bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Intraoperative Hydrodebrider Treatment on Postoperative Sinonasal Inflammation
Authors: Banglawala Sarfaraz M. , Mulligan Jennifer K. , Psaltis Alkis J. , Wang Eric W. , Nguyen Shaun A. , Mulligan Ryan M. , Crosby Brittany L , Schlosser Rodney J. 
Published: September 2014

Background The impact of intraoperative hydrodebrider sinus irrigation (HSI) during endoscopic sinus surgery (ESS) on postoperative inflammation, endoscopy, and patient-reported outcomes has not been studied. Methods A clinical trial of 12 patients with symmetric chronic rhinosinusitis were prospectively randomized to HSI on one side after undergoing bilateral ESS. The contralateral side was not treated with any irrigation and served as an internal control. Preoperative computed tomography, endoscopic, 22-item Sino-Nasal Outcome Test (SNOT-22), and symptom visual analog scale (VAS) scores for each side were obtained. At 1 and 3 months postsurgery, endoscopy, SNOT-22, and sinus VAS were recorded. Sinonasal mucus levels of interleukin (IL)-6, IL-10, IL-17a, and tumor necrosis factor (TNF) alpha were measured at the time of surgery, 1 and 3 months, postoperatively, from each side. Results VAS scores improved on both sides (p < 0.05) and SNOT-22 improved at all postoperative time points (p < 0.05). Endoscopic scores of HSI-treated sides did not improve compared with baseline. HSI had no additional significant impact on postoperative VAS at any time point. HSI significantly decreased IL-17a levels when compared with the control side at 1 month (p = 0.034) and 3 months ( = 0.031). No significant change was seen in TNF-alpha, IL-6, or IL-10 on either side at any time point. Conclusion Intraoperative HSI at the time of ESS failed to establish any improvement in postoperative endoscopy or most local cytokine levels after ESS.
A Comparative and Descriptive Study of Asthma in Chronic Rhinosinusitis with Nasal Polyps
Authors: Håkansson Kåre , Thomsen Simon Francis , Konge Lars , Mortensen Jann , Backer Vibeke , von Buchwald Christian 
Published: September 2014

Background Chronic rhinosinusitis (CRS) is a common health problem that is subclassified as CRS with nasal polyps (CRSwNPs) or CRS without NPs (CRSsNP). In accordance with the united airways concept, CRSwNPs frequently coexists with asthma but to date, this association remains unexplained and its strength is uncertain. Here, we aimed to examine the association between CRSwNPs and asthma in collaboration between the neighboring specialities: otorhinolaryngology and respiratory medicine. Methods A prospective clinical study was performed comprising 40 CRS patients scheduled for functional endoscopic sinus surgery and 21 control persons. We performed nasal endoscopy, peak expiratory flow, spirometry, and bronchodilation tests. In selected cases, additional pulmonary tests were performed. Atopy was assessed by skin-prick test or by measuring specific IgE in serum. Results Asthma was diagnosed in 26 patients with CRSwNPs (65%; odds ratio = 5.9 [1.79,19.65]; p = 0.003), and 5 control persons (24%). Twenty-five percent of the CRSwNP patients had undiagnosed asthma. Atopy was not significantly associated with CRSwNPs (p = 0.39) or with coexisting asthma within the CRSwNP group (p = 0.50). Conclusion Compared with previous studies, we found a very high prevalence of asthma and, frequently, asthma was undiagnosed. Furthermore, CRSwNPs was associated with chronic bronchitis and, in those with asthma, lower airway obstruction. These results call for a closer collaboration between otorhinolaryngology and respiratory medicine in relation to patients with CRSwNPs, in research as well as in clinical practice.
Prevalence of Uncontrolled Allergic Rhinitis in Wuhan, China: A Prospective Cohort Study
Authors: Wang Youna , Zhu Rongfei , Liu Guanghui , Li Wenjing , Chen Hao , Daurès Jean-Pierre , Chiriac Anca Mirela , Demoly Pascal 
Published: September 2014

