Rat model of chronic tympanic membrane perforation: A longitudinal histological evaluation of underlying mechanisms

Publication date: Available online 25 December 2016
Source:International Journal of Pediatric Otorhinolaryngology
Author(s): Allen Y. Wang, Lawrence J. Liew, Yi Shen, Jeffrey T. Wang, Magnus von Unge, Marcus D. Atlas, Rodney J. Dilley
ObjectiveTo evaluate histologically the progressive development and underlying mechanisms of chronic tympanic membrane perforation (TMP) in a rat model using a two-weeks ventilation tube (VT) treatment combined with topical application of mitomycin C/dexamethasone (VT-M/D), compared with normal tympanic membrane and acute TMPs.MethodsFifty male Sprague-Dawley rats were divided into three experimental groups: a normal control group (n = 5), an acute TMP group (n = 5) (i.e. 3 days post-myringotomy) and a VT-M/D group (n = 40). The TMs were regularly assessed by otoscopy. The normal control animals were sacrificed on day 0 and the acute TMP group was sacrificed 3 days post-myringotomy for histological and immunohistochemical evaluations. The VT-M/D group was sacrificed at various time points - 14 and 17 days, 3, 4, 6, 8 and 10 weeks.ResultsOn longitudinal histological examination, compared with normal TM and acute TMP, the perforation edges at the later time points illustrated thickened stratified squamous epithelium rimming around the edges, significant increase in keratin and collagen deposition, increased macrophage infiltration as well as reduced cellular proliferation. Three phases of TMP healing process were identified - the acute healing phase (3–17 days), the transition phase (3–4 weeks) and the chronic phase (6–10 weeks).ConclusionBased on the histological results of this study, the progressive development of chronic TMPs appeared to be associated with increased epidermal thickening, collagen and keratin deposition, macrophage infiltration and reduced cellular proliferation. After the 3–4 weeks of transition phase, the TMPs seemed to have transformed into a non-healing chronic TMP between 6 and 10 weeks.



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This second edition of “Fractures of the facial skeleton” is a soft cover book of 166 pages written for...

This second edition of "Fractures of the facial skeleton" is a soft cover book of 166 pages written for postgraduate students, trainees and practitioners dealing with facial trauma in the craniomaxillofacial region. It follows the first edition published in 2001. In 10 chapters dealing with well chosen facial trauma topics an excellent overview of the basics is provided including incidence, aetiology, general principles of treatment, emergency management of facial trauma, clinical features, imaging, treatment of hard and soft tissue injuries, post-operative care and complications.

http://ift.tt/2hVHM3s

Corrigendum to “Oral microbiome, periodontitis and risk of head and neck cancer” [Oral Oncol. 53 (2016) 17–19]

The authors regret the error published on Page 17, Line 8. Please note the corrected statement: "Still, germ-free rats presented with lower acetaldehyde concentration, indicating that might exist a link between poor oral hygiene, alcohol consumption and increased risk of OCC [2,6]".

http://ift.tt/2hDzkTx

Fractures of the Facial Skeleton, 2nd ed., M. Perry, A. Brown, P. Banks. Wiley Blackwell (2015), ISBN: 978-1-119-96766-8

Publication date: Available online 24 December 2016
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): Eppo Wolvius




http://ift.tt/2isDYDx

Use of pentoxifylline and tocopherol in radiation-induced fibrosis and fibroatrophy

Radiation-induced fibrosis in the head and neck is a well-established pathophysiological process after radiotherapy. Recently pentoxifylline and tocopherol have been proposed as treatments to combat the late complications of radiation-induced fibrosis and a way of dealing with osteoradionecrosis. They both have a long history in the management of radiation-induced fibrosis at other anatomical sites. In this paper we review their use in sites other than the head and neck to illustrate the potential benefit that they offer to our patients.

http://ift.tt/2hk0UHm

Star excursion balance test for assessment of dynamic instability of the ankle in patients after harvest of a fibular free flap: a two-centre study

We aimed to show that the star excursion balance test can identify instability in the ankle of patients who have had harvest of a fibular free flap. We compared the reach distance of the operated leg against that of the non-operated leg in 26 patients who had had harvest of the flap over a period of three years from August 2009 at two different centres. The goal of the test is to reach as far as possible with one leg in eight directions while balancing on the other. We also assessed the overall function of the operated leg using the Foot and Ankle Disability Index (FADI) and the American Orthopaedic Foot and Ankle Score (AOFAS).

http://ift.tt/2i4ie1U

Postoperative radiotherapy for patients with oral squamous cell carcinoma with intermediate risk of recurrence: a case match study

Introduction/Aims: The purpose of this study was to determine the effect of postoperative radiotherapy (PORT) on recurrence and survival in patients with oral squamous cell carcinoma (OSCC) of intermediate risk of recurrence.

http://ift.tt/2hjWDnv

Classification of Mandibular Condylar Fractures

Publication date: Available online 24 December 2016
Source:Atlas of the Oral and Maxillofacial Surgery Clinics
Author(s): David B. Powers




http://ift.tt/2hnWT6H

Clinicopathologic analysis of atypical hand, foot, and mouth disease in adult patients

Hand, foot, and mouth disease is a contagious viral infection usually affecting children. A resurgence of cases in adults, mainly caused by coxsackievirus A6 and with an atypical and more severe presentation, has taken place.

http://ift.tt/2hjScsI

Inflammatory bowel disease among patients with psoriasis treated with ixekizumab: A presentation of adjudicated data from an integrated database of 7 randomized controlled and uncontrolled trials

Inflammatory bowel disease (IBD) occurs more frequently in patients with psoriasis. The 2 diseases have significant genetic overlap, but the pathogenesis underlying their co-occurrence is unknown.

http://ift.tt/2hdDXTg

Recurrence of moderately dysplastic nevi with positive histologic margins

The Pigmented Lesion Subcommittee of the Melanoma Prevention Working Group recently published a consensus statement that incompletely excised moderately dysplastic nevi (MDN) without clinical residual pigmentation can be observed and not re-excised. However, data regarding recurrence of MDN with positive histologic margins are quite scant.

http://ift.tt/2i4kd6B

Virtual reconstruction of midface defects using statistical shape models

This study evaluates the accuracy of a statistical shape model (SSM) for virtual fracture reconstruction of the lateral midface.

http://ift.tt/2iePUcT

The ATA wishes you a Happy Holiday Season

Season's Greetings to all our Friends of the ATA

The post The ATA wishes you a Happy Holiday Season appeared first on American Thyroid Association.

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Warthin tumor within the superficial lobe of the parotid gland: a suggested criterion for diagnosis

Abstract

The location of Warthin tumor (WT) in the parotid gland impacts the surgical approach and may be indicative of the elusive origin of this intriguing entity. Location in the deep versus superficial lobe of the gland is not directly addressed when defining WT characteristics. Our observation, of rare occurrence of deep lobe WT, if at all, led to the current investigation. The study design is cohort study. This is a retrospective chart review of all patients undergoing parotidectomy for WT in two tertiary academic referral centers: the Sheba Medical Center (SMC), Israel, and the Christiana Care (CC), Newark, Delaware, USA. 122 consecutive adult patients underwent parotidectomy for WT (72 from SMC and 50 from CC). Seventy percent were males, with a mean age of 60.6 years. Bilateral WT or multi-centric WT were found in 9.8 and 17.2% of the cases, respectively. In one case, the tumor was described as originating in the deep lobe. In all other cases, the tumor originated and was limited to the superficial lobe. 99.2% of WT originated in the superficial lobe, corresponding with the few reports directly addressing its location in the gland. The reason for the tumor to be limited almost uniformly to the superficial lobe is unknown, and could be related to the etiopathogenesis of this elusive entity. We suggest adding tumor location within the superficial lobe to the common characteristics of WT (male, smoking, and lower pole) that serve as "common criterion" while evaluating a parotid lesion.

http://ift.tt/2irQraD

Star excursion balance test for assessment of dynamic instability of the ankle in patients after harvest of a fibular free flap: a two-centre study

Publication date: Available online 24 December 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): K.C. Shah, J.P. Peehal, A. Shah, S. Crank, H.S. Flora
We aimed to show that the star excursion balance test can identify instability in the ankle of patients who have had harvest of a fibular free flap. We compared the reach distance of the operated leg against that of the non-operated leg in 26 patients who had had harvest of the flap over a period of three years from August 2009 at two different centres. The goal of the test is to reach as far as possible with one leg in eight directions while balancing on the other. We also assessed the overall function of the operated leg using the Foot and Ankle Disability Index (FADI) and the American Orthopaedic Foot and Ankle Score (AOFAS). The star excursion balance test is simple and cheap, and is quick and easy to do in the outpatient department.



http://ift.tt/2i65D0L

Use of pentoxifylline and tocopherol in radiation-induced fibrosis and fibroatrophy

Publication date: Available online 24 December 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): V. Patel, M. McGurk
Radiation-induced fibrosis in the head and neck is a well-established pathophysiological process after radiotherapy. Recently pentoxifylline and tocopherol have been proposed as treatments to combat the late complications of radiation-induced fibrosis and a way of dealing with osteoradionecrosis. They both have a long history in the management of radiation-induced fibrosis at other anatomical sites. In this paper we review their use in sites other than the head and neck to illustrate the potential benefit that they offer to our patients.



http://ift.tt/2iemNq1

Serpinb9 is a marker of antigen cross-presenting dendritic cells

Publication date: February 2017
Source:Molecular Immunology, Volume 82
Author(s): M.S. Mangan, J. Vega-Ramos, L.T. Joeckel, A.J. Mitchell, A. Rizzitelli, B. Roediger, D. Kaiserman, W.W. Weninger, J.A. Villadangos, P.I. Bird
Serpinb9 (Sb9, also called Spi6) is an intracellular inhibitor of granzyme B (grB) that protects cytotoxic lymphocytes from grB-mediated death. In addition, Sb9 is also expressed in accessory immune cells, including dendritic cells (DCs), although its role is debated. Recently, we have demonstrated that Sb9 plays a grB-independent role in cross-presentation of antigens by CD8⁺ DCs. Here, using a mouse line expressing green fluorescent protein knocked in under the control of the Sb9 promoter, we demonstrate that Sb9 expression is highest in those tissue-resident and migratory DC subsets capable of cross-presentation. Further, we show that CD8⁺ DCs can be divided into two subsets based on Sb9 expression, and that only the subset expressing higher levels of Sb9 is capable of cross-presentation. These findings add support for role for Sb9 cross-presentation, and indicate that high Sb9 expression is a novel marker of cross-presentation capable DCs.



