bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Link between Rhinitis and Rapid-Eye-Movement Sleep Breathing Disturbances in Children with Obstructive Sleep Apnea
Authors: Huseni Shehlanoor , Gutierrez Maria J. , Rodriguez-Martinez Carlos E. , Nino Cesar L. , Perez Geovanny F. , Pancham Krishna , Nino Gustavo 
Published: January 2014

Background Rhinitis and obstructive sleep apnea (OSA) often coexist during childhood. To delineate this clinical association, we examined OSA severity and polysomnogram (PSG) features in children with rhinitis and OSA. Given that rapid-eye-movement (REM) sleep is characterized by nasal congestion, we hypothesized that children with rhinitis have more REM-related breathing abnormalities. Methods We conducted a retrospective cross-sectional analysis of 145 children with PSG-diagnosed A. Outcomes included PSG parameters and obstructive apnea–hypopnea index (OAHI) during REM and non-REM. Linear multivariable models examined the joint effect of rhinitis and OSA parameters with control for potential confounders. Results Rhinitis was present in 43% of children with OSA (n = 63) but overall OAHI severity was unaffected by the presence of rhinitis. In contrast, OAHI during REM sleep in children with moderate-severe OSA was significantly increased subjects with rhinitis and OSA (44.1/hr; SE = 6.4) compared with those with OSA alone (28.2/hr; SE = 3.8). Conclusion Rhinitis is highly prevalent in children with OSA. Although OSA is not more severe in children with rhinitis, they do have a distinct OSA phenotype characterized by more REM-related OSA. Further research is needed to delineate the link between REM-sleep and the physiology of the nose during health and disease.
Role of Staphylococcal Enterotoxin B on the Differentiation of Regulatory T Cells in Nasal Polyposis
Authors: Cho Soo-Na , Song Chang-Hwa , Jin Jun , Kim Sung Ha , Rha Ki-Sang , Kim Yong Min 
Published: January 2014

Background The pathogenesis of nasal polyposis has not been fully understood. Recent studies indicate that there is a subset of CD4+CD25high FoxP3+T cells (regulatory T cells [Tregs]) that express retinoic acid receptor related orphan receptor C (RORC) or IL-17, and these cells might be new proinflammatory cells because of the expression of IL-17 with loss of their suppressive function. The goals of this study were to localize Th17-like Tregs (Th17-like Tregs or RORC+Tregs) in nasal polyps and to investigate the role of staphylococcal enterotoxin B (SEB) on the differentiation of Tregs to RORC+Tregs in vitro. Methods A total of 60 patients were enrolled in this study. Of the 60 patients, 40 had chronic rhinosinusitis with nasal polyps (CRSwNPs), and 20 subjects who were undergoing septoplasty were enrolled as control subjects. The nasal polyps of CRSwNP patients were subclassified as either eosinophilic polyp (EP) and noneosinophilic polyp (NEP) according to the result of hematoxylin and eosin stain. Tissues and whole blood were collected from all subjects. Double immunofluorescent staining and reverse-transcription polymerase chain reaction for RORC and FOXP3 were conducted on the tissues. RORC expressions of Tregs were measured in the tissue using flow cytometry. The proportions of RORC+Tregs subsets and cytokines profiles from the supernatant were measured using flow cytometry after stimulation with SEB. Results The cells that express both RORC and FOXP3 and RORC+Tregs were significantly higher in the nasal polyps, especially in EPs compared with NEPs, and control mucosa. RORC+Tregs in peripheral blood mononuclear cells significantly increase in patients with EPs 24 hours after SEB stimulation in vitro. Conclusion The results indicate that SEB may be involved in the differentiation of Tregs to RORC+Tregs, and these cells may be involved in the pathogenesis of eosinophilic nasal polyposis.
Decision-Making Analysis for Allergen Immunotherapy versus Nasal Steroids in the Treatment of Nasal Steroid–Responsive Allergic Rhinitis
Authors: Kennedy Joshua L. , Robinson Derek , Christophel Jared , Borish Larry , Payne Spencer 
Published: January 2014

