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Find video protocols related to scientific articles indexed in Pubmed.
Use of copolymer polylactic and polyglycolic Acid resorbable plates in repair of orbital floor fractures.
Facial Plast Surg
PUBLISHED: 11-14-2014
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The fractures of the orbital floor are common after craniofacial trauma. Repair with resorbable plates is a viable reconstructive option; however, there are few reports in the literature. This study describes our experience using copolymer polylactic and polyglycolic acid (PLLA/PGA) orbital reconstruction plates (LactoSorb, Lorenz Surgical, Jacksonville, FL) in 29 cases of the orbital floor fracture repair. We conducted a retrospective review of 29 orbital floor fractures at a single institution repaired through transconjunctival, preseptal dissection using PLLA/PGA plates fashioned to repair the orbital floor defect. Associated fractures included zygomaticomaxillary, LeFort, and nasoethmoid fractures. There were six patients with complications. Four patients had transient diplopia with complete resolution of symptoms within 1 year. One patient had diplopia postoperatively, but was later lost to follow-up. Two patients have had persistent enophthalmos since 1 year. In each of these cases, the floor fracture was coincident with significant panfacial or neurotrauma. We did not encounter any adverse inflammatory reactions to the implant material itself. The study concluded that orbital floor fracture repair with resorbable plates is safe, relatively easy to perform, and in the majority of cases was effective without complications. In the presence of severe orbital trauma, more rigid implant materials may be appropriate.
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How health professions education can advance patient safety and quality improvement.
Healthc Q
PUBLISHED: 10-26-2014
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A commonly held belief is that education and training are weak interventions that have limited success on their own in improving system reliability, clinical processes and, ultimately, patient safety and healthcare quality (Caffazzo and St-Cyr 2012). Yet, for emerging fields such as patient safety and quality improvement (PS/QI), one should not underestimate the importance of educating frontline staff in the fundamentals of these disciplines. For most healthcare institutions, there is a major bandwidth problem when it comes to PS/QI work, which acts as a critical barrier to accelerating change and improving patient safety and healthcare quality. Too few people are relied on to solve all of the institution's safety and quality problems.
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Deorphanization of the human leukocyte tyrosine kinase (LTK) receptor by a signaling screen of the extracellular proteome.
Proc. Natl. Acad. Sci. U.S.A.
PUBLISHED: 10-20-2014
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There are many transmembrane receptor-like proteins whose ligands have not been identified. A strategy for finding ligands when little is known about their tissue source is to screen each extracellular protein individually expressed in an array format by using a sensitive functional readout. Taking this approach, we have screened a large collection (3,191 proteins) of extracellular proteins for their ability to activate signaling of an orphan receptor, leukocyte tyrosine kinase (LTK). Only two related secreted factors, FAM150A and FAM150B (family with sequence similarity 150 member A and member B), stimulated LTK phosphorylation. FAM150A binds LTK extracellular domain with high affinity (KD = 28 pM). FAM150A stimulates LTK phosphorylation in a ligand-dependent manner. This strategy provides an efficient approach for identifying functional ligands for other orphan receptors.
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Effect of a postdischarge virtual ward on readmission or death for high-risk patients: a randomized clinical trial.
JAMA
PUBLISHED: 10-01-2014
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Hospital readmissions are common and costly, and no single intervention or bundle of interventions has reliably reduced readmissions. Virtual wards, which use elements of hospital care in the community, have the potential to reduce readmissions, but have not yet been rigorously evaluated.
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Rethinking nasal tip support: A finite element analysis.
Laryngoscope
PUBLISHED: 08-11-2014
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We employ a nasal tip finite element model (FEM) to evaluate contributions of two of the three major tip support mechanisms: attachments between the upper and lower lateral cartilages and attachment of the medial crura to the caudal septum.
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Population-based assessment of currently proposed ideals of nasal tip projection and rotation in young women.
JAMA Facial Plast Surg
PUBLISHED: 07-31-2014
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There is no universally accepted quantitative metric that defines the ideal nasal tip rotation and projection.
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Morning handover of on-call issues: opportunities for improvement.
JAMA Intern Med
PUBLISHED: 07-23-2014
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Handover is the process of transferring pertinent patient information and clinical responsibility between health care practitioners. Few studies have examined morning handover from the overnight trainee to the daytime team.
