to be successful at analyzing a multichiral center drug stereoisomer, entecavir (ETV), both qualitatively and quantitatively. On the basis of the KM, the bivalent complex ion [MII(A)(ref*)2]2+ (MII = divalent metal ion, A = analyte, and ref* = chiral reference) was set as precursor ion in MS/MS. The experiment results suggest strong chiral selectivity between ETV and its isomers when using ZnII coordinated with the chiral reference R‐besivance (R‐B). The logarithm of the fragment ion abundance ratio and the enantiomeric percentage (%) exhibits a strong linear relation because of the competitive loss of the reference and analyte. The product ion pair [ZnII(R‐B)A‐H]+ (m/z 733) and [ZnII(R‐B)2‐H]+ (m/z 849), together with [R‐B + H]+ (m/z 394) and [A + H]+ (m/z 278), can realize the identification of ETV and all of its chiral isomers. Theoretical calculation were also performed using the B3LYP functional with the 6‐31G* and LanL2DZ basis set to clarify the mechanism of structural difference of these bivalent complex ions. The results reveal that MS‐KM can be used to detect optical impurities without a chiral chromatographic column and fussy sample pretreatment. The established method has been used to determine stereoisomeric impurities of less than 0.1% in ETV crude drug, a demonstration of its simple and effective nature for rapid detection of stereoisomeric impurities.
Parvalbumin‐producing striatal interneurons receive excitatory inputs onto proximal dendrites from the motor thalamus in male mice
Authors: Nakano Yasutake , Karube Fuyuki , Hirai Yasuharu , Kobayashi Kenta , Hioki Hiroyuki , Okamoto Shinichiro , Kameda Hiroshi , Fujiyama Fumino
Published: January 2018

In rodents, the dorsolateral striatum regulates voluntary movement by integrating excitatory inputs from the motor‐related cerebral cortex and thalamus to produce contingent inhibitory output to other basal ganglia nuclei. Striatal parvalbumin (PV)‐producing interneurons receiving this excitatory input then inhibit medium spiny neurons (MSNs) and modify their outputs. To understand basal ganglia function in motor control, it is important to reveal the precise synaptic organization of motor‐related cortical and thalamic inputs to striatal PV interneurons. To examine which domains of the PV neurons receive these excitatory inputs, we used male bacterial artificial chromosome transgenic mice expressing somatodendritic membrane–targeted green fluorescent protein in PV neurons. An anterograde tracing study with the adeno‐associated virus vector combined with immunodetection of pre‐ and postsynaptic markers visualized the distribution of the excitatory appositions on PV dendrites. Statistical analysis revealed that the density of thalamostriatal appositions along the dendrites was significantly higher on the proximal than distal dendrites. In contrast, there was no positional preference in the density of appositions from axons of the dorsofrontal cortex. Population observations of thalamostriatal and corticostriatal appositions by immunohistochemistry for pathway‐specific vesicular glutamate transporters confirmed that thalamic inputs preferentially, and cortical ones less preferentially, made apposition on proximal dendrites of PV neurons. This axodendritic organization suggests that PV neurons produce fast and reliable inhibition of MSNs in response to thalamic inputs and process excitatory inputs from motor cortices locally and plastically, possibly together with other GABAergic and dopaminergic dendritic inputs, to modulate MSN inhibition.
Impact of the North Pacific subtropical sea surface temperature front on El Niño‐Southern Oscillation
Authors: Zhang Leying , Xu Haiming , Shi Ning , Ma Jing
Published: January 2018

The North Pacific subtropical front (NPSTF) of sea surface temperature (SST) is an important subtropical feature in the North Pacific. In this study, we reveal that the inter‐annual variability of the spring NPSTF has a robust correlation with the El Niño‐Southern Oscillation (ENSO) in the following winter over the period of 1961–2016. When there is a strong spring NPSTF, anomalous cyclonic and anticyclonic circulations in the low troposphere occur to its north and south, respectively. The northeasterly wind anomaly associated with the anticyclonic circulation increases the climatological northeasterly wind over the subtropical Northeast Pacific, resulting in SST decrease via the wind–evaporation–SST feedback. The SST and wind perturbations propagate southwards from the subtropical to the eastern central equatorial Pacific in summer and grow via the Bjerknes feedback from summer to winter, eventually leading to a La Niña event in winter.