Background The purpose of the study was to determine the age at which initiation of specific subcutaneous immunotherapy (SCIT) becomes more cost-effective than continued lifetime intranasal steroid (NS) therapy in the treatment of allergic rhinitis, with the use of a decision analysis model. Methods A Markov decision analysis model was created for this study. Economic analyses were performed to identify “break-even” points in the treatment of allergic rhinitis with the use of SCIT and NS. Efficacy rates for therapy and cost data were collected from the published literature. Models in which there was only incomplete improvement while receiving SCIT were also evaluated for economic break-even points. The primary perspective of the study was societal. Results Multiple break-even point curves were obtained corresponding to various clinical scenarios. For patients with seasonal allergic rhinitis requiring NS (i.e., fluticasone) 6 months per year, the age at which initiation of SCIT provides long-term direct cost advantage is less than 41 years. For patients with perennial rhinitis symptoms requiring year-round NS, the cut-off age for SCIT cost-effectiveness increases to 60 years. Hypothetical subjects who require continued NS treatment (50% reduction of previous dosage) while receiving SCIT also display break-even points, whereby it is economically advantageous to consider allergy referral and SCIT, dependent on the cost of the NS prescribed. Conclusion The age at which SCIT provides economic advantages over NS in the treatment of allergic rhinitis depends on multiple clinical factors. Decision analysis models can assist the physician in accounting for these factors and customize patient counseling with regard to treatment options.
The Effects of Alcohol Consumption and Smoking on Allergy Risk in Korean Adults
Authors: Kang Ju Wan , Baek Seung Hak , Rha Min Seok , Kim Jeong Hong 
Published: January 2014

Background The immune-modulating effects of alcohol and smoking are well known through a great body of research. Furthermore, many studies have been performed on the influence of alcohol and smoking on the development of allergic disease. However, previous studies have reported conflicting results with associations between alcohol intake or smoking and risk of allergy. The purpose of this study was to evaluate the effects of alcohol consumption and smoking on total serum immunoglobulin E (TIgE) and prevalence of sensitization to Dermatophagoides farinae in a representative sample of Korean adults. Methods TIgE levels and IgE levels specific to D. farinae were measured. Alcohol, smoking habit, and other influencing variables were obtained from the 2010 Korean National Health and Nutrition Examination. Results Smoking (smoked five packs or more in lifetime) was independently associated with increased risk of sensitization to D. farinae (odds ratio [OR], 1.439; 95% CI, 1.075–1.927). Frequent alcohol drinking (more than four times a week) also showed similar association when compared with subjects who drank less than once per month (OR, 2.052; 95% CI, 1.257–3.350). TIgE levels were also increased along with increased frequency of alcohol drinking. However, smoking habit was not related to TIgE levels. Conclusion These findings suggest that history of smoking and frequent alcohol consumption are significantly associated with increased prevalence of sensitization to D. farinae. In addition, frequency of alcohol drinking was also related to a moderate increase in TIgE levels in Korean adults.
Anatomic Evaluation of Endoscopic Transnasal Transorbital Approach to the Lateral Orbital Apex
Authors: Kenyon Bianca , Antisdel Jastin L. 
Published: January 2014

Background This anatomic study investigates the feasibility of an endoscopic transnasal transorbital approach to the lateral orbital apex. Methods Five cadavers with no prior history of sinus surgery were studied bilaterally. Standard techniques and instrumentation for functional endoscopic sinus surgery were used to perform dissections and delineate anatomy of sinuses and orbits. Results With resection of the inferior aspect of the lamina papyracea and the medial portion of the orbital floor, followed by incision of the periorbita along the inferomedial aspect of the orbit and removal of minimal orbital fat, a satisfactory view of the surgical field is achieved. The medial and inferior rectus muscles are dissected and retracted to allow visualization of the optic nerve. By dissecting inferior to the optic nerve and using 0 and 30° endoscopes, the lateral orbital apex could be accessed without damage to the optic nerve. Conclusion In patients whose vision is irreparably damaged, one might consider an endoscopic approach to lesions of the lateral orbital apex. Approach in patients with intact vision should be handled with caution because of possible traction of the optic nerve.
Bacteriophage Reduces Biofilm of Staphylococcus Aureus Ex Vivo Isolates from Chronic Rhinosinusitis Patients
Authors: Drilling Amanda , Morales Sandra , Jardeleza Camille , Vreugde Sarah , Speck Peter , Wormald Peter-John 
Published: January 2014

