Validation of a Parent-Reported Diagnostic Instrument in a U.S. Referral Population: The Childhood Eczema Questionnaire

Abstract

Background/Objectives

There is a paucity of validated tools for diagnosing atopic dermatitis (AD) in very young children that do not rely on clinical evaluation. The Childhood Eczema Questionnaire (CEQ)—a diagnostic tool for AD in children younger than 2 years that a caretaker can complete—was recently validated in Sweden. The objective of this study was to validate the tool in a U.S. population. As a substudy, we added an additional question that was independently assessed.

Methods

Children younger than 2 years old were recruited from a dermatology clinic. Their caretakers completed a questionnaire containing the original tool's three questions as well as a fourth question that increased the time frame measured from 1 week to 6 months. Questionnaires with all "yes" answers were considered positive and were compared with a dermatologist diagnosis of AD.

Results

A total of 283 subjects were recruited. The first three questions (the original CEQ) predicted a positive diagnosis of AD with a sensitivity of 0.72 (95% confidence interval [CI] 0.58, 0.82) and a specificity of 0.93 (95% CI 0.87, 0.95). In a separate analysis we included the first two questions and the fourth question and found that the sensitivity increased to 0.82 (95% CI 0.69, 0.90) with a specificity of 0.89 (95% CI 0.83, 0.93).

Conclusion

This study validates a novel parental questionnaire for the diagnosis of AD in children younger than 2 years in a U.S. clinic population.

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Allergic Contact Dermatitis Due to Methylisothiazolinone in a Young Girl's Laundry Detergent

Abstract

Methylisothiazolinone (MI) is an emerging and increasing cause of allergic contact dermatitis (ACD) in children. We present the case of a 7-year-old girl with an unusual dermatitis suspicious for contact allergy. Patch testing confirmed allergy to MI, found only in the patient's laundry detergent. This case highlights the importance of checking household product ingredients and the role of MI as an increasing cause of ACD in children.

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Sizes of pentagonal clusters in fullerenes

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La voie vers un Regsitre linguistique judiciaire européen

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Extracellular ATP is a key modulator of alveolar bone loss in periodontitis

Publication date: September 2017
Source:Archives of Oral Biology, Volume 81
Author(s): Itzhak Binderman, Nasir Gadban, Avinoam Yaffe
Periodontal diseases are initiated by pathogenic bacterial biofilm activity that induces a host inflammatory cells immune response, degradation of dento gingival fibrous tissue and its detachment from root cementum. It is well accepted, that osteoclastic alveolar bone loss is governed exclusively through secretion of proinflammatory cytokines. Nevertheless, our findings suggest that once degradation of collagen fibers by MMPs occurs, a drop of cellular strains cause immediate release of ATP from marginal gingival fibroblasts, cell deformation and influx of Ca+2. Increased extracellular ATP (eATP) by interacting with P2×7 purinoreceptors, present on fibroblasts and osteoblasts, induces generation of receptor activator of nuclear factor kB ligand (RANKL) that further activates osteoclastic alveolar bone resorption and bone loss. In addition, increased eATP levels may amplify inflammation by promoting leukocyte recruitment and NALP3-inflammasome activation via P2×7. Then, the inflammatory cells secrete cytokines, interleukin IL-1, TNF and RANKL that further trigger alveolar bone resorption. Moreover, eATP can be secreted from periodontal bacteria that may further contribute to inflammation and bone loss in periodontitis. It seems therefore, that eATP is a key modulator that initiates the pathway of alveolar bone resorption and bone loss in patients with periodontal disease. In conclusion, we propose that strain release in gingival fibroblasts aligned on collagen fibers, due to activity of MMP, activates release of ATP that triggers the pathway of alveolar bone resorption in periodontitis. We predict that by controlling the eATP interaction with its cellular purinoreceptors will reduce significantly bone loss in periodontitis.



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Hyperlipidemia is involved in apoptosis in rat submandibular glands

Publication date: September 2017
Source:Archives of Oral Biology, Volume 81
Author(s): Koichiro Irie, Takaaki Tomofuji, Daisuke Ekuni, Tetsuji Azuma, Toshiki Yoneda, Yoshihiro Shimazaki, Manabu Morita
ObjectiveThe aim of the present study was to investigate the effects of hyperlipidemia on histological changes and apoptosis in submandibular glands using apolipoprotein E (apoE)-deficient rats.DesignHistopathological findings related to induced apoptosis in the submandibular glands were compared between apoE-deficient rats (n=6; male; age, 16 weeks) and the corresponding wild-type rats (n=6).ResultsApoE-deficient rats showed significantly higher plasma levels of oxidized low-density lipoprotein (LDL), total cholesterol, very LDL and LDL, and lower plasma levels of high-density lipoprotein when compared to control rats (P<0.05). Lipid deposition in the submandibular gland was observed in apoE-deficient rat group and in none of the control group. Significant increases in vacuolization and apoptosis in acinar cells were observed in apoE-deficient rats, as compared to control rats (P<0.05). The number of active caspase-3-positive cells was also higher in the apoE-deficient rat group when compared with the control group (P<0.01).ConclusionsAccording to our results, hyperlipidemia induced apoptosis in apoE-deficient rat submandibular glands. Oxidized LDL generation in case of hyperlipidemia may trigger off a reaction of apoptotic acinar cells with vacuolization in the submandibular glands.



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Maintenance of claudin-3 expression and the barrier functions of intercellular junctions in parotid acinar cells via the inhibition of Src signaling

Publication date: September 2017
Source:Archives of Oral Biology, Volume 81
Author(s): Megumi Yokoyama, Takanori Narita, Hajime Sakurai, Osamu Katsumata-Kato, Hiroshi Sugiya, Junko Fujita-Yoshigaki
ObjectivesSalivary acinar and duct cells show different expression patterns of claudins, which may reflect their different functions. To study the role of claudins in saliva secretion, we examined alterations in the expression patterns of cell adhesion molecules in parotid glands of γ-irradiated rats and analyzed the influence of those changes on intercellular barrier function using primary cultures of parotid acinar cells.DesignRats were γ-irradiated with doses of 5, 15 or 20Gy, and expression levels of cell adhesion molecules were examined by immunoblotting analysis. Acinar cells were isolated from parotid glands and were cultured in the absence or presence of the Src kinase inhibitor PP1. Changes in protein and mRNA expression patterns were determined by immunoblotting and by RT-PCR analyses, respectively. Intercellular barrier function was examined by measuring transepithelial electrical resistance and the paracellular flux of FITC-dextran.ResultsIn irradiated parotid glands, the expression of claudin-4 was enhanced at 15Gy or higher, levels that induce the hyposecretion of saliva, although that increase was transient. At 30days after irradiation, expression levels of cell adhesion molecules were decreased. In primary cultures, the expression of claudin-4 was also increased transiently but the expression of claudin-3 and E-cadherin was decreased. The barrier function of tight junctions was disrupted although the localization of occludin was maintained. The Src kinase inhibitor PP1 suppressed those changes in gene expression and retained the intercellular barrier function.ConclusionsThese results suggest that the inhibition of Src signaling maintains the barrier functions of intercellular junctions in salivary glands, which can be lost due to tissue injury.



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Scarlet Fever

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A 20-year-old man presented to his primary care physician with a 3-day history of swollen tonsils, sore throat, fevers, chills, and rash. The nonpruritic rash had started on his abdomen, spread to his chest and back, and then appeared on his arms, legs, and face. He had no known allergies or exposures to new medications and had no history of similar rash. Examination revealed exudative tonsillitis (Panel A), strawberry tongue, and cervical adenopathy with tenderness. Skin examination revealed diffuse blanching erythema with punctate papules that caused the skin on his chest, abdomen, back, arms, and legs to have a sandpaper-like quality (Panel B shows the left side of his abdomen). His neck and right flank had linear petechial patches. A rapid test for streptococcal pharyngitis was positive. The finding of acute streptococcal pharyngitis along with the diffuse rash led to a diagnosis of scarlet fever. The rash of scarlet fever is a delayed-type hypersensitivity to an exotoxin and therefore occurs in persons who have had a previous exposure to Streptococcus pyogenes. The rash classically manifests with linear petechial confluences that are known as Pastia's lines, which were seen in this patient. The patient was treated with antibiotic agents and had complete resolution of his symptoms within 3 days.

Alyson Brinker, M.D.

Navy Hospital Guam, Yigo, Guam 

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

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Scarlet Fever

http://otorhinolaryngology-crete.blogspot.com/2017/05/scarlet-fever.html

A 20-year-old man presented to his primary care physician with a 3-day history of swollen tonsils, sore throat, fevers, chills, and rash. The nonpruritic rash had started on his abdomen, spread to his chest and back, and then appeared on his arms, legs, and face. He had no known allergies or exposures to new medications and had no history of similar rash. Examination revealed exudative tonsillitis (Panel A), strawberry tongue, and cervical adenopathy with tenderness. Skin examination revealed diffuse blanching erythema with punctate papules that caused the skin on his chest, abdomen, back, arms, and legs to have a sandpaper-like quality (Panel B shows the left side of his abdomen). His neck and right flank had linear petechial patches. A rapid test for streptococcal pharyngitis was positive. The finding of acute streptococcal pharyngitis along with the diffuse rash led to a diagnosis of scarlet fever. The rash of scarlet fever is a delayed-type hypersensitivity to an exotoxin and therefore occurs in persons who have had a previous exposure to Streptococcus pyogenes. The rash classically manifests with linear petechial confluences that are known as Pastia's lines, which were seen in this patient. The patient was treated with antibiotic agents and had complete resolution of his symptoms within 3 days.

Alyson Brinker, M.D.

Navy Hospital Guam, Yigo, Guam 

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Allergic respiratory disease (ARD), setting forth the basics: proposals of an expert consensus report

The variability of symptoms observed in patients with respiratory allergy often hampers classification based on the criteria proposed in guidelines on rhinitis and asthma.

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Therapie der akuten lymphatischen Leukämie des Erwachsenen

Zusammenfassung

Hintergrund

Die akute lymphatische Leukämie (ALL) ist die häufigste maligne Erkrankung im Kindesalter und hat an den akuten Leukämien des Erwachsenenalters einen Anteil von etwa 20 %.

Ergebnisse

In den vergangenen Jahrzehnten wurden bezüglich der Charakterisierung der ALL und der Optimierung ihrer Therapie wesentliche Fortschritte erzielt. Es wurden biologische Subgruppen und Risikogruppen mit unterschiedlichem klinischem Verlauf identifiziert. Auf der Zuordnung zu diesen Untergruppen basieren aktuelle, individualisierte risikoadaptierte Therapieprotokolle. Etwa 90% der erwachsenen ALL-Patienten erreichen nun eine komplette Remission, und die Heilungschancen erhöhten sich in den vergangenen 30 Jahren von unter 10 % auf über 50 %.

Schlussfolgerungen

Wesentlich für die Verbesserung der Therapieergebnisse waren eine Optimierung der Chemotherapie und Supportivbehandlung, die Integration der Stammzelltransplantation in die Erstlinienbehandlung, individualisierte Therapiemodifikationen unter Berücksichtigung der minimalen Resterkrankung und zielgerichtete Therapien wie der Einsatz von Tyrosinkinaseinhibitoren bei der Ph/BCR-ABL-positiven ALL (Ph: Philadelphia-Chromosom, BCR: „breakpoint cluster region", ABL: „Abelson murine leukemia viral oncogene homolog 1").

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Patterns of Initial Recurrence in Completely Resected Papillary Thyroid Carcinoma

Thyroid , Vol. 0, No. 0.


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Serum Alanine Aminotransferase Trends and Their Relationship with Obesity and Metabolic Syndrome in United States Adolescents, 1999–2014

Metabolic Syndrome and Related Disorders , Vol. 0, No. 0.


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Targeting T cell metabolism to regulate T cell activation, differentiation and function in disease

Chirag H Patel | Jonathan D Powell

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THE USE OF AN ACELLULAR OXYGEN CARRIER IN A HUMAN LIVER MODEL OF NORMOTHERMIC MACHINE PERFUSION.