A strong spring NPSTF induces an anomalous anticyclonic circulation to its south through both transient eddy activity and atmospheric heat source anomaly. The enhanced air temperature gradient due to a strong NPSTF increases the atmospheric baroclinicity, favouring an enhanced transient eddy activity over the NPSTF and to the north. The enhanced transient eddy activity triggers a significant negative height anomaly to the north via high‐frequency transient eddy feedback forcing, which is conductive to an anticyclonic circulation over the subtropical North Pacific through the downstream effect of Rossby waves. On the other hand, the convergence and increased atmospheric baroclinicity related to the strong NPSTF act to enhance precipitation over the NPSTF and to the north, corresponding to the increased atmospheric heat source, which can also excite an anomalous anticyclonic circulation over the subtropical North Pacific.
Nondestructive, indirect assessment of the biomechanical properties of the rat intervertebral disc using contrast‐enhanced μCT
Authors: Newton Michael D. , Hartner Samantha E. , Gawronski Karissa , Davenport Erik J. , Timmons Shannon C. , Baker Kevin C. , Maerz Tristan
Published: January 2018

Mechanical characterization of the intervertebral disc involves labor‐intensive and destructive experimental methodology. Contrast‐enhanced micro‐computed tomography is a nondestructive imaging modality for high‐resolution visualization and glycosaminoglycan quantification of cartilaginous tissues. The purpose of this study was to determine whether anionic and cationic contrast‐enhanced micro‐computed tomography of the intervertebral disc can be used to indirectly assess disc mechanical properties in an ex vivo model of disc degeneration. L3/L4 motion segments were dissected from female Lewis rats. To deplete glycosaminoglycan, samples were treated with 0 U/ml (Control) or 5 U/ml papain. Contrast‐enhanced micro‐computed tomography was performed following incubation in 40% Hexabrix (anionic) or 30 mg I/ml CA4+ (cationic) for 24 h (n = 10/contrast agent/digestion group). Motion segments underwent cyclic mechanical testing to determine compressive and tensile modulus, stiffness, and hysteresis. Glycosaminoglycan content was determined using the dimethylmethylene blue assay. Correlations between glycosaminoglycan content, contrast‐enhanced micro‐computed tomography attenuation, and mechanical properties were assessed via the Pearson correlation. The predictive accuracy of attenuation on compressive properties was assessed via repeated random sub‐sampling cross validation. Papain digestion produced significant decreases in glycosaminoglycan content and corresponding differences in attenuation and mechanical properties. Attenuation correlated significantly to glycosaminoglycan content and to all compressive mechanical properties using both Hexabrix and CA4+. Predictive linear regression models demonstrated a predictive accuracy of attenuation on compressive modulus and stiffness of 79.8–86.0%. Contrast‐enhanced micro‐computed tomography was highly predictive of compressive mechanical properties in an ex vivo simulation of disc degeneration and may represent an effective modality for indirectly assessing disc compressive properties. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2030–2038, 2018.
Silicon concentrations in soil and bark in Irish Sitka spruce forests
Authors: Hogan Brian , McDermott Frank , Schmidt Olaf
Published: January 2018

The relationship between plant‐available silicon (Si) soil concentrations and bark Si concentrations in coniferous species is poorly understood. The objectives of this research were to generate baseline data on Si concentrations in soils and bark of Sitka spruce (Picea sitchensis) seedlings in Ireland and to understand better the relationship between soil and bark Si concentrations. Seedlings were harvested from eight plantation forestry sites and two tree nurseries, and Si concentrations in the bark tissue as well as plant‐available Si concentrations in soils (CaCl2 extractant) were measured. Bark Si concentrations varied significantly between sites and were lowest [mean 790 (± 242 SD) mg kg−1 dry plant tissue] on acidic, organic rich peat soils, while the highest Si concentrations occurred in seedlings [mean 3688 (± 633 SD) mg kg−1 dry plant tissue] grown on soils with low C concentration and higher pH values (≈ 4.5 to 5.5 in H2O). Plant‐available Si soil concentrations were not related to soil C concentrations. There was a negative (but statistically not significant) relationship between plant–soil concentrations and soil pH. A significant negative relationship was observed between plant‐available soil Si concentrations and bark Si concentrations, which may be related to the presence of soil from mixed soil horizons forming the mounds that seedlings were planted on. Uptake and sequestration of Si by seedlings may have been related to the rate of growth of the seedlings, as bark Si concentrations were highest on sites that were expected to have greater seedling growth rates. The negative relationship between bark and plant‐available Si soil concentrations suggest that uptake of Si by Sitka spruce is rejective at higher concentrations.
Effect of drying methods (microwave vacuum, freeze, hot air and sun drying) on physical, chemical and nutritional attributes of five pepper (Capsicum annuum var. annuum) cultivars
Authors: Maurya Vaibhav Kumar , Gothandam Kodiveri Muthukaliannan , Ranjan Vijay , Shakya Amita , Pareek Sunil
Published: January 2018