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The Effect of pH on Rabbit Septal Cartilage Shape Change: Exploring the Mechanism of Electromechanical Tissue Reshaping.
Eplasty
PUBLISHED: 06-27-2014
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Electromechanical reshaping (EMR) involves the application of an electrical current to mechanically deformed cartilage to create sustained tissue shape change. Although EMR may evolve to become an inexpensive and reliable way of producing shape change in cartilage during reconstructive surgery, the precise mechanism of EMR is unknown. We aim to examine the isolated effect of protonation (pH) on shape change in cartilage.
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In vivo needle-based electromechanical reshaping of pinnae: New Zealand White rabbit model.
JAMA Facial Plast Surg
PUBLISHED: 05-24-2014
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Electromechanical reshaping (EMR) is a low-cost, needle-based, and simple means to shape cartilage tissue without the use of scalpels, sutures, or heat that can potentially be used in an outpatient setting to perform otoplasty.
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Targeting IL-34 in chronic inflammation.
Drug Discov. Today
PUBLISHED: 04-30-2014
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A second ligand for colony-stimulating factor-1 receptor (CSF-1R) with distinct biologic activities had long been implicated but not appreciated until the recent discovery of interleukin (IL)-34. IL-34 and CSF-1 signal through this common receptor to mediate the biology of mononuclear phagocytic cells. Aberrant macrophage activation by CSF-1 and/or IL-34 is associated with numerous diseases, and clinical therapies targeting this pathway are being tested. Although IL-34 and CSF-1 have distinct activities under physiologic conditions, they appear functionally redundant in various disease states. Thus, blocking the activity of both might be necessary for maximal efficacy.
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Metabolism of stromal and immune cells in health and disease.
Nature
PUBLISHED: 04-08-2014
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Cancer cells have been at the centre of cell metabolism research, but the metabolism of stromal and immune cells has received less attention. Nonetheless, these cells influence the progression of malignant, inflammatory and metabolic disorders. Here we discuss the metabolic adaptations of stromal and immune cells in health and disease, and highlight how metabolism determines their differentiation and function.
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In-depth analysis of pH-dependent mechanisms of electromechanical reshaping of rabbit nasal septal cartilage.
Laryngoscope
PUBLISHED: 03-12-2014
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Electromechanical reshaping (EMR) involves reshaping cartilage by mechanical deformation and delivering electric current to the area around the bend axis, causing local stress relaxation and permanent shape change. The mechanism of EMR is currently unclear, although preliminary studies suggest that voltage and application time are directly related to the concentration and diffusion of acid-base products within the treated tissue with little heat generation. This study aims to characterize local tissue pH changes following EMR and to demonstrate that local tissue pH changes are correlated with tissue damage and shape change.
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Exposure to low levels of jet-propulsion fuel impairs brainstem encoding of stimulus intensity.
J. Toxicol. Environ. Health Part A
PUBLISHED: 03-05-2014
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Jet propulsion fuel-8 (JP-8) is a kerosene-based fuel that is used in military jets. The U.S. Armed Services and North Atlantic Treaty Organization countries adopted JP-8 as a standard fuel source and the U.S. military alone consumes more than 2.5 billion gallons annually. Preliminary epidemiologic data suggested that JP-8 may interact with noise to induce hearing loss, and animal studies revealed damage to presynaptic sensory cells in the cochlea. In the current study, Long-Evans rats were divided into four experimental groups: control, noise only, JP-8 only, and JP-8 + noise. A subototoxic level of JP-8 was used alone or in combination with a nondamaging level of noise. Functional and structural assays of the presynaptic sensory cells combined with neurophysiologic studies of the cochlear nerve revealed that peripheral auditory function was not affected by individual exposures and there was no effect when the exposures were combined. However, the central auditory nervous system exhibited impaired brainstem encoding of stimulus intensity. These findings may represent important and major shifts in the theoretical framework that governs current understanding of jet fuel and/or jet fuel + noise-induced ototoxicity. From an epidemiologic perspective, results indicate that jet fuel exposure may exert consequences on auditory function that may be more widespread and insidious than what was previously shown. It is possible that a large population of military personnel who are suffering from the effects of jet fuel exposure may be misidentified because they would exhibit normal hearing thresholds but harbor a "hidden" brainstem dysfunction.