Background: Normothermic machine perfusion of the liver (NMP-L) is a novel technique that preserves liver grafts under near-physiological conditions whilst maintaining their normal metabolic activity. This process requires an adequate oxygen supply, typically delivered by packed red blood cells (RBC). We present the first experience using an acellular hemoglobin-based oxygen carrier (HBOC) Hemopure in a human model of NMP-L. Methods: Five discarded high-risk human livers were perfused with HBOC-based perfusion fluid and matched to 5 RBC-perfused livers. Perfusion parameters, oxygen extraction, metabolic activity and histological features were compared during 6 hours of NMP-L. The cytotoxicity of Hemopure was also tested on human hepatic primary cell line cultures using an in vitro model of ischemia reperfusion injury. Results: The vascular flow parameters and the perfusate lactate clearance were similar in both groups. The HBOC-perfused livers extracted more oxygen than those perfused with RBCs (O2ER 13.75 vs 9.43 % x105 per gram of tissue, p=0.001). In vitro exposure to Hemopure did not alter intracellular levels of reactive oxygen species and there was no increase in apoptosis or necrosis observed in any of the tested cell lines. Histological findings were comparable between groups. There was no evidence of histological damage caused by Hemopure. Conclusion: Hemopure can be used as an alternative oxygen carrier to packed red cells in NMP-L perfusion fluid. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Endoscopic esophageal and tracheal cauterization for closure of recurrent tracheoesophageal fistula: A case report and review of the literature

Publication date: July 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 98
Author(s): Stacie Gregory, Robert H. Chun, Daiva Parakininkas, Louella Amos, Roger Fons, Diana G. Lerner, Dave R. Lal, Cecille Sulman
ObjectiveRecurrent tracheoesophageal fistula (TEF) can be a diagnostic and therapeutic challenge. Traditional treatment is thoracotomy, which carries significant morbidity and technical difficulty especially in a previously operated field. Recently, endoscopic techniques have been advocated as a primary approach for treatment of recurrent TEF prior to open repair. This case report describes the endoscopic technique used to address a recurrent TEF. The existing literature of all reported endoscopic cauterization methods is reviewed.MethodsAn 8 month old with proximal esophageal atresia and distal TEF underwent endoscopic closure of a recurrent TEF. The fistula was approached endotracheally utilizing Bugbee electrocautery (EC) and endoluminally through the esophagus using argon plasma coagulator and placement of porcine submucosa graft into the tract. Current literature review is presented with a synthesis of data on cases utilizing endoscopically applied EC and the combined results of this closure technique.ResultsOur patient has maintained successful closure after a single treatment confirmed on follow up endoscopy 6 months post repair. Including this patient, there have been 30 patients with recurrent TEF treated utilizing endoscopic EC reported in the literature. The overall success rate is 78.8% with a mean of 1.88 procedures per successful closure. Comparing EC alone to EC combined with tissue glues or laser, success rates are 67% and 86% respectively.ConclusionEndoscopic repair of recurrent TEF has proven to be safe and effective in the literature as an alternative to a second thoracotomy/open surgical repair. EC combined with tissue glues or laser is more effective than EC alone based on available data.



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Spontaneous CSF rhinorrhea from the trigeminal canal in an adolescent

Publication date: July 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 98
Author(s): Jonathan C. Simmonds, Andrew R. Scott
We report a case of a seventeen-year old, healthy, non-obese young woman who presented with retro-orbital headaches and metallictasting, left-sided rhinorrhea. Computed tomography revealed a defect along the medial wall of the canal of V2 within a well-pneumatized lateral recess of the left sphenoid sinus. Prior imaging obtained 4 years earlier in the context of nasal trauma showed no such defect - thus lending support for the arachnoid granulation hypothesis of spontaneous CSF leaks from the sphenoid sinus. We perform a literature review and describe a successful repair through an endoscopic transpterygoid approach, which allowed for resolution of symptoms with minimal postoperative morbidity.



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Silent sinus syndrome and maxillary sinus atelectasis in children

Publication date: July 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 98
Author(s): Farneti Paolo, Sciarretta Vittorio, Macrì Giovanni, Piccin Ottavio, Pasquini Ernesto
ObjectiveSilent sinus syndrome (SSS) and chronic maxillary atelectasis (CMA) are unusual conditions having subtle symptoms with a possible progressive evolution. They are particularly infrequent in the pediatric population. Our objective was to review our experience with pediatric patients having SSS or CMA, and to review all cases involving patients under 14 years of age reported in the literature.MethodsA retrospective review of 6 patients diagnosed with SSS or CMA surgically treated from 2001 to 2014 was carried out. All cases reported in literature were reviewed.ResultsAll patients underwent functional endoscopic sinus surgery with an improvement in symptoms after surgery. Diplopia disappeared in two patients who presented with it and enophthalmos improved in all five patients presenting with it. Only one patient out of four presenting with headache had a persistence of the symptoms which were, however, milder than they had been preoperatively. Endoscopic examination demonstrated a reventilated maxillary sinus in all cases. A radiological examination at follow-up was performed in 5 cases and demonstrated a reexpansion of the maxillary sinus as compared to the contralateral side in all patients except one. None of the patients required an orbital floor reconstruction. Eleven similar cases reported in the literature were analyzed and compared.ConclusionEndoscopic uncinectomy and middle meatal antrostomy should be the treatment of choice for these conditions in patients presenting with enophthalmos and/or hypoglobus and symptoms related to it. Orbital floor reconstruction should be performed as a delayed procedure only in selected cases. Chronic maxillary atelectasis or SSS should be considered as a possible cause of persistent headache of unknown origin in pediatric patients.



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Impacto de la laringectomía total en la situación laboral

Publication date: Available online 17 May 2017
Source:Acta Otorrinolaringológica Española
Author(s): Jose Miguel Costa, Montserrat López, Jacinto García, Xavier León, Miquel Quer
IntroducciónLa laringectomía total es una de las cirugías oncológicas más mutilantes. No existen estudios específicos que evalúen el retorno laboral después de la misma.Pacientes y métodosSe realizó un estudio transversal de una muestra de 116 pacientes laringectomizados que se hallaban libres de enfermedad y con un seguimiento mínimo de 2 años desde la laringectomía total. Se les realizó una encuesta dirigida a conocer la situación laboral, tanto previa como posterior. En el momento de la cirugía 62 (53%) estaban activos laboralmente, 40 (35%) estaban jubilados y 14 (12%) tenían una situación de invalidez.ResultadosEl 60% tenía profesiones con bajo grado de cualificación, siendo el grupo más numeroso los trabajadores de la construcción. De los 62 pacientes laboralmente activos en el momento de la laringectomía total 29 pasaron a inactivos y 33 (53%) mantuvieron la actividad laboral. Los factores más importantes para mantener la actividad laboral fueron el nivel de cualificación profesional y el método de rehabilitación vocal. El 80% de los pacientes con cualificación alta-intermedia mantuvieron su trabajo, frente al 35% en los de cualificación profesional baja (p<0,001). El 70% de los pacientes con prótesis fonatoria mantuvo la actividad laboral, frente a un 31% de los pacientes rehabilitados con erigmofonía (p=0,004). La regresión logística confirmó estas variables como independientes para seguir trabajando.ConclusionesEste es el primer estudio que analiza el impacto de la laringectomía total en la situación laboral. Los factores más importantes para volver a trabajar fueron tener un trabajo cualificado alto-intermedio y la utilización de prótesis fonatoria como método de rehabilitación vocal.IntroductionTotal laryngectomy is one of the most mutilating oncological operations. There are no specific studies evaluating return to work after this surgery.Patients and methodsA cross-sectional study was performed on a sample of 116 laryngectomized patients who were disease- free and had a minimum follow-up of 2 years from total laryngectomy. A survey was conducted to find out their employment situation before and after surgery. At the time of surgery, 62 (53%) were working, 40 (35%) were retired and 14 (12%) were in a disability situation.Results60% had professions with low qualification requirements, the largest group being construction workers. Of the 62 patients active at the time of total laryngectomy, 29 became inactive and 33 (53%) maintained their work activity. The most important factors in maintaining work activity were the level of professional qualification and the method of vocal rehabilitation. Eighty percent of the patients with high-intermediate qualification maintained their jobs, compared to 35% of those with low professional qualifications (P<.001). Seventy percent of the patients with voice prostheses maintained their work activity, compared to 31% of the patients rehabilitated with oesophageal voice (P=.004). Logistic regression confirmed these as independent variables for continuing to work.ConclusionsThis is the first study that analyzes the impact of total laryngectomy on the work situation. The most important factors for a return to work were having a high-intermediate skilled job and the use of voice prosthesis as a method of vocal rehabilitation.



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Enfermedad de Castleman cervical pediátrica

Publication date: Available online 17 May 2017
Source:Acta Otorrinolaringológica Española
Author(s): Cristina Marco Martin, Roberto Méndez Gallart, Carlos Aliste Santos, Máximo Francisco Fraga Rodriguez, Adolfo Bautista Casasnovas




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The feasibility of endoscopy-CT image registration in the head and neck without prospective endoscope tracking

by W. Scott Ingram, Jinzhong Yang, Beth M. Beadle, Richard Wendt III, Arvind Rao, Xin A. Wang, Laurence E. Court

Purpose

Endoscopic examinations are frequently-used procedures for patients with head and neck cancer undergoing radiotherapy, but radiation treatment plans are created on computed tomography (CT) scans. Image registration between endoscopic video and CT could be used to improve treatment planning and analysis of radiation-related normal tissue toxicity. The purpose of this study was to explore the feasibility of endoscopy-CT image registration without prospective physical tracking of the endoscope during the examination.

Methods

A novel registration technique called Location Search was developed. This technique uses physical constraints on the endoscope's view direction to search for the virtual endoscope coordinates that maximize the similarity between the endoscopic video frame and the virtual endoscopic image. Its performance was tested on phantom and patient images and compared to an established registration technique, Frame-To-Frame Tracking.

Results

In phantoms, Location Search had average registration errors of 0.55 ± 0.60 cm for point measurements and 0.29 ± 0.15 cm for object surface measurements. Frame-To-Frame Tracking achieved similar results on some frames, but it failed on others due to the virtual endoscope becoming lost. This weakness was more pronounced in patients, where Frame-To-Frame tracking could not make it through the nasal cavity. On successful patient video frames, Location Search was able to find endoscope positions with an average distance of 0.98 ± 0.53 cm away from the ground truth positions. However, it failed on many frames due to false similarity matches caused by anatomical structural differences between the endoscopic video and the virtual endoscopic images.

Conclusions

Endoscopy-CT image registration without prospective physical tracking of the endoscope is possible, but more development is required to achieve an accuracy suitable for clinical translation.

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Een (iets té) compacte schrijfcompagnon. Recensie van Renkema, Jan en Eric Daamen, Schrijfwijzer Compact. Amsterdam, Boom, 2016

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Experimental and numerical plasticity analysis of heterogeneous welds

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Inflammatory infiltrate and mucosal remodeling in chronic rhinosinusitis with and without polyps: structured histopathologic analysis

Background

Chronic rhinosinusitis (CRS) is commonly classified into CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). Structured histopathologic reporting has the potential to identify salient histologic markers to differentiate subtypes and provide insights into pathophysiologic mechanisms in CRS.

Methods

A structured histopathology report of 13 variables was prospectively employed to analyze ethmoid sinus tissue removed during endoscopic sinus surgery for 99 patients, including 43 CRSsNP and 56 CRSwNP. These variables were compared in association with presence of nasal polyps, radiographic computed tomography scores (Lund-Mackay Score [LMS]), subjective symptoms scores (SNOT-22), duration of CRS, comorbid asthma, and atopy.

