bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polyphenol‐rich pomegranate juice reduces IgE binding to cashew nut allergens
Authors: Li Yichen , Mattison Christopher P 
Published: August 2017

AbstractBACKGROUNDFood allergy negatively impacts quality of life and can be life‐threatening. Cashew nuts can cause severe reactions in very small amounts, and they are included in a group of foods most commonly responsible for causing food allergy. Polyphenols and polyphenol‐rich juices have been demonstrated to complex with peanut allergens. Here, the interaction between cashew nut allergens and polyphenol‐rich juices is evaluated biochemically and immunologically.RESULTSVarious juices, including pomegranate (POM), blueberry (BB), and concord grape (CG) juices, were evaluated for polyphenol content and formation of polyphenol–cashew allergen complexes. Among the various juices studied, POM juice showed a greater capacity to form complexes with cashew proteins. Dynamic light scattering (DLS) demonstrated a sharp increase in cashew protein extract particle size to around 3580 nm, and fewer cashew proteins were resolved by electrophoresis after treatment with POM juice. Immunoassays demonstrated reduced IgG and IgE binding to cashew allergens due to allergen precipitation by POM juice. These observations support the formation of complexes between polyphenol and cashew proteins that can prevent antibody recognition of cashew allergens through allergen precipitation.CONCLUSIONPOM juice treatment of cashew extract effectively reduces antibody binding through allergen precipitation, and these findings could be applied to the development of less allergenic cashew nut products and oral immunotherapy. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
Magnetic dispersive solid‐phase extraction based on modified magnetic nanoparticles for the detection of cocaine and cocaine metabolites in human urine by high‐performance liquid chromatography–mass spectrometry
Authors: Yang Feiyu , Zou Yun , Ni Chunfang , Wang Rong , Wu Min , Liang Chen , Zhang Jiabin , Yuan Xiaoliang , Liu Wenbin 
Published: August 2017

AbstractAn easy‐to‐handle magnetic dispersive solid‐phase extraction procedure was developed for preconcentration and extraction of cocaine and cocaine metabolites in human urine. Divinyl benzene and vinyl pyrrolidone functionalized silanized Fe3O4 nanoparticles were synthesized and used as adsorbents in this procedure. Scanning electron microscopy, vibrating sample magnetometry, and infrared spectroscopy were employed to characterize the modified adsorbents. A high‐performance liquid chromatography with mass spectrometry method for determination of cocaine and its metabolites in human urine sample has been developed with pretreatment of the samples by magnetic dispersive solid‐phase extraction. The obtained results demonstrated the higher extraction capacity of the prepared nanoparticles with recoveries between 75.1 to 105.7% and correlation coefficients higher than 0.9971. The limits of detection for the cocaine and cocaine metabolites were 0.09–1.10 ng/mL. The proposed magnetic dispersive solid‐phase extraction method provided a rapid, environmentally friendly and magnetic stuff recyclable approach and it was confirmed that the prepared adsorbents material was a kind of highly effective extraction materials for the trace cocaine and cocaine metabolites analyses in human urine.
Use of pharyngeal packs in functional endoscopic sinus surgery: A randomized controlled trial
Authors: Green Ross , Konuthula Neeraja , Sobrero Maximiliano , Saini Alok , Parasher Arjun , Pool Christopher , Levine Adam I. , DeMaria Samuel , Tufts Ryan , Govindaraj Satish , Iloreta Alfred Marc 
Published: August 2017