Background Allergic rhinitis (AR) is a highly prevalent disease that affects the quality of life, especially in the “severe chronic upper airway disease” (SCUAD) group of patients who still have severe symptoms after adequate treatment. This study investigated the prevalence of uncontrolled AR and SCUAD consulting in the Allergy Department of Tongji Hospital, Wuhan, China. Methods In this prospective cohort study, all patients consulting for AR were prospectively assessed using visual analog scale (VAS) and Allergic Rhinitis Control Test (ARCT) and put on standardized treatment based on the Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines. After 15 days, they were reevaluated by a telephone interview using a numerical scale (NS) and ARCT. A score of ARCT of <20 defined uncontrolled AR and a score of NS of ≥ 5 at day 15 defined SCUAD patients. Results A total of 252 patients were included. Moderate/severe AR (VAS ≥ 5) was diagnosed in 82.9 of the patients which had an impact on sleep (86.9%), work life (84.9%), social activities (81%), and physical activities (90.1%). Patients with uncontrolled AR (27.7%) at day 15 more frequently presented a higher weight (p = 0.042), history of ear, nose, and throat (ENT) infection or antibiotics intake for respiratory infection in the last 12 months (62.3% versus 45.6%; p = 0.018), smoking (15.9% versus 6.7%; p = 0.024), and smell disturbance (26.1% versus 11.7%; p = 0.005). Patients with SCUAD (24.5%) more frequently presented a history of ENT infection or antibiotics intake for respiratory infection in the last 12 months (63.9% versus 45.7%; p = 0.014) and smell disturbance (27.9% versus 11.7%; p = 0.003), and less commonly had atopic dermatitis (13.1% versus 28.2%; p = 0.017). Conclusion Uncontrolled AR and SCUAD patients are numerous. VAS and ARCT are simple and quantitative methods and self-completion questionnaires that can be used for a global evaluation of the severity and control of AR.
House Dust Mite Allergen Levels in Households and Correlation with Allergic Rhinitis Symptoms
Authors: Wang Yanjun , Xiong Liyan , Yin Xiaoyan , Wang Jinghui , Zhang Quanming , Yu Zizhong , Gong Guoqing , Zheng Yiwu , Chen Jianjun , Kong Weijia 
Published: September 2014

Background House dust mite (HDM) allergen is a risk factor for the development of allergic rhinitis (AR). Objectives To determine the levels of indoor allergens in the households of patients with AR in Wuhan city, identify the environmental risk factors for high allergen exposure, and investigate the correlations between allergen exposure and specific immunoglobulin E levels and symptoms. Methods The study examined 50 patients with AR. Two dust samples were collected from the bedding of each patient, one in summer and one in winter. Major allergens Der p 1 and Der f 1, from Dermatophagoides pteronyssinus and Dermatophagoides farinae, were measured with an enzyme-linked immunosorbent assay. Participants completed a standardized questionnaire about their living environments, and their rhinitis symptom scores were calculated. Specific immunoglobulin E levels against Der p and Der f were measured. Results The percentage of bedding samples with high HDM allergen (Der f 1 + Der p 1) levels (>10 μg/g) was 44% in summer and 46% in winter. There was no significant difference between the level of mite allergens in summer and winter; however, the level of Der f 1 was higher than that of Der p 1 (p < 0.05). The age of the mattress and pillow was significantly correlated with allergen concentration. Indoor HDM allergen level affected the severity of nasal itching. Conclusions HDMs are important indoor allergens in Wuhan. Mattresses and pillows that have been used for a long time contain high levels of allergens. High levels of exposure to HDM allergens correlates with the severity of nasal itching.
Utility of Apparent Diffusion Coefficient in Characterization of Different Sinonasal Pathologies
Authors: Taha Mohamed S. , Fiky Lobna M. El , Taha Togan M. , Sabra Reda M. , Youssef Tamer A. , Nada Ihab M. 
Published: September 2014

Background Sinonasal lesions are a heterogeneous group of lesions that span from a tumor to tumor-like nature. Characterization of such cases preoperatively can improve the surgical control and the overall outcome of these patients. Objective In this prospective study, we aimed at evaluation of the role of apparent diffusion coefficient (ADC) in the differentiation between benign and malignant sinonasal lesions. Subjects and methods All patients scheduled to have sinonasal surgical intervention at Ain Shams University Hospitals, Cairo, Egypt, were enrolled. Diffusion-weighted (DW) magnetic resonance imaging (MRI) with calculation of ADC were done for all cases. Radiologic findings were then compared with histologic findings, and the sensitivity, specificity, negative and positive predictive values (PPVs) of the conventional MRI, DW-MRI, and ADC value in differentiation of benign from malignant sinonasal lesions were then calculated. Results There were 59 patients with median age of 43 years old. There were 20 cases of inflammatory lesions, 16 cases of benign tumors, and 23 cases of malignant lesions. The ADC values of all cases ranged from 0.4 x 10−3 to 2 x 10−3 ( median .5 x 10−3). The median ADC value for the malignant lesions was 0.6 x 10−3, whereas that for the inflammatory conditions was 1.6 x 10−3 and that for the benign tumors was 1.5 x 10−3 with a highly significant difference (p < .001). Analysis of the conventional MRI and DW-MRI to differentiate between malignant and benign lesions showed that the sensitivity, specificity, PPV, and negative predictive value (NPV) were 100%, 97%, 96%, and 100% and 91%, 97%, 95%, and 95%, respectively. Conclusion DW-MRI did not add significantly to the information gained from conventional MRI. It should be considered complimentary only to standard MRI in uncertain cases when malignancy is still a concern.
Radiographic measurements of C-2 in patients with atlas assimilation
Authors: Aoyama Tatsuro , Yasuda Muneyoshi , Yamahata Hitoshi , Takeuchi Mikinobu , Joko Masahiro , Hongo Kazuhiro , Takayasu Masakazu 
Published: September 2014