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Endoscopic excision of juvenile nasopharyngeal angiofibroma: A case series

Publication date: Available online 24 December 2016
Source:Egyptian Journal of Ear, Nose, Throat and Allied Sciences
Author(s): L.Y. Lim, Irfan Mohamad, I.P. Tang
ObjectivesTo present the outcome of excision of juvenile nasopharyngeal angiofibroma (JNA)-through endoscopic approach.MethodRetrospective case series review of six cases of JNA patients, encountered between 2013 and 2015. All patients underwent endoscopic excision, preceded by embolisation.ResultsAll patients were male, comprised of Chinese, Malay and Bidayuh ethnics, presenting with typical complaints of progressive unilateral nasal blockage, spontaneous painless epistaxis hyposmia and sleep disturbance. The patients' presentation comprised of all four stages based on Fisch classification, with one recurrence case. Maxillary artery was the main blood supply to the lesion. Surgical approach applied was endoscopic four-handed technique of excision. All patients were discharged well with no major complications, nor cases of recurrence.ConclusionEndoscopic approach is possible for varies stages of JNA. Preoperative angiographic embolisation has minimised the blood loss intraoperatively. The endoscopic method has reduced the post-operative morbidity.



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Critical evaluation of reverse engineering tool Imagix 4D!

IntroductionThe comprehension of legacy codes is difficult to understand. Various commercial reengineering tools are available that have unique working styles, and are equipped with their inherent capabilities and shortcomings. The focus of the available tools is in visualizing static behavior not the dynamic one. Therefore, it is difficult for people who work in software product maintenance, code understanding reengineering/reverse engineering. Consequently, the need for a comprehensive reengineering/reverse engineering tool arises. We found the usage of Imagix 4D to be good as it generates the maximum pictorial representations in the form of flow charts, flow graphs, class diagrams, metrics and, to a partial extent, dynamic visualizations.Case description and evolutionWe evaluated Imagix 4D with the help of a case study involving a few samples of source code. The behavior of the tool was analyzed on multiple small codes and a large code gcc C parser. Large code evaluation was performed to uncover dead code, unstructured code, and the effect of not including required files at preprocessing level. The utility of Imagix 4D to prepare decision density and complexity metrics for a large code was found to be useful in getting to know how much reengineering is required. At the outset, Imagix 4D offered limitations in dynamic visualizations, flow chart separation (large code) and parsing loops. Conclusion: The outcome of evaluation will eventually help in upgrading Imagix 4D and posed a need of full featured tools in the area of software reengineering/reverse engineering. It will also help the research community, especially those who are interested in the realm of software reengineering tool building.

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The evolution of hierarchical triple star-systems

Field stars are frequently formed in pairs, and many of these binaries are part of triples or even higher-order systems. Even though, the principles of single stellar evolution and binary evolution, have been accepted for a long time, the long-term evolution of stellar triples is poorly understood. The presence of a third star in an orbit around a binary system can significantly alter the evolution of those stars and the binary system. The rich dynamical behaviour in three-body systems can give rise to Lidov-Kozai cycles, in which the eccentricity of the inner orbit and the inclination between the inner and outer orbit vary periodically. In turn, this can lead to an enhancement of tidal effects (tidal friction), gravitational-wave emission and stellar interactions such as mass transfer and collisions. The lack of a self-consistent treatment of triple evolution, including both three-body dynamics as well as stellar evolution, hinders the systematic study and general understanding of the long-term evolution of triple systems. In this paper, we aim to address some of these hiatus, by discussing the dominant physical processes of hierarchical triple evolution, and presenting heuristic recipes for these processes. To improve our understanding on hierarchical stellar triples, these descriptions are implemented in a public source code TrES, which combines three-body dynamics (based on the secular approach) with stellar evolution and their mutual influences. Note that modelling through a phase of stable mass transfer in an eccentric orbit is currently not implemented in TrES, but can be implemented with the appropriate methodology at a later stage.

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Infinity of subharmonics for Duffing equations with convex and oscillatory nonlinearities

The existence of infinity of subharmonics for Duffing equations with convex and oscillatory nonlinearities is shown. This result is a corollary of two theorems. These theorems, one for a weak sub-quadratic potential and another for a geometric case, roughly speaking, are complementary. The approach of this paper is based on the phase-plane analysis for the time map and using the Poincaré-Birkhoff twist theorem.

http://ift.tt/2intK7E

DEF - a programming language agnostic framework and execution environment for the parallel execution of library routines

There is high demand for library routines that can be included into arbitrary programs and executed in parallel in the Cloud. So our approach is to provide a framework that supports the parallelized execution of library routines, written in different programming languages, from any platform. Our Distributed Execution Framework (DEF) allows to (1) deploy arbitrary routines into a central library and (2) integrate these library routines at runtime into user programs in a way that allows the routines to be executed in parallel in the Cloud. The programming and runtime environment of the library routine is completely transparent to the user and the chosen programming and runtime environment. DEF provides client and library APIs with primitives like search_lib(), create_task(), submit_job() which are integrated into the user's program to access the DEF runtime. DEF allows the user to configure clusters in a public/private Cloud and automatically distributes the tasks for executing the library routines on the workers of the cluster.

http://ift.tt/2hLTOfy

Correlations of microRNA-124a and microRNA-30d with clinicopathological features of breast cancer patients with type 2 diabetes mellitus

This study intends to investigate the correlations of miR-124a and miR-30d with clinicopathological features of breast cancer (BC) patients with type 2 diabetes mellitus (T2DM). A total of 72 BC patients with T2DM (diabetic group) and 144 BC patients without T2DM (non-diabetic group) were enrolled in this study. Blood glucose was detected by glucose oxidase methods. Glycosylated hemoglobin (HbA1c) was measured by high performance liquid chromatography. Fasting insulin (FIns) was measured by chemiluminescent microparticle immunoassay. Automatic biochemical analyzer was used to detect triglyceride, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Estradiol (E 2 ) was detected by radioimmunoassay. Homeostasis model assessment was applied to assess the insulin resistance (HOMA-IR) and β-cell insulin secretion (HOMA-IS). The expressions of miR124a and miR-30d were measured by quantitative real-time polymerase chain reaction (qRT-PCR). There were significant differences in age, the ratio of menopause, body mass index (BMI), HDL-C, TC, 2-h plasma glucose (2hPG), FIns, HbA1c, HOMA-IS and HOMA-IR between the diabetic and non-diabetic groups. The diabetic group had higher incidence of lymph node metastasis than non-diabetic group. The miR-124a expression was down-regulated while the miR-30d expression was up-regulated in BC patients with T2DM. The correlation analysis showed that miR-124a expression was positively correlated with HDL-C, while it was negatively correlated with age, HbA1c, LDL-C and E 2 . However, the miR-30d expression was negatively correlated with HDL-C but positively correlated with age, HbA1c, LDL-C and E 2 . In conclusion, miR-124a and miR-30d may be correlated with clinicopathological features of BC patients with T2DM. The miR-124a and miR-30d could serve as novel biomarkers for early diagnosis of BC in patients with T2DM.

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Molecular cloning, polymorphism, and functional activity of the bovine and water buffalo Mx2 gene promoter region

Background: Bovine Mx2 gene sequences were already reported, but further information about the gene properties is not yet available. The objective of the current study was to elucidate the structural properties of the bovine Mx2 gene mainly the promoter region and its possible functional role. If available, such information would help in assessing the functional properties of the gene, which was reported to confer antiviral action against recombinant VSV. Results: Examinations on the bovine genomic BAC clone—confirmed to contain the Mx2 gene—revealed 883-bp sequences. A computer scan unequivocally identified a 788-bp promoter region containing a typical TATA box, three ISREs and other promoter-specific motifs. Comparative analysis of nine bovine genomic DNA samples showed 19 nucleotide substitutions suggesting the existence of five different genotypes in the promoter region. The water buffalo Mx2 promoter region was determined by using primers based on the bovine Mx2 promoter region disclosing 893-bp, with 56 substitutions, two insertions, 9 and 1 nt at two different sites. A functional analysis of the putative ISRE indicated that ISRE played a synergetic role in the activation of bovine Mx2 gene transcription. Conclusion: Bovine and water buffalo Mx2 promoter region was identified disclosing, the conserved ISRE, located in the proximal end of the promoter region like other members of the antiviral family, suggesting functional activity under interferon stimulation.

http://ift.tt/2igk7vl

A new proof-of-work mechanism for bitcoin

Background: Bitcoin system, when more than 51% computing power is controlled by a single node, the block chain can be distorted maliciously. This is called 51% attack which is a well-known potential risk that could destroy the Bitcoin system.MethodThe paper proves that under the current proof-of-work mechanism, computing power eventually will be centralized at a single node if miners are rational enough.ResultThe paper propose a new proof-of-work mechanism that improves decentralization and reduces the risk of 51% attack without increasing the risk of Sybil attack.ConcusionsThis new mechanism introduces a series of principles such as Career open to all talents, without distinction of birth, Distribution according to labor and All Men are created equal.

