bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding Winter Precipitation Impacts on Automated Gauge Observations within a Real-Time System
Authors: Martinaitis Steven M. , Cocks Stephen B. , Qi Youcun , Kaney Brian T. , Zhang Jian , Howard Kenneth
Published: August 2015

Precipitation gauge observations are routinely classified as ground truth and are utilized in the verification and calibration of radar-derived quantitative precipitation estimation (QPE). This study quantifies the challenges of utilizing automated hourly gauge networks to measure winter precipitation within the real-time Multi-Radar Multi-Sensor (MRMS) system from 1 October 2013 to 1 April 2014. Gauge observations were compared against gridded radar-derived QPE over the entire MRMS domain. Gauges that reported no precipitation were classified as potentially stuck in the MRMS system if collocated hourly QPE values indicated nonzero precipitation. The average number of potentially stuck gauge observations per hour doubled in environments defined by below-freezing surface wet-bulb temperatures, while the average number of observations when both the gauge and QPE reported precipitation decreased by 77%. Periods of significant winter precipitation impacts resulted in over a thousand stuck gauge observations, or over 10%–18% of all gauge observations across the MRMS domain, per hour. Partial winter impacts were observed prior to the gauges becoming stuck. Simultaneous postevent thaw and precipitation resulted in unreliable gauge values, which can introduce inaccurate bias correction factors when calibrating radar-derived QPE. The authors then describe a methodology to quality control (QC) gauge observations compromised by winter precipitation based on these results. A comparison of two gauge instrumentation types within the National Weather Service (NWS) Automated Surface Observing System (ASOS) network highlights the need for improved gauge instrumentation for more accurate liquid-equivalent values of winter precipitation.
Dynamic Magnetic Resonance Imaging of the Pharynx during Deglutition
Authors: Amin Milan R. , Achlatis Stratos , Lazarus Cathy L. , Branski Ryan C. , Storey Pippa , Praminik Bidyut , Fang Yixin , Sodickson Daniel K.
Published: August 2015

Objectives:

We utilized dynamic magnetic resonance imaging to visualize the pharynx and upper esophageal segment in normal, healthy subjects.

Methods:

A 3-T scanner with a 4-channel head coil and a dual-channel neck coil was used to obtain high-speed magnetic resonance images of subjects who were swallowing liquids and pudding. Ninety sequential images were acquired with a temporal resolution of 113 ms. Imaging was performed in axial planes at the levels of the oropharynx and the pharyngoesophageal segment. The images were then analyzed for variables related to alterations in the area of the pharynx and pharyngoesophageal segment during swallowing, as well as temporal measures related to these structures.

Results:

All subjects tolerated the study protocol without complaint. Changes in the area of the pharyngeal wall lumen and temporal measurements were consistent within and between subjects. The inter-rater and intra-rater reliabilities for the measurement tool were excellent.

Conclusions:

Dynamic magnetic resonance imaging of the swallow sequence is both feasible and reliable and may eventually complement currently used diagnostic methods, as it adds substantive information.
New Method for in-Office Secondary Voice Prosthesis Insertion under Local Anesthesia by Reverse Puncture from Esophageal Lumen
Authors: Fukuhara Takahiro , Fujiwara Kazunori , Nomura Kenichi , Miyake Naritomo , Kitano Hiroya
Published: August 2015

Objectives:

We clarify and demonstrate the utility of our new method of voice prosthesis insertion using puncture from the esophageal lumen.

Methods:

Our new reverse puncture method using a flexible endoscope can be performed in an outpatient clinic under local anesthesia. We conducted a clinical trial with patients with head and neck cancer between April 2010 and February 2012. Our study focused on the following three points: 1) the percentage of patients for whom the procedure was successful; 2) the duration of the operation; and 3) any adverse effects.

Results:

The puncture was performed successfully for 21 of 22 patients (95%). The mean duration of the operation, excluding the time for local anesthesia, was only 11.6 minutes. All patients began voice rehabilitation and attained peroral intake immediately after the operation. None of the patients suffered complications from the procedures.

Conclusions:

Most patients were treated with our new method with ease and at low risk. The high success rate and the absence of complications demonstrate the benefits of our method. We conclude that our method can be recommended for secondary reverse tracheoesophageal puncture.
Correlation between Expression of Extracellular Matrix Metalloproteinase Inducer and Matrix Metalloproteinase-2 and Cervical Lymph Node Metastasis of Nasopharyngeal Carcinoma
Authors: Huang Tian , Chen Mao-Huai , Wu Ming-Yao , Wu Xian-Ying
Published: August 2015

Objectives:

We evaluated the expression of extracellular matrix metalloproteinase inducer (EMMPRIN) and matrix metalloproteinase-2 (MMP-2) in nasopharyngeal carcinoma (NPC) and studied their relationship with cervical lymph node metastasis.

Methods:

Immunohistochemical staining was used to detect the expression of EMMPRIN and MMP-2 in specimens from patients with chronic nasopharyngitis (CN), nonmetastastic NPC (NM-NPC), and lymph node–metastatic NPC (LNM-NPC).