BACKGROUND

A randomized block design experiment was performed to investigate the influence of drying on the physical, chemical and nutritional quality attributes of five prominent cultivars of India under sun drying (SD) (mean temperature 35.5 °C, average daily radiation 5.26 kW h m−2 and mean relative humidity 73.66% RH), hot air drying (HD) at 65 °C, microwave vacuum drying (MVD) (800 W, 5 kPa) and freeze drying (FD) (−50 °C, 5 kPa). Water activity, pH, total phenolic content (TPC), ascorbic acid (AA), capsaicin, β‐carotene, color and Scoville heat unit were studied.

RESULTS

TPC, AA, capsaicin content, β‐carotene, color and water activity were significantly affected by the drying method. FD was observed to be most efficient in minimizing the loss of color, capsaicin and β‐carotene. The hotness of analyzed samples decreased in the order ‘Bird's Eye’ > ‘Sannam S4’ > ‘CO‐4’ > ‘PLR‐1’ > ‘PKM‐1’ among the studied cultivars, and FD > MVD > HD > SD among the drying methods.

CONCLUSION

The FD method was observed to be the most efficient drying method for retaining capsaicin content over other drying methods (SD, HD, MVD), whereas MVD was found to be most efficient in minimizing the loss to nutritional attributes for all five pepper cultivars. © 2018 Society of Chemical Industry
Monitoring of starter culture‐initiated liquid wheat and teff sourdough fermentations by selected ion flow tube‐mass spectrometry
Authors: Van Kerrebroeck Simon , Harth Henning , Comasio Andrea , De Vuyst Luc
Published: January 2018

BACKGROUND

Selected ion flow tube–mass spectrometry (SIFT‐MS) is a direct‐injection mass spectrometric technique that has been introduced recently into the field of food and flavor analysis. It also shows potential for use in the monitoring of food fermentations. Therefore, this study aimed at the online monitoring of different volatile compounds produced during starter culture‐initiated liquid sourdough fermentations by SIFT‐MS, for which a new workflow was developed.

RESULTS

The online monitoring of the volatile sample compounds acetoin and ethyl acetate, diacetyl, and ethanol was made possible during the production of sourdoughs obtained through fermentation with several interesting strains belonging to the species Lactobacillus crustorum, Lactobacillus fermentum, Lactobacillus hilgardii, Lactobacillus nagelii, Lactobacillus sakei, and Gluconobacter oxydans. Acetoin and ethyl acetate could not be distinguished based solely on SIFT‐MS data. Diacetyl production was monitored in the case of Lb. crustorum LMG 23699 as a starter culture strain, thereby making the distinction between those volatiles produced in sourdough without extra ingredients added or after the addition of citrate or malate.

CONCLUSION

Starter culture‐initiated liquid sourdough fermentations were monitored successfully. The volatile compound production of the different starter culture strains tested reflected differences in their metabolism and/or competitiveness in a sourdough matrix. © 2018 Society of Chemical Industry
Adjuvant radiation therapy improves patient survival in early‐stage merkel cell carcinoma: A 15‐year single‐institution study
Authors: Han Albert Y. , Patel Pratik B. , Anderson Mitchell , Diaz Miguel F. P. , Chin Robert , St. John Maie A.
Published: January 2018

Objectives/Hypothesis

Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine neoplasm of the skin. Growing evidence supports the benefit of postoperative adjuvant radiation therapy (RT) for locoregional control, but whether it improves overall survival (OS) has been debated. Our objective was to compare the OS of MCC patients who received postoperative RT with those who received surgery alone.

Study Design

Retrospective case series.