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Experimental Measurements and Computational Predictions of Regional Particle Deposition in a Sectional Nasal Model.
J Aerosol Med Pulm Drug Deliv
PUBLISHED: 03-04-2014
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Abstract Background: Knowledge of the regional deposition of inhaled particles in the nose is important for drug delivery and assessment of the toxicity of inhaled materials. In this study, computational fluid dynamics (CFD) predictions and experimental measurements in a nasal replica cast were used to study regional deposition of inhaled microparticles. Methods: The replica cast was sectioned into six regions of interest based on nasal anatomy: the nasal vestibule, nasal valve, anterior turbinates, olfactory region, turbinates, and nasopharynx. Monodisperse fluorescein particles with aerodynamic diameters of 2.6-14.3??m were passed through the assembled cast in the presence of steady inspiratory airflow at 15?L/min. After each experiment, the cast was disassembled and the deposited fluorescein in each region was washed out and quantified with fluorescence spectrometry. A nasal CFD model was developed from the same magnetic resonance imaging scans that were used to construct the replica cast. Steady-state inspiratory airflow and particle deposition calculations were conducted in the CFD model using Fluent(™) at flow rates producing Stokes numbers comparable to experimental conditions. Results: Total and regional particle deposition predictions from the CFD model were compared with experimental measurements from the replica cast. Overall, good agreement was observed between CFD predictions and experimental measurements with similar deposition trends in each region of interest. CFD predictions in central nasal regions demonstrated well-defined maximum values of 15%, 7%, and 12% in the anterior turbinates, olfactory, and turbinates regions, respectively, at particle sizes of 10-11??m. Conclusions: These results demonstrate the use of a sectioned nasal CFD model based on anatomical regions of interest for nasal drug delivery to elucidate patterns of regional deposition within a human nasal cavity.
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Analyzing nasal septal deviations to develop a new classification system: a computed tomography study using MATLAB and OsiriX.
JAMA Facial Plast Surg
PUBLISHED: 02-22-2014
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IMPORTANCE Accurately characterizing nasal septal deviations is valuable for surgical planning, classifying nasal septal deviations, providing a means to accurately perform outcomes research, and understanding the causes of chronic conditions. OBJECTIVE To determine and quantify regions of septal deformity that can be used to develop a comprehensive classification system. DESIGN, SETTING, AND PARTICIPANTS A retrospective case series study was conducted at an academic tertiary care hospital. Sixty-four participants were selected based on a convenience sample of computed tomography (CT) scans of the paranasal sinuses and midface available between June 29, 2011, and August 16, 2012. Exclusion criteria consisted of incomplete or inadequate CT series. The most recent CT scans were chosen for analyses regardless of the indication for imaging. Digital Imaging and Communications in Medicine format bitmap file–formatted data were obtained and analyzed using MATLAB and OsiriX. The line to curve ratio, deviation area, and root mean square (RMS) values of the septal contour vs the ideal straight septum fit were calculated. Analysis was performed to detect significant differences (P < .05) using the 3 measures.MAIN OUTCOMES AND MEASURES Quantitative analysis of nasal septal deviation.RESULTS The population consisted of 50 male and 14 female patients aged 3 to 83 years(mean, 42 years). Mean line to curve ratios, areas, and RMS values were highest in contours that intersected the perpendicular plate–vomer junction, with a mean line to curve ratio of1.04 and mean deviated area of 627.16 arbitrary units (P = .02). Maximal deviation areas were also seen midway from the perpendicular plate–vomer junction to the nasal spine with a mean area of 577.31 arbitrary units (P = .01). The RMS values were significantly elevated along the crista galli and perpendicular plate–vomer junction (P < .05).CONCLUSIONS AND RELEVANCE Maximum septal deviation is seen at the perpendicular plate–vomer junction and in the regions near the crista galli and anterior nasal spine.Deviation area and RMS values are important measures to characterize septal deviations.Understanding septal deviations can aid in developing a functional classification system of nasal septal deviations for clinical use and a means to better record and compare surgical outcomes.
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Preclinical investigations of articular cartilage ablation with femtosecond and pulsed infrared lasers as an alternative to microfracture surgery.