Results:

The rates of positive EMMPRIN expression in CN, NM-NPC, and LNM-NPC were 13.3%, 30.0%, and 66.7%, respectively. Significant differences were found between the rates in CN and LNM-NPC (p < 0.01) and between the rates in NM-NPC and LNM-NPC (p = 0.01). In the LNM-NPC group, NPC cells had a higher rate of expression of EMMPRIN in tumor metastases than in the primary tumor (81.8% versus 66.7%; p = 0.01). The rates of positive MMP-2 expression in CN, NM-NPC, and LNM-NPC were 13.3%, 35.0%, and 60.6%, respectively. A significant difference was found between the rates in CN and LNM-NPC (p < 0.01). In the LNM-NPC group, NPC cells had a higher rate of MMP-2 expression in tumor metastases than in the primary tumor (72.7% versus 60.6%; p < 0.01). The expressions of MMP-2 and EMMPRIN were highly correlated (rs = 0.466; p < 0.01).

Conclusions:

Nasopharyngeal carcinoma cells may attain enhanced metastastic capability through the expression of MMP-2 induced by EMMPRIN.
Revision Zenker Diverticulum: Laser versus Stapler Outcomes following Initial Endoscopic Failure
Authors: Adam Stewart I. , Paskhover Boris , Sasaki Clarence T.
Published: August 2015

Objectives:

We used a retrospective chart review to analyze revision endoscopic carbon dioxide (CO2) laser and staple repairs of recurrent Zenker diverticulum (ZD).

Methods:

The medical records of patients with recurrent ZD after primary endoscopic repair were selected. The chart data included method of repair (CO2 laser or stapler), demographics (age and sex), defect size (in centimeters), preoperative and postoperative symptoms, and complications. Patients' dysphagia was graded on a modified Functional Oral Intake Scale from 1 to 4 (1 being normal intake and 4 being severely limited intake or gastrostomy tube dependence). Regurgitation was also graded on a 1-to-4 scale (1 being no regurgitation and 4 being aspiration).

Results:

A total of 148 consecutive patients with ZD were treated with endoscopic repair between 2000 and 2010. Twelve of these patients had revisions after failed primary endoscopic management procedures, all done with the stapler. Eight revision surgeries were performed by CO2 laser, and 4 by stapler repair. No difference was noted in patient age or defect size (laser, 3.06-cm defects; stapler, 2.75-cm defects). The length of hospital stay and the time to oral intake for the patients who had a revision stapler procedure were significantly greater (p values of 0.029 and 0.009) than those for the patients in the primary stapler procedure group. Better postoperative regurgitation scores were noted for patients who had a CO2 laser procedure.

Conclusions:

Secondary endoscopic repair for ZD recurrence is an effective treatment method. Better symptom outcomes were observed with secondary CO2 laser repair than with stapler revision. Patients with revision stapling had longer hospital stays and a longer time to oral intake than did patients with primary staple repairs.
Standardization of Reporting Post-Tonsillectomy Bleeding
Authors: Walner David L. , Karas Anatoli
Published: August 2015

Objectives:

Postoperative bleeding is a well-recognized complication after tonsillectomy. We believe significant variation exists in how bleeding following tonsillectomy is reported and that a standardized system is needed. Our goal was to develop such a system.

Methods:

Relevant literature was found on Ovid Medline. Studies published from 1996 to 2009 involving post-tonsillectomy bleeding were analyzed, and data were collected on the basis of strict criteria. A standardized system for reporting post-tonsillectomy bleeding was then developed.

Results:

A review of the literature found variation in the reporting of post-tonsillectomy bleeding and found that categorization systems for reporting bleeding are often not used. The following standardization system is proposed. Type I is bleeding, historical or observed, that does not require any intervention or control of the bleeding (except for oral rinses or intravenous administration of fluids). Type II is bleeding that requires control with local measures under topical or local anesthesia. Type III is bleeding that requires control with local measures, suture ligation, and/or aggressive cauterization in the operating room. Type IV is bleeding that requires control that includes external carotid artery ligation or embolization. Type V is bleeding that leads to the patient's death. The postoperative day on which the bleeding occurs is also reported.

Conclusions:

The literature on tonsillectomy varies greatly in describing and reporting post-tonsillectomy bleeding. We propose a system to standardize the reporting of post-tonsillectomy bleeding.
Recurrent Laryngeal Nerve Transection and Anastomosis: Rat Laryngeal Motoneuron Survival and Effect of the Anastomosis Site
Authors: Pitman Michael J. , Berzofsky Craig , Alli Opeyemi , Sharma Sansar
Published: August 2015

Objectives:

We investigated the quantity of recurrent laryngeal nerve motoneurons (RLNMs) that survive after transection and anastomosis of the rat recurrent laryngeal nerve (RLN), as well as the impact of the anastomosis site on RLN regeneration.

Methods:

Ten rats underwent right RLN transection and anastomosis. After 16 weeks, Fluoro-Ruby (FR) was applied to the RLN that was transected proximal or distal to the anastomosis site. The brain stems were harvested, and the nucleus ambiguus was evaluated for labeled RLNMs. The RLNM counts were compared to each other and to those from 3 control rats in which FR was applied to an acutely transected RLN.