Methods

Cases of MCC between 2001 and 2016 at the University of California, Los Angeles Health System were reviewed. We identified 87 unique cases of MCC. Among the patients, 74% were identified as male and 26% as female. The average age at diagnosis was 71.2 years. The median survival was 48.0 months. The OS of all the patients at 2 years, 5 years, and 10 years was 54%, 46%, and 26%, respectively. Univariate analysis showed that stage, T stage, N stage, and M stage were significant determinants of OS. The inclusion of RT was not found to be a determinant; however, when restricting the analysis to early‐stage MCC (stages I and II), postoperative adjuvant RT was associated with significantly improved OS. A Cox regression model confirmed that inclusion of RT was an independent prognosticator of OS even when controlled for overall stage and negative margin status. The small sample size and retrospective nature of this study limit its statistical power.

Conclusions

MCC is an aggressive tumor with a poor prognosis for survival especially in elderly patients. In this study, we found that RT during early‐stage MCC improves OS. Prospective randomized control trials are necessary to validate the observed benefit for MCC patients.

Level of Evidence

4 Laryngoscope, 1862–1866, 2018
Meta‐analysis of subjective complaints of vertigo and vestibular tests after cochlear implantation
Authors: Hänsel Toni , Gauger Ulrich , Bernhard Nikolai , Behzadi Nina , Romo Ventura Maria Eugenia , Hofmann Veit , Olze Heidi , Knopke Steffen , Todt Ingo , Coordes Annekatrin
Published: January 2018

Objective

Postoperative vertigo is a common complaint after cochlear implantation, but published incidence rates differ vastly. The aim of the present study was to investigate both subjective complaints of vertigo before and after cochlear implantation and related vestibular diagnostic tests on cochlear implant candidates.

Data Sources

We performed a systematic literature search according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement in PubMed, Cochrane Register, and EMBASE.

Review Methods

We presented 116 eligible studies investigating subjective complaints of vertigo after cochlear implantation and/or related vestibular diagnostic tests. We conducted three meta‐analyses of 46 eligible studies with matched pre‐ and postoperative data to calculate the odds ratio of new vertigo onset, as well as the impairment of vestibular receptors measured by nystagmography and cervical vestibular evoked myogenic potentials (cVEMP). Postoperative vertigo was calculated from 95 studies and further subdivided by mean age with pooled data.

Results

We observed a significant increase in postoperative vertigo and significant impairment of nystagmography and cVEMP detection. Vertigo after cochlear implantation was reported in 9.3% of the patients with a continuous increase in patient age at surgery. In a subgroup of studies, new onset of vertigo was found in 17.4% of the patients. In addition, 7.2% of the patients had persisting vertigo complaints, whereas 11.6% described an altered vertigo quality and 7.7% had their preoperative complaints resolved. A comparison of round window approach and cochleostomy revealed significantly increased vertigo after cochleostomy. Both insertion methods showed similar effects in nystagmography and cVEMP testing.

Conclusion

Cochlear implantation has a significant impact on subjective vertigo and vestibular receptor function. This is affected by the patient's age at the time of surgery. The surgical technique (round window or cochleostomy) may influence the outcome, but this requires further investigation. Younger patients may compensate better following vestibular dysfunction. Perioperative testing is required to correlate vestibular impairment and subjective complaints.Laryngoscope, 2018Laryngoscope, 128:2110–2123, 2018
Esophagram findings in cervical esophageal stenosis: A case‐controlled quantitative analysis
Authors: West Jacob , Kim Cherine H. , Reichert Zachary , Krishna Priya , Crawley Brianna K. , Inman Jared C.
Published: January 2018

Objective

Cervical esophageal stenosis is often diagnosed with a qualitative evaluation of a barium esophagram. Although the esophagram is frequently the initial screening exam for dysphagia, a clear objective standard for stenosis has not been defined. In this study, we measured esophagram diameters in order to establish a quantitative standard for defining cervical esophageal stenosis that requires surgical intervention.

Study Design

Single institution case‐control study.

Methods

Patients with clinically significant cervical esophageal stenosis defined by moderate symptoms of dysphagia (Functional Outcome Swallowing Scale > 2 and Functional Oral Intake Scale < 6) persisting for 6 months and responding to dilation treatment were matched with age, sex, and height controls. Both qualitative and quantitative barium esophagram measurements for the upper, mid‐, and lower vertebral bodies of C5 through T1 were analyzed in lateral, oblique, and anterior–posterior views.