ObjectiveTo determine if pharyngeal packs have an effect on postoperative pain and postoperative nausea and vomiting in functional endoscopic sinus surgery (FESS).Study DesignForty‐six patients scheduled for routine endoscopic sinus surgery were recruited into this study. The patients were randomly allocated to have or to not have pharyngeal packing prior to surgery.MethodsThe placement of pharyngeal packs during FESS is controversial. Theoretically, pharyngeal packs may prevent postoperative nausea and vomiting by preventing ingestion of blood during sinus surgery. However, prior studies have not conclusively demonstrated this to be the case in FESS. Pharyngeal packs have been associated with complications including throat pain, aspiration, and death. The objective of this randomized control trial was to determine if pharyngeal packs have an effect on postoperative throat pain, nausea, and vomiting in order to determine their importance during FESS.Patients were blinded to intervention. Postoperatively, throat pain and nausea/vomiting scores were recorded.ResultsThere was no significant difference in mean throat pain at 4 hours following surgery (P = 0.860). At 24 hours after surgery, patients without pharyngeal packing experienced more pain than those who had a throat pack placed (P = 0.002). There was no significant difference in the level of nausea at 4 hours after surgery (P = 0.315) or at 24 hours after surgery (P = 0.315).ConclusionWe recommend against the routine use of placing pharyngeal packs during FESS.Level of Evidence1b. Laryngoscope, 127:2460–2465, 2017
Three‐dimensional tissue‐engineered skeletal muscle for laryngeal reconstruction
Authors: Brookes Sarah , Voytik‐Harbin Sherry , Zhang Hongji , Halum Stacey 
Published: August 2017

ObjectiveThere is an unmet need for tissue‐engineered three‐dimensional (3D) muscle constructs for laryngeal reconstruction. Functional engineered muscle could be used to repair postoncologic or traumatic defects or to medialize the vocal fold in cases of paresis/paralysis. Autologous, organized, engineered muscle that has adequate bulk integrates into host tissue and restores function currently does not exist.MethodsPrimary skeletal muscle progenitor cells (MPCs) were isolated from F344 rats. Three‐dimensional muscle constructs were created by encapsulating MPCs via flow alignment in a customized collagen formulation and cultured under passive tension. Muscle‐specific immunohistochemistry and confocal microscopy were used to evaluate muscle tissue differentiation. After 2 weeks of culture, muscle constructs were implanted into surgically created defects in the rat larynx. Postmortem function testing and histology was performed at 1 and 3 months.ResultsImmunohistochemistry with confocal microscopy demonstrated well‐differentiated myotubes, which were well aligned and distributed throughout the engineered construct in vitro. There was evidence of restoration of normal laryngeal function at 1 month postoperative, as indicated by safe swallow (no aspiration events), weight gain, and excellent animal survival. Postmortem specimens demonstrated functional muscle contraction on ex vivo testing, and histology confirmed integration into host tissue.ConclusionThis is the first study to demonstrate that functional, 3D tissue‐engineered skeletal muscle can be developed from primary MPCs and standardized oligomeric collagen. Collectively, these findings may have tremendous clinical implications for autologous laryngeal muscle repair and reconstruction.Level of EvidenceNA. Laryngoscope, 128:603–609, 2018
Postoperative IPTH compared with IPTH gradient as predictors of post‐thyroidectomy hypocalcemia
Authors: Al Khadem Mai G. , Rettig Eleni M. , Dhillon Vaninder K. , Russell Jonathon O. , Tufano Ralph P. 
Published: August 2017

Objectives/HypothesisPredicting patients' risk for hypocalcemia after thyroidectomy may allow for same‐day discharge. This study was designed to compare postoperative intact parathyroid hormone (IPTH) alone with percentage change in IPTH (IPTH gradient) in predicting post‐thyroidectomy hypocalcemia.Study DesignRetrospective cohort study.MethodsPatients undergoing total thyroidectomy by the senior author from May 2015 to May 2016 were included. Serum IPTH was measured preoperatively and 1 hour postoperatively, and IPTH gradient was calculated. Postoperative hypocalcemia was mild (≥8.0, <8.4) or severe (<8.0 and/or hypocalcemic symptoms). Postoperative IPTH and IPTH gradient were compared with hypocalcemia using logistic regression. Receiver operating characteristic analysis of IPTH measures as predictors of hypocalcemia was performed, and the area under the curve (AUC) was calculated.ResultsOverall, 119 patients were included. Forty‐seven percent of the patients developed postoperative hypocalcemia, including 26 (22%) with mild and 30 (25%) with severe hypocalcemia. Thirteen patients had hypocalcemic symptoms. Median IPTH gradient and postoperative IPTH each differed significantly by category of hypocalcemia (P < .001). Higher IPTH gradient was significantly associated with odds of severe and symptomatic hypocalcemia (adjusted odds ratio [aOR]: 1.21, 95% confidence interval [CI]: 1.06‐1.39 and aOR: 1.34, 95% CI: 1.05‐1.71 per 10% increase), whereas lower postoperative IPTH was not (aOR: 1.27, 95% CI: 0.95‐1.68 and aOR: 1.44, 95% CI: 0.90‐2.31 per 10 pg/mL decrease). The AUC for predicting severe hypocalcemia was nonsignificantly higher for IPTH gradient than postoperative IPTH (AUC = 0.77 vs. 0.69, P = .10). The AUC for predicting symptomatic hypocalcemia was significantly higher for IPTH gradient (AUC = 0.75 vs. 0.72, P = .03).ConclusionsOur results suggest that the IPTH gradient may be more useful than postoperative IPTH alone in predicting risk of post‐thyroidectomy hypocalcemia.Level of Evidence4. Laryngoscope, 128:769–774, 2018
Rethinking the laryngopharyngeal reflux treatment algorithm: Evaluating an alternate empiric dosing regimen and considering up‐front, pH‐impedance, and manometry testing to minimize cost in treating suspect laryngopharyngeal reflux disease
Authors: Carroll Thomas L. , Werner Astrid , Nahikian Kael , Dezube Aaron , Roth Douglas F. 
Published: August 2017