Results

Overall inflammation did not differentiate between CRSsNP and CRSwNP (p < 0.26). Compared to CRSsNP, CRSwNP had statistically significant increase in basement membrane thickening (76.8% vs 48.8%, p < 0.004), subepithelial edema (19.6% vs 2.3%, p < 0.01), fibrosis (58.9% vs 27.9%, p < 0.002), hyperplastic/papillary changes (12.5% vs 0.0%, p < 0.016), eosinophilia (41.1% vs 18.6%, p < 0.047), and eosinophilic aggregates (30.4% vs 11.6%, p < 0.022). Higher LMS was associated with increased eosinophilia (p < 0.001), eosinophil aggregates (p < 0.000), inflammation (p < 0.023), basement membrane thickening (p < 0.037), hyperplastic/papillary changes (p < 0.040) and fibrosis (p < 0.000). SNOT-22 scores were not associated with any histologic parameters.

Conclusion

Significant histopathologic differences were evident in patients with CRSwNP and CRSsNP. No single feature reliably differentiated between the 2 subtypes, underscoring the heterogeneity of CRS and limitation of this phenotypic classification system. Eosinophilic aggregates were associated with significantly worse disease, possibly signifying a unique subtype. Further studies are needed to understand the relationship of histopathologic features to disease outcome.

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Diffuse Parotid Swelling From an Underlying Parotid Mass

A child presented with left jaw pain and symptoms of an upper respiratory infection; the swelling resolved leaving a firm, slightly mobile, subcentimeter mass palpable in the anterior parotid gland that enlarged and became painful. What is your diagnosis?

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Evaluation of Monitored Anesthesia Care in Sialendoscopy

This cohort study compares the outcomes of sialendoscopy procedures in patients who underwent general anesthesia with endotracheal intubation or monitored anesthesia care.

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Indocyanine Green Dye Angiography to Predict Postoperative Fistulas After Laryngectomy

This study examines whether noninvasive angiography with indocyanine green dye can be used to evaluate native pharyngeal vascularity to anticipate pharyngocutaneous fistula development after salvage laryngectomy in patients with head and neck cancer.

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Cost as a Barrier for Hearing Aid Adoption

This Viewpoint explores the broader barriers audiologists face in providing services and technologies to those with reduced hearing ability and why cost is not the main barrier for patients.

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Genetic etiology of oral cancer

Publication date: July 2017
Source:Oral Oncology, Volume 70
Author(s): Johar Ali, Bibi Sabiha, Hanif Ullah Jan, Syed Adnan Haider, Abid Ali Khan, Saima S. Ali
Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide. It accounts for 2.5% of all new cancer cases and 1.9% of all cancer deaths annually. More than 90% of oral cancers (occurring in the mouth, lip, and tongue) are oral squamous cell carcinoma. The incidence rate of oral cancer varies widely throughout the world, with an evident prevalence in South Asian countries. This high incidence occurs in correlation with oral cancer-associated behaviors such as alcohol, tobacco use. Researchers have reported that these behaviors lead to genetic variations in tumor suppressor genes (APC, p53), proto-oncogenes (Myc), oncogene (Ras) and genes controlling normal cellular processes (EIF3E, GSTM1). Processes such as segregation of chromosomes, genomic copy number, loss of heterozygosity, telomere stabilities, regulations of cell-cycle checkpoints, DNA damage repairs and defects in notch signaling pathways are involved in causing oral cancer. In order to develop preventive and therapeutic options, it is necessary to comprehend the basic molecular mechanisms forcing oral tumorigenesis. This review examines, in detail, the mechanisms of genetic alteration which are considered to be responsible for the initiation of oral cancer.



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Nasal Reconstruction in the Vasculopathic Patient

Saddle nose deformity ranks high among the burden of disease in patients diagnosed with systemic vascular disorders. Nearly one-quarter of patients diagnosed with granulomatosis with polyangiitis (GPA) develop this deformity. The process contributes to the overall cosmetic, mental, and functional toll taken on by a patient. It is only in the last several decades that literature has surfaced highlighting surgical interventions for vasculitis-induced saddle nose deformity.

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Carbon Dioxide Laser as an Office-Based Surgical Tool

In the mid-19th century, the first transoral laryngeal procedures were performed in awake patients without sedation. As topical and general anesthesia techniques advanced toward the turn of the 20th century, laryngeal surgeons transitioned such care to the operating room, where improved visualization and precision were achieved under anesthesia. During this period of endoscopic laryngeal surgery, the armamentarium of surgeons expanded greatly, and several procedural innovations were made, although for some recurrent conditions, the operating room setting presented drawbacks. For benign diseases, surgeons developed individualized functional thresholds, typically measured by ventilatory or phonatory dysfunction, for taking a patient to the operating room for surgical treatment. This protocol is, of course, more problematic in recurrent diseases, such as papillomatosis, which inherently require repeated and often frequent surgical procedures that impart safety, logistical, and cost burdens.

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Repetitive Transcranial Magnetic Stimulation for Tinnitus

This Viewpoint discusses evidence of the efficacy of repetitive transcranial magnetic stimulation for treatment of tinnitus and the need for a randomized clinical trial.

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Cetuximab and Radiotherapy in Laryngeal Preservanion—Reply

In Reply We thank Drs D'Ascanio, Ricci, and Piazza for their interest in the article "Cetuximab and Radiotherapy in Laryngeal Preservation for Cancers of the Larynx and Hypopharynx: A Secondary Analysis of a Randomized Clinical Trial." The contribution of the article was a retrospective subgroup analysis of a randomized trial of primary radiation with and without cetuximab for patients with locoregionally advanced head and neck cancers. Patients with advanced laryngeal and hypopharyngeal tumors often require laryngectomy if they are to undergo surgery. We examined patients with advanced laryngeal and hypopharyngeal tumors from our overall trial of patients with locoregionally advanced head and neck cancer.

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Cognitive Training for Adults With Bothersome Tinnitus

This randomized clinical trial evaluates the effect of a cognitive training program on bothersome tinnitus in adults.

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Left-Sided Facial Pain, Fullness, and Trismus

A young man had left-sided facial pain, fullness, trismus, and decreased acuity in his left lower visual field; physical examination revealed a mass that extended inferiorly to the zygoma into the buccal cavity and posterolaterally to the left superior molars. What is your diagnosis?

http://ift.tt/2kWo49Q

Quality of Life in Children After Submucous Inferior Turbinoplasty

This case series examines changes in sinonasal quality of life for children after outfracture of inferior turbinates and concomitant submucous microdebrider inferior turbinoplasty for chronic nasal congestion.

http://ift.tt/2kWrdGJ

Drug-Induced Sleep Endoscopy With Online Cardiorespiratory Monitoring

This cohort study describes a drug-induced sleep endoscopy technique implemented with simultaneous polygraphic monitoring of cardiorespiratory parameters in patients with obstructive sleep apnea syndrome.

http://ift.tt/2lDOha8

Middle Ear Mass Causing Vertigo and Facial Nerve Weakness

A woman had vertigo, profound mixed hearing loss, a mass obstructing the external auditory canal, and facial nerve weakness; computed tomography revealed a soft-tissue mass emanating from the middle ear involving the facial canal with surrounding bony erosion. What is your diagnosis?

http://ift.tt/2iUhBIi

Otogenic Temporomandibular Arthritis in Children

This study describes the symptoms, imaging characteristics, course, and treatment of otogenic septic arthritis of the temporomandibular joint in children.

http://ift.tt/2lDNcPn

Permanent 3D-Printed Tracheal Splint for Severe Tracheomalacia

This case report describes the treatment of severe acquired tracheomalacia with a patient-specific, 3D-printed, permanent tracheal splint.

http://ift.tt/2k5T2eF

Otolaryngology Consultation Trends at an Academic Quaternary Care Center

This study examines trends in otolaryngology–head and neck surgery consultations conducted in emergency departments and inpatient services.

http://ift.tt/2iUnDsH

May 2017 Issue Highlights

http://ift.tt/2rvJQBA

Antireflux Medication and Laryngopharyngeal Reflux in Nasal Resistance

This case-control study describes the association of oral antireflux medication with laryngopharyngeal reflux and nasal resistance.

http://ift.tt/2m6WmV4

Expanding Perspectives in Airway Stenosis

As surgeons, we take pride in our craft and, therefore, are biased toward our preferred techniques. Similarly, our clinical research is often guided by this motivation, steering us to share the outcomes of our favored techniques. This natural bias is evident in the literature. For example, at the time of publication, a PubMed search "Laryngostenosis/surgery[Mesh]" (which includes subglottic stenosis) revealed 1294 articles on surgical approaches to upper airway stenosis. In contrast, the search "Laryngostenosis/drug therapy[Mesh]" (which includes use of mitomycin and other adjuvant therapies) resulted in only 80 articles. The article by Feinstein et al in this issue of JAMA Otolaryngology–Head & Neck Surgery joins several others to reinforce the concept that perhaps it is not the surgical finesse or latest technology used in endoscopic procedures to modify the structural airway anatomy that matters, but rather how we can manipulate the immunologic response and wound healing process afterward. However, this is in contrast to more technically difficult open airway reconstruction, clearly demonstrating improved outcomes and higher "cure rate" in high-volume centers.

http://ift.tt/2l48k0k

Office-Based Laryngeal Surgery Using Carbon Dioxide Lasers

This study evaluates the outcomes and technical problems of using a carbon dioxide laser for office-based laryngeal surgery among adults with vocal lesions treated in a single institution in Taiwan.

http://ift.tt/2lPPZbW

Reconstruction of Saddle Nose Deformity in Granulomatosis With Polyangiitis

This systematic review identifies which techniques were most successful in reconstructive rhinoplasty for patients with a saddle nose deformity secondary to granulomatosis with polyangiitis disease.

http://ift.tt/2hz7CKC

Predictors of Obstructive Sleep Apnea Severity in Adolescents

This case series examines the clinical and demographic factors associated with obstructive sleep apnea severity in adolescents.

http://ift.tt/2l4hwS4

A Cystic Lesion of the Lower Lip

A man presented with an intraoral cystic lesion of the left lower lip; the lesion had developed spontaneously and grew slowly but progressively, and there was an outflow of a clear serous fluid on palpation. What is your diagnosis?

http://ift.tt/2iXCXGO

Endoscopic Management of Subglottic Stenosis

This case series assesses whether surgical technique or adjunctive measures are associated with duration between surgical procedures for subglottic stenosis.

http://ift.tt/2mpkS3c

Understanding the relationship between olfactory-specific quality of life, objective olfactory loss, and patient factors in chronic rhinosinusitis

Background

Chronic rhinosinusitis (CRS) significantly impacts olfaction. However, the relationship between objective olfaction and patient-reported olfactory-specific quality of life (QOL) is not well understood. Furthermore, objective olfactory testing can be time consuming, so we sought to determine if patient-reported olfactory QOL can be used as screening tool for olfactory dysfunction.

Methods

Olfactory dysfunction was evaluated in 109 patients with CRS using the Questionnaire of Olfactory Disorders–Negative Statements (QOD-NS) and the Sniffin' Sticks Test, assessing for olfactory threshold, discrimination, identification, and overall composite scores (TDI; composite score of threshold, discrimination, and identification). Regression analysis was performed to correlate olfactory metrics and patient and disease-specific factors with QOD-NS scores. Optimal QOD-NS scores to classify patients based upon objective olfactory function were established.

Results

Bivariate and multivariate regression analyses of QOD-NS and CRS-associated comorbidities, objective measures of disease, demographics, and CRS-specific QOL were performed. Non-white race, depression, and worse 22-item Sino-Nasal Outcome Test (SNOT-22) scores correlated with worse QOD-NS scores (p < 0.005). Worse TDI scores correlated with worse QOD-NS scores, and discrimination had the strongest correlation (p < 0.001). Mean ± standard deviation (SD) QOD-NS scores for normosmia, hyposmia, and anosmia were 44 ± 7.2, 35.7 ± 12.8, and 31.6 ± 10.7, respectively. Receiver operating characteristic curve analysis revealed an area under the curve of 0.770 (p < 0.001), and a QOD-NS cutoff of 38.5 to have maximal Youden's index to define normal vs abnormal TDI score.

Conclusion

In CRS, QOD-NS correlates with non-white race, depression, SNOT-22, and TDI score, with discrimination having the strongest correlation. The QOD-NS also appears to be a feasible tool for olfaction screening.

http://ift.tt/2rvhtn5

How does the pattern of aeroallergen sensitization change over time across all ages?