Object
The object of this study was to evaluate the radiographic characteristics of C-2 using multiplanar CT measurements for anchor screw placement in patients with C-1 assimilation (C1A). Insertion of a C-2 pedicle screw in the setting of C1A is relatively difficult and technically demanding, and there has been no report about the optimal sizes of the pedicles and laminae of C-2 for screw placement in C1A.

Methods
An institutional database was searched for all patients who had undergone cervical CT scanning and cervical spine surgery between April 2006 and December 2012. Two neurosurgeons reviewed the CT scans from 462 patients who met these criteria, looking for C1A and other anomalies of the craniocervical junction such as high-riding vertebral artery (VA), basilar invagination, and VA anomaly. The routine axial images were reloaded on a workstation, and reconstruction CT images were used to measure parameters: the minimum width of bilateral pedicles and laminae and the length of bilateral laminae of the atlas.

Results
Seven patients with C1A were identified, and 14 sex-matched patients without C1A were randomly selected from the same database as a control group. The mean minimum pedicle width was 5.21 mm in patients with C1A and 7.17 mm in those without. The mean minimum laminae width was 5.29 mm in patients with C1A and 6.53 mm in controls. The mean minimum pedicle and laminae widths were statistically significantly smaller in the patients with C1A (p < 0.05).

Conclusions
In patients with C1A, the C-2 bony structures are significantly smaller than normal, making C-2 pedicle screw or translaminar screw placement more difficult.
Hochlagenaufforstungen in Lawinenverbauungen im Berner Oberland
Authors: Ryter Ueli 
Published: September 2014

Regeneration at high altitude in avalanche control stands in the Bernese Oberland
Since the 1950s, high altitude regeneration projects have been carried out in the avalanche control areas of the Bernese Oberland, using site-appropriate seedlings of domestic provenance from the cantonal nurseries. These plantations are intended to prevent, in the medium to long term, the start of avalanches. On the one hand, the article presents an analysis of the measures taken since 1995, and the field measurements made in the high altitude plantation at Schwanderort (1730–1780 m) above Brienz. This provides information on the development of young Spruce under extreme external conditions. On the other hand, the article investigates from what age the regeneration can provide avalanche protection functions, based on the growth characteristics of 112 trees of different ages, from 24 avalanche protection projects. Site conditions at high altitude are much more extreme and vary more from year to year than at lower altitude. Nineteen years after the plantation at Schwanderort, 60% of the Spruce are still alive; over this period, their average height has increased from 19 cm to 152 cm. Because of the short vegetative period, their height growth takes place between 20 June and end of July, and is stopped or strongly reduced when average temperatures are below 10°C. Analysis shows that at the upper forest limit, one must wait 45–50 years before regeneration can fulfil its avalanche protection function.
Methode zur standardisierten Beurteilung der Schutzwälder im Kanton Freiburg
Authors: Eyer Willy , Mazotti Benoît 
Published: September 2014