J Biomed Opt
PUBLISHED: 02-03-2014
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Microfracture surgery is a bone marrow stimulation technique for treating cartilage defects and injuriesin the knee. Current methods rely on surgical skill and instrumentation. This study investigates the potential useof laser technology as an alternate means to create the microfracture holes. Lasers investigated in this study include an erbium:YAG laser (? = 2.94 ?m), titanium:sapphire femtosecond laser system (? = 1700 nm), and Nd:glass femtosecond laser (? = 1053 nm). Bovine samples were ablated at fluences of 8 to 18 J?cm2 with the erbium:YAG laser, at a power of 300 ± 15 mW with the titanium:sapphire femtosecond system, and at an energy of 3 ?J?pulse with the Nd:glass laser. Samples were digitally photographed and histological sections were taken for analysis. The erbium:YAG laser is capable of fast and efficient ablation; specimen treated with fluences of 12 and 18 J?cm2 experienced significant amounts of bone removal and minimal carbonization with saline hydration. The femtosecond laser systems successfully removed cartilage but not clinically significant amounts of bone. Precise tissue removal was possible but not to substantial depths due to limitations of the systems. With additional studies and development, the use of femtosecond laser systems to ablate bone may be achieved at clinically valuable ablation rates.
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The rabbit costal cartilage reconstructive surgical model.
Facial Plast Surg
PUBLISHED: 01-31-2014
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Rib grafts in facial plastic surgery are becoming more frequently used. Small animal models, although not ideal may be used to emulate costal cartilage-based procedures. A surgical characterization of this tissue will assist future research in the selection of appropriate costal segments, based on quantitative and qualitative properties. The objective of this study is to assess the surgical anatomy of the rabbit costal margin and evaluate costal cartilage for use in either in vivo or ex vivo studies and to examine reconstructive procedures. Detailed thoracic dissections of 21 New Zealand white rabbits were performed post-mortem. Costal cartilage of true, false, and floating ribs were harvested. The length, thickness, and width at proximal, medial, and distal locations of the cartilage, with perichondrium intact were measured. Further qualitative observation and digital images of curvature, flexibility, and segmental cross-sectional shape were recorded. The main outcome measure(s) is to characterize, describe, and assess the consistency of dimensions, location, and shape of costal cartilage. In this study, 12 to 13 ribs encase the thoracic cavity. Cartilage from true ribs has an average length, width, and depth of 23.75?±?0.662, 3.02?±?0.025, and 2.18?±?0.018?mm, respectively. The cartilage from false ribs has an average length, width, and depth of 41.97?±?1.48, 2.00?±?0.07, 1.19?±?0.03?mm, and that of floating ribs are 7.66?±?0.29, 1.98?±?0.04, and 0.96?±?0.03 mm. Rib 8 is found to be the longest costal cartilage (49.10?±?0.64 mm), with the widest and thickest at ribs 1 (3.91?±?0.08 mm) and 6 (2.41?±?0.11 mm), respectively. Cross-sectional segments reveal the distal cartilage to maintain an hourglass shape that broadens to become circular and eventually ovoid at the costochondral junction. The New Zealand white rabbit is a practical source of costal cartilage that is of sufficient size and reproducibility to use in surgical research where the long-term effects of operations, therapies, devices, and pharmacologic on cartilage can be studied in vivo.
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Understanding the effect of resident duty hour reform: a qualitative study.
CMAJ Open
PUBLISHED: 01-01-2014
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Concern surrounding the effect of resident fatigue on patient care recently led the National Steering Committee on Resident Duty Hours to publish Canadian recommendations suggesting that duty periods of 24 or more consecutive hours without restorative sleep should be avoided. We sought to characterize how different training programs are preparing for the effect of such changes on education, patient care and provider well-being.
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Incomplete and transitory decrease of glycolysis: A new paradigm for anti-angiogenic therapy?