Background

Identification of aeroallergen sensitization is important for diagnosis and management of allergic diseases. Immunoglobulin E (IgE) sensitization status is known to change over time. However, few studies have explored changes in sensitization patterns across all age groups. The aim of the present study was to evaluate the changing patterns of in vitro IgE sensitization tests in allergic rhinitis patients across all age groups.

Methods

We recruited all patients who were diagnosed as having rhinitis and who underwent in vitro IgE sensitization testing from 2007 to 2016. Of these, we included 138 who underwent repeat testing. We analyzed epidemiological data and allergen sensitization patterns.

Results

Of all patients, 56.5% of exhibited changes in allergen sensitization patterns. The allergens to which all age groups were sensitive were most commonly mites, with the exception of patients aged 40 to 59 years. The age group in which "new sensitization," composed of those with "newly developed sensitization" and "sensitization to more allergens," was most frequent was the 2 to 12 years old group, followed by the 20 to 39 years old group. The age group in which "desensitization," composed of those with "negative conversion" and "desensitization to fewer allergens," was most prevalent was the 20 to 39 years old group followed by the 13 to 19 years old group. Grass pollen was the most common newly-sensitized allergen and also the most common desensitized allergen.

Conclusion

IgE sensitization to aeroallergens can change in individuals with allergy. These changes may be different according to the patient's age. If rhinitis symptoms or treatment efficacy changes, repeat IgE sensitization testing is needed to find changes in allergen sensitization patterns.

http://ift.tt/2qWrk8o

The role of photoheterotrophic and chemoautotrophic prokaryotes in the microbial food web in terrestrial Antarctica: a cultivation approach combined with functional analysis

http://ift.tt/2rvjZsu

What Should I Do If My Child is Stung by a Bee?

 

Lisa Kertz, a nurse practitioner, is back on another episode of MomDocs to discuss what a parent should do after their child is stung by a bee. Most kids are not allergic to bee stings, but oral and topical antihistamines can be helpful to reduce swelling.

The post What Should I Do If My Child is Stung by a Bee? appeared first on ChildrensMD.

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Staphylococcus aureus colonization at ICU admission as a risk factor for developing S. aureus ICU pneumonia

http://ift.tt/2q0lGgm

CHARACTERIZATION OF CELL SCAFFOLDING PROPERTIES OF HOLLOW FIBER MEMBRANE BIOREACTORS (HFMBS) FOR BONE TISSUE ENGINEERING BY MICROCOMPUTED TOMOGRAPHY

http://ift.tt/2qvo6qV

MODEL-PREDICTED EFFECT OF CELL PROLIFERATION AND DIFFERENTIATION ON THE DARCY PERMEABILITY AND PERFUSION PATTERN OF ANNULAR POROUS CONSTRUCTS CULTURED IN rPBBs FOR BONE TISSUE ENGINEERING

http://ift.tt/2q0lFci

Role of RIP1 in TNF-induced cell death in vitro and in vivo

http://ift.tt/2qvvWRi

Media Advisory: Alan Alda to Give Lecture on the Importance of Clear Science Communication at Johns Hopkins

You might remember him as Hawkeye Pierce on "M*A*S*H," as Senator Vinick on "The West Wing," or as the host of PBS' "Scientific American Frontiers" for more than a decade. This Friday, Alan Alda will be visiting Johns Hopkins to share his thoughts on the importance of clear science communications to faculty, staff and students. Since 2009, he has been running the Alan Alda Center for Communicating Science at Stonybrook University, and has been a proponent of science communication and making science more accessible to everyone.

http://ift.tt/2rv9Z2D

How the Injured Brain Tells the Body It’s Hurt

Johns Hopkins researchers say they have identified a new way that cells in the brain alert the rest of the body to recruit immune cells when the brain is injured. The work was completed in mouse models that mimic infection, stroke or trauma in humans.

http://ift.tt/2qwXVAr

Characterizing microglia activation: a spatial statistics approach to maximize information extraction.

Davis, BM; Salinas-Navarro, M; Cordeiro, MF; Moons, L; Groef, LD; (2017) Characterizing microglia activation: a spatial statistics approach to maximize information extraction. Sci Rep , 7 (1) , Article 1576. 10.1038/s41598-017-01747-8 . Green open access

http://ift.tt/2qVSpsi

Global aquifers dominated by fossil groundwaters but wells vulnerable to modern contamination

Jasechko, S; Perrone, D; Befus, KM; Bayani Cardenas, M; Ferguson, G; Gleeson, T; Luijendijk, E; Jasechko, S; Perrone, D; Befus, KM; Bayani Cardenas, M; Ferguson, G; Gleeson, T; Luijendijk, E; McDonnell, JJ; Taylor, RG; Wada, Y; Kirchner, JW; - view fewer (2017) Global aquifers dominated by fossil groundwaters but wells vulnerable to modern contamination. Nature Geoscience , 2017 10.1038/ngeo2943 . (In press).

http://ift.tt/2rv1RzW

Posture and gesture in ancient Maya art and culture

Maitland Gardner, AJ; (2017) Posture and gesture in ancient Maya art and culture. Doctoral thesis, UCL (University College London).

http://ift.tt/2qVUJiX

The causal impact of material productivity on macroeconomic competitiveness in the European Union

Flachenecker, F; The causal impact of material productivity on macroeconomic competitiveness in the European Union. Environmental Economics and Policy Studies 10.1007/s10018-016-0180-3 . (In press). Green open access

http://ift.tt/2rvaFpi

Mathematics teacher capacity for change

Golding, J; (2017) Mathematics teacher capacity for change. Oxford Review of Education 10.1080/03054985.2017.1331846 . (In press).

http://ift.tt/2rvbCOp

Carbon Nanotubes in TiO 2 Nanofiber Photoelectrodes for High-Performance Perovskite Solar Cells

Batmunkh, M; Macdonald, TJ; Shearer, CJ; Bat-Erdene, M; Wang, Y; Biggs, MJ; Parkin, IP; Batmunkh, M; Macdonald, TJ; Shearer, CJ; Bat-Erdene, M; Wang, Y; Biggs, MJ; Parkin, IP; Nann, T; Shapter, JG; - view fewer (2017) Carbon Nanotubes in TiO 2 Nanofiber Photoelectrodes for High-Performance Perovskite Solar Cells. Advanced Science , 4 (4) , Article 1600504. 10.1002/advs.201600504 . Green open access

http://ift.tt/2qVCuKn

Modulation of the Gut-Liver Axis in Cirrhosis with Activated Carbon

Macnaughtan, JS; (2017) Modulation of the Gut-Liver Axis in Cirrhosis with Activated Carbon. Doctoral thesis, UCL (University College London). Green open access

http://ift.tt/2ruPDXX

Mechanistic studies on skin permeation models

Luo, L; (2017) Mechanistic studies on skin permeation models. Doctoral thesis, UCL (University College London).

http://ift.tt/2qWal5U

Intermolecular Charge Transfer Parameters, Electron–Phonon Couplings, and the Validity of Polaron Hopping Models in Organic Semiconducting Crystals: Rubrene, Pentacene, and C 60

Yang, H; Gajdos, F; Blumberger, J; (2017) Intermolecular Charge Transfer Parameters, Electron–Phonon Couplings, and the Validity of Polaron Hopping Models in Organic Semiconducting Crystals: Rubrene, Pentacene, and C 60. The Journal of Physical Chemistry C , 121 (14) pp. 7689-7696. 10.1021/acs.jpcc.7b00618 .

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Tau association with synaptic vesicles causes presynaptic dysfunction.

Zhou, L; McInnes, J; Wierda, K; Holt, M; Herrmann, AG; Jackson, RJ; Wang, Y-C; Zhou, L; McInnes, J; Wierda, K; Holt, M; Herrmann, AG; Jackson, RJ; Wang, Y-C; Swerts, J; Beyens, J; Miskiewicz, K; Vilain, S; Dewachter, I; Moechars, D; De Strooper, B; Spires-Jones, TL; De Wit, J; Verstreken, P; - view fewer (2017) Tau association with synaptic vesicles causes presynaptic dysfunction. Nat Commun , 8 , Article 15295. 10.1038/ncomms15295 . Green open access

http://ift.tt/2qVXJvw

Role of Neuropilins in Zebrafish Heart Regeneration

Lowe, VJ; (2017) Role of Neuropilins in Zebrafish Heart Regeneration. Doctoral thesis, UCL (University College London). Green open access

http://ift.tt/2rv1GEM

Deletion of exons 9 and 10 of the Presenilin 1 gene in a patient with Early-onset Alzheimer Disease generates longer amyloid seeds.

Le Guennec, K; Veugelen, S; Quenez, O; Szaruga, M; Rousseau, S; Nicolas, G; Wallon, D; Le Guennec, K; Veugelen, S; Quenez, O; Szaruga, M; Rousseau, S; Nicolas, G; Wallon, D; Fluchere, F; Frébourg, T; De Strooper, B; Campion, D; Chávez-Gutiérrez, L; Rovelet-Lecrux, A; - view fewer (2017) Deletion of exons 9 and 10 of the Presenilin 1 gene in a patient with Early-onset Alzheimer Disease generates longer amyloid seeds. Neurobiol Dis 10.1016/j.nbd.2017.04.020 . (In press).

http://ift.tt/2ruPVgS

Placental infection and maternal immunity in the Baby Bio Bank

Leon, LJ; (2017) Placental infection and maternal immunity in the Baby Bio Bank. Doctoral thesis, UCL (University College London). Green open access

http://ift.tt/2q05Gv4

Three-dimensional spatial navigation in real and virtual museums

Lazaridou, A; (2017) Three-dimensional spatial navigation in real and virtual museums. Doctoral thesis, UCL (University College London).

http://ift.tt/2qvrBxu

Copper and bloomery iron smelting in Central China: Technological traditions in the Daye County (Hubei)

Larreina Garcia, D; (2017) Copper and bloomery iron smelting in Central China: Technological traditions in the Daye County (Hubei). Doctoral thesis, UCL (University College London). Green open access

http://ift.tt/2q0jrd4

Faunistic, taxonomic and ecological research of ants from the Galápagos Islands with emphasis on invasive species

http://ift.tt/2rv3j4l

The impact of hot-melt extrusion on the tableting behaviour of polyvinyl alcohol

http://ift.tt/2qwJ4Go

Evaluation of spin freezing versus conventional freezing as part of a continuous pharmaceutical freeze-drying concept for unit doses

http://ift.tt/2ruJeuU

Case 15-2017 — A 27-Year-Old Woman with Anemia, Thrombocytosis, and Skin Lesions after Travel Abroad

Presentation of Case. Dr. Alyssa R. Letourneau: A 27-year-old woman was evaluated in the infectious disease clinic of this hospital because of skin lesions, anemia, thrombocytosis, and an elevated blood alkaline phosphatase level. Eleven months before this presentation, the patient traveled abroad;…

http://ift.tt/2pOTiT9

Methodological perspectives on the application of compound-specific stable isotope fingerprinting for sediment source apportionment

http://ift.tt/2pPfb53

The interior as architectural principle

The principle of architecture is the creation of an "inside" or an interior. There are three layers of meaning involved in isolating and defining a space as an "inside": the floor/earth, the wall/world, the ceiling/heavens. The three combined constitute and define a particular version of the archetypical "interior": the room. Each architectural interior, though, is at the same time a closed space, on itself, and at the same time represents and relates to an "outside" or to the World. This article is published as part of a collection on interiorities

http://ift.tt/2qAEp44

Theoretical Analysis of the Influence of Pore Geometry on Monomolecular Cracking and Dehydrogenation of n-Butane in Brønsted Acidic Zeolites