Results

Stenotic patients versus nonstenotic controls showed no significant differences in age, sex, height, body mass index, or ethnicity. Stenosis was most commonly at the sixth cervical vertebra (C 6) lower border and C7 upper border. The mean intraesophageal minimum/maximum ratios of controls and stenotic groups in the lateral view were 0.63 ± 0.08 and 0.36 ± 0.12, respectively (P < 0.0001). Receiver operating characteristic analysis of the minimum/maximum ratios, with a <0.50 ratio delineating stenosis, demonstrated that lateral view measurements had the best diagnostic ability. The sensitivity of the radiologists' qualitative interpretation was 56%. With application of lateral intraesophageal minimum/maximum ratios, we observed improved sensitivity to 94% of the esophagram, detecting clinically significant stenosis.

Conclusion

Applying quantitative determinants in esophagram analysis may improve the sensitivity of detecting cervical esophageal stenosis in dysphagic patients who may benefit from surgical therapy.

Level of Evidence

IIIb. Laryngoscope, 128:2022–2028, 2018
Publication trends and levels of evidence in obstructive sleep apnea literature
Authors: Gouveia Christopher J. , Zaghi Soroush , Awad Michael , Camacho Macario , Liu Stanley Y. C. , Capasso Robson , Kern Robert C.
Published: January 2018

Objectives/Hypothesis

Examine trends in clinical research and levels of evidence related to obstructive sleep apnea (OSA) in the medical literature. Describe the features and trends of OSA research within otolaryngology journals.

Study Design

Retrospective analysis.

Methods

Review of OSA research articles from 2006, 2011, and 2016 in four leading medical sleep and otolaryngology journals. Level of evidence was graded, and study characteristics were measured.

Results

Seven hundred eight total articles were reviewed. OSA articles significantly increased in both number and proportion of total articles in the medical sleep (P < .001) and otolaryngology (P = .004) journals. Surgically focused articles did not significantly increase in either literature. There was no significant difference between medical sleep and otolaryngology literature levels of evidence regarding OSA, and no trend toward higher levels of evidence over time. Medical sleep publications had significantly higher proportions of grant‐funded (P < .001) and National Institutes of Health (NIH)–funded (P < .001) publications versus otolaryngology journals. Over time, otolaryngology journals had decreasing numbers of grant‐funded and NIH‐funded projects.

Conclusions

OSA research is increasingly present in medical sleep and otolaryngology literature. Levels of evidence are modest for the two specialties, and have shown no trend toward increasing over time. Concurrently, otolaryngologists are less likely to be grant funded than their medical colleagues, and sleep surgery has stagnated in the studied journals. This study encourages continued efforts to publish high‐quality research on OSA. It may also help guide our specialty when setting priorities regarding research funding and support for sleep surgeons.

Level of Evidence

NA Laryngoscope, 128:2193–2199, 2018
Reducing rates of operative intervention for pediatric post‐tonsillectomy hemorrhage
Authors: Whelan Rachel L. , Shaffer Amber , Anderson Martin E. , Hsu Jessica , Jabbour Noel
Published: January 2018

Objectives/Hypothesis

The aims of this study were to determine the frequency of rebleeding in patients admitted for observation after presentation for nonactive hemorrhage in the post‐tonsillectomy period, compare rebleeding rates between patients managed with observation versus initial operative control, and describe the complication profile associated with observation as a management strategy for post‐tonsillectomy bleeding.

Study Design

Case series with retrospective review of patients.

Methods

Patients presenting from September 1, 2013 to August 31, 2015 for post‐tonsillectomy hemorrhage to a tertiary pediatric care center were evaluated for inclusion in the study. Inclusion criteria included patients ≤18 years of age without active bleeding at the time of the initial examination. Proportions were compared using χ2 and Fisher exact tests, whereas continuous data were compared using the Wilcoxon rank sum test.

Results

Of 3,866 tonsillectomy patients, 285 (7.4%) presented with concern for oropharyngeal bleeding in the postoperative period, of whom 224 were admitted for nonactive bleeding. Of patients with nonactive bleeding, 203 (90.6%) were managed with observation and 21 (9.4%) with operative intervention. Rate of rebleeding was 26/203 (12.8%) after inpatient observation and 3/21 (14.3%) after operative intervention (P = 1.000). Frequency of rebleeding requiring operative control in patients undergoing initial observation was 14/203 (6.9%).