Method for a standardised assessment of protection forests in the canton of Fribourg
The canton of Fribourg has developed a method to monitor protection forests based on available data: site maps, stand maps, map of protection forests (SilvaProtect; with the corresponding hazardous processes) and silvicultural references. In all, eight different indicators issued from a GIS environment are interpreted according to a “traffic light” system (three categories). The analysis can be applied at different scales: catchment areas, forest management units, forest districts and the canton as a whole. The results are used to set priorities and facilitate the planning of silvicultural interventions and logging operations. Moreover, this monitoring method 1) assesses the degree to which a forest fulfils its protection function and 2) identifies the satisfactory and the potentially deficient areas of protection forests.
Cutting Edge: The UNC93B1 Tyrosine-Based Motif Regulates Trafficking and TLR Responses via Separate Mechanisms
Authors: Pelka Karin , Phulphagar Kshiti , Zimmermann Jana , Stahl Rainer , Schmid-Burgk Jonathan L. , Schmidt Tobias , Spille Jan-Hendrik , Labzin Larisa I. , Agrawal Sudhir , Kandimalla Ekambar R. , Casanova Jean-Laurent , Hornung Veit , Marshak-Rothstein Ann , Höning Stefan , Latz Eicke 
Published: September 2014

Abstract
Sensing of nucleic acids by TLRs is crucial in the host defense against viruses and bacteria. Unc-93 homolog B1 (UNC93B1) regulates the trafficking of nucleic acid–sensing TLRs from the endoplasmic reticulum to endolysosomes, where the TLRs encounter their respective ligands and become activated. In this article, we show that a carboxyl-terminal tyrosine-based sorting motif (YxxΦ) in UNC93B1 differentially regulates human nucleic acid–sensing TLRs in a receptor- and ligand-specific manner. Destruction of YxxΦ abolished TLR7, TLR8, and TLR9 activity toward nucleic acids in human B cells and monocytes, whereas TLR8 responses toward small molecules remained intact. YxxΦ in UNC93B1 influenced the subcellular localization of human UNC93B1 via both adapter protein complex (AP)1- and AP2-dependent trafficking pathways. However, loss of AP function was not causal for altered TLR responses, suggesting AP-independent functions of YxxΦ in UNC93B1.
Latent Infection with Cytomegalovirus Is Associated with Poor Memory CD4 Responses to Influenza A Core Proteins in the Elderly
Authors: Derhovanessian Evelyna , Maier Andrea B. , Hähnel Karin , McElhaney Janet E. , Slagboom Eline P. , Pawelec Graham 
Published: September 2014

Abstract
Influenza remains a major pathogen in older people. Infection with CMV and the accumulation of late-differentiated T cells associated with it have been implicated in poor Ab responsiveness to influenza vaccination in the elderly, most of whom are CMV positive. However, whether CMV infection also affects memory T cell responses to influenza remains unknown. To investigate this, we assessed T cell responses to influenza A matrix protein and nucleoprotein ex vivo in 166 Dutch individuals (mean age 62.2 y, range 42–82) and validated the results in a second cohort from North America (mean age 73.1 y, range 65–81, n = 28). We found that less than half of the CMV-infected older subjects mounted a CD4 T cell response to influenza Ags, whereas ∼80% of uninfected elderly did so. A similar proportion of younger subjects possessed influenza A virus–responsive CD4 T cells, and, interestingly, this was the case whether they were CMV-infected. Thus, the effect of CMV was only seen in the older donors, who may have been exposed to the virus for decades. The percentage of donors with CD8 responses to influenza A virus was lower than those with CD4; this was not influenced by whether the subjects were CMV seropositive or seronegative. CMV-seropositive responders had significantly higher frequencies of late-differentiated CD4 T-cells (CD45RA+/−CCR7−CD27−CD28−) compared with CMV-infected nonresponders. These data add to the accumulating evidence that infection with CMV has profound but heterogeneous effects on responses to the products of other viruses and have implications for the design of influenza vaccines, especially in the elderly.
Endothelial Microparticles Interact with and Support the Proliferation of T Cells
Authors: Wheway Julie , Latham Sharissa L. , Combes Valery , Grau Georges E. R. 
Published: September 2014