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Dirichlet type problems for Dunkl-Poisson equations

In this paper, using the intertwine relations of differential operators, we study one representation of real analytic functions by Dunkl-harmonic functions, which is a generalization of the well-known Almansi formula. As an application of the representation, we construct a solution of the Dunkl-Poisson equations in Clifford analysis. Then we investigate solutions of homogeneous and inhomogeneous Dirichlet type problems for Dunkl-Poisson's equation, and inhomogeneous Dirichlet problems for Dunkl-Laplace's equation.MSC: 30G35, 35J05, 58C50.

http://ift.tt/2hXcAPm

Prognostic impact of preoperative anemia on non-muscle-invasive bladder carcinoma treated with GreenLight laser vaporization

Abstract

In this study, we aimed to evaluate the impact of preoperative anemia (PA) on oncological outcomes among patients with non-muscle-invasive bladder cancer (NMIBC) treated with GreenLight laser vaporization of bladder tumor (PV-BT). Between January 2010 and December 2015, 407 patients with NMIBC who underwent PV-BT surgery were stratified into normal and anemia groups based on the World Health Organization classification (anemia cutoff value: hemoglobin level, <13.0 m g/dL in men and <12.0 mg/dL in women). The Student's t test and chi-square test were performed to assess the effects of PA on clinical and pathological characteristics of patients with NMIBC. The Kaplan-Meier method was used to investigate the influence of PA on oncological survival outcomes. Before PV-BT, 139 patients (34.2%) were anemic. No significant differences in age, sex, smoking habit, tumor size, focality, grade, and stage were found between the anemia and normal groups. At a median follow-up period of 32.5 months (range, 8–60 months), 74 patients (18.2%) had urothelial recurrence, 30 (7.4%) died from any cause, and 21 (5.2%) died from bladder cancer. In the Kaplan-Meier analysis, preoperative anemia was significantly associated with decreased cancer-specific survival (CSS) and overall survival (OS) of the patients with NMIBC. However, recurrence-free survival (RFS) showed no statistically significant difference between the PA and normal groups. The preoperative anemic patients with NMIBC who underwent PV-BT surgery had worse CSS and OS. PA can be a useful and cost-effective prognostic marker in the clinical practice for NMIBC treatment.

http://ift.tt/2idTvrV

Influence of saline-based hydroxyethyl starch on umbilical cord blood electrolytes

Abstract

Hydroxyethyl starch (HES) is widely used to prevent and treat spinal anesthesia-induced hypotension during cesarean section. However, the use of saline-based HES may lead to hyperchloremia. This study aimed to clarify the effects of saline-based HES on umbilical cord chloride level at delivery. We retrospectively analyzed 93 consecutive single-pregnancy patients who underwent cesarean section with combined spinal-epidural anesthesia. The patients were divided into two groups, depending on the use of 6% HES 130/0.4: group A (461 ± 167 ml of saline-based HES was administered; 43 patients) and group B (HES not administered; 50 patients). The major outcome was umbilical cord chloride level at delivery. The volume infused from operating room admission until delivery was not significantly different between groups. The umbilical cord chloride level at delivery was statistically significantly higher in group A than in group B, but clinically similar (108 ± 2 vs. 107 ± 2 mmol/l, P = 0.02). No differences were observed in the Apgar score or other umbilical cord laboratory data at delivery (Na⁺, K⁺, pH, base excess). In conclusion, we suggest that although the use of up to 500 ml of saline-based HES during cesarean section influences umbilical cord blood electrolytes, the effect is not of a clinically significant magnitude.

http://ift.tt/2hUbDJu

VideoEndocrinology™ High-Impact Videos

FREE ACCESS through January 6, 2017.

Transoral Excision of Nodal Metastatic Papillary Thyroid Carcinoma
William M. Dougherty, Mark J. Jameson, David C. Shonka Jr

Transoral Endoscopic Thyroidectomy Vestibular Approach
Angkoon Anuwong, Thanyawat Sasanakietkul, Pornpeera Jitpratoom

Transoral Robotic Thyroidectomy
Jeremy D. Richmon, Ralph P. Tufano, Jon Russell, Andrew Day, Hamad M. Chaudhary, Salem I. Noureldine

The post VideoEndocrinology™ High-Impact Videos appeared first on American Thyroid Association.

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Outcomes of implant therapy in patients with a history of aggressive periodontitis. A systematic review and meta-analysis

Abstract

Objective

To investigate the outcomes of implant therapy in partially dentate patients treated for aggressive periodontitis (GAgP) in comparison to periodontally healthy (HP) and patients treated for chronic periodontitis (CP) utilizing radiographic and clinical parameters.

Material and methods

An electronic search of databases, supplemented by hand searching, was conducted to identify relevant clinical studies. Sequential screenings at the title, abstract and full-text levels were performed independently and in duplicate. A random effects meta-analysis was conducted and bias corrected bootstrap 95 % confidence intervals were estimated for group comparisons.

Results

The search strategy revealed a total of 899 results. After title screening, abstract scanning, and full-text reading, seven articles fulfilled the inclusion criteria. The 3-year survival rate for CP and HP patients was 100 % while in GAgP subjects, the respective value was 97.98 %; this difference being statistically significant. The 3-year mean marginal bone loss (MBL) was 1.07 mm for the GAgP group, 0.47 mm for the CP group, and 0.69 mm for the HP group. A significant difference between the GAgP and CP groups was identified (p < 0.05). The weighted mean differences of MBL concerning the above groups were also calculated and examined for statistical significance in both 1 and 3 years.

Conclusions

The 3-year survival rate and peri-implant marginal bone loss was found statistically significantly lower in GAgP subjects (SR 97.98 % vs 100 %) in comparison to HP and CP individuals.

Clinical relevance

The outcome of implant therapy in terms of survival rate and marginal bone loss is considered very important for the clinician in decision making when placing implants in patients with a history of aggressive periodontitis.

http://ift.tt/2irl9Rm

The influence of implantoplasty on the diameter, chemical surface composition, and biocompatibility of titanium implants

Abstract

Objectives

The objective of the study was to assess the influence of implantoplasty (IP) on the diameter, chemical surface composition, and biocompatibility of titanium implants in vitro.

Material and methods

Twenty soft tissue-level (TL; machined transmucosal—M and rough endosseous part—SLA) and 20 bone-level (BL; SLA) implants were allocated to IP covering 3 or 6 mm of the structured surface (SLA) area. The samples were subjected to diameter, energy-dispersive X-ray spectroscopy (EDX), and cell viability (ginigval fibroblasts, 6 days) assessments.

Results

Median diameter reductions varied between 0.1 (TL 3 mm) and 0.2 mm (TL 6 mm). EDX analysis revealed that IP and M surfaces were characterized by a comparable quantity (Wt%) of elements C, O, Na, Cl, K, and Si, but a significantly different quantity of elements Ti and Al. When compared to SLA surfaces, significant differences were noted for elements C, O, Na, Ti, and Al. At BL implants, the extension of IP (i.e., 3 to 6 mm) was associated with a significant increase in cell viability.

Conclusions

IP applied to SLA implants was associated with (i) a minimal diameter reduction, (ii) an undisturbed cell viability, and (iii) a chemical elemental composition comparable to M surfaces.

Clinical relevance

This specific IP procedure appears to be suitable for the management of exposed SLA implant surfaces.

http://ift.tt/2iotidi

Opiorphin in burning mouth syndrome patients: a case-control study

Abstract

Objectives

Opiorphin is a pentapeptide isolated from human saliva that suppresses pain from chemically induced inflammation and acute physical pain. Burning mouth syndrome (BMS) is a chronic condition of a burning sensation in the mouth, where no underlying dental or medical cause can be identified. We aimed to measure the level of opiorphin in whole unstimulated (UWS) and stimulated (SWS) saliva of patients with BMS.

Materials and methods

Originally developed and validated LC-MS/MS method was used for opiorphin quantification. Samples were obtained from 29 BMS patients and 29 age- and sex-matched controls.

Results

The average concentration of opiorphin in UWS and SWS in the BMS group was 8.13 ± 6.45 and 5.82 ± 3.59 ng/ml, respectively. Opiorphin in BMS patients' UWS was significantly higher, compared to the control group (t = 2.5898; p = 0.0122). SWS opiorphin levels were higher, but not significantly, in BMS patients than in controls.

Conclusions

Our results indicate that higher quantities of salivary opiorphin in BMS may be a consequence of chronic pain, but we cannot exclude that they occur as a result of emotional and behavioral imbalances possibly associated with BMS. To our knowledge, this is the first original article measuring opiorphin in a pain disorder.

Clinical relevance

Opiorphin may be a measurable biomarker for chronic pain, which could help in objectifying otherwise exclusively a subjective experience. Increased opiorphin could serve as a universal objective indicator of painful conditions. Since opiorphin may also reflect emotional and socio-relational imbalances occurring with BMS, it could as well represent a biomarker for BMS. Knowledge on opiorphin's involvement in pain pathways could contribute to developing new clinical diagnostic methods for BMS.

http://ift.tt/2iowntW

Exploration of bacterial species associated with the salivary microbiome of individuals with a low susceptibility to dental caries

Abstract

Objective

Dental caries is caused by acidogenic plaque microbiota formed on saliva-bathed tooth surfaces, in which multiple organisms act collectively to initiate and expand a cavity. We explored bacterial species associated with the salivary microbiome of individuals with low susceptibility to dental caries.

Materials and methods

The bacterial composition of saliva from 19 young adults was analyzed using barcoded pyrosequencing of the 16S rRNA gene; we compared 10 caries-experienced (CE) and nine caries-free (CF) individuals. A quantitative PCR assay of saliva from 139 orally healthy adults aged 40–59 years was carried out to confirm the result obtained by pyrosequencing analysis.

Results

The microbiomes of CF individuals showed more diverse communities with a significantly greater proportion of the genus Porphyromonas. Among operational taxonomic units (OTUs) corresponding to the genus Porphyromonas, the OTU corresponding to P. pasteri was the most predominant and its relative abundance in CF individuals was significantly greater than in CE individuals (P < 0.001, Wilcoxon rank sum test). A quantitative PCR assay of saliva confirmed that the amounts of P. pasteri were significantly higher in individuals with lower caries experience (filled teeth <15, n = 67) than in those with higher caries experience (filled teeth ≥15, n = 72) (P < 0.001, Student's t test).

Conclusion

These results revealed an association between a greater abundance of P. pasteri and lower susceptibility to dental caries.

