bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender Differences in Successful NIH Grant Funding in Otolaryngology
Authors: Eloy Jean Anderson , Svider Peter F. , Kovalerchik Olga , Baredes Soly , Kalyoussef Evelyne , Chandrasekhar Sujana S. 
Published: April 2013

ObjectiveTo evaluate gender differences in NIH funding among faculty in otolaryngology departments and discuss potential reasons for these differences.Study Design and SettingAnalysis of NIH funding data available on the online NIH RePORTER system.MethodsFiscal year 2011 and 2012 NIH funding awards to principal investigators (PIs) in otolaryngology departments were obtained and used to examine faculty listings from otolaryngology departments for academic rank and gender. The Scopus database was used to determine publication range of these faculty members.ResultsIndividual mean NIH awards to men ($362,946 ± $21,247 standard error of mean) were higher than those to women ($287,188 ± $38,029). Male PIs were found to have higher mean NIH funding totals (aggregating grants for PIs with multiple awards) than female PIs ($498,593 vs $359,276). Upon organization by academic rank and years active, men had significantly higher funding levels at both the level of assistant professor and at 10 to 20 years of experience. Of all NIH grants awarded, men had a higher percentage of the more prestigious R‐series grants (76.2%) than did women (63.4%).ConclusionsMale faculty members have higher NIH funding levels than their female colleagues, a disparity that exists separate from career longevity, as it is true both at the rank of assistant professor and for those with 10 to 20 years of research experience. The larger proportion of R‐series NIH grants awarded to male faculty may contribute to this finding. This discrepancy in percentage and dollars of funding exists despite the increasing percentages of women in higher ranks.
Use of Apneic Oxygenation for the Performance of Pan‐endoscopy
Authors: Rudlof Burkard , Hohenhorst Winfried 
Published: April 2013

ObjectiveTo evaluate the efficacy of apneic oxygenation for the performance of pan‐endoscopy.Study DesignClinical retrospective study.SettingA university teaching hospital in Wuppertal, Germany.SubjectsForty‐seven patients who underwent pan‐endoscopy under apneic oxygenation during a period of 1 year.MethodsAfter preoxygenation and induction of anesthesia, an 8 French catheter was introduced into the trachea for oxygen supply. Pan‐endoscopy was carried out, as long as there were no signs of desaturation. The data were collected retrospectively from the anesthesia charts.ResultsApnea was well tolerated up to 45 minutes in most of the patients. In 2 patients, the method was carried out incorrectly, and in 1 obese patient, it was not possible to get an acceptable oxygenation.ConclusionWith appropriate monitoring, sufficient nitrogen elution, and proper patient selection, we believe that this technique is superior to jet ventilation and intubation for pan‐endoscopy, allowing unimpeded operative visualization.
Hemorrhage after Transoral Robotic‐Assisted Surgery
Authors: Asher Scott A. , White Hilliary N. , Kejner Alexandra E. , Rosenthal Eben L. , Carroll William R. , Magnuson J. Scott 
Published: April 2013

ObjectiveAn increasing number of head and neck surgeons have begun using transoral robotic‐assisted surgery. Our objective was to examine the postoperative bleeding complications we have encountered to determine risk factors and to discuss the topic of hemorrhage control.Study DesignCase series with chart review.MethodsMedical records were reviewed in 147 consecutive patients undergoing transoral robotic‐assisted surgery for any indication at one tertiary academic medical center between March 2007 and September 2011.ResultsEleven of 147 (7.5%) patients undergoing transoral robotic‐assisted surgery experienced some degree of postoperative hemorrhage, with 9 patients requiring reoperation for examination and/or control of bleeding. Bleeding occurred at a mean of 11.1 ± 9.2 days after initial operation. Eight of 11 (72%) patients who bled were on antithrombotic medication (anticoagulants or antiplatelet agents) for other medical comorbidities. The postoperative hemorrhage rate in patients taking antithrombotic medication (8/48 patients = 17%) was significantly higher than in those not taking antithrombotics (3/99 patients = 3%), P =. 0057. While the bleeding rate in salvage surgery (3/29 = 10.3%) was slightly higher than in primary surgery (8/118 = 6.8%), this difference did not reach statistical significance.ConclusionPotential for postoperative bleeding in association with antithrombotic medications in patients undergoing transoral robotic‐assisted surgery should be recognized. Various effective techniques for management of these patients without robotic assistance were demonstrated.
Long‐term Outcome of Round Window Vibrant SoundBridge Implantation in Extensive Ossicular Chain Defects
Authors: Colletti Liliana , Mandalà Marco , Colletti Vittorio 
Published: April 2013