Background Staphylococcus aureus is the most common organism in recalcitrant chronic rhinosinusitis (CRS) and is often resistant to traditional antibiotic therapy. Bacteriophages (“phages”) are a potential candidate for a new, effective therapy. For phages to be useful in setting CRS, two minimum requirements must be presented: (1) phages must be effective against S. aureus biofilms and (2) phages must have a broad spectrum of activity. This study aimed to assess the in vitro activity of a phage cocktail (CockTail of Staphylococcus aureus specific bacteriophage [CT-SA]) against S. aureus biofilms and a broad panel of strains isolated from patients with CRS. Methods The study examined 66 clinical isolates (CIs) of S. aureus. All isolates were tested for the susceptibility to phage lysis by spotting CT-SA onto bacterial lawns. To measure its effect on S. aureus biofilms, a minimum biofilm eradication concentration assay was used, using five S. aureus isolates. Biofilms of these isolates were grown, treated with CT-SA for 48 hours, fluorescently stained, and viewed using confocal scanning laser microscopy. Results CT-SA lysed 62 of 66 (94%) CIs of S. aureus. CT-SA treatment yielded significant reductions in biofilm mass for 4/5 CIs tested and for ATCC 25923. Challenge of S. aureus with a single phage resulted in the emergence of bacteriophage-insensitive mutants (BIM) with a frequency of 10−7, and challenge with CT-SA completely prevented their development. Conclusion This study indicates that phage cocktail CT-SA can effectively eliminate S. aureus, in planktonic and biofilm forms, from the great majority of CIs from this hospital setting. In addition, its potential effect in preventing the emergence BIMs was a established. Thus, CT-SA has the potential to treat S. aureus infection and biofilm in CRS patients.
Differences in Skull Base Thickness in Patients with Spontaneous Cerebrospinal Fluid Leaks
Authors: Psaltis Alkis J. , Overton Lewis J. , Thomas William W. , Fox Nyssa Flemming , Banks Caroline A. , Schlosser Rodney J. 
Published: January 2014

Background This study was designed to determine if differences in overall skull base thickness exist in patients with spontaneous cerebrospinal fluid (SCSF) leaks and to compare our institution's 10-year experience with the endoscopic repair of these leaks to the existing literature. A retrospective cohort study was performed in a tertiary rhinologic practice. Methods A retrospective study by two blinded independent reviewers compared the skull base thickness on computerized tomography (CT) imaging in our SCSF leak patients to nonleaking controls and patients with traumatic CSF leaks. Surgical outcomes were compared with a pooled analysis of the published literature Results SCSF leaks were seen most commonly in obese, middle-aged women of African American descent. SCSF leak patients were shown to have thinner skull bases in the region of the ethmoid roof, lateral lamella, and anterior face of the sella (p < 0.05) compared with patients with traumatic leaks and nonleaking controls. No racial difference in skull base thickness was observed when patients were matched according to leak type. The success rate of primary endoscopic intervention in our patients was high at 94% and comparable with the published literature. Conclusion Differences in skull base thickness exist in SCSF patients, but whether this predisposes to such leaks or is a consequence of the underlying pathophysiology remains unknown. The endoscopic endonasal approach provides a highly effective means of repairing such leaks with success rates comparable with the endoscopic repair of other leak types. Adjuvant measures including weight reduction, lumbar drain, and acetazolamide use may increase success rates and should be considered in their management.
Can Computed Tomography Score Predict Outcome of Adenoidectomy for Chronic Rhinosinusitis in Children
Authors: Ramadan Hassan H. , Makary Chadi A. 
Published: January 2014

Background Chronic adenoiditis (CA) and chronic rhinosinusitis (CRS) in children are difficult to distinguish based on symptoms alone. A computed tomography (CT) scan is one way to distinguish between the two entities. The purpose of this study was to determine whether CT scores can predict outcome of adenoidectomy. Methods A retrospective review was performed over a 10-year period. All children who failed medical treatment had a CT scan and an adenoidectomy, which were reviewed. Children who had a CT score of ≥5 were included in the CA with concurrent CRS group, whereas those who had a CT score of <5 were included in the CA without CRS group. Results Two hundred thirty-three children met the aforementioned criteria. Mean age was 5.5 years and mean CT score was 6.4. The CRS group had a success rate of 43%, whereas the CA group had a 65% success rate (p = 0.0017). Those children who were asthmatic and had CRS had a success rate of 28% compared with 53% for those who had CA (p = 0.022). Conclusion Making the diagnosis of CRS in children seems to be critical in determining whether, initially, an adenoidectomy alone is an appropriate treatment, specifically for those who have asthma.
A Radiological Analysis of Inferior Turbinate in Patients with Deviated Nasal Septum by Using Computed Tomography
Authors: Orhan Israfil , Ayd1n Salih , Ormeci Tugrul , Y1ilmaz Fahrettin 
Published: January 2014