Conclusions

In our pilot study, rates of rebleeding in patients observed for nonactive post‐tonsillectomy hemorrhage was not statistically different than those managed with initial operative exploration. Although preliminary in nature, our data suggest observation may have comparable safety and efficacy when compared to operative management for pediatric patients presenting with nonactive post‐tonsillectomy bleeding. Further data collection to establish an optimal management algorithm is ongoing.

Level of Evidence

4 Laryngoscope, 1958–1962, 2018
Economic evaluation of floseal compared to nasal packing for the management of anterior epistaxis
Authors: Le Andre , Thavorn Kednapa , Lasso Andrea , Kilty Shaun J.
Published: January 2018

Objectives/Hypothesis

To evaluate the cost‐effectiveness of Floseal, a topically applied hemostatic agent, and nasal packing for the management of epistaxis in Canada.

Study Design

Outcomes research, a cost‐utility analysis.

Methods

We developed a Markov model to compare the costs and health outcomes of Floseal with nasal packing over a lifetime horizon from the perspective of a publicly funded healthcare system. A cycle length of 1 year was used. Efficacy of Floseal and packing was sought from the published literature. Unit costs were gathered from a hospital case costing system, whereas physician fees were extracted from the Ontario Schedule of Benefits for Physician Services. Results were expressed as an incremental cost per quality‐adjusted life year (QALY) gained. A series of one‐way sensitivity and probabilistic sensitivity analyses were performed.

Results

From the perspective of a publicly funded health are system, the Floseal treatment strategy was associated with higher costs ($2,067) and greater QALYs (0.27) than nasal packing. Our findings were highly sensitive to discount rates, the cost of Floseal, and the cost of nasal packing. The probabilistic sensitivity analysis suggested that the probability that Floseal treatment is cost‐effective reached 99% if the willingness‐to‐pay threshold was greater than $120,000 per QALY gained.

Conclusions

Prior studies have demonstrated Floseal to be an effective treatment for anterior epistaxis. In the Canadian healthcare system, Floseal treatment appears to be a cost‐effective treatment option compared to nasal packing for anterior epistaxis.

Level of Evidence

2c Laryngoscope, 1778–1782, 2018
On the discretisation in time of the stochastic Allen–Cahn equation
Authors: Kovács Mihály , Larsson Stig , Lindgren Fredrik
Published: January 2018

We consider the stochastic Allen–Cahn equation perturbed by smooth additive Gaussian noise in a bounded spatial domain with smooth boundary in dimension , and study the semidiscretisation in time of the equation by an Euler type split‐step method with step size . We show that the method converges strongly with a rate . By means of a perturbation argument, we also establish the strong convergence of the standard backward Euler scheme with the same rate.
Algebraic cycles and EPW cubes
Authors: Laterveer Robert
Published: January 2018

Let X be a hyperkähler variety with an anti‐symplectic involution ι. According to Beauville's conjectural “splitting property”, the Chow groups of X should split in a finite number of pieces such that the Chow ring has a bigrading. The Bloch–Beilinson conjectures predict how ι should act on certain of these pieces of the Chow groups. We verify part of this conjecture for a 19‐dimensional family of hyperkähler sixfolds that are “double EPW cubes” (in the sense of Iliev–Kapustka–Kapustka–Ranestad). This has interesting consequences for the Chow ring of the quotient , which is an “EPW cube” (in the sense of Iliev–Kapustka–Kapustka–Ranestad).
Indaceno‐Based Conjugated Polymers for Polymer Solar Cells
Authors: Yin Yuli , Zhang Yong , Zhao Liancheng
Published: January 2018

Polymer solar cells have received considerable attention due to the advantages of low material cost, tunable band gaps, ultralight weight, and high flexible properties, and they have been a promising organic photovoltaic technology for alternative non‐renewable fossil fuels for the past decade. Inspired by these merits, numerous state‐of‐the‐art organic photovoltaic materials have been constructed. Among them, indaceno‐based polymer materials have made an impact in obtaining an impressive power conversion efficiency of more than 11%, which shows the momentous potential of this class of materials for commercial applications. In this review, recent progress of indaceno‐based organic polymer solar cells are reviewed, and the structure–property device performance correlations of the reported materials are highlighted. Then, common regularities of these successful cases are collected, and encouraging viewpoints on the further development of more exciting indaceno‐based organic photovoltaic materials are provided.
Oncogene RNA helicase DDX6 promotes the process of c‐Myc expression in gastric cancer cells
Authors: Taniguchi Kohei , Iwatsuki Ayako , Sugito Nobuhiko , Shinohara Haruka , Kuranaga Yuki , Oshikawa Yuki , Tajirika Toshihiro , Futamura Manabu , Yoshida Kazuhiro , Uchiyama Kazuhisa , Akao Yukihiro
Published: January 2018