Cell Cycle
PUBLISHED: 12-13-2013
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During vessel sprouting, a migratory endothelial tip cell guides the sprout, while proliferating stalk cells elongate the branch. Tip and stalk cell phenotypes are not genetically predetermined fates, but are dynamically interchangeable to ensure that the fittest endothelial cell (EC) leads the vessel sprout. ECs increase glycolysis when forming new blood vessels. Genetic deficiency of the glycolytic activator PFKFB3 in ECs reduces vascular sprouting by impairing migration of tip cells and proliferation of stalk cells. PFKFB3-driven glycolysis promotes the tip cell phenotype during vessel sprouting, since PFKFB3 overexpression overrules the pro-stalk activity of Notch signaling. Furthermore, PFKFB3-deficient ECs cannot compete with wild-type neighbors to form new blood vessels in chimeric mosaic mice. In addition, pharmacological PFKFB3 blockade reduces pathological angiogenesis with modest systemic effects, likely because it decreases glycolysis only partially and transiently.
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Analysis of cartilage-polydioxanone foil composite grafts.
Facial Plast Surg
PUBLISHED: 12-10-2013
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This study presents an analytical investigation into the mechanical behavior of a cartilage-polydioxanone (PDS) plate composite grafts. Numerical methods are used to provide a first-order, numerical model of the flexural stiffness of a cartilage-PDS graft. Flexural stiffness is a measure of resistance to bending and is inversely related to the amount of deformation a structure may experience when subjected to bending forces. The cartilage-PDS graft was modeled as a single composite beam. Using Bernoulli-Euler beam theory, a closed form equation for the theoretical flexural stiffness of the composite graft was developed. A parametric analysis was performed to see how the flexural properties of the composite model changed with varying thicknesses of PDS foil. The stiffness of the cartilage-PDS composite using 0.15-mm-thick PDS was four times higher than cartilage alone. The composite with a 0.5-mm-thick PDS graft was only 1.7 times stiffer than the composite with the 0.15-mm-thick PDS graft. Although a thicker graft material will yield higher flexural stiffness for the composite, the relationship between composite stiffness and PDS thickness is nonlinear. After a critical point, increments in graft thickness produce gradually smaller improvements in flexural stiffness. The small increase in stiffness when using the thicker PDS foils versus the 0.15?mm PDS foil may not be worth the potential complications (prolonged foreign body reaction, reduction in nutrient diffusion to cartilage) of using thicker artificial grafts.
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Azole resistance in Cryptococcus gattii from the Pacific Northwest: Investigation of the role of ERG11.
Antimicrob. Agents Chemother.
PUBLISHED: 08-26-2013
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Cryptococcus gattii is responsible for an expanding epidemic of serious infections in Western Canada and the Northwestern United States (Pacific Northwest). Some patients with these infections respond poorly to azole antifungals, and high azole MICs have been reported in Pacific Northwest C. gattii. In this study, multiple azoles (but not amphotericin B) had higher MICs for 25 Pacific Northwest C. gattii than for 34 non-Pacific Northwest C. gattii or 20 Cryptococcus neoformans strains. We therefore examined the roles in azole resistance of overexpression of or mutations in the gene (ERG11) encoding the azole target enzyme. ERG11/ACT1 mRNA ratios were higher in C. gattii than in C. neoformans, but these ratios did not differ in Pacific Northwest and non-Pacific Northwest C. gattii strains, nor did they correlate with fluconazole MICs within any group. Three Pacific Northwest C. gattii strains with low azole MICs and 2 with high azole MICs had deduced Erg11p sequences that differed at one or more positions from that of the fully sequenced Pacific Northwest C. gattii strain R265. However, the azole MICs for conditional Saccharomyces cerevisiae erg11 mutants expressing the 5 variant ERG11s were within 2-fold of the azole MICs for S. cerevisiae expressing the ERG11 gene from C. gattii R265, non-Pacific Northwest C. gattii strain WM276, or C. neoformans strains H99 or JEC21. We conclude that neither ERG11 overexpression nor variations in ERG11 coding sequences was responsible for the high azole MICs observed for the Pacific Northwest C. gattii strains we studied.
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Preliminary investigations on therapy thresholds for laser dosimetry, cryogen spray cooling duration, and treatment cycles for laser cartilage reshaping in the New Zealand white rabbit auricle.