Background The aim of this study was to evaluate the relationship between nasal septum deviation grade and inferior turbinate hypertrophy with the computed tomography (CT). Methods The paranasal sinus CTs of 82 patients with septum deviation were evaluated. Nonhypertrophied inferior turbinates on the deviated side of the nasal septum were accepted as the control group and hypertrophic inferior turbinates of the other side were taken as the compensatory group in the same patient. The turbinate bone, medial mucosa, lateral mucosa, septal deviation angle, and deviation volume were measured using three-dimensional CT. Results The study group included 82 patients (M/F, 42/40) and ages ranged from 17 to 79 years (mean, 38.5 ± 14 years). There was a statistically significant positive correlation between the deviation angle and the deviation volume (p < 0.01). The measurements of the inferior turbinate bone and medial and lateral mucosal thickness were statistically different between the compensatory group and the control group (p < 0.01). There were no statistically significant differences in comparisons between the lateral and medial mucosal thickness with the deviation angle and the deviation volume in the two groups (p > 0.05). A positive correlation between the measurements of the deviation angle, deviation volume, and bone thickness was found statistically significant in the compensatory group (p < 0.05). Conclusion The compensatory hypertrophy of inferior turbinates in patients with nasal septum deviation is not only caused by mucosal hypertrophy, but also by hypertrophy of the inferior turbinate bone itself. The assistance of preoperative CT before septoplasty can be useful when deciding on the surgical technique to fix turbinate.
The Philippine Komedya and the Recuperation of the Cosmopolitan: From Colonial Legacy to Cross-Cultural Encounter
Authors: Tiatco Anril P. 
Published: January 2014

ABSTRACT:This article critiques the komedya vis-à-vis its institutionalization as national theatre form and proposes a cosmopolitan alternative in the critique. It argues that the imposition of a nationalist perspective in the reading the form falls into the trap of territoriality and “othering” because of its Roman Catholic and Tagalog-centric orientations. The cosmopolitan critique is necessary because it embodies a middle-path alternative to the essentializing and territorializing character of popular nationalism and the anarchy of pluralism. The discussion of cosmopolitanism comes from the irony that komedya could have offered a cosmopolitan possibility when Filipino artists began its indigenization. The efficacy of this possibility was overpowered by methodological nationalism based on the hegemony of the center (The Greater Manila Area) and its central religion – Catholicism. Thus, the komedya was contextualized as a Catholic theatre form and strengthened a particular hostility against non-Catholics, especially the Muslims.
The Haunted Stage ofSummer and Smoke: Tennessee Williams’s Forgotten Silent Film Sequences
Authors: Maruéjouls-Koch Sophie 
Published: January 2014

ABSTRACT:Recent re-evaluation of Tennessee Williams’s late plays has brought to light another side of the playwright, an avant-garde impulse ignored by his contemporaries because it did not match his image as a poetic realist. Of course, this new Williams did not appear out of the blue; he was there from the beginning, if less conspicuous, but the weight of prejudice drove him underground. Thus, the avant-garde is most visible in the early plays, in deviations from artistic norms that did not always make it to the published versions. Summer and Smoke (1948) is a case in point. Examination of the unpublished drafts of the play reveals an ambitious project that never saw the light of day. Inspired by Erwin Piscator’s Epic Theatre, Williams intended to put a screen on the stage, inviting the spectator to see differently, in a manner reminiscent of Brecht’s “exercise in complex seeing.” The drafts, therefore, unveil the avant-garde ideas of a playwright who never ceased experimenting with form, finally to find his true voice, a voice that resonates most loudly in the late plays.
La lutte contre les conflits d'intérêts : essor de la transparence ou règne de la méfiance ?
Authors: Mekki Mustapha 
Published: January 2014

