bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment management between orthodontists and general practitioners performing clear aligner therapy
Authors: Best Alexandra D. , Shroff Bhavna , Carrico Caroline K. , Lindauer Steven J. 
Published: November 2016

ABSTRACTObjective:To investigate differences in case selection, treatment management, and aligner treatment expertise between orthodontists and general practitioners.Materials and Methods:A parallel pair of original surveys with three sections (case selection, treatment management, and demographics) was sent to orthodontists (N = 1000) and general dentists (N = 1000) who were providers of aligner treatment.Results:Orthodontists had treated significantly more patients with aligners, had treated more patients with aligners in the previous 12 months, and had received more aligner training than general dentists (P &lt; .0001). In general, case confidence increased with increasing experience for both orthodontists and general dentists. After adjusting for experience, there was a significant difference in aligner case confidence between orthodontists and general dentists for several malocclusions. General dentists were more confident than orthodontists in treating deep bite, severe crowding, and Class II malocclusions with aligners (P ≤ .0001). Significant differences were also found for all treatment management techniques except interproximal reduction.Conclusion:There was a significant difference in case selection, treatment management, and aligner expertise between orthodontists and general dentists, although the differences in case selection were small. Overall, it was shown that orthodontists and general dentists elected to treat a variety of moderate to severe malocclusions with aligners but with different utilization of recommended auxiliaries, perhaps demonstrating a difference in treatment goals.
Design and Fabrication of an Adjustable Sitting Inclinations Spinal Cord Rehabilitation Chair
Authors: Ajao K.R. , Yahaya T. , Ajimotokan H. A. , Adeleke A. A. , Bello M. , Ojegbenro O. 
Published: November 2016

Abstract
The adjustable sitting inclination rehabilitation chair was fabricated with mild steel and soft upholstered fabric was used for the overlay on the seat, headrest and armrest. The components were coupled with a linear actuator at the upper frame for the reclining of the backrest about it axis. The wheels are located outboard of the seat of the chair to enhance stability while foot rest supports the posterior weight of the users. The narrow seat allows free movement of the leg when the user is seated. Sitting inclinations of 120 and 135° protect the spine disc from compression and proffer more comfort for the users than other angles experimented. The adjustable sitting inclination SCRC is simple and affordable for low-income people with Spinal cord injury, especially for those in developing countries in order to support other therapies for their recovery processes.
Using Software Zelio Soft in Educational Process to Simulation Control Programs for Intelligent Relays
Authors: Michalik Peter , Mital Dusan , Zajac Jozef , Brezikova Katarina , Duplak Jan , Hatala Michal , Radchenko Svetlana 
Published: November 2016

Abstract
Article deals with point to using intelligent relay and PLC systems in practice, to their architecture and principles of programming and simulations for education process on all types of school from secondary to universities. Aim of the article is proposal of simple examples of applications, where is demonstrated methodology of programming on real simple practice examples and shown using of chosen instructions. In practical part is described process of creating schemas and describing of function blocks, where are described methodologies of creating program and simulations of output reactions on changeable inputs for intelligent relays.
Novel use of an Ultrasonic Bone Aspirator for Extended Endoscopic Frontal Sinusotomy: A Feasibility Study
Authors: Massey Conner J. , Bury Sean , Diamond Jay , Singh Ameet 
Published: November 2016

Introduction Extended endoscopic frontal sinusotomy is often required for surgical management of anterior skull base pathology. Such approaches are necessary for access to pathology and maintenance of postoperative frontal sinus outflow tract drainage. Cold steel instrumentation and endoscopic high-speed microdrills are typically used for bony removal during extended frontal sinus approaches but are associated with certain drawbacks, such as thermal injury and obscuration of the surgical field with bone dust. Objective We investigated the ultrasonic bone aspirator (UBA) as an adjunctive tool for extended endoscopic frontal sinusotomy in the setting of skull base surgery. Methods Medical records of patients who underwent either Draf IIB or Draf III sinusotomies from 2011 to 2014 were reviewed. The patients were split into two cohorts based on instrumentation: those who received sinusotomy primarily with the UBA, and those who had sinusotomy performed with conventional instrumentation only. The patients were followed up after surgery with routine endoscopic examinations and imaging when indicated. Patient demographics, surgical approach, operative complications, and postoperative outcomes were evaluated. Results A total of 18 patients underwent endoscopic extended frontal sinusotomy for a variety of skull base pathologies with the UBA and the conventional instrumentation cohorts, which contained nine patients each. Five of the nine patients in the UBA cohort received Draf III sinusotomies compared with three of nine in the conventional cohort. Three patients in the UBA cohort experienced postoperative transient pressure hyperemia of the lip; this was seen in a single patient in the conventional cohort. All patients with postoperative endoscopic examinations maintained frontal sinus ostial patency to varying degrees, irrespective of cohort. Lund-Mackay scores and the need for operative revision of the frontal sinus were similar for both groups and seemed to be related to the use of postoperative radiation. Conclusion The UBA was a safe, effective tool for extended endoscopic frontal sinusotomy in endoscopic skull base surgery.
Olfactory Cleft Computed Tomography Analysis and Olfaction in Chronic Rhinosinusitis
Authors: Kohli Preeti , Schlosser Rodney J. , Storck Kristina , Soler Zachary M. 
Published: November 2016