Lasers Med Sci
PUBLISHED: 08-04-2013
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Previous studies have demonstrated the feasibility of laser irradiation (??=?1.45 ?m) in tandem with cryogen spray cooling (CSC) to reshape rabbit auricular cartilage using a total energy density of 14 J/cm(2). The aim of this study was to further explore and identify the dosimetry parameter space for laser output energy, CSC duration, and treatment cycles required to achieve shape change while limiting skin and cartilage injury. Ten New Zealand white rabbits were treated with the 1.45 ?m diode laser combined with cryogen spray cooling (Candela Smoothbeam™, Candela Co., Wayland, MA, USA). The ears central portion was bent around a cylindrical jig and irradiated in consecutive spots of 6 mm diameter (13 or 14 J/cm(2) per spot) along three rows encompassing the bend. CSC was delivered during irradiation in cycles consisting of 25-35 ms. At thin and thick portions of the ear, 4-7 and 6-10 treatment cycles were delivered, respectively. After surgery, ears were examined and splinted for 6 weeks. Treatment parameters resulting in acceptable (grades 1 and 2) and unacceptable (grade 3) skin injuries for thick and thin regions were identified, and shape change was observed. Confocal and histological analysis of cartilage tissue revealed several outcomes correlating to laser dosimetry, CSC duration, and treatment cycles. These outcomes included expansion of cartilage layers (thickening), partial cartilage injuries, and full-thickness cartilage injuries. We determined therapy thresholds for laser output energy, cryogen spray cooling duration, and treatment cycles in the rabbit auricular model. These parameters are a starting point for future clinical procedures aimed at correcting external ear deformities.
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Why resident duty hours regulations must address attending physicians workload.
Acad Med
PUBLISHED: 07-27-2013
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For much of the past decade, the duty hours debate has focused primarily on the intended and unintended effects of resident duty hours restrictions on resident well-being and fatigue, patient safety, discontinuity and handoffs, and opportunities for teaching. On the other hand, attending physicians needs and perspectives generally have been ignored. The authors of this commentary discuss the report by Roshetsky and colleagues in this issue of Academic Medicine, which found that attending physicians reported a greater clinical workload since the implementation of the 2003 Accreditation Council for Graduate Medical Education resident duty hours regulations, and that this increase in attending physicians workload appears to correlate with decreased time for teaching. However, attending physicians not having time to teach may be but the tip of the iceberg. Other potential implications include faculty members decreased availability for direct supervision of residents, their reduced emphasis on resident assessment, and their burnout and dissatisfaction, which ultimately also negatively affect patient care. Therefore, deliberate efforts to address attending physicians workload must receive greater attention if the duty hours movement is to achieve its ultimate goal of improving patient outcomes. In this commentary, the authors advocate that duty hours regulations require programs to seek creative solutions to address these issues, just as the 2011 regulations require programs to address patient handoff training.
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In vivo electromechanical reshaping of ear cartilage in a rabbit model: a minimally invasive approach for otoplasty.
JAMA Facial Plast Surg
PUBLISHED: 07-03-2013
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To report the first successful study to date of in vivo electromechanical reshaping of ear cartilage in a rabbit model.
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Sustaining quality improvement and patient safety training in graduate medical education: lessons from social theory.
Acad Med
PUBLISHED: 06-29-2013
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Despite an official mandate to incorporate formal quality improvement (QI) and patient safety (PS) training into graduate medical education, many QI/PS curricular efforts face implementation challenges and are not sustained. Educators are increasingly turning to sociocultural theories to address issues such as curricular uptake in medical education. The authors conducted a case study using Bourdieus concepts of "field" and "habitus" to identify theoretically derived strategies that can promote sustained implementation of QI/PS curricula.
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Nasal tip support: A finite element analysis of the role of the caudal septum during tip depression.
Laryngoscope
PUBLISHED: 06-28-2013
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Although minor and major tip support mechanisms have been described in detail, no quantitative models exist to provide support for the relative contributions of the structural properties of the major alar cartilage, the fibrous attachments to surrounding structures, and the rigid support structures in an objective manner.
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Partial and Transient Reduction of Glycolysis by PFKFB3 Blockade Reduces Pathological Angiogenesis.
Cell Metab.
