bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transoral Robotic Surgery for Obstructive Sleep Apnea
Authors: Justin Grant A. , Chang Edward T. , Camacho Macario , Brietzke Scott E. 
Published: March 2016

ObjectiveTo perform a systematic review of the international biomedical literature evaluating the effectiveness, complications, and safety of transoral robotic surgery (TORS) for the treatment of obstructive sleep apnea (OSA).Data SourcesPubMed/MEDLINE, Embase, and EMB Reviews databases were searched up to November 27, 2015.Review MethodsTwo authors systematically and independently searched for articles on TORS for the treatment of OSA in adults that reported either outcomes for the apnea‐hypopnea index (AHI), lowest oxygen saturation percentage (LSAT) or changes in the Epworth Sleepiness Scale (ESS), and/or rates and types of complications associated with the operation.ResultsIn total, 181 records were identified and 16 articles met inclusion criteria. Transoral robotic surgery was almost always combined with other sleep surgery procedures. The summary estimate of the decrease in AHI using TORS as part of a multilevel surgical approach was 24.0 (95% confidence interval [CI], 22.1‐25.8; P <. 001, I2 = 99%). The summary estimate of a decrease in ESS score was 7.2 (95% CI, 6.6‐7.7; P <. 001, I2 = 99%) and of the overall surgical “success” (defined as AHI <20 and 50% reduction) was 48.2% (95% CI, 38.8%‐57.7%; P <. 001, I2 = 99%). Three large studies reported on their total complication rates with an average of 22.3% (range, 20.5%‐24.7%).ConclusionsThe initial results for the use of TORS as part of a multilevel surgical approach for OSA are promising for select patients. However, the cost and morbidity may be greater than with other techniques offsetting its advantages in visualization and precision. More prospective studies are needed to determine the optimal role of this tool.
Monothermal Caloric Screening Test Accuracy
Authors: Adams Meredith E. , Telian Steven A. , Kane Robert L. , Butler Mary 
Published: March 2016

ObjectiveTo minimize discomfort, time, and costs, vestibular laboratories may perform monothermal caloric irrigations and discontinue testing if responses are symmetric. This systematic review aimed to determine the diagnostic accuracy of the monothermal caloric screening test (MCST) for unilateral vestibular dysfunction compared with bithermal caloric testing (BCT).Data SourcesOvid‐MEDLINE, EMBASE, Scopus, Cochrane CENTRAL, and manual bibliographic searches.Review MethodsInclusion criteria specified concurrent MCST and BCT performance and reporting of test measures (monothermal caloric asymmetry, unilateral weakness). The primary outcomes were between‐measure correlation, sensitivity, and specificity. Meta‐analysis was performed with hierarchical bivariate and univariate random‐effects models. Heterogeneity was assessed with the I2 statistic.ResultsFifteen studies (n = 5572 participants) met inclusion criteria. Thresholds varied between studies. Asymmetries calculated by MCST and BCT were strongly correlated, but a subgroup analysis showed no correlation for those with mild unilateral weakness. The sensitivity and specificity of the MCST ranged from 0.54 to 1.00 and 0.25 to 0.96, respectively. Predictably, higher sensitivity resulted from lower cutoff points for the MCST, higher thresholds for the BCT, and additional test positivity criteria. Warm irrigations yielded higher sensitivity than cool. Studies excluding participants with severe unilateral weakness yielded lower sensitivity estimates. After pooling by threshold, temperature, and risk of bias, most performance estimates remained substantially heterogeneous (I2 > 60%).ConclusionAccuracy of the MCST is lacking precisely where it is needed most—at the border of normal and abnormal vestibular function. To guide clinical practice, research should include analysis of subgroups with varying levels of function and employ standardized testing parameters.
Pediatric Endoscopic Cholesteatoma Surgery
Authors: Hunter Jacob B. , Zuniga M. Geraldine , Sweeney Alex D. , Bertrand Natalie M. , Wanna George B. , Haynes David S. , Wootten Christopher T. , Rivas Alejandro 
Published: March 2016