Background Volumetric analysis of the olfactory cleft by using computed tomography has been associated with olfaction in patients with chronic rhinosinusitis (CRS). However, existing studies have not comprehensively measured olfaction, and it thus remains unknown whether correlations differ across specific dimensions of odor perception. Objective To use comprehensive measures of patient-reported and objective olfaction to evaluate the relationship between volumetric olfactory cleft opacification and olfaction. Methods Olfaction in patients with CRS was evaluated by using “Sniffin’ Sticks” tests and a modified version of the Questionnaire of Olfactory Disorders. Olfactory cleft opacification was quantified by using two- and three-dimensional, computerized volumetric analysis. Correlations between olfactory metrics and olfactory cleft opacification were then calculated. Results The overall CRS cohort included 26 patients without nasal polyposis (CRSsNP) (68.4%) and 12 patients with nasal polyposis (CRSwNP) (31.6%). Across the entire cohort, total olfactory cleft opacification was 82.8%, with greater opacification in the CRSwNP subgroup compared with CRSsNP (92.3 versus 78.4%, p ≤ 0.001). The percent total volume opacification correlated with the total Sniffin’ Sticks score (r = -0.568, p ≤ 0.001) as well as individual threshold, discrimination, and identification scores (p ≤ 0.001 for all). Within the CRSwNP subgroup, threshold (r = -0.616, p = 0.033) and identification (r = -0.647, p = 0.023) remained highly correlated with total volume opacification. In patients with CRSsNP, the threshold correlated with total volume scores (r =-0.457, p = 0.019), with weaker and nonsignificant correlations for discrimination and identification. Correlations between total volume opacification and the Questionnaire of Olfactory Disorders were qualitatively similar to objective olfactory findings in both CRSwNP (r =-0.566, p = 0.070) and CRSsNP (r =-0.310, p = 0.141) subgroups, although neither reached significance. When examined by two-dimensional planes, the percent opacification of the anterior plane had the strongest correlations with objective olfaction. Conclusion Olfactory cleft opacification correlated with objective measures of olfaction in patients with CRS, which correlated with threshold values in patients with CRSsNP and all dimensions of olfaction in those with CRSwNP.
Topical Probiotics as a Therapeutic Alternative for Chronic Rhinosinusitis: A Preclinical Proof of Concept
Authors: Schwartz Joseph S. , Peres Adam G. , Endam Leandra Mfuna , Cousineau Benoit , Madrenas Joaquin , Desrosiers Martin 
Published: November 2016

Introduction Patients with chronic rhinosinusitis (CRS) have been shown to manifest a high inflammatory phenotype, with a sinus microbiome deficient in gram-positive bacteria. Gram-positive bacteria are capable of downregulating proinflammatory host responses via an interleukin (IL) 10 mediated response and may represent a potential therapeutic alternative for CRS. We wanted to (i) immunoprofile the IL-10 induction capacity of two gram-positive probiotic strains and (ii) verify the tolerance of these strains by the sinus epithelium. Methods A peripheral blood mononuclear cell (PBMC) challenge model was used to document probiotic induction of IL-10 and tumor necrosis factor (TNF) alpha responses at various bacterial dilutions. Epithelial cell tolerance was demonstrated by using a primary epithelial cell model derived from patient biopsy specimens (six patients total [three with CRS and three controls]). After an incubation period with either a live or a heat-killed probiotic strain, cell viability was assessed by using light microscopy. Results Both probiotic strains induced high IL-10 secretion in PBMCs, with differing profiles of TNF alpha production. Microscopic evaluation after probiotic incubation demonstrated intact cell viability for all cell cultures. Conclusion We identified well-tolerated, nonpathogenic, “generally recognized as safe” status gram-positive probiotics with anti-inflammatory properties. Topical probiotics represented a potential novel topical therapeutic strategy for CRS relevant for further clinical evaluation.
Practice Patterns in Pediatric Chronic Rhinosinusitis: A Survey of the American Rhinologic Society
Authors: Beswick Daniel M. , Ramadan Hassan , Baroody Fuad M. , Hwang Peter H. 
Published: November 2016