Objectives/HypothesisEmpiric proton pump inhibitor (PPI) trials for laryngopharyngeal reflux (LPR) are common. A majority of the patients respond to acid suppression. This work intends to evaluate once‐daily, 40 mg omeprazole and once‐nightly, 300 mg ranitidine (QD/QHS) dosing as an alternative regimen, and use this study's cohort to evaluate empiric regimens prescribed for LPR as compared to up‐front testing with pH impedance multichannel intraluminal impedance (MII) with dual pH probes and high‐resolution manometry (HRM) for potential cost minimization.Study DesignRetrospective cohort review and cost minimization study.MethodsA chart review identified patients diagnosed with LPR. All subjects were treated sequentially and outcomes recorded. Initial QD/QHS dosing increased after 3 months to BID if no improvement and ultimately prescribed MII and HRM if they failed BID dosing. Decision tree diagrams were constructed to determine costs of two empiric regimens and up‐front MII and HRM.ResultsNinety‐seven subjects met the criteria. Responders and nonresponders to empiric therapy were identified. Seventy‐two subjects (74%) responded. Forty‐eight (67% of responders and 49% of all) improved with QD/QHS dosing. Forty‐nine (51%) subjects escalated to BID dosing. Twenty‐four subjects (33% of responders and 25% of all) improved on BID therapy. Twenty‐five subjects (26%) did not respond to acid suppression. Average weighted cost was $1,897.00 per patient for up‐front testing, $3,033.00 for initial BID, and $3,366.00 for initial QD/QHS.ConclusionsAn alternate QD/QHS regimen improved the majority who presented with presumed LPR. Cost estimates demonstrate that the QD/QHS regimen was more expensive than the initial BID high‐dose PPI for 6 months. Overall per‐patient cost appears less with up‐front MII and HRM.Level of Evidence4. Laryngoscope, 127:S1–S13, 2017
Consulting Dr. Google: Quality of Online Resources About Tympanostomy Tube Placement
Authors: Harris Vandra C. , Links Anne R. , Hong Paul , Walsh Jonathan , Schoo Desi P. , Tunkel David E. , Stewart Charles M. , Boss Emily F. 
Published: August 2017