Recent experimental work has shown that variations in the confinement of n-butane at Bronsted acid sites due to changes in zeolite framework structure strongly affect the apparent and intrinsic enthalpy and entropy of activation for cracking and dehydrogenation. Quantum chemical calculations have provided good estimates of the intrinsic enthalpies and entropies of activation extracted from experimental rate data for MFI, but extending these calculations to less confining zeolites has proven challenging, particularly for activation entropies. Herein, we report our efforts to develop a theoretical model for the cracking and dehydrogenation of n-butane occurring in a series of zeolites containing 10-ring channels and differing in cavity size (TON, FER, SVR, MFI, MEL, STF, and MWW). We combine a QM/MM approach to calculate intrinsic and apparent activation parameters, with thermal corrections to the apparent barriers obtained from configurational-bias Monte Carlo simulations, to account for configurational contributions due to global motions of the transition state. We obtain good agreement between theory and experiment for all activation parameters for central cracking in all zeolites. For terminal cracking and dehydrogenation, good agreement between theory and experiment is found only at the highest confinements. Experimental activation parameters, especially those for dehydrogenation, tend to increase with decreasing confinement. This trend is not captured by the theoretical calculations, such that deviations between theory and experiment increase as confinement decreases. We propose that, because transition states for dehydrogenation are later than those for cracking, relative movements between the fragments produced in the reaction become increasingly important in the less confining zeolites.

http://ift.tt/2pPf89n

Functional community structure of African monodominant Gilbertiodendron dewevrei forest influenced by local environmental filtering

http://ift.tt/2qAEhS8

Study of the Contact Resistance of Interlaced Stainless Steel Yarns Embedded in Hybrid Woven Fabrics

http://ift.tt/2pP6983

Simulation of mass transport during intraperitoneal chemotherapy: a parametrical model of single tumor nodules

OBJECTIVES Patients with peritoneal carcinomatosis suffer from a widespread metastatic growth of tumor nodules in the peritoneal cavity. Although Intraperitoneal (IP) chemotherapy allows for higher intratumor concentrations of the cytotoxic agent compared to intravenous administration, actual application of IP chemotherapy is limited due to poor drug penetration (typically a few millimeters) in the tumor tissue. It is thus essential to better understand the drug transport during IP chemotherapy. METHODS A 3D computational fluid dynamics model of a tumor nodule with necrotic core was created in Comsol® (COMSOL, Inc., Burlington, USA) describing the drug transport occurring during IP chemotherapy, including convective/diffusive/reactive drug transport in two tumor geometries (a spherical baseline model with radius rsphere,large=1 cm/rsphere,small=2 mm and rnecrotic,large=5 mm/rnecrotic,large=1 mm). To assess the efficiency of drug administration, a penetration depth (PD) was defined as the percentage of the total radius in which the drug concentration resulted to be over 6.6E-3 mol/m3. These baseline models were subsequently adapted to evaluate the effect of therapy-related parameters (different drugs, vascular properties etc.) on drug penetration. RESULTS A large differences in PD (PD; % of total radius) were found in the baseline cases for the two different scales (PDsphere,large= 4.04%; PDsphere,small=20.82%).Vascular normalization therapy yielded different outcomes (ΔPDsphere,large+2.95%; ΔPDsphere,small +17.95%). Both cases showed less penetration when paclitaxel was used as opposed to cisplatin. This effect was more pronounced in the smaller geometry (ΔPDsphere,large =-1.91%; ΔPDsphere,small =-10.25%). CONCLUSIONS The model is able to predict drug penetration depth for different sets of IP chemotherapy-related parameters, which may lead to optimization of drug transport during IP chemotherapy.

http://ift.tt/2qAx3xv

Liber amicorum Christian Burvenich

http://ift.tt/2pOXl28

Nutrient cycling in two continuous cover scenarios for forest conversion of pine plantations on sandy soil, I: nutrient cycling via aboveground tree biomass

Conversion of coniferous pine plantations into mixed-species forests on sandy soils is an important concern for forest and nature management in Europe. However, little is know of the effect of the applied sylvicultural strategy on bio-geochemical cycling throughout the conversion process. This study examined the aboveground biomass production and nutrient (N, P, K, Ca, and Mg) cycling in terms of litterfall, immobilization in stems and branches, canopy exchange, and yearly root uptake in two scenarios of continuous cover forestry a decade after the first intervention for converting a homogeneous Scots pine (Pinus sylvestris L.) forest. Four regeneration types were studied: silver birch (Betula pendula L.) and pine after a shelterwood cutting and birch and pine after a group cutting. In conclusion, it can be stated that both the tree species and the conversion scenario influence the circulation of nutrients through the forest ecosystem: cycling of N, P, and K is determined by the tree species as well as the conversion scenario, whereas circulation of Ca and Mg is predominantly influenced by the type of conversion.

http://ift.tt/2qApEhI

Nutrient cycling in a poplar plantation (Populus trichocarpa x Populus deltoides 'Beaupré') on former agricultural land in northern Belgium

Hydrological fluxes, atmospheric deposition, litterfall, and soil percolation of the most important nutrients were measured in an 18-year-old poplar plantation on a well-drained silt loam soil during 2 consecutive years. Downward soil water flux and transpiration are the most important factors in the water balance. Around 80% of total nitrogen input (6.6 and 6.5 kmol center dot ha(-1) in years 1 and 2, respectively) originates from litterfall. After nitrification only a negligible amount of nitrate leaches during the growing season. Yearly uptake of nitrogen by the poplar ecosystem (woody biomass, leaves, and ground vegetation) approximately equals the input, of which more than 50% is accounted for by the leaves. This indicates very efficient nitrogen cycling. Total deposition of base cations originates from two processes, dry deposition (Mg2+ and Ca2+) and canopy leaching (K+ and Ca2+). Litter input of Ca2+ represents about 83% of the total input (stand deposition + litterfall), Mg2+ about 61%, and K+ less then 50%. Percolation of base cations at 1 m depth is very limited. Rather high Ca2+ and K+ contents of the woody biomass can lead to high exports at harvest. Nutrient cycling in the poplar stand proved to be very efficient, with no significant nutrient losses.

http://ift.tt/2pPgYH6

Improved AFLP analysis of tree species

Amplified fragment length polymorphism (AFLP) is a high-throughput, molecular-marker technique that is used increasingly in a variety of genetic analyses. Here, the conditions for carrying out AFLP analysis have been established for different tree species, including both angiosperm and gymnosperm trees, with genome sizes ranging from 0.54 to 38 pg DNA/2C. Specific parameters have been determined to provide informative and reproducible AFLP fingerprints of peach (Prunus persica L.), eucalypt, oak, poplar, and loblolly pine (Pinus taeda L.). Typically, 80-130 amplified DNA fragments (i.e., loci analyzed per primer combination) were obtained. Subsequently, these AFLP conditions were evaluated for intra- and inter-specific genetic variability studies as well as for genome mapping purposes of woody species. This work demonstrates that AFLP is a powerful tool in forest tree genetics.

http://ift.tt/2qA6PLO

To Evaluate the Efficacy of NY-ESO-1-specific T Cell Receptor (TCR) Affinity Enhancing Specific T Cell in Solid Tumors

Conditions:   Bone Sarcoma;   Soft Tissue Sarcoma;   Melanoma;   Liver Cancer;   Esophageal Cancer;   Breast Cancer;   Thyroid Cancer;   Ovarian Cancer
Interventions:   Drug: Cyclophosphamide;   Biological: TAEST16001
Sponsors:   Zhujiang Hospital;   Xiangxue Life Science Research Center;   Guangdong Xiangxue Precision Medical Technology Co., Ltd;   Guangzhou Xiangxue Pharmaceutical Co., Ltd
Recruiting - verified May 2017

http://ift.tt/2ruRjA2

The Feasibility and Safety of the TOETVA for Benign Thyroid Nodules

Condition:   Thyroid Diseases
Intervention:   Procedure: Transoral endoscopic thyroidectomy vestibular approach
Sponsor:   The University of Hong Kong
Not yet recruiting - verified May 2017

http://ift.tt/2qVryfK

New Insights in the Synthesis and Surface Chemistry of Colloidal Quantum Dots

http://ift.tt/2pWTZWB

Water-related ecosystem services of forests: learning from regional cases

http://ift.tt/2riHGYJ

Stem diameter variation: endogenous regulation versus environmental dynamics and its impliation for functional modelling

http://ift.tt/2pWRUdm

Nutrient cycling in two continuous cover scenarios for forest conversion of pine plantations on sandy soil, II: nutrient cycling via throughfall deposition and seepage flux

This study examined ion throughfall deposition and seepage fluxes in silver birch (Betula pendula L.) and Scots pine (Pinus sylvestris L.) regenerations a decade after a forest conversion intervention in two continuous cover scenarios (shelterwood cut versus group cut), as well as a 70-year-old control stand of Scots pine. Ion throughfall deposition was significantly influenced by the conversion scenario, being higher in the shelterwood cut than in the group cut. Compared with the control stand, nitrogen and acidifying throughfall deposition was significantly lower (-60%) in all regeneration types except for the birch regeneration under shelter. After shelter removal, ion throughfall deposition was significantly lower in all regeneration types than in the control stand. Seepage of NO3- and SO42- was significantly affected by the tree species, being higher in the birch than the pine regenerations, and SO42- seepage was significantly higher under shelter than in the group cut. After shelter removal, neither tree species nor scenario influenced the SO42- seepage, whereas the tree species still affected NO3- seepage. We conclude that the chosen forest conversion scenario is of profound influence on the ion throughfall and seepage fluxes during the first phase of a forest conversion process.

http://ift.tt/2riqYZD

Improving broad-leaved tree species by genetic engineering and utilisation of molecular markers

http://ift.tt/2pXeNNS

Study estimates number of U.S. women living with metastatic breast cancer

A new study shows that the number of women in the United States living with distant metastatic breast cancer (MBC), the most severe form of the disease, is growing. This is likely due to the aging of the U.S. population and improvements in treatment.

http://ift.tt/2riqFxT

Iliopsoas and intraperitoneal abscesses associated with pyoderma gangrenosum

http://ift.tt/2pXaTEI

Bilateral breast keloids in an elderly woman associated with bilateral breast cancers and high concentration of serum tumor growth factor-β

Abstract

We report a case of bilateral annular breast keloids in a 72-year-old woman who had been suffering from bilateral breast cancers. Histopathologically, the keloids showed unique distribution of α-SMA+, CD34− myofibroblasts and α-SMA−, CD34+ fibroblasts depending on the region. High serum levels of tumor growth factor-β were detected at 6 months after the development of the breast keloids, but not at 10 months. CD163-positive cells were abundantly detected in the skin of the elevated portion of the keloids. In contrast, these cells were considerably less numerous in the skin of the central healing portion compared with the skin of the elevated expanding portion. One interesting idea based on these results is that high levels of tumor growth factor-β released from CD163-positive cells played a crucial role in the formation of breast keloids through active induction of fibroblast differentiation into myofibroblasts. The present case strongly supports the previously proposed idea that keloids can form as a paraneoplastic phenomenon in breast cancer patients with keloid constitution.

http://ift.tt/2rimjqo

Segmental testicular infarction: a case report

Segmental testicular infarction is a very rare condition, which can mimic a testicular torsion or testicular cancer. Correct diagnosis is difficult but it is important to avoid unnecessary radical treatment.

http://ift.tt/2rv1Agv

Oxford Handbook of Medical Dermatology, second edition, 2016

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Erratum

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Corrigendum

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Issue Information

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An isolated ulcerated forehead lesion in a 70-year-old man

http://ift.tt/2qAvTCp

Unilateral Enlarged Vestibular Aqueduct Syndrome and Bilateral Endolymphatic Hydrops

Enlarged vestibular aqueduct (EVA) syndrome is a common congenital inner ear malformation characterized by a vestibular aqueduct with a diameter larger than 1.5 mm, mixed or sensorineural hearing loss that ranges from mild to profound, and vestibular disorders that may be present with a range from mild imbalance to episodic objective vertigo. In our study, we present the case of a patient with unilateral enlarged vestibular aqueduct and bilateral endolymphatic hydrops (EH). EH was confirmed through anamnestic history and audiological exams; EVA was diagnosed using high-resolution CT scans and MRI images. Therapy included intratympanic infusion of corticosteroids with a significant hearing improvement, more evident in the ear contralateral to EVA. Although most probably unrelated, EVA and EH may present with similar symptoms and therefore the diagnostic workup should always include the proper steps to perform a correct diagnosis. Association between progression of hearing loss and head trauma in patients with a diagnosis of EVA syndrome is still uncertain; however, these individuals should be advised to avoid activities that increase intracranial pressure to prevent further hearing deterioration. Intratympanic treatment with steroids is a safe and well-tolerated procedure that has demonstrated its efficacy in hearing, tinnitus, and vertigo control in EH.