Clinical relevance

P. pasteri may be a bacterial species that could potentially be used as a marker for maintaining a healthy oral microbiome against dental caries.

http://ift.tt/2hc0P5o

Molecular approaches for the analysis of airborne pollen

Publication date: Available online 23 December 2016
Source:Annals of Allergy, Asthma & Immunology
Author(s): Rashmi Prava Mohanty, Mark Alan Buchheim, Estelle Levetin
BackgroundPollen monitoring is a common and vital tool in the field of allergy, creating awareness in pollen sensitive individuals. Traditionally, pollen monitoring has been based on conventional microscopic counting techniques that are labor intensive and limited in the identification to the genus or family level. Molecular techniques provide an alternative approach that is less labor intensive and enable identification of any species by its genetic fingerprint.ObjectiveTo use quantitative polymerase chain reaction (qPCR) to evaluate pollen concentrations in air samples.MethodsJuniperus pollen was selected as our model because of the importance of this pollen in the southcentral United States. We analyzed 105 air samples collected with a Burkard spore trap from 2013 to 2015 using species-specific primers and probes. To evaluate the feasibility of a molecular approach, we used duplicate air samples that allowed us to compare results from classical identification based on light microscopy with our qPCR results.ResultsPollen concentrations from the qPCR data were significantly correlated with concentrations determined through light microscopy (R = 0.902, P < .001). We also confirmed an overlap in the pollination seasons between Juniperus ashei and Juniperus pinchotii and between J ashei and Juniperus virginiana.ConclusionWe found that this method correctly identified different Juniperus species present in mixed air samples in the southcentral United States, an accomplishment that cannot be achieved using microscopic identification. We conclude that the qPCR method is more accurate and sensitive than current pollen monitoring techniques and, therefore, has the potential to be used in various pollen monitoring stations.



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Acute renal dysfunction caused by nonsucrose intravenous immunoglobulin in common variable immunodeficiency

Publication date: Available online 23 December 2016
Source:Annals of Allergy, Asthma & Immunology
Author(s): Alexander S. Kim, David H. Broide




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Minimally invasive (sinus tarsi) approach for calcaneal fractures

Background: According to the anatomic characteristics of the calcaneus and the sinus tarsi approach, we designed a combined plate. The goal of this study was to retrospectively assess the functional outcomes and complications of treatment with our self-designed plate. Methods: From March 2014 to October 2015, 18 patients with closed calcaneal fractures (14 Sanders type II and 4 type III) were treated with our combined locking plate through a minimally invasive sinus tarsi approach. All patients underwent both clinical and radiological evaluations. Results: The follow-up duration for all patients ranged from 6 to 13.5 months. The radiographs demonstrated significant corrections of the calcaneal width, length, height, Böhler angle, and Gissane angle from preoperatively to 3 months postoperatively and the last follow-up. However, there were no significant differences in the variables between 3 months postoperatively and the last follow-up. The mean Maryland foot score was 88.1 ± 8.8, in which excellent outcomes were achieved in 11 patients, good in 4, and fair in 3 (excellent and good rate, 83.3% (15 of 18)). No statistical significances in the mean Maryland foot score (88.1 ± 8.8 vs 87.8 ± 10.1, p = 0.9), and the excellent and good rate (85.7 vs 75.0%, p = 1.0) was found between type II and type III fractures. No complications were observed in all fractured feet. Conclusion: Treatment with our self-designed combined plate through a sinus tarsi approach may be safe and effective for type II and type III calcaneal fractures.

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A survey of facilitators and barriers to recruitment to the MAGNETIC trial

Background: Recruitment to randomised controlled trials with children is challenging. It is imperative to understand the factors that boost or hinder recruitment of children to clinical trials. We conducted a survey of facilitators and barriers to recruitment to the MAGNETIC trial, using a previously developed web-based tool. Methods: MAGNETIC is a multicentre randomised trial of nebulised magnesium in acute severe asthma, recruiting 508 children from 30 UK sites. Recruiters were asked to grade a list of factors from –3 to +3 depending on whether the factor was perceived as a strong, intermediate or weak barrier (–3 to –1) or facilitator (+1 to + 3), and using (0) if it was thought to be not applicable. Free text responses were invited on strategies applied to counter the identified barriers. Results: The commonly identified facilitators were motivation and experience of study teams, effective communication and coordination between teams at site and between sites and the Clinical Trials Unit, the presence of designated research nurses, good trial management, clinical trial publicity, simple inclusion criteria, effective communication with parents and presentation of trial information in a simple and clear manner. The commonly identified barriers were heavy clinical workload, shift patterns of work, Good Clinical Practice (GCP) training, inadequate number of trained staff, time and setting of consent seeking, non-availability of research staff out of hours and parents' concerns about their child taking an experimental medicine. Having a designated research nurse, arranging GCP training and trial-related training sessions for staff were the most commonly reported interventions. Conclusions: This study highlights important generic and trial-specific facilitators and barriers to recruitment to a paediatric trial in the acute setting and provides information on the recruitment strategies or interventions that were applied to overcome these barriers. This information can be very useful in informing the design and conduct of future clinical trials with children, particularly in the acute or emergency setting.Trial registrationISRCTN, ISRCTN81456894. Registered on 15 November 2007.

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The effect of a germline mutation in the APC gene on β-catenin in human embryonic stem cells

Background: Most cases of colorectal cancer (CRC) are initiated by inactivation mutations in the APC gene, which is a negative regulator of the Wnt-β-catenin pathway. Patients with familial adenomatous polyposis (FAP) inherit a germline mutation in one APC allele, and loss of the second allele leads to the development of polyps that will turn malignant if not removed. It is not fully understood which molecular mechanisms are activated by APC loss and when the loss of the second APC allele occurs. Methods: Two FAP human embryonic stem cell (hESCs) lines were derived from APC mutated embryos following pre-implantation genetic diagnosis (PGD) for FAP. These FAP-hESCs were cultured in vitro and following extended culture: 1) β-catenin expression was analyzed by Western blot analysis; 2) Wnt-β-catenin/TCF-mediated transcription luciferase assay was performed; 3) cellular localization of β-catenin was evaluated by immunoflorecence confocal microscopy; and 4) DNA sequencing of the APC gene was performed. Results: We have established a novel human in-vitro model for studying malignant transformation, using hESCs that carry a germline mutation in the APC gene following PGD for FAP. Extended culturing of FAP1 hESCs led to activation of the Wnt signaling pathway, as demonstrated by enhanced β-catenin/TCF-mediated activity. Additionally, β-catenin showed a distinct perinuclear distribution in most (91 %) of the FAP1 hESCs high passage colonies. DNA sequencing of the whole gene detected several polymorphisms in FAP1 hESCs, however, no somatic mutations were discovered in the APC gene. On the other hand, no changes in β-catenin were detected in the FAP2 hESCs, demonstrating the natural diversity of the human FAP population. Conclusions: Our results describe the establishment of novel hESC lines from FAP patients with a predisposition for cancer mutation. These cells can be maintained in culture for long periods of time and may serve as a platform for studying the initial molecular and cellular changes that occur during early stages of malignant transformation.

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Implementation of next generation sequencing into pediatric hematology-oncology practice: moving beyond actionable alterations

Background: Molecular characterization has the potential to advance the management of pediatric cancer and high-risk hematologic disease. The clinical integration of genome sequencing into standard clinical practice has been limited and the potential utility of genome sequencing to identify clinically impactful information beyond targetable alterations has been underestimated. Methods: The Precision in Pediatric Sequencing (PIPseq) Program at Columbia University Medical Center instituted prospective clinical next generation sequencing (NGS) for pediatric cancer and hematologic disorders at risk for treatment failure. We performed cancer whole exome sequencing (WES) of patient-matched tumor-normal samples and RNA sequencing (RNA-seq) of tumor to identify sequence variants, fusion transcripts, relative gene expression, and copy number variation (CNV). A directed cancer gene panel assay was used when sample adequacy was a concern. Constitutional WES of patients and parents was performed when a constitutionally encoded disease was suspected. Results were initially reviewed by a molecular pathologist and subsequently by a multi-disciplinary molecular tumor board. Clinical reports were issued to the ordering physician and posted to the patient's electronic medical record. Results: NGS was performed on tumor and/or normal tissue from 101 high-risk pediatric patients. Potentially actionable alterations were identified in 38% of patients, of which only 16% subsequently received matched therapy. In an additional 38% of patients, the genomic data provided clinically relevant information of diagnostic, prognostic, or pharmacogenomic significance. RNA-seq was clinically impactful in 37/65 patients (57%) providing diagnostic and/or prognostic information for 17 patients (26%) and identified therapeutic targets in 15 patients (23%). Known or likely pathogenic germline alterations were discovered in 18/90 patients (20%) with 14% having germline alternations in cancer predisposition genes. American College of Medical Genetics (ACMG) secondary findings were identified in six patients. Conclusions: Our results demonstrate the feasibility of incorporating clinical NGS into pediatric hematology-oncology practice. Beyond the identification of actionable alterations, the ability to avoid ineffective/inappropriate therapies, make a definitive diagnosis, and identify pharmacogenomic modifiers is clinically impactful. Taking a more inclusive view of potential clinical utility, 66% of cases tested through our program had clinically impactful findings and samples interrogated with both WES and RNA-seq resulted in data that impacted clinical decisions in 75% of cases.

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Increase in circulating Th17 cells during anti-TNF therapy is associated with ultrasonographic improvement of synovitis in rheumatoid arthritis

Background: Anti-TNF agents have revolutionised rheumatoid arthritis (RA) treatment; however, a third of patients fail to achieve therapeutic responses. Unexpectedly, studies in murine and human arthritis have indicated that anti-TNF treatment can increase circulating T helper 17 (Th17) cells, but the relationship to treatment response is unclear. To identify immune correlates of anti-TNF treatment response, we conducted a longitudinal study using clinical, ultrasound and T cell assessments. Methods: Patients with RA (n = 25) were studied at protocol visits during the initial 12 weeks of anti-TNF treatment. Improvement in the disease activity score of 28 joints (DAS28) >1.2 defined treatment responders (n = 16) and non-responders (n = 9). Changes in synovial thickening and vascularity of 10 metacarpophalangeal joints were quantitatively assessed by grey scale and power Doppler ultrasound. The frequency of circulating Th17 cells was determined by IL17 enzyme-linked immunospot assay (Elispot) and flow cytometry (fluorescence-activated cell sorting (FACS)). Results: The frequency of circulating IL17-producing cells increased significantly 12 weeks after anti-TNF initiation (Elispot median (range) specific spot forming cells (spSFC)/10 6 360 (280–645) vs 632 (367 − 1167), p = 0.003). The increase in CD4 + IL17+ cells at 12 weeks was confirmed by FACS (median (range) %, 0.7 (0.5–0.9) vs 1.05 (0.6–1.3); p = 0.01). The increase in circulating Th17 cells inversely correlated with reduction in synovial vascularity (r = -0.68, p = 0.007) and thickening (r = -0.39; p = 0.04). Higher frequencies of circulating Th17 cells at baseline were associated with poorer anti-TNF treatment response defined by ultrasonographic measures. Conclusions: These results demonstrate a link between changes in circulating Th17 cells with resolution of ultrasonographic features of synovial inflammation and vascularity during anti-TNF treatment. The findings may reflect redistribution of Th17 cells from inflamed joints or TNF-driven regulation of Th17 cell production.Trial RegistrationClinicalTrials.gov: NCT01060098. Registered 29 January 2010.