Results:

The number of RLNMs that were stained after RLN transection, anastomosis, and regeneration was consistent with the total number of RLNMs in the nucleus ambiguus of control rats. This finding confirms that most RLNMs survived after RLN transection and anastomosis. The quantity of labeled RLNMs was statistically similar whether the FR was applied proximal or distal to the anastomosis, implying that most of the viable axons that were present proximal to the anastomosis crossed into the distal nerve.

Conclusions:

Rat RLNMs survive nerve transection, anastomosis, and regeneration. The anastomosis site does not significantly impede axonal regeneration, and most of the axons traverse the anastomosis into the distal nerve.
Autism spectrum disorder: Presentation and prevalence in a nationally representative Australian sample
Authors: Randall Melinda , Sciberras Emma , Brignell Amanda , Ihsen Elfriede , Efron Daryl , Dissanayake Cheryl , Williams Katrina
Published: August 2015

Objective:

The aim of this study was to identify the prevalence of parent-reported autism spectrum disorder diagnosis in Australia, and examine the developmental profile of children with autism spectrum disorder compared to their peers.

Design/Setting:

Secondary analyses were undertaken on data from the Longitudinal Study of Australian Children.

Participants:

Children were recruited at kindergarten (K cohort) and birth (B cohort), and subsequently completed two-yearly ‘waves’ of assessments.

Main Outcomes:

Autism spectrum disorder diagnostic status was ascertained at Wave 4 along with age of diagnosis by parent report. Standardised tools were used to assess children’s quality of life, behaviour, receptive vocabulary and non-verbal intelligence.

Results:

Prevalence of autism spectrum disorder was 2.5% (95% confidence interval = [2.0, 3.0]) in the B cohort compared to 1.5% (95% confidence interval = [1.2, 2.0]) in the K cohort. In both cohorts, children with autism spectrum disorder had poorer mean quality of life, emotional-behavioural functioning and receptive vocabulary compared with non-autism spectrum disorder peers, and a higher proportion of children with autism spectrum disorder had problems in these areas. However, between 6% and 9% of children with moderate to severe autism spectrum disorder and 12–20% with mild autism spectrum disorder were not reported to have problems with social interaction.

Conclusion:

The prevalence of a parent-reported diagnosis of autism spectrum disorder before age 7 in Australia was higher in the B cohort. Data from future Longitudinal Study of Australian Children waves will clarify whether autism spectrum disorder has been diagnosed earlier in the B cohort or if there is a continued increase in prevalence. Future waves will also provide crucial information about the types and severity of problems experienced during the primary and secondary school years which will assist service planning.
Environmental Behavior in Cross-National Perspective
Authors: Pisano Ignacio , Lubell Mark
Published: August 2015

This article seeks to explain cross-national differences on environmental behavior. After controlling for a series of sociodemographic and psychosocial factors, it was predicted that national levels of wealth, postmaterialism, education development, and environmental problems are positively related to environmental behavior. The national-level variance is to a substantial degree explained by individual-level variables, capturing compositional effects. The remaining variance is explained by the contextual-level variables. All of the country-level variables are predictors in the expected direction, with the exception of environmental degradation, which is negatively related to behavior, and education development, which has no impact on private environmental behavior. More importantly, cross-level interactions show that in more developed countries, there are stronger relationships between proecological attitudes and reported proenvironmental behavior. These findings contribute to the growing cross-cultural research on environmental behavior pointing out the necessity of simultaneously assessing the effects of both individual and contextual-level forces affecting behavior across nations.
Assessing Technology in the Absence of Proof
Authors: de Vries Peter W. , van den Berg Stéphanie M. , Midden Cees
Published: August 2015

Objective:

The present research addresses the question of how trust in systems is formed when unequivocal information about system accuracy and reliability is absent, and focuses on the interaction of indirect information (others’ evaluations) and direct (experiential) information stemming from the interaction process.

Background:

Trust in decision-supporting technology, such as route planners, is important for satisfactory user interactions. Little is known, however, about trust formation in the absence of outcome feedback, that is, when users have not yet had opportunity to verify actual outcomes.

Method:

Three experiments manipulated others’ evaluations (“endorsement cues”) and various forms of experience-based information (“process feedback”) in interactions with a route planner and measured resulting trust using rating scales and credits staked on the outcome. Subsequently, an overall analysis was conducted.

Results:

Study 1 showed that effectiveness of endorsement cues on trust is moderated by mere process feedback. In Study 2, consistent (i.e., nonrandom) process feedback overruled the effect of endorsement cues on trust, whereas inconsistent process feedback did not. Study 3 showed that although the effects of consistent and inconsistent process feedback largely remained regardless of face validity, high face validity in process feedback caused higher trust than those with low face validity. An overall analysis confirmed these findings.

Conclusion:

Experiential information impacts trust even if outcome feedback is not available, and, moreover, overrules indirect trust cues—depending on the nature of the former.

Application:

Designing systems so that they allow novice users to make inferences about their inner workings may foster initial trust.
The Effects of Age, Gender, and Hand on Force Control Capabilities of Healthy Adults
Authors: Lee Baekhee , Lee Mina , Yoh Myeung Sook , You Heecheon , Park Hyunji , Jung Kihyo , Lee Byung Hwa , Na Duk L. , Kim Geon Ha
Published: August 2015

Objective:

The present study examined the effects of age (20s to 70s), gender (male and female), and hand (dominant and nondominant) on force control capabilities (FCCs) in four force control phases (initiation, development, maintenance, and termination).