ObjectiveTo evaluate retrospectively the long‐term safety and efficacy of the first 50 patients, all suffering from severe ossicular chain defects and with moderate to severe mixed hearing loss, who received the Vibrant SoundBridge with the floating mass transducer located on the round window membrane. To evaluate differences in outcome versus etiology and age of the patient population.Study DesignCase series with planned data collection.SettingTertiary referral medical center.Subjects and MethodsPatients eligible for implantation of the floating mass transducer on the round window membrane ranged in age from 2 months to 74 years with a moderate to severe conductive or mixed hearing loss from different etiologies. For each adult patient, preoperative versus postoperative bone and air conduction thresholds, air‐bone gaps, and speech understanding scores were evaluated at 24‐month follow‐up. At 60‐month follow‐up, data were available from 33 patients. Preoperative and postoperative free‐field auditory brainstem responses were studied in infants and children. Intraoperative and short‐ and long‐term postoperative complications are presented.ResultsThere were significant improvements in speech perception and pure‐tone audiometry in adults and auditory brainstem response thresholds in infants immediately after surgery and at follow‐up examinations (12 to 71 months). No significant complications or device extrusions were observed in the present series.ConclusionsInfants, children, and adults with moderate to severe conductive or mixed hearing loss obtained substantial benefit from implantation of the floating mass transducer on the round window membrane regardless of the etiology of hearing loss and previous surgery.
Salvage Laryngectomy in Patients with Recurrent Laryngeal Cancer in the Setting of Nonoperative Treatment Failure
Authors: Li Mingsi , Lorenz Robert R. , Khan Mumtaz J. , Burkey Brian B. , Adelstein David J. , Greskovich John F. , Koyfman Shlomo A. , Scharpf Joseph 
Published: April 2013

ObjectiveTo investigate the effectiveness of salvage partial and total laryngectomy in the treatment of recurrent laryngeal cancer in the setting of initial nonoperative treatment failure and to identify factors influencing long‐term survival.Study DesignCase series with planned chart review.SettingTertiary medical center.Subjects and MethodsPatients with recurrent squamous cell carcinoma of the larynx initially treated with either radiation or chemoradiation, who underwent salvage laryngectomy at the Cleveland Clinic Foundation from 1997 to 2011, were identified. The cohort was divided into an early‐stage group and an advanced‐stage group based on initial tumor staging. Survival outcome was evaluated separately in each group against tumor staging, methods of treatment, and nodal status. Secondary endpoints of speech and swallowing were also evaluated.ResultsA total of 100 patients were identified, with 72 patients in the early‐stage group and 28 patients in the advanced‐stage group. The overall postsalvage locoregional control rate was 70%, and the 5‐year disease‐specific survival was 70% and 55.2% in the early and advanced group, respectively (P =. 39). The 5‐year disease‐specific survival was not significant in either group when compared with recurrent staging, initial treatment, salvage treatment, or nodal disease (P = ns). Using voice prostheses, good to excellent speech function was achieved postoperatively in most patients.ConclusionTumor staging, methods of initial and salvage treatment, and nodal disease were not significant predictors of survival. Both salvage partial and total laryngectomy were effective methods in the treatment of recurrent laryngeal cancer in carefully selected patients.
Head and Neck Cancer Stem Cells: The Effect of HPV—An In Vitro and Mouse Study
Authors: Tang Alice L. , Owen John H. , Hauff Samantha J. , Park Jung Je , Papagerakis Silvana , Bradford Carol R. , Carey Thomas E. , Prince Mark E. 
Published: April 2013