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Intravitreal dexamethasone implant for the treatment of cystoid macular oedema associated with acute retinal necrosis

Background: Acute retinal necrosis is a rare but devastating ocular condition. We report two cases of acute retinal necrosis in immunocompetent patients, complicated by cystoid macular oedema and treated with intravitreal dexamethasone (OZURDEX®) implant. Results: Two patients diagnosed with acute retinal necrosis were treated with intravenous acyclovir. Both of them developed cystoid macular oedema following resolution of viral retinitis. Ocular condition of the first patient was further complicated by central serous chorioretinopathy. Under unavoidable circumstances, cystoid macular oedema in both the patients was treated with intravitreal dexamethasone implant with great caution. Resolution of cystoid macular oedema without recurrence of viral retinitis was noted in the long-term follow-up. Conclusions: Findings of the case report should be interpreted cautiously, and extreme caution should be exercised prior deciding the management with a corticosteroid implant in patients with viral retinitis. However, intravitreal dexamethasone implant can be a useful option in selected patients with cystoid macular oedema in acute retinal necrosis.

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Tocotrienols induce endoplasmic reticulum stress and apoptosis in cervical cancer cells

Background: We have previously reported that γ- and δ-tocotrienols (γ- and δ-T3) induce gene expression and apoptosis in human breast cancer cells (MDA-MB-231 and MCF-7). This effect is mediated, at least in part, by a specific binding and activation of the estrogen receptor-β (ERβ). Transcriptomic data obtained within our previous studies, interrogated by different bioinformatic tools, suggested the existence of an alternative pathway, activated by specific T3 forms and leading to apoptosis, also in tumor cells not expressing ER. In order to confirm this hypothesis, we conducted a study in HeLa cells, a line of human cervical cancer cells void of any canonical ER form. Results: Cells were synchronized by starvation and treated either with a T3-rich fraction from palm oil (10–20 μg/ml) or with purified α-, γ-, and δ-T3 (5–20 μg/ml). α-tocopherol (TOC) was utilized as a negative control. Apoptosis, accompanied by a significant expression of caspase 8, caspase 10, and caspase 12 was observed at 12 h from treatments. The interrogation of data obtained from transcriptomic platforms (NuGO Affymetrix Human Genechip NuGO_Hs1a520180), further confirmed by RT-PCR, suggested that the administration of γ- and δ-T3 associates with Ca 2+ release. Data interrogation were confirmed in living cells; in fact, Ca-dependent signals were observed followed by the expression and activation of IRE-1α and of other molecules involved in the unfolded protein response, the core pathway coping with endoplasmic reticulum stress in eukaryotic cells, finally leading to apoptosis. Conclusions: Our study demonstrates that γ- and δ-T3 induce apoptosis also in tumor cells lacking of ERβ by triggering signals originating from endoplasmic reticulum stress. Our observations suggest that tocotrienols could have a significant role in tumor cell physiology and a possible therapeutic potential.

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Cholesterol levels and long-term rates of community-acquired sepsis

Background: Dyslipidemia is a risk factor for cardiovascular disease, with elevated low-density lipoprotein cholesterol (LDL-C) and decreased high-density lipoprotein cholesterol (HDL-C) recognized as risk factors for acute coronary events. Studies suggest an association between low cholesterol levels and poor outcomes in acute sepsis. We sought to determine the relationship between baseline cholesterol levels and long-term rates of sepsis. Methods: We used data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort, a population-based cohort of 30,239 community-dwelling adults. The primary outcome was first sepsis event, defined as hospitalization for an infection with the presence of ≥2 systemic inflammatory response syndrome criteria (abnormal temperature, heart rate, respiratory rate, white blood cell count) during the first 28 hours of hospitalization. Cox models assessed the association between quartiles of HDL-C or LDL-C and first sepsis event, adjusted for participant demographics, health behaviors, chronic medical conditions, and biomarkers. Results: We included 29,690 subjects with available baseline HDL-C and LDL-C. There were 3423 hospitalizations for serious infections, with 1845 total sepsis events among 1526 individuals. Serum HDL-C quartile was not associated with long-term rates of sepsis (hazard ratio (HR) (95% CI): Q1 (HDL-C 5–40 mg/dl), 1.08 (0.91–1.28); Q2 (HDL-C 41–49 mg/dl), 1.06 (0.90–1.26); Q3 (HDL-C 50–61 mg/dl), 1.04 (0.89–1.23); Q4, reference). However, compared with the highest quartile of LDL-C, low LDL-C was associated with higher rates of sepsis (Q1 (LDL-C 3–89 mg/dl), 1.30 (1.10–1.52); Q2 (LDL-C 90–111 mg/dl), 1.24 (1.06–1.47); Q3 (LDL-C 112–135 mg/dl), 1.07 (0.91–1.26); Q4, reference). Conclusion: Low LDL-C was associated with higher long-terms rates of community-acquired sepsis. HDL-C level was not associated with long-term sepsis rates.

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Comparative safety and effectiveness of serotonin receptor antagonists in patients undergoing chemotherapy: a systematic review and network meta-analysis

Background: Although serotonin (5-HT 3 ) receptor antagonists are effective in reducing nausea and vomiting, they may be associated with increased cardiac risk. Our objective was to examine the comparative safety and effectiveness of 5-HT 3 receptor antagonists (e.g., dolasetron, granisetron, ondansetron, palonosetron, tropisetron) alone or combined with steroids for patients undergoing chemotherapy. Methods: We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials from inception until December 2015 for studies comparing 5-HT 3 receptor antagonists with each other or placebo in chemotherapy patients. The search results were screened, data were abstracted, and risk of bias was appraised by pairs of reviewers, independently. Random-effects meta-analyses and network meta-analyses (NMAs) were conducted. Results: After screening 9226 citations and 970 full-text articles, we included 299 studies (n = 58,412 patients). None of the included studies reported harms for active treatment versus placebo. For NMAs on the risk of arrhythmia (primary outcome; three randomized controlled trials [RCTs], 627 adults) and mortality (secondary outcome; eight RCTs, 4823 adults), no statistically significant differences were observed between agents. A NMA on the risk of QTc prolongation showed a significantly greater risk for dolasetron + dexamethasone versus ondansetron + dexamethasone (four RCTs, 3358 children and adults, odds ratio 2.94, 95% confidence interval 2.13–4.17).For NMAs on the number of patients without nausea (44 RCTs, 11,664 adults, 12 treatments), number of patients without vomiting (63 RCTs, 15,460 adults, 12 treatments), and number of patients without chemotherapy-induced nausea or vomiting (27 RCTs, 10,924 adults, nine treatments), all agents were significantly superior to placebo. For a NMA on severe vomiting (10 RCTs, 917 adults), all treatments decreased the risk, but only ondansetron and ramosetron were significantly superior to placebo. According to a rank-heat plot with the surface under the cumulative ranking curve results, palonosetron + steroid was ranked the safest and most effective agent overall. Conclusions: Most 5-HT 3 receptor antagonists were relatively safe when compared with each other, yet none of the studies compared active treatment with placebo for harms. However, dolasetron + dexamethasone may prolong the QTc compared to ondansetron + dexamethasone. All agents were effective for reducing risk of nausea, vomiting, and chemotherapy-induced nausea or vomiting.Trial registrationThis study was registered at PROSPERO: (CRD42013003564).

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Development of a prediction model for a severe reaction in cow's milk challenges

Publication date: Available online 23 December 2016
Source:Allergology International
Author(s): Shiro Sugiura, Kemal Sasaki, Teruaki Matsui, Tomoko Nakagawa, Naoyuki Kando, Komei Ito




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Welcoming Ambiguity in Dental Medicine – An Opportunity for Curricular Development?

Publication date: Available online 24 December 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Paul C. Edwards




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Perception vs. Reality-Findings from a Phosphor Plate Quality Assurance Study

Publication date: Available online 24 December 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Allison Buchanan, Bryan Benton, Adam Carraway, Stephen Looney, Sajitha Kalathingal
ObjectiveTo evaluate the image quality of a photostimulable phosphor (PSP) plate system to determine if image degradation has occurred after a number of clinical uses.Study DesignTwenty DIGORA Optime PSP plates (Soredex Orion Corp., Helsinki, Finland) were imaged throughout clinical use. Image quality was assessed using spatial and contrast resolution through the use of the dental radiographic phantom designed for the Nationwide Evaluation of X-Ray Trends (NEXT) surveys of 1993 and 1999. Spatial resolution was summarized in line pairs per millimeter (lp/mm). The paired t-test was used to analyze the contrast wells. The contrast-to-noise ratio (CNR) was calculated to determine the signal-to-noise ratio as another measure of contrast. Descriptive statistics were used to summarize the contrast-to-noise ratios.ResultsSpatial resolution decreased after 48 clinical uses. No significant differences were found for the pairwise comparisons of the contrast wells. No CNR varied by more than two-tenths value difference.ConclusionsDigora Optime PSP plates displayed unaffected image quality up to 48 clinical uses. Additional studies are needed to confirm these results and to establish guidelines for appropriate replacement intervals for PSP plates.



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Temporomandibular disorders and painful comorbidities: clinical association and underlying mechanisms

Publication date: Available online 24 December 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Yuri Martins Costa, Paulo César Rodrigues Conti, Flavio Augusto Cardoso de Faria, Leonardo Rigoldi Bonjardim
The association between temporomandibular disorders (TMD) and a) headaches, b) cervical spine dysfunction (CSD) and c) fibromyalgia is not artefactual. The aim of this review is to describe the comorbid relationship between TMD and these three major painful conditions, and to discuss the clinical implications and the underlying pain mechanisms involved in these relationships. Common neuronal pathways and central sensitization processes are acknowledged as the main factors for the association between TMD and primary headaches, although the establishment of cause-effect mechanisms requires further clarification and characterization. The biomechanical aspects are not the main factors involved in comorbid relationship between TMD and CSD, which can be better explained by the neuronal convergence of the trigeminal and cervical spine sensory pathways, as well as by central sensitization processes. The association between TMD and fibromyalgia also finds support in the literature and the proposed main mechanism underlying this relationship is the impairment of the descending pain inhibitory system. In this particular scenario, cause-effect relationship is more likely to occur in one direction, i.e., fibromyalgia as a risk factor for TMD. Therefore, the association between TMD and painful comorbidities requires clinical awareness in order to recognize these related conditions and support of multidisciplinary approaches.