Human DEAD‐box RNA helicase gene DDX6 was cloned from B‐cell lymphoma cell line RC‐K8. Previously, we reported that DDX6 acts as oncogene in several cancers such as colorectal cancer and hepatocellular carcinoma. However, the detailed mechanism of DDX6 action in carcinogenesis is largely unknown. In this study, we examined the functions of DDX6 in clinical gastric cancer (GC) samples and GC cells. DDX6 protein expression levels of cancer samples were higher than those of the adjacent normal tissues in 25 clinical GC samples (median value: 1.4 times higher). Also, the results of an RNA immunoprecipitation‐assay (RIP‐assay) showed that DDX6 associated with c‐Myc mRNA. Moreover, enforced overexpression of DDX6 promoted both mRNA and protein expression of c‐Myc in GC cells. On the other hand, the gene silencing of DDX6 induced growth suppression through down‐regulation of c‐Myc in GC cells grown in either two or three dimensions. Furthermore, c‐Myc mRNA expression levels of cancer samples were higher than those of the adjacent normal tissues in DDX6 up‐regulated‐GC clinical samples. Our findings in this study suggested that DDX6 acted as oncogene in GC cells through promotion of c‐Myc expression by association with the mRNA of c‐Myc.
Integrating exome sequencing into a diagnostic pathway for epileptic encephalopathy: Evidence of clinical utility and cost effectiveness
Authors: Palmer Elizabeth E. , Schofield Deborah , Shrestha Rupendra , Kandula Tejaswi , Macintosh Rebecca , Lawson John A. , Andrews Ian , Sampaio Hugo , Johnson Alexandra M. , Farrar Michelle A. , Cardamone Michael , Mowat David , Elakis George , Lo William , Zhu Ying , Ying Kevin , Morris Paula , Tao Jiang , Dias Kerith‐Rae , Buckley Michael , Dinger Marcel E. , Cowley Mark J. , Roscioli Tony , Kirk Edwin P. , Bye Ann , Sachdev Rani K.
Published: January 2018

Background

Epileptic encephalopathies are a devastating group of neurological conditions in which etiological diagnosis can alter management and clinical outcome. Exome sequencing and gene panel testing can improve diagnostic yield but there is no cost‐effectiveness analysis of their use or consensus on how to best integrate these tests into clinical diagnostic pathways.

Methods

We conducted a retrospective cost‐effectiveness study comparing trio exome sequencing with a standard diagnostic approach, for a well‐phenotyped cohort of 32 patients with epileptic encephalopathy, who remained undiagnosed after “first‐tier” testing. Sensitivity analysis was included with a range of commercial exome and multigene panels.

Results

The diagnostic yield was higher for the exome sequencing (16/32; 50%) than the standard arm (2/32; 6.2%). The trio exome sequencing pathway was cost‐effective compared to the standard diagnostic pathway with a cost saving ofAU$5,236 (95% confidence intervals $2,482; $9,784) per additional diagnosis; the standard pathway cost approximately 10 times more per diagnosis. Sensitivity analysis demonstrated that the majority of commercial exome sequencing and multigene panels studied were also cost‐effective. The clinical utility of all diagnoses was reported.