ObjectivesTo determine if the behavior of cancer stem cells (CSCs) is affected by human papillomavirus (HPV) status.Study DesignAn in vitro and in vivo analysis of HPV and CSCs.SettingUniversity laboratory.Subjects and MethodsWe isolated CSCs from HPV‐positive and HPV‐negative cell lines. Two HPV‐negative cell lines underwent lentiviral transduction of E6/E7. Chemoresistence was determined using colony formation assays. Native HPV‐positive and HPV E6/E7‐transduced cells were compared for lung colonization after tail vein injection in NOD/SCID mice.ResultsThe proportion of CSC is not significantly different in HPV‐positive or HPV‐negative head and neck squamous cell carcinoma (HNSCC) cell lines. The HNSCC CSCs are more resistant to cisplatin than the non‐CSCs, but there were no significant differences between HPV‐positive and HPV‐negative cells. The HPV‐negative cancer cells yielded low colony formation after cell sorting. After transduction with HPV E6/E7, increased colony formation was observed in both CSCs and non‐CSCs. Results from tail vein injections yielded no differences in development of lung colonies between HPV E6/E7‐transduced cells and nontransduced cells.ConclusionsHuman papillomavirus status does not correlate with the proportion of CSCs present in HNSCC. The HPV‐positive cells and those transduced with HPV E6/E7 have a greater clonogenicity than HPV‐negative cells. The HNSCC CSCs are more resistant to cisplatin than non‐CSCs. This suggests that common chemotherapeutic agents may shrink tumor bulk by eliminating non‐CSCs, whereas CSCs have mechanisms that facilitate evasion of cell death. Human papillomavirus status does not affect CSC response to cisplatin therapy, suggesting that other factors explain the better outcomes for patients with HPV‐positive cancer.
Microvascular Anastomotic Coupler Assessment in Head and Neck Reconstruction
Authors: Frederick John W. , Sweeny Larissa , Carroll William R. , Rosenthal Eben L. 
Published: April 2013

ObjectiveTo assess the advantages of using mechanical anastomotic systems in head and neck free tissue transfer.Study designCase series with chart review.SettingA university‐based tertiary care center.Subjects and MethodsA retrospective review of mechanical venous coupler devices in head and neck reconstruction performed between October 2004 and December 2006. A total of 261 venous anastomoses were performed in 234 consecutive patients. Five types of flaps were performed: radial forearm (66%), anterior lateral thigh (12%), fibula (9%), rectus abdominis (8%), and latissimus dorsi (2%). Demographic data were collected, and the outcomes measured were flap survival and microvascular complications.ResultsThe size of the venous anastomosis ranged from 1.5 to 4.0 mm, with most being 3.0 mm (56%) followed by 3.5 mm (23%). The most common recipient vein used was a stump off the internal jugular vein (76%) followed by the external jugular vein (17%). Microvascular complications occurred in <5% (n = 11) of patients, with >50% of those being arterial insufficiency (n = 7). Total failures occurred in 3% (n = 7) of patients: 1.5% (n = 4) acute failures (<5 days) and 1.5% (n = 3) late failures. Of the acute failures, causes included venous congestion (n = 1) and arterial insufficiencies (n = 3). The venous coupler used in the failures was 3.0 mm in diameter. Free flap failures resulting from arterial insufficiency involved coupling to the external jugular vein, while the remaining free flap failures (n = 4) used the internal jugular vein.ConclusionWith an early venous failure rate of 0.38%, mechanical anastomosis is an adequate alternative to hand‐sewn techniques.
Effect of Reamer Design on Posteriorization of the Tibial Tunnel During Endoscopic Transtibial Anterior Cruciate Ligament Reconstruction
Authors: Bhatia Sanjeev , Korth Kyle , Van Thiel Geoffrey S. , Gupta Deepti , Cole Brian J. , Bach Bernard R. , Verma Nikhil N. 
Published: April 2013