Background The management of pediatric chronic rhinosinusitis (PCRS) is evolving. Objective To assess current practice patterns of members of the American Rhinologic Society (ARS) in managing PCRS. Methods A 27-item Web-based survey on treatment of PCRS was electronically distributed to the ARS membership. Results The survey was completed by 67 members, 40% of whom had completed a rhinology fellowship. The most frequently used medical therapies as part of initial treatment for PCRS were nasal saline solution irrigation, (90%), topical nasal steroids (93%), oral antibiotics (52%), and oral steroids (20%). For initial surgical therapy, 90% performed adenoidectomy; in addition, 31% also performed sinus lavage, 17% performed balloon catheter dilation (BCD), and 17% performed endoscopic sinus surgery (ESS). Sixty percent performed adenoidectomy before obtaining computed tomography imaging. When initial surgical treatment failed, 85% performed traditional ESS. In patients with pansinusitis, 50% of the respondents performed frontal sinusotomy and 70% performed sphenoidotomy. BCD was not frequently used; overall, 66% never or rarely used it, 20% sometimes used it, 12% usually used it, and 3% always or almost always used BCD. Conclusions Most aspects of PCRS management among ARS members were aligned with published consensus statements. Adenoidectomy was almost always included as part of first-line surgical treatment but was also combined with adjunctive surgical procedures with moderate frequency. ESS was performed by a minority of rhinologists as a primary procedure for medically refractory PCRS but was favored when previous surgery failed. BCD was uncommonly used in PCRS.
New Routes of Allergen Immunotherapy
Authors: Aricigil Mitat , Muluk Nuray Bayar , Sakarya Engin Umut , Sakalar Emine Giiven , Senturk Mehmet , Reisacher William R. , Cingi Cemal 
Published: November 2016

Objectives Allergen immunotherapy is the only cure for immunoglobulin E mediated type I respiratory allergies. Subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) are the most common treatments. In this article, we reviewed new routes of allergen immunotherapy. Methods Data on alternative routes to allow intralymphatic immunotherapy (ILIT), epicutaneous immunotherapy (EPIT), local nasal immunotherapy (LNIT), oral immunotherapy (OIT), and oral mucosal immunotherapy (OMIT) were gathered from the literature and were discussed. Results ILIT features direct injection of allergens into lymph nodes. ILIT may be clinically effective after only a few injections and induces allergen-specific immunoglobulin G, similarly to SCIT. A limitation of ILIT is that intralymphatic injections are required. EPIT features allergen administration by using patches mounted on the skin. EPIT seeks to target epidermal antigen–presenting Langerhans cells rather than mast cells or the vasculature; this should reduce both local and systemic adverse effects. LNIT involves the spraying of allergen extracts into the nasal cavity. Natural or chemically modified allergens (the latter, termed allergoids, lack immunoglobulin E reactivity) are prepared in a soluble form. OIT involves the regular administration of small amounts of a food allergen by mouth and commences with low oral doses, which are then increased as tolerance develops. OMIT seeks to deliver allergenic proteins to an expanded population of Langerhans cells in the mucosa of the oral cavity. Conclusions ILIT, EPIT, LNIT, OIT, and OMIT are new routes for allergen immunotherapy. They are safe and effective.
Effect of Doxycycline on Transforming Growth Factor-Beta-1–Induced Matrix Metalloproteinase 2 Expression, Migration, and Collagen Contraction in Nasal Polyp–Derived Fibroblasts
Authors: Shin Jae-Min , Park Joo-Hoo , Kang Byungjin , Lee Seoung-Ae , Park Il-Ho , Lee Heung-Man 
Published: November 2016