ObjectiveTympanostomy tube (TT) placement is common in children; however, family‐centeredness and utility of online information used for decision making and understanding is unknown. We evaluate the quality of leading Internet resources describing TT placement.Study DesignCross‐sectional descriptive design.MethodsWe performed a Google (Menlo Park, CA) search for terms related to TTs. We defined quality using scaled readability measures (Flesch Reading Ease and Flesch‐Kincaid Grade‐Level), understandability and actionability (Patient Education Materials Assessment Tool), shared decision‐making centrality (Center for Medicare and Medicaid Services informed consent guidelines), and clinical practice guideline (CPG) compatibility. Three reviewers coded each measure. Fleiss κ interrater reliability analysis was performed.ResultsTen most frequently encountered websites were analyzed. One of 10 met national health literacy standards (mean 10th‐grade level reading, median 9th, range 6–15th). All sites were understandable (mean understandability 81.9%, range 73%–92%). Most had low actionability scores (7 of 10, median 47%, mean 44.6%, range 0–80). Shared decision‐making centrality was high (mean 5, range 4–6), but most did not list alternative treatment options. Although CPG compatibility was high (mean 3.4, range 1–4), many websites contained inconsistent recommendations about tube duration, follow‐up, and water precautions. There was inter‐rater agreement for understandability scoring (κ = 0.20; P = 0.02).ConclusionInternet resources about TT placement vary in quality pertaining to health literacy, principles of shared decision making, and consistency with practice guidelines. With growing emphasis on patient‐/family‐centered engagement in healthcare decision making, standardization of content and improved usability of educational materials for common surgical procedures in children such as tympanostomy tube placement should be a public health priority.Level of EvidenceNA. Laryngoscope, 128:496–501, 2018
Directional DBS increases side‐effect thresholds—A prospective, double‐blind trial
Authors: Dembek Till A. , Reker Paul , Visser‐Vandewalle Veerle , Wirths Jochen , Treuer Harald , Klehr Martin , Roediger Jan , Dafsari Haidar S. , Barbe Michael T. , Timmermann Lars 
Published: August 2017

ABSTRACTObjectiveThe objective of this study was to investigate whether directional deep brain stimulation (DBS) of the subthalamic nucleus in Parkinson's disease (PD) offers increased therapeutic windows, side‐effect thresholds, and clinical benefit.MethodsIn 10 patients, 20 monopolar reviews were conducted in a prospective, randomized, double‐blind design to identify the best stimulation directions and compare them to conventional circular DBS regarding side‐effect thresholds, motor improvement, and therapeutic window. In addition, circular and best‐directional DBS were directly compared in a short‐term crossover. Motor outcome was also assessed after an open‐label follow‐up of 3 to 6 months.ResultsStimulation in the individual best direction resulted in significantly larger therapeutic windows, higher side‐effect thresholds, and more improvement in hand rotation than circular DBS. Rigidity and finger tapping did not respond differentially to the stimulation conditions. There was no difference in motor efficacy or stimulation amplitudes between directional and circular DBS in the short‐term crossover. Follow‐up evaluations 3 to 6 months after implantation revealed improvements in motor outcome and medication reduction comparable to other DBS studies with a majority of patients remaining with a directional setting.ConclusionDirectional DBS can increase side‐effect thresholds while achieving clinical benefit comparable to conventional DBS. Whether directional DBS improves long‐term clinical outcome needs to be investigated in the future. © 2017 International Parkinson and Movement Disorder Society
It's not just the basal ganglia: Cerebellum as a target for dystonia therapeutics
Authors: Tewari Ambika , Fremont Rachel , Khodakhah Kamran 
Published: August 2017

AbstractDystonia is a common movement disorder that devastates the lives of many patients, but the etiology of this disorder remains poorly understood. Dystonia has traditionally been considered a disorder of the basal ganglia. However, growing evidence suggests that the cerebellum may be involved in certain types of dystonia, raising several questions. Can different types of dystonia be classified as either a basal ganglia disorder or a cerebellar disorder? Is dystonia a network disorder that involves the cerebellum and basal ganglia? If dystonia is a network disorder, how can we target treatments to alleviate symptoms in patients? A recent study by Chen et al, using the pharmacological mouse model of rapid‐onset dystonia parkinsonism, has provided some insight into these important questions. They showed that the cerebellum can directly modulate basal ganglia activity through a short latency cerebello‐thalamo‐basal ganglia pathway. Further, this article and others have provided evidence that in some cases, aberrant cerebello‐basal ganglia communication can be involved in dystonia. In this review we examine the evidence for the involvement of the cerebellum and cerebello‐basal ganglia interactions in dystonia. We conclude that there is ample evidence to suggest that the cerebellum plays a role in some dystonias, including the early‐onset primary torsion dystonia DYT1 and that further studies examining the role of this brain region and its interaction with the basal ganglia in dystonia are warranted. © 2017 International Parkinson and Movement Disorder Society
Clinicopathologic discrepancies in a population‐based incidence study of parkinsonism in olmsted county: 1991‐2010
Authors: Turcano Pierpaolo , Mielke Michelle M. , Josephs Keith A. , Bower James H. , Parisi Joseph E. , Boeve Bradley F. , Savica Rodolfo 
Published: August 2017