Background: It is known that small alterations in tunnel positioning during anterior cruciate ligament (ACL) reconstruction significantly affect ACL length and tensioning patterns as well as alter force vectors and joint kinematics. Purpose: To compare the amount of inadvertent posteriorization of the ACL tibial tunnel anatomy during transtibial ACL femoral reaming in the “over-the-top” position with a full femoral reamer versus a half femoral reamer, in comparison to the native tibial ACL footprint. It is hypothesized that the half reamer will result in less distortion of tibial tunnel anatomy and improved anatomic footprint coverage. It is also hypothesized that the true center of the tibial ACL footprint lies more anterior than previously described. Study Design: Controlled laboratory study. Methods: Eight cadaveric knee specimens were securely fixed to a stationary table at 90° of flexion and neutral rotation. After removal of the anterior capsule and patella, native joint anatomy was precisely recorded with a digitizer accurate to 0.05 mm. Tibial and femoral tunnels were then drilled in the manner of transtibial ACL reconstructions using the optimal tibial starting point of 15.9 mm below the medial plateau and 9.8 mm posteromedial to the medial margin of the tibial tubercle. After the 11-mm tibial tunnel was drilled, femoral tunnels were first drilled with a 10-mm half-fluted reamer, followed by a 10-mm full reamer. Each tibial tunnel’s location and geometry relative to the native ligamentous insertion sites and joint anatomy were digitized. Results: Digitized measurements of ACL insertional anatomy demonstrated that the center of the native ACL tibial footprint was 2.0 ± 0.49 mm (range, 1.1-2.7 mm) anterior to the posterior aspect of the lateral meniscus’ anterior horn. Use of the 10-mm full femoral reamer resulted in a tibial-articular aperture that had a posterior edge 4.35 mm more posterior ( P = .049) and extra-anatomic ( P = .006) than the footprint of the 10-mm half femoral reamer. Conclusion: Half-fluted reamers may be more advantageous for femoral tunnel reaming with a more oblique transtibial approach, as they result in less posterior tibial tunnel expansion than full reamers, possibly leading to improved graft function. Based on the digitized anatomy, the center of the tibial attachment site is anterior to the posterior aspect of the lateral mensicus’s anterior horn, which has been traditionally described as the anatomic center. Clinical Relevance: Use of half-fluted reamers for transtibial femoral tunnel reaming could lead to more anatomic tunnel placement and possibly improved graft mechanics after transtibial single-bundle ACL reconstruction.
Articular Cartilage Evaluation After TruFit Plug Implantation Analyzed by Delayed Gadolinium-Enhanced MRI of Cartilage (dGEMRIC)
Authors: Bekkers Joris E.J. , Bartels Lambertus W. , Vincken Koen L. , Dhert Wouter J.A. , Creemers Laura B. , Saris Daniel B.F. 
Published: April 2013

Background: Quantitative MRI of articular cartilage has rapidly developed in recent years and provides the clinician with a noninvasive tool to determine the biological consequence of an intervention. Purpose: To evaluate the quality of intra-articular cartilage, using the dGEMRIC scanning technique, 1 year after TruFit implantation. The hypothesis was that implantation of a TruFit plug does not lead to damage at the opposing articular cartilage. Study Design: Case series; Level of evidence, 4. Methods: A total of 13 patients (age, 32 ± 8 years) were evaluated with dGEMRIC at 12 ± 4 months after treatment of an osteochondral lesion by implantation of 1 or multiple TruFit plugs. The dGEMRIC scanning protocol was applied 90 minutes after intravenous Magnevist (0.2 mmol/kg body weight) injection. Different regions of interest (ROIs) were defined: the femur cartilage, cartilage directly surrounding the implanted TruFit plug, the TruFit plug, and the articulating and nonarticulating tibia cartilage. The average dGEMRIC index (T1gd; magnetic resonance imaging relaxation time per ROI) was calculated by a pixel-by-pixel curve fitting using the Levenberg-Marquardt method. Differences between the mean T1gd of the individual ROI for all patients were tested using analysis of variance with post hoc Bonferroni correction. A P value <.05 was considered statistically significant. Results: The average T1gd of the TruFit ROI (385 ± 74 ms) was comparable with those in the femur (409 ± 49 ms) and surrounding (392 ± 64 ms) ROIs ( P ≥ .339). The average T1gds for the articulating (578 ± 133 ms) and nonarticulating (516 ± 118 ms) ROIs were higher compared with the femur (409 ± 49 ms), surrounding (392 ± 64 ms), and TruFit (385 ± 74 ms) ROIs ( P < .002), while no difference was observed between the tibia ROIs ( P = .160). Conclusion: Implantation of the TruFit plug in osteochondral lesions does not damage the opposing or surrounding surface, and newly formed tissue inside the plug has cartilage-like dGEMRIC characteristics 12 months after implantation. The implantation of synthetic TruFit plugs is safe for the opposing cartilage, an item that is frequently discussed when using such materials to treat focal cartilage defects.
Bone–Patellar Tendon–Bone Autograft Versus Allograft in Outcomes of Anterior Cruciate Ligament Reconstruction
Authors: Kraeutler Matthew J. , Bravman Jonathan T. , McCarty Eric C. 
Published: April 2013