Objectives(1) To describe and review a single center’s pediatric endoscopic cholesteatoma experience, including surgical and audiologic outcomes. (2) To assess the most common locations of residual cholesteatoma following endoscopic removal.Study DesignCase series with chart review.SettingTertiary otologic referral center.SubjectsPatients <19 years of age who underwent cholesteatoma removal with either endoscopic or microscopic visualization.MethodsIn a comparison of patients who underwent total endoscopic ear surgery (TEES), combined endoscopic‐microscopic surgery, or microscopic surgery, analyzed outcomes included locations and incidence of recurrent and residual cholesteatoma, complications, and audiometric testing.ResultsSixty‐six patients (mean age, 10.9 years; range, 4‐18 years; 43.4% female) with 76 ears met inclusion criteria. The average overall follow‐up was 18.8 months (range, 6.7‐48.3). Forty‐seven (61.8%) ears underwent microscopic removal of cholesteatoma; 29 (38.1%) ears underwent combined endoscopic‐microscopic removal; and 8 (10.5%) ears underwent TEES removal. Significantly more mastoidectomies were completed in microscopic cases as compared with endoscopic cases (P =. 049). Though second‐look procedures occurred in 15 (51.7%) endoscopic cases and 10 (21.3%) microscopic cases (P =. 006), the rate of residual disease was 20.0% and 40.0% in endoscopic and microscopic cases, respectively (P =. 38). When controlling for preoperative hearing, only the air‐bone gap for TEES demonstrated significant improvement (P =. 009). No complications were noted.ConclusionThe present report describes our experience with pediatric endoscopic cholesteatoma surgery, demonstrating similar hearing outcomes, rates of recurrence and residual disease, and complication rates as compared with traditional microscopic techniques.
Inhibition of Inflammation‐Associated Olfactory Loss by Etanercept in an Inducible Olfactory Inflammation Mouse Model
Authors: Jung Yong Gi , Lane Andrew P. 
Published: March 2016

ObjectiveTo determine the effect of a soluble human tumor necrosis factor alpha (TNF‐α) receptor blocker (etanercept) on an inducible olfactory inflammation (IOI) mouse model.Study DesignAn in vivo study using a transgenic mouse model.SettingResearch laboratory.Subjects and MethodsTo study the impact of chronic inflammation on the olfactory system, a transgenic mouse model of chronic rhinosinusitis–associated olfactory loss was utilized (IOI mouse), expressing TNF‐α in a temporally controlled fashion within the olfactory epithelium. In one group of mice (n = 4), etanercept was injected intraperitoneally (100 μg/dose, 3 times/week) concurrent with a 2‐week period of TNF‐α expression. A second group of mice (n = 2) underwent induction of TNF‐α expression for 8 weeks, with etanercept treatment administered during the final 2 weeks of inflammation. Olfactory function was assayed by elecro‐olfactogram (EOG), and olfactory tissue was processed for histology and immunohistochemical staining. Each group was compared with an equal‐number control group.ResultsCompared with nontreated IOI mice, etanercept‐treated IOI mice showed significantly improved EOG responses after 2 weeks (P <. 001). After 8 weeks of induced inflammation, there was massive loss of olfactory epithelium and no EOG response in nontreated IOI mice. However, in etanercept‐treated mice, regeneration of olfactory epithelium was observed.ConclusionConcomitant administration of etanercept in IOI mice results in interruption of TNF‐α‐induced olfactory loss and induction of neuroepithelial regeneration. This demonstrates that etanercept has potential utility as a tool for elucidating the role of TNF‐α in other olfactory inflammation models.
Ciprofloxacin Decreases Collagen in Mouse Tympanic Membrane Fibroblasts
Authors: Orobello Nicklas C. , Dirain Carolyn O. , Schultz Gregory , Milne‐Davies Bailey A. , Ng Maria R. A. , Antonelli Patrick J. 
Published: March 2016