http://ift.tt/2qAmivf

Opportunities to breed for broad mite resistance in Rhododendron simsii hybrids

Broad mites, Polyphagotarsonemus latus Banks, are a key pest in many ornamental plants including pot azalea, Rhododendron simsii hybrid. These minute mites (<200 mu m) cause browning and curling of leaves and flowers leading to economic losses as damaged plants are unmarketable. Development of resistant cultivars might lead to a sustainable solution in controlling this pest. We studied the response upon a broad mite infestation in R. simsii by means of gene expression. Data showed the induction of the jasmonic acid defence pathway in response to a broad mite infestation. Furthermore, an oxidative stress response was observed in infested plants when compared to control plants. Scanning electron microscopy of leaf morphology in eight R. simsii cultivars with a known susceptibility for broad mites revealed the presence of different trichome types. Short trichomes with a sticky end were seen in resistant or more tolerant genotypes. The outcome of this study might provide new insights in breeding for resistance against this pest in azalea.

http://ift.tt/2pOZRVV

The presence of beneficial arthropods in organic versus IPM pear orchards and their ability to predate pear suckers (Cacopsylla pyri)

In Belgium, two cultivation methods of pear are widely applied, namely organic farming and integrated pest management (IPM). Organic pear orchards are characterized by the use of green techniques such as natural fertilizers and the restricted use of crop protection products, whereas integrated pest management combines a well-tuned integration of biological pest control and crop protection treatments. It is generally considered that these two cultivation methods have different effects on the density of beneficial arthropods in the orchard and the occurrence of common pests as well. Therefore, a large-scale monitoring study was executed comprising extensive samplings throughout the year in 14 pear orchards and comparing beneficial fauna population developments between organic and IPM pear orchards. Pear sucker (Cacopsylla sp. or pear psylla) which is considered the major pest of pear in Belgium, was monitored as well. Organic orchards clearly displayed a lower pear psylla pressure correlating with higher proportions of specific predator populations, particularly velvet mites (Trombidiidae) and spiders (Araneae). IPM orchards showed higher numbers of Anthocoris spp. in summer. In addition, predation of C. pyri was verified by PCR-based gut content analysis. Regarding the results of this prey-predator PCR, Anthocoridae had the highest chance for detection of psyllid DNA in their gut. Velvet mites also scored particularly well for the PCR detections, indicating that other arthropods besides Anthocoridae could have an impact on the psyllid pressure in a pear orchard.

http://ift.tt/2qAeEkl

Peripheral back muscle dysfunctions and central pain mechanisms: An innovative perspective on differences between recurrent and chronic pain

http://ift.tt/2qAaMje

TreeWatch.net : a water and carbon monitoring and modeling network to assess instant tree hydraulics and carbon status

TreeWatch.net is an initiative that has been developed to watch trees grow and function in real-time. It is a water- and carbon-monitoring and modeling network, in which high quality measurements of sap flow and stem diameter variation are collected on individual trees. Automated data processing using a cloud service enables instant visualization of water movement and radial stem growth. This can be used to demonstrate the sensitivity of trees to changing weather conditions, such as drought, heat waves, or heavy rain showers. But TreeWatch.net's true innovation lies in its use of these high precision harmonized data to also parameterize process-based tree models in real-time, which makes displaying the much needed mechanisms underlying tree responses to climate change possible. Continuous simulation of turgor to describe growth processes and long-term time series of hydraulic resistance to assess drought-vulnerability in real-time are only a few of the opportunities our approach offers. TreeWatch.net has been developed with the view to be complementary to existing forest monitoring networks and with the aim to contribute to existing dynamic global vegetation models. It provides high-quality data and real-time simulations in order to advance research on the impact of climate change on the biological response of trees and forests. Besides its application in natural forests to answer climate-change related scientific and political questions, we also envision a broader societal application of TreeWatch.net by selecting trees in nature reserves, public areas, cities, university areas, schoolyards, and parks to teach youngsters and create public awareness on the effects of changing weather conditions on trees and forests in this era of climate change.

http://ift.tt/2pOoiD4

Use of sigma factors from Bacillus subtilis in the development of an orthogonal expression system in Escherichia coli

Background: Technological advances in synthetic biology, systems biology, and metabolic engineering have boosted applications of industrial biotechnology for an increasing number of complex and high added-value molecules. In general, the transfer of multi- gene or poorly understood heterologous pathways into the production host leads to imbalances due to lack of adequate regulatory mechanisms. Hence, fine-tuning expression of synthesis pathways in specific conditions is mandatory. Objectives: Here we develop a new genetic circuit for regulated expression specifically in stationary phase due to clear advantages during this period (reduction of toxicity, competition). Methods: This circuit consists of a heterologous sigma factor (𝛔) recognizing specific promoter sequences, which are not recognised by the native 𝛔 factors of E. coli and is expressed upon entering the stationary phase. First, several 𝛔 factors of B. subtilis were tested for their orthogonality in E. coli on the level of promoter recognition, by using a red-fluorescent reporter system. Secondly, the potential of 𝛔 factors of B. subtilis to work together with the E. coli core RNA polymerase was tested, by expressing these proteins together with their promoters. Based on the results a specific factor will be chosen for further optimalisation and the corresponding gene can be cloned in the 𝛔S factor operon of E. coli, which is most abundantly expressed in stationary conditions. Conclusions: Combining all these elements should allow us to create an orthogonal genetic circuit that is able to transcribe specific genes under stationary phase with a limited influence on the host cell's metabolism.

http://ift.tt/2qA4AYG

Natural born criminals: nature's zugzwang? Het theoretisch paradigma van de biosociale criminologie onder de microscoop

Deze bijdrage bespreekt de biosociale criminologie en haar historische evolutie. Ook hedendaagse inzichten en toepassingen komen aan bod. We kunnen niet spreken van een 'criminologische traditie' in België omwille van een langdurige breuklijn tussen biosociaal en criminologisch onderzoek. De effecten van en de kritieken op het 'Lombrosiaanse denken' heeft menig humaan wetenschapper beïnvloed om biosociale verklaringen niet op te nemen in de analyse. Het paradigma waarmee de Italiaanse School bekendheid heeft gekregen is in ons land naar de achtergrond verschoven. Op internationaal niveau merken we echter dat biosociaal onderzoek aan een heropleving toe is (Blokland, Thienpont & Donker, 2005; Simons, Lei, Beach, Brody, Philibert & Gibbons, 2011, 2012; Hanlon, Brook, Stratton, Jensen & Rubin, 2013; Raine, 2013). Om dergelijke 'shifts' beter te begrijpen is het noodzakelijk om de evoluties en trends van de biosociale criminologie onder de loep te nemen. Daarnaast is het van primordiaal belang om het concept 'paradigma' te behandelen. Welke plaats krijgt het biosociale denken binnen de criminologie toebedeeld en is er een mogelijkheid om hedendaagse inzichten te integreren in humaan wetenschappelijk onderzoek? Dit ethisch en methodologisch vraagstuk is geen evident gegeven. Paradigma's kunnen immers al snel een limitatieve manier van werken vooropstellen waarbij weinig tot geen rekening wordt gehouden met andere zienswijzen. Ons inziens biedt een integratieve onderzoekshouding een interessant alternatief. Criminologen zijn geen biologen en vice versa. Willen we daadwerkelijk een multidisciplinaire werking voorop stellen (Barak, 1998, 2009) dan is het noodzakelijk om hiervoor een platform te creëren. In the end is de grootste uitdaging van de hedendaagse criminologie het besef dat meerdere disciplines onderzoek verrichten naar criminaliteit. Het biosociaal paradigma is hiervan een perfect voorbeeld.

http://ift.tt/2pOoi62

Aspects of feasibility of a shipboard algal photobioreactor to capture carbon dioxide emissions

Koutita, K; (2017) Aspects of feasibility of a shipboard algal photobioreactor to capture carbon dioxide emissions. Doctoral thesis, UCL (University College London). Green open access

http://ift.tt/2pWZ3u4

Offspring schooling associated with increased parental survival in rural KwaZulu-Natal, South Africa

De Neve, J-W; Harling, G; (2017) Offspring schooling associated with increased parental survival in rural KwaZulu-Natal, South Africa. Social Science & Medicine , 176 pp. 149-157. 10.1016/j.socscimed.2017.01.015 . Green open access

http://ift.tt/2riezob

Bayesian variable selection for probit models with an application to clinical diagnosis

Kotti, E; (2017) Bayesian variable selection for probit models with an application to clinical diagnosis. Doctoral thesis, UCL (University College London).

http://ift.tt/2pX0pVL

Intimate relationships as means for ethical self-formation and social change in evangelical churches of Austin, Texas

Knuutila, PA; (2017) Intimate relationships as means for ethical self-formation and social change in evangelical churches of Austin, Texas. Doctoral thesis, UCL (University College London).

http://ift.tt/2pX64Lo

Maternal Nonstandard Work Schedules and Breastfeeding Behaviors

Zilanawala, A; (2017) Maternal Nonstandard Work Schedules and Breastfeeding Behaviors. Maternal and Child Health Journal 10.1007/s10995-016-2233-4 . (In press). Green open access

http://ift.tt/2ri9gFz

Severe hearing loss and outer hair cell death in homozygous Foxo3 knockout mice after moderate noise exposure

Gilels, F; Paquette, ST; Beaulac, HJ; Bullen, A; White, PM; (2017) Severe hearing loss and outer hair cell death in homozygous Foxo3 knockout mice after moderate noise exposure. Scientific Reports , 7 , Article 1054. 10.1038/s41598-017-01142-3 . Green open access

http://ift.tt/2pX2ZLe

A mixed methods study: evaluating the impact of a bespoke professional development based on an analysis of existing quality in one local authority

Kingston, D; (2017) A mixed methods study: evaluating the impact of a bespoke professional development based on an analysis of existing quality in one local authority. Doctoral thesis, UCL (University College London). Green open access

http://ift.tt/2ri0LKu

Assessing savings potentials from changes in energy behaviours of hospital staff: benefits and challenges of energy audits

Morgenstern, P; Raslan, R; Ruyssevelt, P; (2015) Assessing savings potentials from changes in energy behaviours of hospital staff: benefits and challenges of energy audits. In: Dyhr-Mikkelsen, K and Broc, JS, (eds.) Proceedings of ECEEE 2015 Summer Study on energy efficiency. (pp. pp. 1797-1807). European Council for an Energy Efficient Economy (ECEEE): Belambra Les Criques, Toulon/Hyères, France. Green open access

http://ift.tt/2pWVwMj

Improving the efficiency of HIV care: exploring the role of global donor strategies on access to prevention, testing and treatment

Kim, SW; (2017) Improving the efficiency of HIV care: exploring the role of global donor strategies on access to prevention, testing and treatment. Doctoral thesis, UCL (University College London). Green open access

http://ift.tt/2rihbT4

Defining novel mediators and mechanisms of neural microvasculature permeability

Kenny, B-AM; (2017) Defining novel mediators and mechanisms of neural microvasculature permeability. Doctoral thesis, UCL (University College London).

http://ift.tt/2pWW9p3

An historical geography of the Turkish bath in Victorian Britain

Jones, C; (2017) An historical geography of the Turkish bath in Victorian Britain. Doctoral thesis, UCL (University College London).

http://ift.tt/2ri9fBv

Cardiac Imaging for Regenerative Therapy and Tissue Engineering

Jackson, LH; (2017) Cardiac Imaging for Regenerative Therapy and Tissue Engineering. Doctoral thesis, UCL (University College London). Green open access

http://ift.tt/2pWB6TO

Oligodendrocyte Population Dynamics and Plasticity Probed by Genetic Manipulation in Mice