Background: Bone–patellar tendon–bone (BPTB) is a common autograft and allograft source used for anterior cruciate ligament (ACL) reconstruction. Although the failure rate is generally higher for allografts, donor site morbidity and anterior knee pain can be issues with BPTB autografts. Controversy exists regarding the functional outcomes, complications, and knee stability of these grafts, previous comparisons of which have been based on smaller samples of case series. Purpose: To compare BPTB autografts to allografts for ACL reconstruction, specifically with regard to patient satisfaction, return to preinjury activity level, and postoperative functional outcomes. Study Design: Meta-analysis. Methods: A total of 76 studies published between 1998 and 2012, including a total of 5182 patients, were reviewed. It was not required for studies to be comparative in nature. Outcomes evaluated were graft rupture rate, return to preinjury activity level, overall and subjective International Knee Documentation Committee (IKDC), Lysholm, Tegner activity, Cincinnati Knee Rating System, pivot shift, and single-legged hop tests, as well as KT-1000 arthrometer side-to-side difference and presence of anterior knee pain. Summary odds ratios with 95% confidence intervals were calculated to compare BPTB autografts to allografts for each outcome. Results: Outcomes on subjective IKDC, Lysholm, Tegner, single-legged hop, and KT-1000 arthrometer were statistically significantly in favor of autografts. Return to preinjury activity level, overall IKDC, pivot shift, and anterior knee pain were significantly in favor of allografts, although allograft BPTB demonstrated a 3-fold increase in rerupture rates compared with autograft (12.7% vs 4.3%). There was no significant difference between the 2 groups for Cincinnati Knee scores. Conclusion: Patients undergoing ACL reconstruction with BPTB autografts demonstrate lower rates of graft rupture, lower levels of knee laxity, and improved single-legged hop test results and are more generally satisfied postoperatively compared with patients undergoing reconstruction with allograft BPTB.
Comparison of the Balance Accelerometer Measure and Balance Error Scoring System in Adolescent Concussions in Sports
Authors: Furman Gabriel R. , Lin Chia-Cheng , Bellanca Jennica L. , Marchetti Gregory F. , Collins Michael W. , Whitney Susan L. 
Published: April 2013

Background: High-technology methods demonstrate that balance problems may persist up to 30 days after a concussion, whereas with low-technology methods such as the Balance Error Scoring System (BESS), performance becomes normal after only 3 days based on previously published studies in collegiate and high school athletes. Purpose: To compare the National Institutes of Health’s Balance Accelerometer Measure (BAM) with the BESS regarding the ability to detect differences in postural sway between adolescents with sports concussions and age-matched controls. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Forty-three patients with concussions and 27 control participants were tested with the standard BAM protocol, while sway was quantified using the normalized path length (mG/s) of pelvic accelerations in the anterior-posterior direction. The BESS was scored by experts using video recordings. Results: The BAM was not able to discriminate between healthy and concussed adolescents, whereas the BESS, especially the tandem stance conditions, was good at discriminating between healthy and concussed adolescents. A total BESS score of 21 or more errors optimally identified patients in the acute concussion group versus healthy participants at 60% sensitivity and 82% specificity. Conclusion: The BAM is not as effective as the BESS in identifying abnormal postural control in adolescents with sports concussions. The BESS, a simple and economical method of assessing postural control, was effective in discriminating between young adults with acute concussions and young healthy people, suggesting that the test has value in the assessment of acute concussions.
Median Group® in a Psychiatric Outpatient Service and in a Psychiatric Diagnosis and Treatment Service (SPDC)
Authors: Schoellberger Roberto , Pozzi Laura 
Published: April 2013

Outlined is a brief description of two pieces of research into the Median Group experience in an open psychiatric outpatient service and in a closed ward. The first is about the self-definition and well being of 30 patients in three Median Groups, mostly under drug prescription, and 31 patients only under drug prescription. On nine sub scales (five levels each) of SCL (Symptom Check List)-90-R, only the field of somatization shows small differences between the experimental and the control group, whereas in all the others the differences are statistically significant, which means a better quality of life. The other research has been undertaken by Laura Pozzi, who introduced the Median Group to a closed psychiatric ward of a general hospital. It shows a high level of acceptance within the group, and on the group ward level, a sudden decrease of aggressive episodes has been registered.