Les derniers scandales (Cahuzac, Woerth, Mediator), qui ont défrayé la chronique tant dans la sphère publique que dans la sphère privée, ont révélé l’installation insidieuse et progressive d’une « société de défiance ». L’une des principales causes de cette méfiance à l’égard des décideurs politiques, juridiques ou économiques est l’existence de nombreux conflits d’intérêts illégitimes. Tant le droit privé que le droit public tentent aujourd’hui d’instaurer une plus grande transparence afin de restaurer ce lien de confiance indispensable à la construction d’une société de droit dans un État de droit. Cependant, pour lutter efficacement contre les mauvais conflits d’intérêts, encore faut-il choisir les armes adéquates. À défaut, il se pourrait que le remède soit bien pire que le mal !
Transparence : la double peine des familles
Authors: de Béchillon Denys 
Published: January 2014

L’embarquement des familles du personnel politique dans l’injonction générale de transparence réputée propre à prévenir les conflits d’intérêts et à garantir le retour de la confiance fonctionne comme une double peine : parce qu’il jette ces proches au feu d’une frénésie de lumière et de purification déraisonnable autant qu’improductive, mais aussi – et peut-être surtout – parce qu’il les y jette à leur corps défendant, sans qu’ils soient jamais appelés à y consentir, et donc au mépris de leurs droits.
Les conflits d'intérêts chez les élus
Authors: Prat Michel-Pierre , Janvier Cyril 
Published: January 2014

Le conflit d’intérêts des élus est généralement abordé sous l’angle répressif : il n’est condamnable que s’il est consommé. Une approche plus constructive, qui restaurerait l’indispensable lien de confiance entre citoyens et élus, passerait par une politique de prévention structurée, s’appuyant sur les travaux des commissions Sauvé et Jospin par exemple. Le projet de loi relatif à la déontologie et à la prévention des conflits d’intérêts dans la vie publique s’inscrit cependant en retrait par rapport à ces initiatives, tout comme les premières discussions parlementaires. La loi risque de se révéler insuffisante, ne répondant pas aux attentes citoyennes...
La presse française en manque d'une instance déontologique
Authors: Gerbaud Dominique 
Published: January 2014

La presse française fait exception en Europe. La déontologie ne repose que sur la conscience individuelle des journalistes et n’est régie par aucun code précis qui s’imposerait à toute la profession. Les chartes professionnelles datent des années 1900, n’ont pas de caractère contraignant et n’abordent que de façon très éloignée les conflits d’intérêts. Pourtant, ils sont légion dans la profession. Cela va des doubles casquettes de journalistes qui se font rémunérer pour de menus travaux de conseils ou d’animation aux compagnes de ministres qui restent journalistes politiques, en passant par les voyages de presse. Il manque en France une instance déontologique nationale. Elle est en voie de constitution.
A few cognitive issues in multimedia language teaching
Authors: Raby Françoise , Baille Jacques 
Published: January 2014

Quels seront les effets de la révolution multimédia ? Le multimédia signifie l’intégration des équipements, mais cela ne signifie pas pour autant une intégration des processus cognitifs. La recherche appliquée en linguistique ne permet pas, pour le moment, de répondre à la question de savoir si le multimédia impose une nouvelle structuration des contenus linguistiques. L’introduction du multimédia dans l’apprentissage des langues devrait donc favoriser un nouveau type de recherche didactique visant à établir de nouveaux modèles d’apprentissage.
Organising information for multimedia learning
Authors: Bickerton David 
Published: January 2014

Les supports texte, sons et images pour apprenants en langues qui sont créés et distribués aujourd’hui peuvent l’être sous forme numérique. Cet article examine un échantillon de systèmes en vigueur (surtout en Grande-Bretagne) pour la classification de documents à des fins didactiques. Il suggère que nos techniques de gestion de données « bibliographiques » fortement structurées devront faire place à des systèmes permettant un accès direct et flexible selon des critères spécifiques à l’apprenant et à ses besoins immédiats. Cette conception d’un accès dynamique aux données définit l’approche de l’équipe de recherche du projet MELODI et mène à des conclusions importantes pour toute institution qui souhaite gérer et échanger des documents à destination d’apprenants de langues.