Purpose It is well known that doxycycline has antibacterial and anti-inflammatory effects. In this study, we aimed to investigate the effects of doxycycline on the transforming growth factor (TGF) beta 1–induced matrix metalloproteinase (MMP) 2 expression, migration, and collagen contraction, and to determine its molecular mechanism on nasal polyp–derived fibroblasts (NPDF). Methods NPDFs were isolated from the nasal polyps of six patients. Doxycycline was used to pretreat TGF-beta-1–induced NPDFs and ex vivo organ cultures of nasal polyps. Cytotoxicity was evaluated by using a 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyl-tetrazolium bromide assay. Smad2/3 is one of the major transcription factors of TGF-beta signaling. The expression levels of MMP2 and Smad2/3 were measured by using Western blotting, reverse transcription-polymerase chain reaction, and immunofluorescence staining. The enzymic activity of MMP2 was analyzed by using gelatin zymography. Fibroblast migration was evaluated by using transwell migration assays. Contractile activity was measured by a collagen gel contraction assay. Results The expression level of MMP2 in nasal polyp tissues increased in comparison with inferior turbinate tissues. TGF-beta-1–induced NPDFs were not affected by doxycycline (0–40 μg/mh). The expression levels of MMP2 and activation of Smad2/3 in TGF-beta-1–induced NPDFs and in organ cultures of nasal polyps were significantly downregulated with doxycycline pretreatment. Doxycycline also reduced TGF-beta-1–induced fibroblast migration and collagen contraction in NPDFs. Conclusion Doxycycline inhibited TGF-beta-1–induced MMP2 expression, migration, and collagen contraction via the Smad2/3 signal pathways in NPDFs.
The Effects of Radioactive Iodine Therapy on Olfactory Function
Authors: Suat Bilici , Tuna Edizer Deniz , Ozgur Yigit , Muhammet Yildiz , Fikret Cermik Tevfik 
Published: November 2016

Purpose To determine the possible adverse effects of radioactive iodine (RAI) treatment on the olfactory functions of patients with differentiated thyroid carcinoma. Materials and Methods This prospective clinical study included 63 Turkish patients who had been diagnosed with papillary thyroid carcinoma only to ensure homogeneity. The Connecticut Chemosensory Clinical Research Center olfactory test was administered at 1 week before treatment and at the third week and the first year after treatment. Triiodothyronine, thyroxine, thyroid stimulating hormone, thyroglobulin, and antithyroglobulin levels were measured 1 week before treatment and 2 weeks after treatment. Results The smell threshold test, smell identification test, and total smell scores showed statistically significant decreases after treatment when compared with the pretreatment scores (p = 0.000). No significant differences were noted between the late term and early term after RAI for either the identification score (p = 0.502) or the total score (p = 0.051). The Spearman correlation analysis indicated a significant correlation between age and RAI before and after treatment for the smell threshold test, smell identification test, and total smell scores (p < 0.05). A total of 54% of the patients displayed normosmia in the posttreatment period. A few patients had mild hyposmia before RAI, 27% had mild hyposmia in the early stage after RAI, and 29% had mild hyposmia in the late stage. Conclusion The olfactory function deteriorated in almost half of the patients in the early stage after RAI. Mild and moderate hyposmia in particular occurred in the first year after RAI.
Rapamycin Inhibits Transforming Growth Factor Beta 1 Induced Myofibroblast Differentiation via the Phosphorylated-Phosphatidylinositol 3-Kinase Mammalian Target of Rapamycin Signal Pathways in Nasal Polyp–Derived Fibroblasts
Authors: Ko Dong-Yn , Shin Jae-Min , Um Ji-Young , Kang Byungjin , Park Il-Ho , Lee Heung-Man 
Published: November 2016