Iannarelli, P; (2017) Oligodendrocyte Population Dynamics and Plasticity Probed by Genetic Manipulation in Mice. Doctoral thesis, UCL (University College London). Green open access

http://ift.tt/2ri9agQ

Associative Obligation and the Social Contract

Weale, A; (2017) Associative Obligation and the Social Contract. Philosophia 10.1007/s11406-016-9797-5 . (In press). Green open access

http://ift.tt/2pWHk6e

Characterisation of a mouse model of AP-4 deficiency syndrome

Ivankovic, D; (2017) Characterisation of a mouse model of AP-4 deficiency syndrome. Doctoral thesis, UCL (University College London).

http://ift.tt/2rhKl4S

Tanzania’s community forests: their impact on human well-being and persistence in spite of the lack of benefit

Gross-Camp, N; (2017) Tanzania's community forests: their impact on human well-being and persistence in spite of the lack of benefit. Ecology and Society , 22 (1) , Article 37. 10.5751/ES-09124-220137 . Green open access

http://ift.tt/2pX1Zqu

Nanoparticle theranostics for applications in cancer diagnostics and cancer therapy

Hobson, NJ; (2017) Nanoparticle theranostics for applications in cancer diagnostics and cancer therapy. Doctoral thesis, UCL (University College London).

http://ift.tt/2rietgj

Space and Politics in the Penguins' movement: geographies of the political construction of the Chilean student movement

Hernandez Santibanez, I; (2017) Space and Politics in the Penguins' movement: geographies of the political construction of the Chilean student movement. Doctoral thesis, UCL (University College London).

http://ift.tt/2pWWkkw

The DNA replication stress checkpoint transcriptional response and its role in replication stress tolerance

Herlihy, AE; (2017) The DNA replication stress checkpoint transcriptional response and its role in replication stress tolerance. Doctoral thesis, UCL (University College London).

http://ift.tt/2riehxF

Reinforcement Learning from Self-Play in Imperfect-Information Games

Heinrich, J; (2017) Reinforcement Learning from Self-Play in Imperfect-Information Games. Doctoral thesis, UCL (University College London). Green open access

http://ift.tt/2pWHjiG

Cahiers inlichtingenstudies/Cahiers d'études du renseignement

inlichtingensdiensten ; VSSE ; SGRS

http://ift.tt/2ri187Y

La guerre à Gaza, un an après: du discours médiatique à l'analyse politologique

Media Studies ; Science politique ; relations internationales

http://ift.tt/2pWNMtV

Clinical severity in Japanese patients with neurofibromatosis 1 based on DNB classification

Abstract

Neurofibromatosis 1 (NF1) is a genetic disease characterized by cutaneous, neurological and osseous complications. Although clinical manifestations of NF1 are variable, there has been no report on evaluation of severity in patients with NF1. To elucidate the grade of severity of NF1, a retrospective study was conducted in 124 NF1 patients at the Department of Dermatology of Tottori University Hospital in 2007–2016. The DNB classification (dermatological, neurological and bone manifestations) in Japan was used for assessment. Based on our current epidemiological data, there were 55 patients (44.3%) in stage 1, 23 (18.6%) in stage 2, three (2.4%) in stage 3, one (0.8%) in stage 4 and 42 (33.9%) in stage 5. The grade of severity in patients with NF1 tended to be higher with aging. Remarkably, 61.8% of the patients in stage 5 had diffuse plexiform neurofibromas with functional disability. We should pay attention to diffuse plexiform neurofibromas that greatly affect quality of life in patients with NF1.

http://ift.tt/2pZCnZj

In Vitro Functional Quality Characterization of NOTA-Modified Somatropins

http://ift.tt/2ruLDqj

"Managing Uncertainties": the protection of critical infrastructures and intelligence services

http://ift.tt/2qV2Tbi

Private inlichtingendiensten: hun rol en activiteiten in publiek-militaire inlichtingenstrategieën

http://ift.tt/2rups3t

Het 7e jaar integrale veiligheid: De private veiligheidsector als afnemer van studenten

http://ift.tt/2qV5Ngi

"Managing Uncertainties": the protection of critical infrastructures and intelligence services

http://ift.tt/2ruppEP

Critical infrastructures protection: a judicial conceptualisation

http://ift.tt/2qV1Wjd

Elbow lameness in dogs of six years and older : arthroscopic and imaging findings of medial coronoid disease in 51 dogs

Objectives: To report on the frequency and distribution of lesions of the medial coronoid process in dogs of six years of age and older, and to describe the arthroscopic findings in the affected joints. To compare those lesions seen in 'old' dogs with those seen in 'young' dogs between the ages of five and 18 months. Methods: A retrospective study of dogs six-years-old and older admitted for elbow lameness and subsequent elbow arthroscopy. The dogs were divided into groups according to the lesions of the medial coronoid process diagnosed during arthroscopic examination and computed tomography (Q. The radiographic degree of osteoarthritis (OA) and arthroscopically diagnosed lesions on the medial humeral condyle are described. Results: In 51 'old' dogs, five types of lesions could be identified on arthroscopy and CT: chondromalacia-like lesions (2%), fissures (27.5%), non-displaced fragments (12%), displaced fragments (27.5%), and erosions within the medial compartment without fragmentation (31%). A significantly different distribution of lesions was seen in 'young' dogs: fissures (23%), non-displaced fragments (45%), displaced fragments (29%), and erosions within the medial compartment without fragmentation (3%). No difference in radiographic degree of CIA was seen between the two groups. Clinical significance: This study demonstrates the relatively high incidence of medial coronoid disease in dogs older than six years of age, and it highlights one particular problem in 'old' dogs: the complete erosion of the medial compartment.

http://ift.tt/2rusAfO

Indenylidene ruthenium complex bearing a sterically demanding NHC ligand : an efficient catalyst for olefin metathesis at room temperature

The synthesis and characterization of a novel indenylidene-containing ruthenium catalyst bearing the N-heterocyclic carbene (NHC) ligand 1,3-bis(2,6-diisopropylphenyl)-4,5-dihydroimidazol-2-ylidene (SIPr) are reported. Comparative reactivity studies with other indenylidene complexes using various substrates show the importance of the sterically demanding SIPr ligand on catalyst reaction profile. The investigation of the reaction scope for ring-closing metathesis transformations establishes the influence of the NHC on catalyst activity especially as a function of substrate steric bulk. The novel catalyst was found very efficient at room temperature for nonsterically hindered substrates. Since the new catalyst was found to be soluble in a variety of solvents, a number of these were examined to gauge the importance of solvent effects.

http://ift.tt/2qV2O7u

Terminal restriction fragment length polymorphism analysis of the microflora in necrotic teeth of patients irradiated in the head and neck region

This study evaluated the microflora in root canals of necrotic teeth after radiotherapy of the head and neck region. The microbial composition of samples taken from necrotic root canals in patients treated with irradiation of the head and neck (group A, n = 13) and in healthy controls (group B, n = 11) was analyzed by terminal restriction fragment-length polymorphism (T-RFLP) analysis. A total of 50 different terminal restriction fragment lengths (T-RFs) (each representing one or more bacterial species) were detected in the T-RFLP profiles, 44 in group A and 28 in group B. A mean of 13.2 T-RFs per sample were detected in group A and 6.6 T-RFs were present per sample for group B (p < 0.05). Twenty-two different T-RFs (mainly subspecies of Lactobacillus spp., Capnocytophaga spp., and Actinomyces spp.) found in group A were not found in group B. In conclusion, the diversity of root canal microflora increases significantly after head-neck radiotherapy.

http://ift.tt/2rupqIT

Lung function parameters in omalizumab responder patients: an interesting tool?

Abstract

Background

Omalizumab, an anti-IgE antibody, is used to treat patients with severe allergic asthma. The evolution of lung function parameters over time and the difference between omalizumab responder and non-responder patients remain inconclusive. The objective of this real-life study was to compare the changes in FEV1 of omalizumab responders and non-responders at 6 months.

Methods

A multicenter analysis was performed in 10 secondary and tertiary institutions. Lung function parameters (forced vital capacity (FVC), pre- and post-bronchodilator FEV1, residual volume (RV) and total lung capacity (TLC) were determined at baseline and at 6 months. Omalizumab response was assessed at the 6-month visit. In the omalizumab responder patients, lung function parameters were also obtained at 12, 18 and 24 months.

Results

Mean pre-bronchodilator FEV1 showed improvement in responders at 6 months, while a decrease was observed in non-responders (+0.2 ± 0.4L and -0.1 ± 0.4L respectively, p<0.01). After an improvement at 6 months, pre- and post-bronchodilator FEV1 remained stable at 12, 18 and 24 months. The FEV1/FVC remained unchanged over time, but the proportion of patients with an FEV1/FVC ratio < 0.7 decreased at 6, 12, 18 and 24 months (55.2%, 54.0%, 54.0% and 44.8%, respectively, p<0.05). Mean RV values decreased at 6 months but increased at 12 months and 24 months (p<0.05). RV/TLC ratio decreased at 6 months and remained unchanged at 24 months.

Conclusion

After omalizumab initiation, FEV1 improved at 6 months in responder patients and then remained stable for 2 years. RV and RV/TLC improved at 6 months.

This article is protected by copyright. All rights reserved.

http://ift.tt/2quyJKu

Private intelligence services: their activities and role in public-military intelligence strategies

http://ift.tt/2qzVRpm

Invasion of equine and bovine alphaherpesviruses through the respiratory mucosa and interaction between equine herpes- and arteritis virus

http://ift.tt/2pOhZz4

‘It’s not about the catalogue, it’s about the data’ Catalogue 2.0: The future of the library catalogue

Published in 2013, Catalogue 2.0: The Future of the Library Catalogue, set out to provide an overview of the current state of the art of the library catalogue and to look to the future, to see what it may become. This paper reviews the key technologies and data solutions that were put forward in Catalogue 2.0, exploring the new developments and current state-of-the art since its publication. Finally, exploring the potential that library catalogues and collections have for digital scholarship, with a view to providing both a user-centred vision and practical solutions as to how digital access to library catalogues and collections can be modernised.

http://ift.tt/2qzpYNW

Towards a national web in a federated country: a Belgian case study

Although the .be domain was introduced in June 1988, the Belgian web is currently not systematically archived. As of August 2016, 1.550.147 domains are registered by DNS Belgium. Without a Belgian web archive, the content of these websites will not be preserved for future generations and a significant portion of Belgian history will be lost forever. In this paper we present the initial findings of a research project exploring the policy, legal, technical and scientific issues around archiving the Belgian web. The aim of this project is to a) identify current best practices in web-archiving b) pilot a Belgian web archive and c) identify research use cases for the scientific study of the Belgian web. This case study is seen as a first step towards implementing a long-term web archiving strategy for Belgium.

http://ift.tt/2qzFRDT

DARIAH – Networking for the European Research Area

DARIAH, the Digital Research Infrastructure for the Arts and Humanities, is committed to enhancing and supporting digitally-enabled research in the arts and humanities across Europe. One of DARIAH's underlying principles is to help European countries establish or strengthen their own arts and humanities research infrastructures. For countries that have joined the EU since 2004, this is particularly crucial. This article explores how through its Members, Cooperating Partners and affiliated projects, DARIAH helps to facilitate the sharing of digital arts and humanities knowledge throughout the European Research Area and beyond.