ObjectivesTo determine how collagen production by tympanic membrane fibroblasts is affected by ciprofloxacin at levels found in eardrops.Study DesignProspective, controlled, and blinded cell culture study.SettingAcademic tertiary medical center.SubjectsCell culture of mouse fibroblasts.MethodsA primary fibroblast culture was established from mouse tympanic membranes. Fibroblasts were cultured until they were 75% confluent, then treated with dilute hydrochloric acid (control) or ciprofloxacin (0.01% or 0.3%) for 24 or 72 hours for Western blotting and for 24 or 48 hours for cytotoxicity assay. Cells were observed with phase‐contrast microscope. Western blotting was performed for collagen type 1 α1 (collagen 1A1) and α‐tubulin.ResultsFibroblasts treated with 0.01% and 0.3% ciprofloxacin for 24 hours had lower levels of collagen 1A1 (P =. 0005 and P <. 0001, respectively) and α‐tubulin (both P <. 0001) than control fibroblasts. Collagen 1A1 and α‐tubulin levels were lower in fibroblasts treated with 0.3% than with 0.01% ciprofloxacin (P =. 02 and P =. 014). After 72 hours, 0.3% ciprofloxacin completely eliminated collagen 1A1 and α‐tubulin (P <. 001). Cells treated with 0.01% ciprofloxacin for 72 hours also had lower collagen 1A1 (P <. 0001) and α‐tubulin (P =. 005) as compared with the control. Seventy‐two‐hour incubation in 0.01% or 0.3% ciprofloxacin resulted in lower levels of collagen 1A1 (P =. 009 and P <. 0001, respectively) and α‐tubulin (P =. 007 and P <. 0001, respectively) than 24‐hour incubation. Cytotoxicity assay and phase‐contrast microscopy mirrored these findings.ConclusionsTreatment of tympanic membrane fibroblasts with 0.3% ciprofloxacin, as found in eardrops, reduces fibroblast viability and collagen and α‐tubulin protein levels. These findings could explain tympanic membrane healing problems associated with quinolone eardrops.
Effects of a Fibrin Sealant on Skin Graft Tissue Adhesion in a Rodent Model
Authors: Balceniuk Mark D. , Wingate Nicholas A. , Krein Howard , Curry Joseph , Cognetti David , Heffelfiner Ryan , Luginbuhl Adam 
Published: March 2016

ObjectiveTo establish a rodent model for skin grafting with fibrin glue and examine the effects of fibrin glue on the adhesive strength of skin grafts without bolsters.Study DesignAnimal cohort.SettingAcademic hospital laboratory.Subjects and MethodsThree skin grafts were created using a pneumatic microtome on the dorsum of 12 rats. Rats were evenly divided into experimental (n = 6) and control (n = 6) groups. The experimental group received a thin layer of fibrin glue between the graft and wound bed, and the control group was secured with standard bolsters. Adherence strength of the skin graft was tested by measurement of force required to sheer the graft from the recipient wound. Adhesion strength measurements were taken on postoperative days (PODs) 1, 2, and 3.ResultsThe experimental group required an average force of 719 g on POD1, 895 g on POD2, and 676 g on POD3, while the average force in the control group was 161 g on POD1, 257 g on POD2, and 267 g on POD3. On each of the 3 PODs, there was a significant difference in adherence strength between the experimental and control groups (P =. 036, P =. 029, P =. 024).ConclusionThere is a significant difference in the adhesion strength of skin grafts to the wound bed in the early postoperative period of the 2 groups. In areas of high mobility, using the fibrin sealant can keep the graft immobile during the critical phases of early healing.
Sinus Computed Tomography Imaging in Pediatric Cystic Fibrosis
Authors: Gergin Ozgul , Kawai Kosuke , MacDougall Robert D. , Robson Caroline D. , Moritz Ethan , Cunningham Michael , Adil Eelam 
Published: March 2016

Study ObjectiveTo evaluate the prevalence of computed tomography (CT) sinus imaging in a pediatric cystic fibrosis (CF) population, determine changes in Lund Mackay (LM) scores over time, and estimate radiation exposure.Study DesignCase series with chart review.SettingTertiary care children’s hospital.Subjects and MethodsIn total, 202 pediatric patients with CF who underwent endoscopic sinus surgery (ESS) were included. The total number of CT scans was calculated for each patient, with specific focus on the indications for and subsequent outcomes of the sinus CT scan subgroup.ResultsPatients underwent a total of 1718 CT scans, 832 of which were sinus CT scans (mean of 4.2 sinus scans per patient). Disease evaluation (54%) and preoperative planning (35%) were the most common indications. Otolaryngologists were more likely to order imaging for preoperative evaluation, and those scans were more likely to result in surgery compared with those requested by other physicians (P <. 001). Ninety CT scans (10.8%) led to no change in management. There was no significant difference in LM scores between patients admitted to the hospital or prescribed antibiotics and those who were not. There was also no significant change in LM score following ESS after adjusting for age and sex (P =. 23).ConclusionBased on LM scores, all sinus CT scans in patients with CF reveal moderate to severe sinus disease. Effort should be made to minimize radiation exposure in patients with CF by limiting sinus CT scans to the preoperative context or for evaluation of potential sinusitis complications.
Ethical challenges when using coercion in mental healthcare: A systematic literature review
Authors: Hem Marit Helene , Gjerberg Elisabeth , Husum Tonje Lossius , Pedersen Reidar 
Published: March 2016