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Racial disparities in oropharyngeal cancer survival

Publication date: February 2017
Source:Oral Oncology, Volume 65
Author(s): Uchechukwu C. Megwalu, Yifei Ma
BackgroundOropharyngeal cancer is an important cause of mortality and morbidity. Several studies have revealed racial disparities in head and neck cancer outcomes. The goal of our study was to evaluate the impact of race on survival in patients with oropharyngeal cancer, using a large population-based cancer database.Materials and methodsThis was a retrospective cohort study. Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) 18 Database of the National Cancer Institute. The study cohort included patients diagnosed with oropharyngeal squamous cell carcinoma between 2004 and 2012. The outcomes of interest were overall survival (OS) and disease-specific survival (DSS).ResultsAfter adjusting for age, sex, marital status, tumor site, and year of diagnosis, black race was associated with worse OS (HR 1.67, p<0.0001) and DSS (HR 1.67, p<0.0001).ConclusionBlack race is associated with worse survival in patients with oropharyngeal cancer. Further research is needed to elucidate the mechanism by which race impacts survival in oropharyngeal cancer. This may reveal potential areas of opportunity for public health interventions aimed at addressing disparities in cancer outcomes.



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Definitive proton beam therapy for adenoid cystic carcinoma of the nasopharynx involving the base of skull

Publication date: February 2017
Source:Oral Oncology, Volume 65
Author(s): Michelle S. Gentile, Darwin Yip, Norbert J. Liebsch, Judith A. Adams, Paul M. Busse, Annie W. Chan
ObjectivesManagement of unresectable adenocystic carcinoma (ACC) of the nasopharynx is challenging given the high dose required for tumor control while respecting dose constraints. We evaluated long-term outcomes and toxicity in patients with unresectable ACC of the nasopharynx treated with definitive proton beam therapy.MethodsBetween 2000 and 2013, 14 patients with ACC of the nasopharynx were treated. Ninety-three percent had T4 disease. All had involvement of the skull base. Seventy-nine percent and 21% of patients underwent biopsy and endoscopic debulking surgery, respectively. Median dose was 73.8Gy (RBE). Fifty percent of patients received concurrent chemotherapy. Locoregional control and overall survival probabilities were estimated by the Kaplan-Meier method. Treatment toxicity was scored by the Common Terminology Criteria for Adverse Events version 4.0.ResultsMedian follow-up of surviving patients was 69months. There were 3 local, 1 regional, and 4 distant failures. Median time of local failures was 69months (range: 63–161). All local recurrences were within previous high-dose regions. Four patients developed metastatic disease at a median of 30months (range: 4–64). Five-year overall survival was 59%. The most common cause of death was due to metastatic disease. There was one acute grade 3 toxicity. No patient required gastrostomy tube or hospitalization. Three patients developed grade 3 or higher late toxicity. Two of these patients received combined modality treatment. With 176months follow-up, no second cancer was observed.ConclusionProton beam therapy results in promising local control with acceptable toxicity in patients with unresectable ACC of the nasopharynx. As late recurrence is common, longer follow-up is necessary to confirm our findings.



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Corrigendum to “Oral microbiome, periodontitis and risk of head and neck cancer” [Oral Oncol. 53 (2016) 17–19]

Publication date: Available online 24 December 2016
Source:Oral Oncology
Author(s): Leonardo Victor Galvão-Moreira, Maria Carmen Fontoura Nogueira da Cruz




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Eosinophilic esophagitis and colonic mucosal eosinophilia in Netherton syndrome

Publication date: Available online 23 December 2016
Source:Journal of Allergy and Clinical Immunology
Author(s): Colombe Paluel-Marmont, Nathalia Bellon, Patrick Barbet, Stéphanie Leclerc-Mercier, Smail Hadj-Rabia, Christophe Dupont, Christine Bodemer

Teaser

Nutritional management in Netherton syndrome (NS) is complicated by frequent digestive symptoms. We report the presence of eosinophilic esophagitis and colonic mucosal eosinophilia in NS. Digestive endoscopies should be considered in NS patients with growth retardation and digestive symptoms.


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Catabolism of C1 inhibitor influences the response to replacement therapy in hereditary angioedema

Publication date: Available online 23 December 2016
Source:Journal of Allergy and Clinical Immunology
Author(s): Marco Cicardi, Andrea Zanichelli, Chiara Suffritti, Maddalena A. Wu, Thomas Machnig, Annalisa De Silvestri, Mario Regazzi, Carmine Tinelli
Hereditary angioedema due to C1 inhibitor deficiency (C1-INH-HAE) is a disabling and life-threatening disease for which plasma-derived C1 inhibitor (pdC1-INH) is an effective treatment. Poor responses to pdC1-INH are rare. The aim of this prospective study was to evaluate the pharmacokinetics and pharmacodynamics of C1 inhibitor (C1-INH) in a C1-INH-HAE patient with poor response to treatment to investigate the mechanism underlying poor response to pdC1-INH. Seventeen C1-INH-HAE patients with normal responses to treatment served as retrospective controls. In the poor response patient, higher than standard doses of pdC1-INH did not change the PK but led to normalization of PD parameters and symptoms disappeared, recurring upon dose reduction. Therefore, we conclude that hyperactivation of the complement and contact systems in highly symptomatic C1-INH-HAE patients does not account for interpatient variability in response to pdC1-INH, which may be connected to differences in hepatic clearance of infused pdC1-INH.

Teaser

Pharmacokinetic data in a patient with poor treatment response to plasma-derived C1 inhibitor compared with 17 control patients suggest that poor treatment response likely depends on increased catabolism, but not through interaction with target proteases.


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Doxorubicin enhances the capacity of B cells to activate T cells in Urothelial Urinary Bladder Cancer

Publication date: Available online 24 December 2016
Source:Clinical Immunology
Author(s): A. Ali Zirakzadeh, Johan Kinn, David Krantz, Robert Rosenblatt, Malin E Winerdal, Jin Hu, Ciputra Adijaya Hartana, Christian Lundgren, Emma Ahlén Bergman, Markus Johansson, Benny Holmström, Johan Hansson, Alexander Sidikii, Janos Vasko, Per Marits, Amir Sherif, Ola Winqvist
Cancer is currently treated by a combination of therapies, including chemotherapy which is believed to suppress the immune system. Combination of immunotherapy and chemotherapy correlates with improved survival but needs careful planning in order to achieve a synergistic effect. In this study we have demonstrated that Doxorubicin treatment of B cells resulted in increased expression of CD86 and concordantly increased CD4⁺ T cell activation in presence of superantigen, an effect that was inhibited by addition of a CD86 blocking antibody. Furthermore Doxorubicin resulted in decreased expression of the anti-inflammatory cytokines IL-10 and TNF-α. Finally, B cells from urinary bladder cancer patients, treated with a neoadjuvant regiment containing doxorubicin, displayed increased CD86-expression. We conclude that doxorubicin induce CD86 expression on B cells and hence enhance their antigen-presenting ability in vitro, a finding verified in patients. Development of tailored time and dose schedules may increase the effectiveness of combining chemotherapy and immunotherapy.



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CD3+CD56+ natural killer T cell activity in children with different forms of juvenile idiopathic arthritis and the influence of etanercept treatment on polyarticular subgroup

Publication date: Available online 24 December 2016
Source:Clinical Immunology
Author(s): Juan Zhou, Yuan Ding, Yu Zhang, Ye Feng, Xuemei Tang, Xiaodong Zhao
Juvenile idiopathic arthritis (JIA) has three major onset types with widely varying clinical features. We assessed the natural killer T (NKT) cell function in patients with different JIA subtypes, and found systemic patients exhibited lower NKT cell counts, perforin and granzyme B expression, while the pauciarticular and polyarticular patients displayed higher perforin and granzyme B expression as compared with the controls. The synovial fluid had more NKT cells with higher levels of perforin, granzyme B, and tumour necrosis factor (TNF)-α than peripheral cells. The polyarticular patients that responded to etanercept had lower NKT cell counts, intracellular perforin, granzyme B and the mean fluorescence intensity of TNF-α than the patients that did not respond. Treatment with etanercept reduced the granzyme B and perforin, interferon (IFN)-γ and TNF-α expression in NKT cells in the responsive group. Therefore, a higher NKT cell function may indicate a decreased response to etanercept in polyarticular patients.



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Virtual reconstruction of midface defects using statistical shape models

Publication date: Available online 24 December 2016
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Marc Anton Fuessinger, Stefan Schlager, Steffen Schwarz, Edward Ellis, Carl-Peter Cornelius, Florian Probst, Marc Christian Metzger, Wiebke Semper-Hogg
PurposeThis study evaluates the accuracy of a statistical shape model (SSM) for virtual fracture reconstruction of the lateral midface.Materials and MethodsA uniform bony defect of the right zygoma was created. A virtual reconstruction was performed by using the standard procedure of mirroring the unaffected to the affected side (Group I) and by using the statistical model based on 178 pathologically unaffected CT scans (Group II). The accuracy of the statistical shape model was evaluated in comparison to the present mirroring protocol. The reconstructed region was compared with the original bone evaluating the mean deviation of both surfaces.ResultsAll zygomas could be reconstructed with all methods. On the affected side the mean deviation was 1.10mm +/-0.23mm in group I and 0.85mm +/-0.26mm in group II. The differences between the groups were significant.ConclusionSSM offers a more precise reconstruction of midface defects than mirroring procedures. As an additional element SSM could automatize the CAS workflow in many respects.