http://ift.tt/2pO86BA

DARIAH and the Benelux

DARIAH, the Digital Research Infrastructure for the Arts and Humanities, aims to enhance and support digitally-enabled research and teaching across the humanities and arts. By bringing together national activities from Member countries, DARIAH is able to offer a portfolio of services and activities centred around research communities. DARIAH was established as a European legal entity in August 2014 with 15 countries - Austria, Belgium, Croatia, Cyprus, Denmark, France, Germany, Greece, Ireland, Italy, Luxembourg, Malta, The Netherlands, Slovenia and Serbia – as Founding Members. This was an important step towards developing a research infrastructure for sharing and sustaining digital arts and humanities knowledge across Europe and beyond. Using the opportunity to present a poster at DH Benelux 2015 as a starting point, the authors would like to explore how DARIAH-BE, DARIAH-LU and DARIAH-NL could collaborate to both strengthen their participation in DARIAH within their individual countries and together as the Benelux region. Initial ideas include: a) increasing collaboration between researchers and infrastructure providers: taking advantage of the geographical proximity and language synergies to participate in shared activities e.g. joint research projects and training events, b) increasing funding opportunities: exploring regional possibilities for funding and establishing partnerships for European funding proposals and c) sharing DARIAH knowledge and experience: increasing understanding and identifying synergies between the DARIAH activities in each country. Through strengthening the collaboration between DARIAH activities in Belgium, Luxembourg and The Netherlands, we would like to facilitate maximum participation of digital humanities researchers in the Benelux region in DARIAH in order to take full advantage of the benefits of being part of the European DARIAH community.

http://ift.tt/2qzGVaX

SUPMAP: het aanbod van illegale drugs in België: wat weten we? Een haalbaarheidsstudie van betrouwbare indicatoren voor het drugsaanbod

Een evenwichtig drugsbeleid start met een grondige kennis van zowel de aanbodzijde als van de vraagzijde. Wat weten politie, justitie, douane, labo's toxicologie en andere relevante diensten over de Belgische drugsmarkt? In dit onderzoek proberen we dit in kaart te brengen. Kennis is macht, zeker in het drugsbeleid. Op het niveau van de drugsvraagzijde werden reeds verschillende indicatoren ontwikkeld, die zowel op nationaal als op Europees niveau (EMCDDA) worden gebruikt. Indicatoren voor de aanbodzijde (de drugsmarkten) werden tot nu toe aanzienlijk minder onderzocht, en de kennis met betrekking tot indicatoren om het drugsaanbod te monitoren is eerder beperkt. Wie zijn de sleutelfiguren voor het monitoren van het drugsaanbod? Welke indicatoren kunnen er voor de verschillende echelons van de drugsmarkten (productie, import, groothandel, tussenhandel en retail) geïdentificeerd worden? Wat zijn haalbare indicatoren? Wat is de waarde van indicatoren zoals inbeslagnames, prijs en kwaliteit? Hoe kan druggerelateerde criminaliteit worden gemonitord binnen de bestaande registratiesystemen? Het antwoord op deze -en andere- vragen kunt u terugvinden in dit boek. Aan de hand van een literatuurstudie en een bevraging van de Belgische law enforcement community en de labo's toxicologie, worden in dit onderzoek de mogelijke indicatoren geïdentificeerd en gecontroleerd op hun haalbaarheid. Aanvullend worden de internationale literatuur en wetenschappelijke bevindingen over drugsmarkten afgetoetst aan de Belgische realiteit.

http://ift.tt/2pOiZDl

Catalogue 2.0: The future of the library catalogue

Will there be a library catalogue in the future and, if so, what will it look like? In the last 25 years, the library catalogue has undergone an evolution, from card catalogues to OPACs, discovery systems and even linked data applications making library bibliographic data accessible on the web. At the same time, users expectations of what catalogues will be able to offer in the way of discovery have never been higher. This edited collection brings together some of the foremost international cataloguing practitioners and thought leaders, including Lorcan Dempsey, Emmanuelle Bermès, Marshall Breeding and Karen Calhoun, to provide an overview of the current state of the art of the library catalogue and look ahead to see what the library catalogue might become. Practical projects and cutting edge concepts are showcased in discussions of: (a) linked data and the Semantic Web (b) user expectations and needs, (c), bibliographic control, (d) the FRBRization of the catalogue (e) innovations in search and retrieval and (f) next-generation discovery products and mobile catalogues.

http://ift.tt/2qzPO49

An improved largest gap routing heuristic for order picking

The largest-gap policy is a routing heuristic for order picking systems. In this paper we develop an improved largest gap routing method. A simulation approach is used to demonstrate the superior performance of the improved largest gap routing over traditional largest gap. Moreover, this paper tests the performance impact of storage assignment rules on largest gap routings. Several scenarios with various order sizes and different item popularity proportions are tested. Monte-Carlo simulation is used to carry out the experiments. The numerical results from the computational analysis show that our improved largest gap routing always outperforms the traditional largest gap routing, i.e. for all order sizes. The effect is the most distinct when the order size is smaller. Finally the study demonstrates that the optimal storage assignment rule to be combined with largest gap routing is within-aisle storage.

http://ift.tt/2pO83po

Besluit

http://ift.tt/2qzH1iM

De drugbehandelingskamer: een andere manier van afhandelen

http://ift.tt/2pOAnrG

Bringing Research Libraries into Europeana: Establishing a Library-Domain Aggregator

Europeana's future strategy requires a domain-level aggregator of library content, positioned alongside other domain aggregators for museums, archives and audio-visual collections. To enable this, LIBER (Association of European Research Libraries), CENL (Conference of European National Librarians) and CERL (Consortium of European Research Libraries) have joined forces to submit the 'Europeana Libraries' project proposal to the European Commission in the context of the CIP-ICT PSP-2010-4 'Digital Libraries' programme in early Summer 2010. This paper outlines the vision of the 'Europeana Libraries' project, which will enable The European Library to become the library-domain aggregator for Europeana.

http://ift.tt/2qzJbPv

The cooperation between the criminal justice system and treatment services. Essential preconditions for a collaboration

http://ift.tt/2pOzkbh

The European Library — gateway to the resources of Europe's national libraries

The European Library aggregates the collections of 48 European national libraries into one single portal. Users will discover and access a wealth of materials and the service aims to promote the outstanding collections of these libraries to a global audience.

http://ift.tt/2qzNUAt

Supporting Teaching and Research in an Online Environment: Developing the University of London Library Model

Founded in 1837, the University of London Library (ULL) is the central research library of the University of London with particular research strengths across the broader arts, humanities and social sciences. With the development of information and communications technology, it has become a hybrid library, offering access to electronic collections but also extending access to services and its physical collections through its website and online catalogue. Research libraries now face the challenge of supporting distance learning. The ULL has risen to this challenge by being a partner in the development of webenhanced distance learning by the University of London External Programme's Virtual Campus Project. To do this, the ULL has initiated the Virtual Library Service (VLS) Project. Within the research-focussed University of London, the ULL has anticipated the potential research-support needs of its students. It is also leading a separately funded Virtual Research Environment (VRE) Project on behalf of the University Libraries Committee to address these needs and inform the University of London's activities in the virtual sphere. The University of London has created the Electronic Library Projects Team (ELPT) to undertake the VLS and VRE projects and ensure that they develop along complementary lines. This paper outlines how the ULL is supporting teaching and research in an online environment through the development of its VLS and VRE models.

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University of London - Virtual Campus Project. Information Resources for Distance Learners: The Implementation of a Model

This paper illustrates the University of London Library, Senate House's model for providing a dedicated Virtual Library Service (VLS) to support the information needs of students registered with the University of London's External Programme. The Virtual Library will offer access to a range of information and learning resources and related services as one of the principal elements in the External Programme's Virtual Campus Project.

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Binding by Random Bursts: A Computational Model of Cognitive Control

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Continuous matrix product states with periodic boundary conditions and an application to atomtronics

We introduce a time evolution algorithm for one-dimensional quantum field theories with periodic boundary conditions. This is done by applying the Dirac-Frenkel time-dependent variational principle to the set of translational invariant continuous matrix product stateswith periodic boundary conditions. Moreover, the ansatz is accompanied with additional boundary degrees of freedom to study quantum impurity problems. The algorithm allows for a cutoff in the spectrum of the transfer matrix and thus has an efficient computational scaling. In particular we study the prototypical example of an atomtronic system-an interacting Bose gas rotating in a ring shaped trap in the presence of a localized barrier potential.

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Detection of biotic and abiotic stresses in crops by using hierarchical self organizing classifiers

Hyperspectral signatures can provide abundant information regarding health status of crops; however it is difficult to discriminate between biotic and abiotic stress. In this study, the case of simultaneous occurrence of yellow rust disease symptoms and nitrogen stress was investigated by using hyperspectral features from a ground based hyperspectral imaging system. Hyperspectral images of healthy and diseased plant canopies were taken at Rothamsted Research, UK by a Specim V10 spectrograph. Five wavebands of 20 nm width were utilized for accurate identification of each of the stress and healthy plant conditions. The technique that was developed used a hybrid classification scheme consisting of hierarchical self organizing classifiers. Three different architectures were considered: counter-propagation artificial neural networks, supervised Kohonen networks (SKNs) and XY-fusion. A total of 12 120 spectra were collected. From these 3 062 (25.3%) were used for testing. The results of biotic and abiotic stress identification appear to be promising, reaching more than 95% for all three architectures. The proposed approach aimed at sensor based detection of diseased and stressed plants so that can be treated site specifically contributing to a more effective and precise application of fertilizers and fungicides according to specific plant's needs.

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Numerical study on the influence of in-depth radiation in the pyrolysis of medium density fibreboard

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Two-hit hypothesis : gestational stress and Interleukin (IL)-1 beta influence expression of stress and inflammation-related genes in uterus and hippocampus of rat offspring

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The influence of age and gender on venous symptomatology : an epidemiological survey in Belgium and Luxembourg

Aim: The aim of this study is to measure the incidence of the symptoms in patients with chronic venous disease (CVD) and to look for the influence of age on the severity of symptoms for both genders. Materials and methods: A survey was carried out in Belgium and Luxembourg between May and September 2013. Patient recruitment was done by 406 general practitioners (GPs). Each GP screened 10-20 consecutive patients older than 18 years. Inquiries were made regarding the presence of symptoms and possible signs of CVD. Patients with diagnosed CVD filled out a questionnaire including a quality of life score (CIVIQ-14). These data were converted into a CIVIQ Global Index Score (GIS). Statistical analysis was performed in order to calculate the effect of age and gender on the number of symptoms and the estimated probabilities of having CVD. Results: Totally 6009 patients were included in this survey. The mean age was 53.4 years. Of all, 61.3% of the patients have CVD (C1-C6). Of all, 64.7% of patients were symptomatic. Age and female gender were major risk factors for developing CVD. Most common symptoms were heavy legs' (70.4%), pain (54.0%), and sensation of swelling (52.7%). The number of symptoms increases with age (p<0.001). Female patients have significantly more symptoms in comparison with male patients in all age groups. In both females and males, age is negatively correlated with GIS score (p<0.001). The estimated probability of having CVD was significantly higher for woman compared to men and increases with age for both gender. Conclusion: CVD is a very common progressive disease with age as a major risk factor. Increasing age results in a higher C-classification, more symptoms, and a lower GIS score (quality of life). Female gender interacts significantly with age and results in a more advanced stage of CVD.

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The impact of an interventional counselling procedure in families with a BRCA1/2 gene mutation : efficacy and safety

Background: Predictive genetic testing has high impact on cancer prevention for BRCA carriers and passing this information in BRCA families is important. Mostly, this is proband-mediated but this path is defective and denies relatives lifesaving information. Objective: To assess the efficacy/safety of an intervention, in which relatives are actively informed. Design: Sequential prospective study in new BRCA families. The proband informed relatives about predictive testing (phase I). After 6 months, a letter was sent to adult relatives who had not been reached (phase II). Then a phone call was made to obtain a final notion of their wishes. All subjects received psychometric testing (State-Trait Anxiety Inventory, STAI), an interview and routine counselling. Results: Twenty families were included. Twenty-four of the relatives could not be reached, 59 were 'decliners', 47 participated by the proband and 42 by the letter. Predictive testing was performed in 98 % of the participants of which 30 were mutation carriers. The intervention is psychologically safe: the 95 % CI for the estimated mean difference in STAI DY1 between phase II/I subjects (mean difference -1.07, 95 % CI -4.4 to 2.35, p = 0.53) shows that the mean STAI DY1 score (measured at first consult) for phase II is no more than 2.35 units higher than for phase I, which is not relevant. Conclusions: A protocol directly informing relatives nearly doubles the number of relatives tested and is psychologically safe. This should lead to a change in counselling guidelines in families with a strong germline predisposition for cancer.

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