Background:

Normative data of FCCs by force control phase are needed for various populations in age and gender to identify a type of motor performance reduction and its severity.

Method:

FCCs of 360 participants (30 for each combination of age group and gender) were measured using a finger dynamometer and quantified in terms of initiation time (IT), development time (DT), maintenance error (ME), and termination time (TT).

Results:

Although gradual increases (1%~28%) by age were shown in IT, DT, and TT, a dramatic increase in ME was observed among participants in their 50s (26%), 60s (68%), and 70s (160%) compared to those in their 20s~40s. The most distinctive interaction effect of age and gender was found in ME out of the four FCC measures. Lastly, hand and its related interactions were not found significant.

Conclusion:

Normative FCC data were established for four age groups (20s~40s, 50s, 60s, and 70s) and gender.

Application:

The normative FCC data can be used for evaluating an individual’s motor performance, screening patients with brain disorders, and designing input devices triggered and/or operated by the finger.
Effect of Load Distribution on the Fiber Buckling Strength of Unidirectional Composites
Authors: Lessard Larry B. , Chang Fu-Kuo
Published: August 2015

An investigation was performed to study the fiber buckling failure of fiber-reinforced composites. This work was especially focused on understanding the effect of fiber-matrix interaction due to nonuniform loading on fiber buckling strength of unidirectional composites. An analytical model based on the energy principle was developed for predicting the fiber buckling strength of unidirectional composites. The model, which included the fiber bending energy and the matrix shearing energy, also considered the matrix extension energy which was attributed to the interaction between the fibers and the matrix. Numerical solutions were generated from the model to study the effect of fiber-matrix interaction on the fiber buckling strength of composites subjected to different types of loadings. Based on the calculations, it was found that the inclusion of fiber-matrix interaction in the fiber buckling analysis is very important for composites with nonuniform stress distributions. This becomes especially important for notched laminates and thick section composites subjected to compressive loading.
Characterization of Face Sheet/Core Shear Fracture of Composite Sandwich Beams
Authors: Carlsson L. A. , Sendlein L. S. , Merry S. L.
Published: August 2015

Debonding failure of cored composite materials is investigated herein. A new test method that subjects the bondline between the core and face sheets to a shear stress singularity is presented and studied analytically by laminated beam shear deformation theory and experimentally on glass/polyester face sheets on balsa wood core sandwich beams.
How Do Friends Manage Income Differences? The Role of Lay Concepts of Justice in the Erosion of Income-Bridging Friendships and Social Segregation
Authors: Pellandini-Simányi Léna
Published: August 2015

When maintaining status-bridging friendships, people encounter inequalities in the context of their most intimate relationships. Using interview data on how people manage friendships with significantly poorer and richer friends in Hungary, this article explores lay discourses of inequality and justice, and the processes through which they lead to the decay (or the preservation) of income-bridging friendships at the micro level and to social segregation at the macro level. It shows, first, that different – egalitarian versus meritocratic – lay conceptions of inequality and justice translate into different everyday strategies of managing income-bridging friendships, focused on the hiding versus legitimization of inequalities, respectively. Second, it traces how both of these strategies, which are aimed at maintaining income-bridging friendships, eventually lead to their decay and to growing segregation between social classes.
Qumran Scholarship and the Study of the Old Testament in the New Testament
Authors: Lim Timothy H.
Published: August 2015

This article argues that Qumran scholarship provides contextual and contingent perspectives in the study of the use of scripture by the New Testament authors. First, post-Qumran textual criticism has highlighted textual diversity in the period of the New Testament, raising questions about alleged exegetical variants as well as the characterizations of the Pauline citations as ‘septuagintal’. Second, while the canon of the Hebrew Bible remained open in the middle of the ﬁrst century, Paul’s implied bible was consistent with the Pharisaic canon that eventually became the Rabbinic Bible. Finally, the theory of the sectarian matrix both accounts for the use of the same biblical passages and the divergent interpretations of them among various sects in the Second Temple period.
Finding Balance Amid Boundarylessness: An Interpretive Study of Entrepreneurial Work–Life Balance and Boundary Management
Authors: Ezzedeen Souha R. , Zikic Jelena
Published: August 2015

In recent years, entrepreneurship has grown as an attractive career alternative, promoting much scholarly attention. Still, little is known about the work–life interface of entrepreneurs, in particular whether entrepreneurship enhances work–life balance or exacerbates conflict between domains. We base this study on boundary theory to explore how subjective perceptions of balance and boundary management might illuminate this contradiction. Indeed, entrepreneurial roles are unique in that they entail high flexibility and permeability, facilitating role blurring, or boundarylessness. We interpretively explored three research questions pertaining to entrepreneurs’ perceptions of their work–life interface and boundaries between roles, as well as the context factors that could explain these perceptions. Findings suggest that several subjective as well as objective factors could explain how entrepreneurial work is sometimes experienced as conflicting, and at other times, perceived as conducive to balance. Theoretical and practical implications and recommendations as well as study limitations are discussed in closing.
Avoiding the Threat
Authors: Williams Jacob , Pazey Barbara , Fall Anna Mária , Yates James R. , Roberts Garrett J.
Published: August 2015