Background: To better understand the kinds of ethical challenges that emerge when using coercion in mental healthcare, and the importance of these ethical challenges, this article presents a systematic review of scientific literature. Methods: A systematic search in the databases MEDLINE, PsychInfo, Cinahl, Sociological Abstracts and Web of Knowledge was carried out. The search terms derived from the population, intervention, comparison/setting and outcome. A total of 22 studies were included. Ethical considerations: The review is conducted according to the Vancouver Protocol. Results: There are few studies that study ethical challenges when using coercion in an explicit way. However, promoting the patient’s best interest is the most important justification for coercion. Patient autonomy is a fundamental challenge facing any use of coercion, and some kind of autonomy infringement is a key aspect of the concept of coercion. The concepts of coercion and autonomy and the relations between them are very complex. When coercion is used, a primary ethical challenge is to assess the balance between promoting good (beneficence) and inflicting harm (maleficence). In the included studies, findings explicitly related to justice are few. Some studies focus on moral distress experienced by the healthcare professionals using coercion. Conclusion: There is a lack of literature explicitly addressing ethical challenges related to the use of coercion in mental healthcare. It is essential for healthcare personnel to develop a strong awareness of which ethical challenges they face in connection with the use of coercion, as well as challenges related to justice. How to address ethical challenges in ways that prevent illegitimate paternalism and strengthen beneficent treatment and care and trust in connection with the use of coercion is a ‘clinical must’. By developing a more refined and rich language describing ethical challenges, clinicians may be better equipped to prevent coercion and the accompanying moral distress.
Practical urinalysis in the cat
Authors: Reppas George , Foster Susan F 
Published: March 2016

Series outline: This is the first article in a two-part series on urinalysis in the cat. The focus of Part 1 is urine macroscopic examination. Part 2, to appear in the May 2016 issue, discusses urine microscopic examination. Practical relevance: Urinalysis is an essential procedure in feline medicine but often little attention is paid to optimising the data yielded or minimising factors that can affect the results. Clinical challenges: For the best results, appropriately collected urine should be prepared promptly by specialist laboratory personnel for the relevant tests and assessed by a clinical pathologist. This is invariably impractical in clinical settings but careful attention can minimise artefacts and allow maximum useful information to be obtained from this seemingly simple process. Audience: Clinical pathologists would be familiar with the information provided in this article, but it is rarely available to general or specialist practitioners, and both can potentially benefit. Equipment: Most of the required equipment is routinely available to veterinarians. However, instructions have been provided to give practical alternatives for specialist procedures in some instances. Evidence base: Evidence for much of the data on urinalysis in cats is lacking. Validation of the human equipment used routinely, such as dipsticks, is also lacking. As such, the evidence base for feline urinalysis is quite poor and information has largely been extrapolated from the human literature. Information from feline studies has been included where available. In addition, practical clinicopathological and clinical observations are provided.
Differences in electrophysiological properties of functionally identified nociceptive sensory neurons in an animal model of cancer-induced bone pain
Authors: Zhu Yong Fang , Ungard Robert , Seidlitz Eric , Zacal Natalie , Huizinga Jan , Henry James L , Singh Gurmit 
Published: March 2016