Abstract
Endothelial cells closely interact with circulating lymphocytes. Aggression or activation of the endothelium leads to an increased shedding of endothelial cell microparticles (MP). Endothelial MP (EMP) are found in high plasma levels in numerous immunoinflammatory diseases, such as atherosclerosis, sepsis, multiple sclerosis, and cerebral malaria, supporting their role as effectors and markers of vascular dysfunction. Given our recently described role for human brain microvascular endothelial cells (HBEC) in modulating immune responses, we investigated how HBEC-derived MP could interact with and support the proliferation of T cells. Like their mother cells, EMP expressed molecules important for Ag presentation and T cell costimulation, that is, β2-microglobulin, MHC II, CD40, and ICOSL. HBEC were able to take up fluorescently labeled Ags with EMP also containing fluorescent Ags, suggestive of Ag carryover from HBEC to EMP. In cocultures, fluorescently labeled EMP from resting or cytokine-stimulated HBEC formed conjugates with both CD4+ and CD8+ subsets, with higher proportions of T cells binding EMP from cytokine-stimulated cells. The increased binding of EMP from cytokinestimulated HBEC to T cells was VCAM-1 and ICAM-1 dependent. Finally, in CFSE T cell proliferation assays using anti-CD3 mAb or T cell mitogens, EMP promoted the proliferation of CD4+ T cells and that of CD8+ T cells in the absence of exogenous stimuli and in the T cell mitogenic stimulation. Our findings provide novel evidence that EMP can enhance T cell activation and potentially ensuing Ag presentation, thereby pointing toward a novel role for MP in neuroimmunological complications of infectious diseases.
Monocyte-Induced Development of Th17 Cells and the Release of S100 Proteins Are Involved in the Pathogenesis of Graft-versus-Host Disease
Authors: Reinhardt Katharina , Foell Dirk , Vogl Thomas , Mezger Markus , Wittkowski Helmut , Fend Falko , Federmann Birgit , Gille Christian , Feuchtinger Tobias , Lang Peter , Handgretinger Rupert , Andreas Bethge Wolfgang , Holzer Ursula 
Published: September 2014

Abstract
Graft-versus-host disease (GvHD) is a major cause of morbidity and mortality after allogeneic hematopoietic cell transplantation. However, the pathophysiology of GvHD remains poorly understood. In this study, we analyzed the induction of Th17 cells by monocytes of patients with GvHD in vitro, demonstrating that monocytes isolated from patients with acute skin and intestinal GvHD stage I–IV and chronic GvHD induce significantly increased levels of Th17 cells compared with patients without GvHD. S100 proteins are known to act as innate amplifier of inflammation. We therefore investigated the presence of S100 proteins in the stool, serum, and bowel tissue of patients with GvHD and the influence of S100 proteins on the induction of Th17 cells. Elevated levels of S100 proteins could be detected in patients with acute GvHD, demonstrating the release of these phagocyte-specific proteins during GvHD. Furthermore, stimulation of monocytes with S100 proteins was found to promote Th17 development, emphasizing the role of S100 proteins in Th17-triggered inflammation. Altogether, our results indicate that induction of Th17 cells by activated monocytes and the stimulatory effects of proinflammatory S100 proteins might play a relevant role in the pathogenesis of acute GvHD. Regarding our data, S100 proteins might be novel markers for the diagnosis and follow-up of GvHD.
National Collegiate Athletic Association Division I Athletic Trainers' Concussion-Management Practice Patterns
Authors: Kelly Kassandra C. , Jordan Erin M. , Joyner A. Barry , Burdette G. Trey , Buckley Thomas A. 
Published: September 2014

Context:
A cornerstone of the recent consensus statements on concussion is a multifaceted concussion-assessment program at baseline and postinjury and when tracking recovery. Earlier studies of athletic trainers' (ATs') practice patterns found limited use of multifaceted protocols; however, these authors typically grouped diverse athletic training settings together.

Objective:
To (1) describe the concussion-management practice patterns of National Collegiate Athletic Association (NCAA) Division I ATs, (2) compare these practice patterns to earlier studies, and (3) objectively characterize the clinical examination.

Design:
Cross-sectional study.

Setting:
Online survey.

Patients or Other Participants:
A total of 610 ATs from NCAA Division I institutions, for a response rate of 34.4%.

Main Outcome Measure(s):
The survey had 3 subsections: demographic questions related to the participant's experiences, concussion-assessment practice patterns, and concussion-recovery and return-to-participation practice patterns. Specific practice-pattern questions addressed balance, cognitive and mental status, neuropsychological testing, and self-reported symptoms. Finally, specific components of the clinical examination were examined.

Results:
We identified high rates of multifaceted assessments (ie, assessments using at least 3 techniques) during testing at baseline (71.2%), acute concussion assessment (79.2%), and return to participation (66.9%). The specific techniques used are provided along with their adherence with evidence-based practice findings. Respondents endorsed a diverse array of clinical examination techniques that often overlapped objective concussion-assessment protocols or were likely used to rule out associated potential conditions. Respondents were cognizant of the Third International Consensus Statement, the National Athletic Trainers' Association position statement, and the revised NCAA Sports Medicine Handbook recommendations.

Conclusions:
Athletic trainers in NCAA Division I demonstrated widespread use of multifaceted concussion-assessment techniques and appeared compliant with recent consensus statements and the NCAA Sports Medicine Handbook.