The purpose of this study is to investigate factors that may influence school administrators’ disciplinary decisions involving students with disabilities. Confirmatory factor analysis suggests that the investigator-developed measures adequately represent the hypothesized latent factors per the pattern of observed responses. The hypothesized structural model fits the data well, indicating a positive and significant relationship between administrators’ perceived threats from students with disabilities and disciplinary decisions involving students with disabilities.
A Speech‐to‐Noise Ratio Test with the Bone‐Anchored Hearing Aid: A Comparative Study
Authors: Carlsson Peder , Håkansson Bo , Rosenhall Ulf , Tjellström Anders
Published: August 2015

Hitherto, for persons with impaired hearing who cannot use an air conduction hearing aid, the only alternative has been a conventional spring‐loaded bone conduction hearing aid. Now, with minor surgery, a titanium screw can be implanted in the bone behind the ear and a coupling, which penetrates the skin, can be attached, giving a new kind of hearing aid—the “bone‐anchored hearing aid.” Improved quality of sound is one of the patients’ subjective assessments. Improvement was not confirmed by a standard speech‐discrimination test. With new speech material consisting of sentences in noise, the speech‐to‐noise ratio (SN) has been determined for 24 patients. Patients who previously used a conventional bone conduction hearing aid improved their SN on the average by 3.3 dB. The most important difference between the two aids related to improved SN is probably the increased audibility between 600 and 6000 Hz.
Regenerated Middle Ear Mucosa after Tympanoplasty. Part II. Scanning Electron Microscopy
Authors: Gamoletti Roberto , Lanzarini Paolo , Sanna Mario , Zini Carlo
Published: August 2015

The ultrastructural appearance of the regenerated middle ear epithelium, found at the second operation of staged ICWT with mastoidectomy, has been investigated herein with the scanning electron microscope. The regenerated epithelium consists of flat nonciliated cells, “elevated” nonciliated cells with microvilli, and ciliated cells. Secretory material is present on the surface of the “elevated” nonciliated cells surrounding the ciliated ones. Regeneration of the mucosa occurs following precise topographic differences that mimic the distribution of epithelial cells in the normal middle ear. It is confirmed that a morphologically normal middle ear epithelium regenerates to cover all denuded bone surfaces within 12 months—after first stage ICWT with mastoidectomy—when silicone rubber sheeting has been used to maintain an aerated middle ear and mastoid space.
Middle Ear Semipermeable Membrane Tubes for Prolonged Retention
Authors: Levinson Stephen R. , Gill Alan J.
Published: August 2015

Our 1981 prospective study confirmed the success of semipermeable membrane tubes in ventilation of middle ears, while protecting them from moisture when the patients bathed or swam. That study employed modem membrane tubes, with membrane‐pore size 2.5 to 5 times greater than tubes used in early studies with less favorable outcomes. Currently, 21 patients with effusion had placement of a Donaldson design (Xomed, Inc., Jacksonville, Fla.) membrane tube in one ear and the new T‐grommet membrane tube in the second ear. The T‐grommet membrane tube is found to outlast the Donaldson design tube significantly. We recommend Donaldson membrane tubes for patients having tubes placed for the first time. For subsequent procedures, we employ T‐grommet membrane tubes. We also use the T‐grommet membrane tube for adults with chronic eustachian tube problems. Both tubes continue to show a low Incidence of complications and draw highest praise from patients for their water‐resistant capabilities.
Topographic Analysis of Horner's Syndrome
Authors: Smith Peter G. , Dyches Timothy J. , Burde Ronald M.
Published: August 2015

Horner's syndrome or oculosympathetic paralysis is not an uncommon finding in patients with head and neck neoplasms. While in most cases the syndrome is easily established at the bedside, it can be confirmed and topographically defined as a central, preganglionic, or postganglionic lesion through sequential pharmacologic testing. The importance of such localization lies in differentiating neoplasia vs. a benign condition as the cause of the syndrome. Such variants as congenital Horner's, an alternating Horner's, and a pseudo‐Horner's syndrome are discussed in regard to their differential features.
Allergic Rhinitis—Update
Authors: Settipane Guy A.
Published: August 2015

More than 20% of the general population is afflicted with a common medical disorder—allergic rhinitis. Recent research in rhinitis has brought about much new information and created possibilities for new means and methods of diagnosis and treatment.
Internal Carotid Artery Epistaxis
Authors: Kleid M. Stephen , Millar Hugh S.
Published: August 2015

Epistaxis from the internal carotid artery (ICA) or bleeding from the ICA at the skull base is a rare, frightening, and difficult management problem. We present five cases, with a variety of causes—in all of which the patients survived massive hemorrhage—and suggest a protocol for management of the condition.
Perioperative Evaluation and Care of Patients with Lesions Involving the Skull Base
Authors: Pensak Myles L. , Jackson C. Gary , Glasscock Michael E. , Gulya Aina J.
Published: August 2015