ABSTRACTObjective: The purpose of this study was to examine the discrepancies between the clinical diagnosis of parkinsonism and neuropathological findings in a population‐based cohort with parkinsonian disorders.Background: The specific clinical diagnosis of parkinsonism is challenging, and definite confirmation requires neuropathological evaluation. Currently, autopsies are seldom performed, and most brain autopsies represent atypical or diagnostically unresolved cases.Methods: We used a defined population‐based incidence cohort with clinical parkinsonism (n = 669) from the Rochester Epidemiology Project in Olmsted County, Minnesota, 1991‐2010. We reviewed reports of all patients who underwent neuropathologic examination at autopsy (n = 60; 9%) and applied consensus pathologic guidelines for neurodegenerative disease diagnosis.Results: Among the 60 patients examined pathologically, the median time from the last recorded clinical diagnosis to death was 7 years (range from 2 to 17 years). Clinical–pathological concordance was found in 52 cases (86.7%), whereas 8 (13.3%) had a clinical‐pathological discrepancy. Four patients with a clinical diagnosis of idiopathic Parkinson's disease had no pathological evidence of Lewy bodies or α‐synucleinopathy; of these, pathological diagnoses were Alzheimer's disease (2 cases), progressive supranuclear palsy (1 case), and vascular parkinsonism (1 case). Two patients with clinical diagnoses of "dementia with Lewy bodies" and one patient with an "unspecified parkinsonism" had a pathological diagnosis of Alzheimer's disease without concomitant α‐synuclein lesions. One patient with clinically diagnosed "progressive supranuclear palsy" had indeterminate pathological findings without α‐synuclein or Aβ‐ or tau‐immunoreactive lesions at autopsy.Conclusions: Overall, the clinical diagnoses of parkinsonian subtypes had good concordance with pathological confirmation (86.7%). However, clinical–pathological discrepancies were documented in 13.3%. © 2017 International Parkinson and Movement Disorder Society
Motor hyperactivity of the iron‐deficient rat — an animal model of restless legs syndrome
Authors: Lai Yuan‐Yang , Cheng Yu‐Hsuan , Hsieh Kung‐Chiao , Nguyen Darian , Chew Keng‐Tee , Ramanathan Lalini , Siegel Jerome M. 
Published: August 2017

AbstractBackgroundAbnormal striatal dopamine transmission has been hypothesized to cause restless legs syndrome. Dopaminergic drugs are commonly used to treat restless legs syndrome. However, they cause adverse effects with long‐term use. An animal model would allow the systematic testing of potential therapeutic drugs. A high prevalence of restless legs syndrome has been reported in iron‐deficient anemic patients. We hypothesized that the iron‐deficient animal would exhibit signs similar to those in restless legs syndrome patients.MethodsAfter baseline polysomnographic recordings, iron‐deficient rats received pramipexole injection. Then, iron‐deficient rats were fed a standard rodent diet, and polysomnographic recording were performed for 2 days each week for 4 weeks.ResultsIron‐deficient rats have low hematocrit levels and show signs of restless legs syndrome: sleep fragmentation and periodic leg movements in wake and in slow‐wave sleep. Iron‐deficient rats had a positive response to pramipexole treatment. After the iron‐deficient rats were fed the standard rodent diet, hematocrit returned to normal levels, and sleep quality improved, with increased average duration of wake and slow‐wave sleep episodes. Periodic leg movements decreased during both waking and sleep. Hematocrit levels positively correlated with the average duration of episodes in wake and in slow‐wave sleep and negatively correlated with periodic leg movements in wake and in sleep. Western blot analysis showed that striatal dopamine transporter levels were higher in iron‐deficient rats.ConclusionsThe iron‐deficient rat is a useful animal model of iron‐deficient anemic restless legs syndrome. © 2017 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society