Purpose Rapamycin has antiproliferative and antifibrogenic effects in vitro and in vivo. The purpose of this study was to evaluate the effects of rapamycin on transforming growth factor (TGF) beta 1 induced myofibroblast differentiation (alpha smooth-muscle actin [SMA]), extracellular matrix production, and collagen contraction in nasal polyp–derived fibroblasts (NPDF). The underlying molecular mechanisms of rapamycin were also determined in NPDFs. Methods NPDFs were grown in culture and transformed into myofibroblasts by using TGF beta 1 (5 ng/mL). For cytotoxicity evaluation, a 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyl-tetrazolium bromide assay was used. Expression levels of alpha SMA, phosphorylated phosphatidylinositol 3-kinase (PI3K), and phosphorylated mammalian target of rapamycin (mTOR) were determined by using Western blot, reverse transcription–polymerase chain reaction, and immunofluorescence staining. The total amount of collagen was analyzed by using the Sircol collagen assay, and contractile activity was measured with a collagen gel contraction assay. Silencing mTOR with mTOR-specific small interference RNA was determined by using reverse transcription–polymerase chain reaction. Results Whereas rapamycin (range, 0–400 nM) had no significant cytotoxic effects on TGF beta 1 induced NPDFs, it significantly reduced the expression levels of alpha–SMA in TGF beta 1 induced NPDFs in a dose-dependent manner. TGF beta 1 induced collagen production and collagen contraction were significantly inhibited by rapamycin treatment. Rapamycin also attenuated the TGF beta 1 induced activation of PI3K and mTOR, and its inhibitory effects were similar to those of mTOR silencing and a specific PI3K inhibitor. Conclusions Rapamycin inhibited TGF beta 1 induced myofibroblast differentiation, extracellular matrix production, and collagen contraction through the PI3K/mTOR signal pathways in NPDFs.
Significance of Undissected Retromaxillary Air Cells as a Risk Factor for Revision Endoscopic Sinus Surgery
Authors: Kuan Edward C. , Clair Jon Mallen-St. , Frederick John W. , Tajudeen Bobby A. , Wang Marilene B. , Harvey Richard J. , Suh Jeffrey D. 
Published: November 2016

Background Retromaxillary air cells (RMC) are posterior ethmoid cells that separate the maxillary and ethmoid sinuses. The clinical significance of these cells in contributing to revision functional endoscopic sinus surgery (FESS) is unknown. Objectives To investigate the prevalence, anatomic dimensions, and radiographic characteristics of RMC in patients with recalcitrant chronic rhinosinusitis after previous FESS. Methods A retrospective review of patients who underwent revision FESS at a tertiary medical center between January 1, 2012, and December 31, 2014. Computed tomographies of patients who underwent revision FESS, including posterior ethmoidectomies, were reviewed. Each side of the scan was assessed for residual RMCs. The radiographic dimensions and Lund-Mackay (LM) scores of these cells were recorded. Results Sixty-nine patients who underwent revision FESS were identified. The median age of the patient population was 51 years (range, 21–79 years). Forty-two percent of the patients had nasal polyps. The mean number of previous FESS was 2 (range, 1–10). Incompletely dissected RMCs were identified in 101 of 138 analyzed sides (73%), despite documented previous posterior ethmoidectomies. Sixty-five percent of RMCs had an LM score of >1; RMCs of patients with polyps were more likely to have an LM score of 2 (p = 0.049). There was a significant correlation between the number of previous FESS procedures and whether the RMCs had been dissected (p = 0.010). There also was a significant correlation between RMC height and the number of previous FESS procedures (p = 0.015). Conclusion RMCs seemed to often be undissected during primary FESS and, thus, were commonly encountered in revision FESS. The majority of analyzed cells in this cohort demonstrated an LM score of >1, which indicated that these cells frequently harbor residual diseased mucosa that may contribute to the need for revision surgery.
Differences in Innate Immune Response Gene Regulation in the Middle Ear of Children who are Otitis Prone and in those not Otitis Prone
Authors: Kaur Ravinder , Casey Janet , Pichichero Michael 
Published: November 2016

Objective Acute otitis media (AOM) causes an inflammatory response in the middle ear. We assessed differences in innate immune responses involved in bacterial defense at onset of AOM in children who were stringently defined as otitis prone (sOP) and children not otitis prone (NOP). Study Design Innate immune genes analysis from middle ear fluid (MEF) samples of children. Methods Genes of toll-like receptors (TLR), nod-like and retinoic acid-inducible gene-I-like receptors, downstream effectors important for inflammation and apoptosis, including cytokines and chemokines, were studied from MEF samples by using a real-time polymerase chain reaction array. Protein levels of differentially regulated genes were measured by Luminex. Results Gene expression in MEF among children who were sOP was significantly different in upregulation of interleukin 8, secretory leukocyte peptidase inhibitor, and chemokine (C-C motif) ligand 3, and in downregulation of interferon regulatory factor 7 and its related signaling molecules interferon alpha, Toll-like receptor adaptor molecule 2, chemokine (C-C motif) ligand 5, and mitogen-activated protein kinase 8 compared with children who were NOP. Differences in innate gene regulation were similar when AOM was caused by Streptococcus pneumoniae or nontypeable Haemophilus influenzae. Conclusion Innate-immune response genes are differentially regulated in children who were sOP compared with children with NOP.