Within the past quarter of a century, contributions to the surgical literature have steadily reflected an increasing interest in the surgical extirpation of lesions involving the skull base. While optimistic reports demonstrate a variety of operative techniques1–9 and clinical experiences,10–12 there has been a paucity of discussion regarding the intraoperative and perioperative management of these complex cases. Cognizant of the fact that the care of these patients is of paramount importance, we herein review our rationale and practiced protocol for management of this unique patient population. The removal of lesions that also require the sacrifice of multiple cranial nerves results in significant postoperative morbidity. With the significant cardiopulmonary challenges attendant upon long procedures, these patients require constant multisystem management. Infection surveillance, wound care, cardiopulmonary support, fluid and nutritional monitoring, vocal and pharyngeal rehabilitation, along with psychological support, manifest in a complicated array of managerial decisions, require an organized approach to optimize patient care.
Marijuana Smoking—Possible Cause of Head and Neck Carcinoma in Young Patients
Authors: Donald Paul J.
Published: August 2015

Six cases of advanced head and neck cancer in young patients, who were regular marijuana users, are presented. Numerous carcinogens, as well as respiratory irritants, are found in marijuana smoke. The active euphoria‐producing agent, Δ‐9 tetrahydrocanabinol, has been implicated in altered DNA, RNA, and protein synthesis and consequent chromosomal aberrations.
Natural History vs. Surgery for Meniere's Disease
Authors: Silverstein Herbert , Smouha Eric , Jones Raleigh
Published: August 2015

Meniere's disease has an episodic course, and certain patients undergo spontaneous remission of their vertigo. A retrospective study of patients treated from 1974 to 1983 was undertaken to evaluate the long‐term outcome of patients with Meniere's disease for whom surgery was recommended, comparing those who had a surgical procedure with a similar group of patients who declined surgery. The surgical procedures performed were endolymphatic subarachnoid shunt (ELS), retrolabyrinthine vestibular neurectomy (RVN), middle fossa vestibular neurectomy (MFVN), and transmeatal cochleovestibular neurectomy (CVN). We used a questionnaire, made up according to the 1985 American Academy of Otolaryngology (AAO) criteria, for reporting results for Meniere's disease treatment, and compared patients who were offered surgery but declined (N = 50) with those who underwent surgery (N = 83). The data were analyzed statistically. Initial evaluation, which included air and bone conduction audiometry, speech discrimination, electronystagmography (ENG), frequency of vertigo attacks per month, and disability, showed both groups to be comparable at the outset. Of the nonoperated group 57% had complete control of vertigo at 2 years; 71% had complete control after an average of 8.3 years. After an ELS, 40% of patients had complete control of vertigo after 2 years; 70% had complete control after an average of 8.7 years. After a neurectomy (RVN or CVN), 93% had complete control of vertigo (average followup, 4.4 years). These results indicate statistically that the ELS procedure does not alter the long‐term natural course of vertigo control in Meniere's disease, whereas both the RVN and CVN significantly improve the patient's chance of being permanently free of vertigo attacks.
Long‐Term Hearing Results following Middle Fossa Vestibular Nerve Section
Authors: Glasscock Michael E. , Johnson Glenn D. , Poe Dennis S.
Published: August 2015

Hearing stabilization following middle fossa vestibular nerve section (MFVNS) has been observed to occur in a large percentage of patients (71% to 86%) after short‐term followup. This study looks at the long‐term audiological followup (5 to 15 years) of 46 patients who underwent a MFVNS for intractable Meniere's disease. Although the percentage of patients with stabilized hearing was relatively high within the first 2 years postoperatively (61%), it dropped to 41% after a longer followup of 5 to 15 years. When this patient population is divided into two groups based on their preoperative PTA, those patients in whom hearing had bottomed out to ≥50 dB PTA preoperatively lost only 5 dB PTA over the course of the follow‐up period. The patients with better preoperative hearing (<50 dB PTA) lost 30 dB PTA over the same follow‐up period. As this pattern is similar to what has been observed in nonsurgically treated Meniere's patients, we conclude that the MFVNS has no beneficial effect on the hearing loss associated with Meniere's disease.
High‐Frequency Electrostimulation Hearing after Mastoidectomy
Authors: Hegewald Mark , Heitman Robin , Wiederhold Michael L. , Cooper J.C. , Gates George A.
Published: August 2015

This study was undertaken to measure the degree of high‐frequency sensorineural hearing loss following mastoid surgery. Twenty‐five patients undergoing mastoidectomy procedures were tested preoperatively, less than 2 days postoperatively, and at 30 days postoperatively using the Tonndorf Audimax 500 high‐frequency audiometer. Electrostimulation thresholds in 1‐kHz intervals, from 1 to 20 kHz, were measured, and the highest detectable frequency was determined to within 0.1 kHz. Surgical drilling time was recorded. Average drilling time was 51 minutes. A significant temporary threshold shift was observed, measurable at multiple frequencies, less than 48 hours after mastoidectomy. There was no clinically significant change in electrostimulation thresholds (measured in 1‐kHz increments, from 1 to 16 kHz) preoperatively to 30 days postoperatively. A statistically significant average loss of 0.89 kHz in the highest frequency producing a measurable response was noted (p< 0.05). Determinations of the highest measurable frequency may be the most sensitive measure of surgically‐induced, high‐frequency sensorineural hearing changes.
Computer‐Generated Three‐Dimensional Reconstruction of the Cochlea
Authors: Ariyasu Laurence , Galey Frank R. , Hilsinger Raymond , Byl Frederick M.
Published: August 2015