Background Bone cancer pain is often severe, yet little is known about mechanisms generating this type of chronic pain. While previous studies have identified functional alterations in peripheral sensory neurons that correlate with bone tumours, none has provided direct evidence correlating behavioural nociceptive responses with properties of sensory neurons in an intact bone cancer model. Results In a rat model of prostate cancer-induced bone pain, we confirmed tactile hypersensitivity using the von Frey test. Subsequently, we recorded intracellularly from dorsal root ganglion neurons in vivo in anesthetized animals. Neurons remained connected to their peripheral receptive terminals and were classified on the basis of action potential properties, responses to dorsal root stimulation, and to mechanical stimulation of the respective peripheral receptive fields. Neurons included C-, Aδ-, and Aβ-fibre nociceptors, identified by their expression of substance P. We suggest that bone tumour may induce phenotypic changes in peripheral nociceptors and that these could contribute to bone cancer pain. Conclusions This work represents a significant technical and conceptual advance in the study of peripheral nociceptor functions in the development of cancer-induced bone pain. This is the first study to report that changes in sensitivity and excitability of dorsal root ganglion primary afferents directly correspond to mechanical allodynia and hyperalgesia behaviours following prostate cancer cell injection into the femur of rats. Furthermore, our unique combination of techniques has allowed us to follow, in a single neuron, mechanical pain-related behaviours, electrophysiological changes in action potential properties, and dorsal root substance P expression. These data provide a more complete understanding of this unique pain state at the cellular level that may allow for future development of mechanism-based treatments for cancer-induced bone pain.
Ferrule Effect
Authors: Skupien J.A. , Luz M.S. , Pereira-Cenci T. 
Published: March 2016

The aim of this study was to systematically review the literature for laboratory and clinical studies to evaluate the effect of ferrule in restored endodontically treated teeth. The search was conducted in 2 databases (PubMed, Scopus) with no publication year/language limits. From 1,872 potentially eligible studies, 124 studies were selected for full-text analysis, and 37 were included for review, with 32 of those considered in the meta-analysis and 5 considered in the survival analysis. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. For laboratory studies, a meta-analysis was performed for the comparison of the fracture resistance of teeth with and without ferrule, and 3 subgroup analyses were conducted for ferrule height, post type, and type of tooth. For clinical studies, the Kaplan-Meier method was used to determine the survival of restorations, with log-rank test used to identify differences between groups ( α = 5%). Teeth without ferrule had a lower fracture resistance ( P < 0.00001), and the higher the height of ferrule, the greater the fracture resistance was, irrespective of the type of post ( P < .000001). Teeth with ferrule had higher clinical longevity ( P = 0.002); however, the presence of a ferrule was related to higher survival only for premolars ( P = 0.05). In conclusion, the presence of a ferrule is responsible for an improvement in the fracture resistance of the restoration in laboratory studies. Yet, other clinical factors besides the ferrule may be associated with survival in molars and anterior teeth and need to be further investigated. Knowledge Transfer Statement: The results of this study can be used by clinicians when deciding which approach to use when planning the restoration of endodontically treated teeth with and without ferrule. Ferrule may lead to higher tooth/restoration survival, while tooth location may influence therapeutic decisions.
MetICA: independent component analysis for high-resolution mass-spectrometry based non-targeted metabolomics
Authors: Liu Youzhong , Smirnov Kirill , Lucio Marianna , Gougeon Régis D. , Alexandre Hervé , Schmitt-Kopplin Philippe 
Published: March 2016

AbstractBackgroundInterpreting non-targeted metabolomics data remains a challenging task. Signals from non-targeted metabolomics studies stem from a combination of biological causes, complex interactions between them and experimental bias/noise. The resulting data matrix usually contain huge number of variables and only few samples, and classical techniques using nonlinear mapping could result in computational complexity and overfitting. Independent Component Analysis (ICA) as a linear method could potentially bring more meaningful results than Principal Component Analysis (PCA). However, a major problem with most ICA algorithms is the output variations between different runs and the result of a single ICA run should be interpreted with reserve.ResultsICA was applied to simulated and experimental mass spectrometry (MS)-based non-targeted metabolomics data, under the hypothesis that underlying sources are mutually independent. Inspired from theIcassoalgorithm, a new ICA method,MetICAwas developed to handle the instability of ICA on complex datasets. Like the originalIcassoalgorithm, MetICAevaluated the algorithmic and statistical reliability of ICA runs. In addition,MetICAsuggests two ways to select the optimal number of model components and gives an order of interpretation for the components obtained.ConclusionsCorrelating the components obtained with prior biological knowledge allows understanding how non-targeted metabolomics data reflect biological nature and technical phenomena. We could also extract mass signals related to this information. This novel approach provides meaningful components due to their independent nature. Furthermore, it provides an innovative concept on which to base model selection: that of optimizing the number of reliable components instead of trying to fit the data. The current version ofMetICAis available athttps://github.com/daniellyz/MetICA.