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Virchows Archiv—an update, and plans for the future

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Rinite alérgica local [Livre artigo]

João Ferreira de Mello Junior
Braz J Otorhinolaryngol 2016;82:621-2

Resumo - Texto Completo - PDF

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Perfil audiológico de pacientes tratados de câncer na infância [Livre artigo]

Patricia Helena Pecora Liberman, Maria Valéria Schmidt Goffi-Gomez, Christiane Schultz, Paulo Eduardo Novaes, Luiz Fernando Lopes
Braz J Otorhinolaryngol 2016;82:623-9

Resumo - Texto Completo - PDF

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Definição do ponto de referência endoscópica nasal ao acesso cirúrgico à base anterior por estudo anatômico em cadáveres [Livre artigo]

Andressa Vinha Zanuncio, Paulo Fernando Tormin Borges Crosara, Helena Maria Gonçalves Becker, Celso Gonçalves Becker, Roberto Eustáquio dos Santos Guimarães
Braz J Otorhinolaryngol 2016;82:630-5

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Adaptação e validação transcultural da Sinus and Nasal Quality of Life Survey (SN-5) para o português brasileiro [Livre artigo]

Priscila Regina Candido Espinola Uchoa, Thiago Freire Pinto Bezerra, Élcio Duarte Lima, Marco Aurélio Fornazieri, Fabio de Rezende Pinna, Fabiana de Araújo Sperandio, Richard Louis Voegels
Braz J Otorhinolaryngol 2016;82:636-42

Resumo - Texto Completo - PDF

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Associação de zumbido e perda auditiva em distúrbios otológicos: estudo epidemiológico de uma década em uma população do Sul da Índia [Livre artigo]

Santoshi Kumari Manche, Jangala Madhavi, Koralla Raja Meganadh, Akka Jyothy
Braz J Otorhinolaryngol 2016;82:643-9

Resumo - Texto Completo - PDF

http://ift.tt/2hichzF

Relação entre perda auditiva senil e atividade vestibular [Livre artigo]

Hanifi Kurtaran, Baran Acar, Emre Ocak, Emre Mirici
Braz J Otorhinolaryngol 2016;82:650-3

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Efeitos do tempo de permanência de splints intranasais sobre a colonização bacteriana, complicações no pós-operatório e desconforto do paciente após septoplastia [Livre artigo]

Abdullah Karatas, Filiz Pehlivanoglu, Mehti Salviz, Nuray Kuvat, Isil Taylan Cebi, Burak Dikmen, Gonul Sengoz
Braz J Otorhinolaryngol 2016;82:654-61

Resumo - Texto Completo - PDF

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O papel do volume plaquetário médio e a relação neutrófilos/linfócitos em abscesso periamigdaliano [Livre artigo]

Mehmet Şentürk, İsa Azgın, Gültekin Övet, Necat Alataş, Betül Ağırgöl, Esra Yılmaz
Braz J Otorhinolaryngol 2016;82:662-7

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Vertigem refratária episódica: papel da gentamicina intratimpânica e potencial evocado miogênico vestibular [Livre artigo]

Erika Celis-Aguilar, Ramon Hinojosa-González, Olivia Vales-Hidalgo, Heloisa Coutinho-Toledo
Braz J Otorhinolaryngol 2016;82:668-73

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Tradução para o português e validação do questionário de controle da rinite Rhinitis Control Assessment Test (RCAT) [Livre artigo]

Pedro Henrique Fernandes, Fausto Matsumoto, Dirceu Solé, Gustavo Falbo Wandalsen
Braz J Otorhinolaryngol 2016;82:674-9

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Comprometimento na qualidade de vida de pacientes com câncer de cabeça e pescoço e de seus cuidadores: estudo comparativo [Livre artigo]

Laís Rigoni, Raphaella Falco Bruhn, Rafael De Cicco, Jossi Ledo Kanda, Leandro Luongo Matos
Braz J Otorhinolaryngol 2016;82:680-6

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Carcinoma ex-adenoma pleomórfico derivado de adenoma pleomórfico recorrente mostra diferença importante por array CGH em comparação com adenoma pleomórfico recorrente sem transformação maligna [Livre artigo]

Fernanda Viviane Mariano, Karina Giovanetti, Luis Fernando Vidal Saccomani, André Del Negro, Luiz Paulo Kowalski, Ana Cristina Victorino Krepischi, Albina Altemani
Braz J Otorhinolaryngol 2016;82:687-94

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Comparação de enxertos com fáscia do músculo temporal e cartilagem de espessura total em timpanoplastias tipo 1 em crianças [Livre artigo]

Yakup Yegin, Mustafa Çelik, Arzu Karaman Koç, Levent Küfeciler, Mustafa Suphi Elbistanlı1, Fatma Tülin Kayhan
Braz J Otorhinolaryngol 2016;82:695-701

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Resultados de diferentes técnicas de reconstrução do nervo facial [Livre artigo]

Aboshanif Mohamed, Eigo Omi, Kohei Honda, Shinsuke Suzuki, Kazuo Ishikawa
Braz J Otorhinolaryngol 2016;82:702-9

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Presbiacusia: será que temos uma terceira orelha? [Livre artigo]

Luis Roque Reis, Pedro Escada
Braz J Otorhinolaryngol 2016;82:710-4

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Leiomiossarcoma da tireoide: apresentação de dois casos e revisão da literatura [Livre artigo]

Mehmet İlhan Şahin, Alperen Vural, İmdat Yüce, Sedat Çağlı, Kemal Deniz, Ercihan Güney
Braz J Otorhinolaryngol 2016;82:715-21

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Estudo do microfonismo coclear na neuropatia auditiva [Livre artigo]

Ilka do Amaral Soares, Pedro de Lemos Menezes, Aline Tenório Lins Carnaúba, Kelly Cristina Lira de Andrade, Otávio Gomes Lins
Braz J Otorhinolaryngol 2016;82:722-36

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Rouquidão: apresentação incomum de linfoma primário de tireoide com infiltração da laringe [Livre artigo]

Ozan Gökdoğan, Ahmet Koybasioglu, Erkin Ismail, Timucin Erol, Gokcen Alagoz, Banu Yagmurlu, Seref Komurcu
Braz J Otorhinolaryngol 2016;82:737-40

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Lipoma do ângulo pontocerebelar em pacientes assintomáticos: relato de caso [Livre artigo]

Ricardo Rodrigues Figueiredo, Andréia Aparecida de Azevedo, João Alfredo de Mesquita Rodrigues Figueiredo, Norma de Oliveira Penido
Braz J Otorhinolaryngol 2016;82:741-2

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Undifferentiated high-grade pleomorphic sarcoma of the larynx treated with partial laringectomy

Publication date: Available online 23 December 2016
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Eduardo Cambruzzi, Ricardo Pedrini Cruz, Vinícius Grando Gava, Karla Lais Pêgas




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Prognostic role of margin status in open and CO2 laser cordectomy for T1a–T1b glottic cancer

Publication date: Available online 24 December 2016
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Vincenzo Landolfo, Carmine Fernando Gervasio, Giuseppe Riva, Massimiliano Garzaro, Rita Audisio, Giancarlo Pecorari, Roberto Albera
IntroductionCordectomy by laringofissure and transoral laser surgery has been proposed for the treatment of early glottic cancer.ObjectivesThe aim of this retrospective study was to evaluate the prognostic value of margin status in 162 consecutive cases of early glottic carcinoma (Tis–T1) treated with CO2 laser endoscopic surgery (Group A) or laryngofissure cordectomy (Group B), and to compare the oncologic and functional results.MethodsClinical prognostic factors, local recurrence rate according to margin status, overall survival and disease-free survival were analyzed.ResultsMargin status is related to recurrence rate in both groups (p<0.05) without significant differences between open and laser cordectomy (p>0.05). The 5 years overall survival and disease-free survival were respectively 90.48% and 85.71% in Group A; 88.14% and 86.44% in Group B (p>0.05). Lower tracheostomy rate, earlier recovery of swallowing function and shorter hospital stay were observed in Group A (p<0.05).ConclusionsMargin status has a prognostic role in T1a–T1b glottic cancer. Transoral laser surgery showed similar oncologic results of open cordectomy, with better functional outcomes.



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Inadvertent misplacement of the inferior vena cava

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Critical evaluation of reverse engineering tool Imagix 4D!

IntroductionThe comprehension of legacy codes is difficult to understand. Various commercial reengineering tools are available that have unique working styles, and are equipped with their inherent capabilities and shortcomings. The focus of the available tools is in visualizing static behavior not the dynamic one. Therefore, it is difficult for people who work in software product maintenance, code understanding reengineering/reverse engineering. Consequently, the need for a comprehensive reengineering/reverse engineering tool arises. We found the usage of Imagix 4D to be good as it generates the maximum pictorial representations in the form of flow charts, flow graphs, class diagrams, metrics and, to a partial extent, dynamic visualizations.Case description and evolutionWe evaluated Imagix 4D with the help of a case study involving a few samples of source code. The behavior of the tool was analyzed on multiple small codes and a large code gcc C parser. Large code evaluation was performed to uncover dead code, unstructured code, and the effect of not including required files at preprocessing level. The utility of Imagix 4D to prepare decision density and complexity metrics for a large code was found to be useful in getting to know how much reengineering is required. At the outset, Imagix 4D offered limitations in dynamic visualizations, flow chart separation (large code) and parsing loops. Conclusion: The outcome of evaluation will eventually help in upgrading Imagix 4D and posed a need of full featured tools in the area of software reengineering/reverse engineering. It will also help the research community, especially those who are interested in the realm of software reengineering tool building.

http://ift.tt/2hPN2FR

The evolution of hierarchical triple star-systems

Field stars are frequently formed in pairs, and many of these binaries are part of triples or even higher-order systems. Even though, the principles of single stellar evolution and binary evolution, have been accepted for a long time, the long-term evolution of stellar triples is poorly understood. The presence of a third star in an orbit around a binary system can significantly alter the evolution of those stars and the binary system. The rich dynamical behaviour in three-body systems can give rise to Lidov-Kozai cycles, in which the eccentricity of the inner orbit and the inclination between the inner and outer orbit vary periodically. In turn, this can lead to an enhancement of tidal effects (tidal friction), gravitational-wave emission and stellar interactions such as mass transfer and collisions. The lack of a self-consistent treatment of triple evolution, including both three-body dynamics as well as stellar evolution, hinders the systematic study and general understanding of the long-term evolution of triple systems. In this paper, we aim to address some of these hiatus, by discussing the dominant physical processes of hierarchical triple evolution, and presenting heuristic recipes for these processes. To improve our understanding on hierarchical stellar triples, these descriptions are implemented in a public source code TrES, which combines three-body dynamics (based on the secular approach) with stellar evolution and their mutual influences. Note that modelling through a phase of stable mass transfer in an eccentric orbit is currently not implemented in TrES, but can be implemented with the appropriate methodology at a later stage.

http://ift.tt/2inlQLl

Infinity of subharmonics for Duffing equations with convex and oscillatory nonlinearities

The existence of infinity of subharmonics for Duffing equations with convex and oscillatory nonlinearities is shown. This result is a corollary of two theorems. These theorems, one for a weak sub-quadratic potential and another for a geometric case, roughly speaking, are complementary. The approach of this paper is based on the phase-plane analysis for the time map and using the Poincaré-Birkhoff twist theorem.

http://ift.tt/2intK7E

Critical evaluation of reverse engineering tool Imagix 4D!