Computer‐generated three‐dimensional reconstructions of the nerve fibers from the organ of Corti to the spiral ganglion were used to determine the optimum maximal length of the cochlear implant electrode. The spiral ganglion within the modiolus is much shorter than the organ of Corti. The spiral ganglion has turns and reaches no higher than the middle of the second turn of the organ of Corti, which has turns. The spiral ganglion is concentric and basal with respect to the organ of Corti. The spiral ganglion dendrites within the osseous spiral lamina of the basal turn project radially, nearly perpendicular to the central axis of the modiolus. Upon entering the modiolus, they turn basally at an angle of approximately 120 degrees. The projection of dendrites within the osseous spiral lamina became increasingly oblique as the ganglion extended apically. The organization of the cochlear nerve results from the spiraling of the ganglion. These findings are in agreement with previous reports. Implications of these findings and their possible relevance to the optimum length of the cochlear implant electrode are discussed with reference to cochlear damage resulting from longer electrodes.
Effects of Fibrin Glue on Rat Facial Nerve Regeneration
Authors: Medders Glen , Mattox Douglas E. , Lyles Alan
Published: August 2015

Studies of nerve repair comparing fibrin glue with suture techniques have produced mixed results. To test the effect of fibrin glue on nerve regeneration without the confounding variables of distraction and/or movement of the anastomosis, nerve repairs were performed with and without fibrin glue on the intratemporal facial nerve of the rat. The location of the nerve transection was the same for control and experimental nerves, but on the experimental side the nerve was repaired with fibrin glue and on the control side of the nerve was reapproximated in the fallopian canal, without glue or sutures. Axon counts distal to the repair revealed no statistically significant difference between the two methods of repair. This result suggests that mechnical obstruction by the fibrin glue between the nerve ends has a negligible effect on nerve regeneration.
Overcoming Laryngospasm by Electrical Stimulation of the Posterior Cricoarytenoid Muscle
Authors: Aviv Jonathan E. , Sanders Ira , Silva David , Kraus Warren M. , Wu Bei‐Lian , Biller Hugh F.
Published: August 2015

The intent of this study was to demonstrate that the technique of transmucosal electrical stimulation of laryngeal muscles may be of clinical use in airway management. Specifically, its ability to overcome laryngospasm was evaluated. Laryngospasm was induced in eight tracheotomized dogs by hyperventilating each dog, and then applying 0.1 M ammonia to the laryngeal mucosa while administering continuous positive airway pressure (CPAP). Laryngospasm was defined by steady apposition of the vocal cords, massive electromyographic activity in the laryngeal adductor muscles, absence of such activity in the posterior cricoarytenoid muscle (PCA), and intraglottic pressure greater than 80 mm Hg. Upon transmucosal application of 10 mAmp current to the PCA bilaterally, the vocal cords abducted for the duration of the stimulus. We theorize that overcoming laryngospasm by electrostimulation involves a reflexive inhibition of the laryngeal adductors. This study provides an objective model for laryngospasm, and demonstrates that electrical manipulation of the vocal cords may have clinical relevance.
Ototoxicity of Antimycotics
Authors: Marsh Roger R. , Tom Lawrence W.C.
Published: August 2015

Neither otomycoses nor defects of the tympanic membrane are rare. In cases of fungal infection when the tympanic membrane is not intact, the possibility exists that antimycotic medication could enter the middle ear and diffuse into the cochlea via the round window. Five antimycotic preparations were tested for acute ototoxic potential in guinea pigs. Those containing acetic acid or propylene glycol caused appreciable elevation of brainstem response thresholds, while little or no impairment resulted from tolnaftate or clotrimazole solutions in polyethylene glycol 400.
A Device for the Intraoperative Identification of the Recurrent Laryngeal Nerve in Piglets
Authors: Smith Dale B. , Woody Edward A. , Richardson Margaret , Olsen Herbert L. , Blakeslee Don B.
Published: August 2015

The recurrent laryngeal nerve (RLN) is one of the most frequently injured nerves in head and neck surgery. Routine identification of the RLN during thyroid surgery has reduced the injury rate from 10% to less than 4%. Difficulty in identification of the RLN contributes to this surgical morbidity. Devices previously used for intraoperative identification of the RLN have failed to achieve the simplicity and reliability necessary for clinical use. This animal study uses a simple double‐ballooned endotracheal tube and pressure transducer system, which assists intraoperative RLN identification through nerve stimulation and graphic documentation of vocal fold (VF) motion. Iatrogenic injury is demonstrated by a dampened stimulation‐pressure tracing. The RLNs of three piglets were injured and examined, and the degree of injury was correlated with perioperative nerve stimulation patterns. The piglet proved to be an adequate model for laryngeal research. An FDA‐approved multi‐institutional prospective human study using this system of Identification of the RLN is in progress.
Hearing Aid Use with Minimal High‐Frequency Hearing Loss
Authors: Bennett Carissa D.
Published: August 2015