Conclusion

Our study supports the integration of exome sequencing and gene panel testing into the diagnostic pathway for epileptic encephalopathy, both in terms of cost effectiveness and clinical utility. We propose a diagnostic pathway that integrates initial rapid screening for treatable causes and comprehensive genomic screening. This study has important implications for health policy and public funding for epileptic encephalopathy and other neurological conditions.
An extension of the Gegenbauer pseudospectral method for the time fractional Fokker‐Planck equation
Authors: Izadkhah Mohammad Mahdi , Saberi‐Nadjafi Jafar , Toutounian Faezeh
Published: January 2018

The time fractional Fokker‐Planck equation has been used in many physical transport problems which take place under the influence of an external force field. In this paper we examine pseudospectral method based on Gegenbauer polynomials and Chebyshev spectral differentiation matrix to solve numerically a class of initial‐boundary value problems of the time fractional Fokker‐Planck equation on a finite domain. The presented method reduces the main problem to a generalized Sylvester matrix equation, which can be solved by the global generalized minimal residual method. Some numerical experiments are considered to demonstrate the accuracy and the efficiency of the proposed computational procedure.
On quasi‐contractive multivalued mappings' open problem in complete metric spaces
Authors: Roldan Lopez de Hierro Antonio Francisco , Khojasteh Farhsid , Moradi Sirous
Published: January 2018

In recent years, many authors have introduced some fixed point theorems for multivalued quasi‐contraction whose contractivity constants α belonged to the interval
. However, as Amini‐Harandi pointed out, it is not clear whether such results also hold when
. Up to now, efforts in this direction either have failed or have been lessened to a lighter version. The main result of the current manuscript gives a partial positive answer to the above‐mentioned problem by adding a necessary and sufficient condition to guarantee existence of strict fixed points of quasi‐contractive multivalued mappings. This problem has remained open for many years. In addition to this, 2 examples are shown to support given results.
Naringin Protects Pancreatic β‐Cells Against Oxidative Stress‐Induced Apoptosis by Inhibiting Both Intrinsic and Extrinsic Pathways in Insulin‐Deficient Diabetic Mice
Authors: Lim Ye Jin , Kim Jung Ho , Pan Jeong Hoon , Kim Jae Kyeom , Park Tae‐Sik , Kim Young Jun , Lee Jin Hyup , Kim Jun Ho
Published: January 2018

Scope

Oxidative stress has been suggested to play a central role in the pathogenesis of diabetes, as well as other metabolic disorders. Naringin, a major flavanone glycoside in citrus species, has been shown to display strong antioxidant potential in in vitro and in vivo models of oxidative stress; however, the underlying protective mechanisms in diabetes are unclear.

Methods and results

To study the protective effects and molecular mechanisms of naringin in preventing islet dysfunction and diabetes, we examined glucose homeostasis, β‐cell apoptosis, and inflammatory response in insulin‐deficient diabetic mice exposed to acute oxidative stress with streptozotocin (STZ). Naringin dose‐dependently ameliorated hyperglycemia and islet dysfunction in insulin‐deficient diabetic mice. Naringin counteracted STZ‐induced β‐cell apoptosis by inhibiting both the intrinsic (mitochondria‐mediated) and extrinsic (death receptor‐mediated) pathways. Furthermore, these protective effects were associated with suppression of DNA damage response and nuclear factor–kappa B– and mitogen–activated protein kinase–mediated signaling pathways, as well as reduction of reactive oxygen species accumulation and pro‐inflammatory cytokine production in the pancreas.

Conclusion

Taken together, our study provides insights into the underlying mechanisms through which naringin protects the pancreatic β‐cells against oxidative stress‐induced apoptosis.
Methods to reduce false reporting of substance abstinence in clinical research
Authors: Japuntich Sandra J. , Arditte Hall Kimberly A. , Joos Celina M. , Rasmusson Ann M. , Pineles Suzanne L.
Published: January 2018

Objectives

Substance use may influence study results in human subjects research. This study aims to report the concordance between self‐report and biochemical assessments of substance use and test the effect of methods to reduce false reports of abstinence in trauma‐exposed women participating in a research study.

Methods

In this pilot study, substance use was assessed during telephone prescreening and via self‐report and biochemical verification (i.e., urine toxicology and alcohol breathalyzer tests) at an in‐person evaluation. Due to the high number of participants who tested positive for substances despite self‐reporting abstinence during prescreening, study procedures were modified to disincentivize false self‐reports of substance use two thirds of the way through recruitment. New potential participants were explicitly informed during prescreening and informed consent that a positive drug or alcohol test during screening would result in exclusion from the study and withholding of payment.

Results

Prior to modifying study methods, 20% of participants who had reported abstinence during the telephone prescreen had a positive substance use test at the in‐person visit. Modifying study procedures resulted in an 81% decrease in positive substance use assessments.

Conclusions

Adoption of this methodology may decrease inadvertent confounding of clinical research outcomes by undetected and/or misreported substance use.