IntroductionThe comprehension of legacy codes is difficult to understand. Various commercial reengineering tools are available that have unique working styles, and are equipped with their inherent capabilities and shortcomings. The focus of the available tools is in visualizing static behavior not the dynamic one. Therefore, it is difficult for people who work in software product maintenance, code understanding reengineering/reverse engineering. Consequently, the need for a comprehensive reengineering/reverse engineering tool arises. We found the usage of Imagix 4D to be good as it generates the maximum pictorial representations in the form of flow charts, flow graphs, class diagrams, metrics and, to a partial extent, dynamic visualizations.Case description and evolutionWe evaluated Imagix 4D with the help of a case study involving a few samples of source code. The behavior of the tool was analyzed on multiple small codes and a large code gcc C parser. Large code evaluation was performed to uncover dead code, unstructured code, and the effect of not including required files at preprocessing level. The utility of Imagix 4D to prepare decision density and complexity metrics for a large code was found to be useful in getting to know how much reengineering is required. At the outset, Imagix 4D offered limitations in dynamic visualizations, flow chart separation (large code) and parsing loops. Conclusion: The outcome of evaluation will eventually help in upgrading Imagix 4D and posed a need of full featured tools in the area of software reengineering/reverse engineering. It will also help the research community, especially those who are interested in the realm of software reengineering tool building.

http://ift.tt/2hPN2FR

The evolution of hierarchical triple star-systems

Field stars are frequently formed in pairs, and many of these binaries are part of triples or even higher-order systems. Even though, the principles of single stellar evolution and binary evolution, have been accepted for a long time, the long-term evolution of stellar triples is poorly understood. The presence of a third star in an orbit around a binary system can significantly alter the evolution of those stars and the binary system. The rich dynamical behaviour in three-body systems can give rise to Lidov-Kozai cycles, in which the eccentricity of the inner orbit and the inclination between the inner and outer orbit vary periodically. In turn, this can lead to an enhancement of tidal effects (tidal friction), gravitational-wave emission and stellar interactions such as mass transfer and collisions. The lack of a self-consistent treatment of triple evolution, including both three-body dynamics as well as stellar evolution, hinders the systematic study and general understanding of the long-term evolution of triple systems. In this paper, we aim to address some of these hiatus, by discussing the dominant physical processes of hierarchical triple evolution, and presenting heuristic recipes for these processes. To improve our understanding on hierarchical stellar triples, these descriptions are implemented in a public source code TrES, which combines three-body dynamics (based on the secular approach) with stellar evolution and their mutual influences. Note that modelling through a phase of stable mass transfer in an eccentric orbit is currently not implemented in TrES, but can be implemented with the appropriate methodology at a later stage.

http://ift.tt/2inlQLl

Infinity of subharmonics for Duffing equations with convex and oscillatory nonlinearities

The existence of infinity of subharmonics for Duffing equations with convex and oscillatory nonlinearities is shown. This result is a corollary of two theorems. These theorems, one for a weak sub-quadratic potential and another for a geometric case, roughly speaking, are complementary. The approach of this paper is based on the phase-plane analysis for the time map and using the Poincaré-Birkhoff twist theorem.

http://ift.tt/2intK7E

Critical evaluation of reverse engineering tool Imagix 4D!

IntroductionThe comprehension of legacy codes is difficult to understand. Various commercial reengineering tools are available that have unique working styles, and are equipped with their inherent capabilities and shortcomings. The focus of the available tools is in visualizing static behavior not the dynamic one. Therefore, it is difficult for people who work in software product maintenance, code understanding reengineering/reverse engineering. Consequently, the need for a comprehensive reengineering/reverse engineering tool arises. We found the usage of Imagix 4D to be good as it generates the maximum pictorial representations in the form of flow charts, flow graphs, class diagrams, metrics and, to a partial extent, dynamic visualizations.Case description and evolutionWe evaluated Imagix 4D with the help of a case study involving a few samples of source code. The behavior of the tool was analyzed on multiple small codes and a large code gcc C parser. Large code evaluation was performed to uncover dead code, unstructured code, and the effect of not including required files at preprocessing level. The utility of Imagix 4D to prepare decision density and complexity metrics for a large code was found to be useful in getting to know how much reengineering is required. At the outset, Imagix 4D offered limitations in dynamic visualizations, flow chart separation (large code) and parsing loops. Conclusion: The outcome of evaluation will eventually help in upgrading Imagix 4D and posed a need of full featured tools in the area of software reengineering/reverse engineering. It will also help the research community, especially those who are interested in the realm of software reengineering tool building.

http://ift.tt/2hPN2FR

The evolution of hierarchical triple star-systems

Field stars are frequently formed in pairs, and many of these binaries are part of triples or even higher-order systems. Even though, the principles of single stellar evolution and binary evolution, have been accepted for a long time, the long-term evolution of stellar triples is poorly understood. The presence of a third star in an orbit around a binary system can significantly alter the evolution of those stars and the binary system. The rich dynamical behaviour in three-body systems can give rise to Lidov-Kozai cycles, in which the eccentricity of the inner orbit and the inclination between the inner and outer orbit vary periodically. In turn, this can lead to an enhancement of tidal effects (tidal friction), gravitational-wave emission and stellar interactions such as mass transfer and collisions. The lack of a self-consistent treatment of triple evolution, including both three-body dynamics as well as stellar evolution, hinders the systematic study and general understanding of the long-term evolution of triple systems. In this paper, we aim to address some of these hiatus, by discussing the dominant physical processes of hierarchical triple evolution, and presenting heuristic recipes for these processes. To improve our understanding on hierarchical stellar triples, these descriptions are implemented in a public source code TrES, which combines three-body dynamics (based on the secular approach) with stellar evolution and their mutual influences. Note that modelling through a phase of stable mass transfer in an eccentric orbit is currently not implemented in TrES, but can be implemented with the appropriate methodology at a later stage.

http://ift.tt/2inlQLl

Infinity of subharmonics for Duffing equations with convex and oscillatory nonlinearities

The existence of infinity of subharmonics for Duffing equations with convex and oscillatory nonlinearities is shown. This result is a corollary of two theorems. These theorems, one for a weak sub-quadratic potential and another for a geometric case, roughly speaking, are complementary. The approach of this paper is based on the phase-plane analysis for the time map and using the Poincaré-Birkhoff twist theorem.

http://ift.tt/2intK7E

Critical evaluation of reverse engineering tool Imagix 4D!

IntroductionThe comprehension of legacy codes is difficult to understand. Various commercial reengineering tools are available that have unique working styles, and are equipped with their inherent capabilities and shortcomings. The focus of the available tools is in visualizing static behavior not the dynamic one. Therefore, it is difficult for people who work in software product maintenance, code understanding reengineering/reverse engineering. Consequently, the need for a comprehensive reengineering/reverse engineering tool arises. We found the usage of Imagix 4D to be good as it generates the maximum pictorial representations in the form of flow charts, flow graphs, class diagrams, metrics and, to a partial extent, dynamic visualizations.Case description and evolutionWe evaluated Imagix 4D with the help of a case study involving a few samples of source code. The behavior of the tool was analyzed on multiple small codes and a large code gcc C parser. Large code evaluation was performed to uncover dead code, unstructured code, and the effect of not including required files at preprocessing level. The utility of Imagix 4D to prepare decision density and complexity metrics for a large code was found to be useful in getting to know how much reengineering is required. At the outset, Imagix 4D offered limitations in dynamic visualizations, flow chart separation (large code) and parsing loops. Conclusion: The outcome of evaluation will eventually help in upgrading Imagix 4D and posed a need of full featured tools in the area of software reengineering/reverse engineering. It will also help the research community, especially those who are interested in the realm of software reengineering tool building.

http://ift.tt/2hPN2FR

The evolution of hierarchical triple star-systems

Field stars are frequently formed in pairs, and many of these binaries are part of triples or even higher-order systems. Even though, the principles of single stellar evolution and binary evolution, have been accepted for a long time, the long-term evolution of stellar triples is poorly understood. The presence of a third star in an orbit around a binary system can significantly alter the evolution of those stars and the binary system. The rich dynamical behaviour in three-body systems can give rise to Lidov-Kozai cycles, in which the eccentricity of the inner orbit and the inclination between the inner and outer orbit vary periodically. In turn, this can lead to an enhancement of tidal effects (tidal friction), gravitational-wave emission and stellar interactions such as mass transfer and collisions. The lack of a self-consistent treatment of triple evolution, including both three-body dynamics as well as stellar evolution, hinders the systematic study and general understanding of the long-term evolution of triple systems. In this paper, we aim to address some of these hiatus, by discussing the dominant physical processes of hierarchical triple evolution, and presenting heuristic recipes for these processes. To improve our understanding on hierarchical stellar triples, these descriptions are implemented in a public source code TrES, which combines three-body dynamics (based on the secular approach) with stellar evolution and their mutual influences. Note that modelling through a phase of stable mass transfer in an eccentric orbit is currently not implemented in TrES, but can be implemented with the appropriate methodology at a later stage.

http://ift.tt/2inlQLl

Infinity of subharmonics for Duffing equations with convex and oscillatory nonlinearities

The existence of infinity of subharmonics for Duffing equations with convex and oscillatory nonlinearities is shown. This result is a corollary of two theorems. These theorems, one for a weak sub-quadratic potential and another for a geometric case, roughly speaking, are complementary. The approach of this paper is based on the phase-plane analysis for the time map and using the Poincaré-Birkhoff twist theorem.

http://ift.tt/2intK7E