This Study evaluated the use of hearing aids by patients with hearing threshold levels of 20 dB or less at 500 and 1000 Hz and 35 dB or less at 2000 Hz. Ninety‐eight patients completed a 30‐day trial with amplification. Six months later, patients were interviewed by telephone and questioned on hearing aid use and perceived unaided and aided difficulty in various listening environments. Results of the study demonstrated that patients with minimal high‐frequency hearing loss can benefit from the use of hearing aids. Ninety‐two percent of the patients elected to purchase the hearing aids and 85% considered the aids a worthwhile investment after 6 months of use. Patients showed a mean improvement from moderate unaided to slight aided difficulty at work and in general social situations. The only variable that predicted success with hearing aids was degree of unaided difficulty at work. Patients who perceived less unaided difficulty at work were less likely to obtain benefit from the use of the hearing aids.
Lack of Efficacy of Middle‐Ear Inflation: Treatment of Otitis Media with Effusion in Children
Authors: Chan Kenny H. , Bluestone Charles D.
Published: August 2015

A randomized controlled trial was conducted to evaluate the efficacy of autoinflation of the middle ear in the treatment of otitis media with effusion. Forty‐one children with middle ear effusion not responsive to antimicrobial therapy enrolled in the study. Of these subjects, 75 percent had effusion duration over 3 months. A system consisting of a disposable anesthesia mask attached to a flowmeter was used to teach children to perform autoinflation based on a modified Valsalva technique. Subjects were stratified according to their ability to achieve tubal opening as assessed by tympanometry and tubosonometry. Subjects were randomly assigned to either treatment or observation group and were followed weekly for 2 weeks; subjects in the treatment group attempted inflation three times each day for 2 weeks. Of the 19 subjects who were in the autoinflation group, only one (5.3 percent) was effusion‐free at the two‐week endpoint and of the 21 subjects in the control, only two (9.5 percent) were without middle‐ear effusion. Autoinflation was ineffective for treatment of children with otitis media with effusion in our study.
A facet-factorial approach towards the development and validation of a jazz rhythm section performance rating scale
Authors: Wesolowski Brian C.
Published: August 2015

The purpose of this study was to develop a valid and reliable rating scale to assess jazz rhythm sections in the context of jazz big band performance. The research questions that guided this study included: (a) what central factors contribute to the assessment of a jazz rhythm section? (b) what items should be used to describe and assess a jazz rhythm section performance? (c) how should the items be categorized? (d) what differences among jazz rhythm sections exist at three performance achievement levels? and (e) what criteria best predict group membership into three performance achievement levels? Items were gathered from research and literature related to the assessment, teaching, and general discussions related to the jazz rhythm section. Twenty-nine item statements were paired with a four-point Likert scale. One hundred and twenty-two responses were gathered from 41 volunteer raters. The results of the data were factor analyzed and yielded a two-factor structure including rhythmic support/drive and style/clarity. The 16-item scale accounted for 79.23% of the variance and the alpha reliability was estimated at 0.986. The rhythmic support/drive factor contributed most to discriminating between overall group differences. More specifically, five out of the 16 items contributed most to discriminating between groups.
Capitalist pigs: Governmentality, subjectivities, and the regulation of pig farming in colonial Hong Kong, 1950–1970
Authors: Wing Chan Kin , Miller Byron
Published: August 2015

This paper analyses the philanthropic governmentality of the Hong Kong colonial government during the Farm Improvement Program (1950–70), focusing on the utilization of pigs, interest-free loans, and the spatial constitution of pig farming as technologies to transform refugee farmers into ‘productive workers’. This research has three primary objectives: to (1) elucidate how the production of knowledge and governing technologies, including the spatial design of livestock production, facilitated the disciplining of pig farmers in a colonial context; (2) expand Foucauldian governmentality analysis into the realm of the regulatory mechanisms of food production systems by documenting how philanthropic pig donations, lending programmes, and the distribution of material benefits promoted capitalist pig production; and (3) demonstrate how technologies – specifically the social construction of pigs and the spatial constitution of pig farming practices – moulded the subjectivities of colonial pig farmers. Empirical analysis is based on archival research and in-depth interviews with 19 pig farmers and two pig farmers’ association leaders. We identify the provision of free pigs and pigsties, the demonstration of new spatial pig-raising practices, and the establishment of interest-free lending systems as the major technologies of governance employed under the Farm Improvement Program. Through these technologies refugee farmers from mainland China learned and internalized concepts of efficiency, productivity, farm management, and self-help. The technologies of the Farm Improvement Program were not just philanthropic activities, they were political tactics to confront the penetration of communism into the colony by changing the practices, productivity, and subjectivities of refugee farmers.
Marital adjustment and psychological distress in Japan
Authors: Li Angela , Robustelli Briana L. , Whisman Mark A.
Published: August 2015

This study was conducted to examine the association between marital adjustment and psychological distress in a large, probability sample of married adults in Japan ( N = 710) from the Midlife Development in Japan study. Results indicate that positive and negative dimensions of marital adjustment were significantly associated with dimensional and categorical measures of psychological distress. Furthermore, the associations between marital adjustment and psychological distress remained significant when statistically controlling for neuroticism, quality of friend and family relationships, and demographic variables. These results demonstrate that the well-established association between marital adjustment and psychological distress found in European American countries is also found in Japan. Findings support continued research on marital functioning and psychological distress in East Asian countries.