PUBLISHED: 06-14-2013
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Strategies targeting pathological angiogenesis have focused primarily on blocking vascular endothelial growth factor (VEGF), but resistance and insufficient efficacy limit their success, mandating alternative antiangiogenic strategies. We recently provided genetic evidence that the glycolytic activator phosphofructokinase-2/fructose-2,6-bisphosphatase 3 (PFKFB3) promotes vessel formation but did not explore the antiangiogenic therapeutic potential of PFKFB3 blockade. Here, we show that blockade of PFKFB3 by the small molecule 3-(3-pyridinyl)-1-(4-pyridinyl)-2-propen-1-one (3PO) reduced vessel sprouting in endothelial cell (EC) spheroids, zebrafish embryos, and the postnatal mouse retina by inhibiting EC proliferation and migration. 3PO also suppressed vascular hyperbranching induced by inhibition of Notch or VEGF receptor 1 (VEGFR1) and amplified the antiangiogenic effect of VEGF blockade. Although 3PO reduced glycolysis only partially and transiently in vivo, this sufficed to decrease pathological neovascularization in ocular and inflammatory models. These insights may offer therapeutic antiangiogenic opportunities.
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Calcium hydroxylapatite associated soft tissue necrosis: A case report and treatment guideline.
J Plast Reconstr Aesthet Surg
PUBLISHED: 05-28-2013
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We present an uncommon case of nasal alar and facial necrosis following calcium hydroxylapatite filler injection performed elsewhere without direct physician supervision. The patient developed severe full-thickness necrosis of cheek and nasal alar skin 24 h after injections into the melolabial folds. Management prior to referral included oral antibiotics, prednisone taper, and referral to a dermatologist (day 3) who prescribed valacyclovir for a presumptive herpes zoster reactivation induced by the injection. Referral to our institution was made on day 11, and after herpetic outbreak was ruled out by a negative Tzanck smear, debridement with aggressive local wound care was initiated. After re-epithelialization and the fashioning of a custom intranasal stent to prevent vestibular stenosis, pulsed dye laser therapy was performed for wound modification. The patient healed with an acceptable cosmetic outcome. This report underscores the importance of facial vasculature anatomy, injection techniques, and identification of adverse events when using fillers. A current treatment paradigm for such events is also presented.
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Real-time subglottic stenosis imaging using optical coherence tomography in the rabbit.
JAMA Otolaryngol Head Neck Surg
PUBLISHED: 05-18-2013
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Subglottic stenosis (SGS) is a severe, acquired, potentially life-threatening disease that can be caused by endotracheal tube intubation. Newborns and neonates are particularly susceptible to SGS owing to the small caliber of their airway.
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Teaching medical error disclosure to physicians-in-training: a scoping review.
Acad Med
PUBLISHED: 04-27-2013
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This scoping review identified published studies of error disclosure curricula targeting physicians-in-training (residents or medical students).
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Role of PFKFB3-driven glycolysis in vessel sprouting.
Cell
PUBLISHED: 04-02-2013
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Vessel sprouting by migrating tip and proliferating stalk endothelial cells (ECs) is controlled by genetic signals (such as Notch), but it is unknown whether metabolism also regulates this process. Here, we show that ECs relied on glycolysis rather than on oxidative phosphorylation for ATP production and that loss of the glycolytic activator PFKFB3 in ECs impaired vessel formation. Mechanistically, PFKFB3 not only regulated EC proliferation but also controlled the formation of filopodia/lamellipodia and directional migration, in part by compartmentalizing with F-actin in motile protrusions. Mosaic in vitro and in vivo sprouting assays further revealed that PFKFB3 overexpression overruled the pro-stalk activity of Notch, whereas PFKFB3 deficiency impaired tip cell formation upon Notch blockade, implying that glycolysis regulates vessel branching.
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Ex vivo electromechanical reshaping of costal cartilage in the New Zealand white rabbit model.
Laryngoscope
PUBLISHED: 04-02-2013
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Determine the effective electromechanical reshaping (EMR) parameters for shape change and cell viability in the ex vivo rabbit costal cartilage model.
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The academic impact of the Triological Society theses--Mosher and Fowler awards: citations, impact factor, and h-index.
Laryngoscope
PUBLISHED: 03-28-2013
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The Triological Society requires thesis submission for full membership. Accepted theses (AT) may be recognized with designations of: Mosher Awards (MA), Fowler Awards (FA), Honorable Mention for Basic Science (HMBS), and Honorable Mention for Clinical Science (HMCS). We sought to determine and compare the scholarly impact of Triological Society theses, their authors, and whether differences exist between AT and those that receive special recognition.
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Inhalation dosimetry of hexamethylene diisocyanate vapor in the rat and human respiratory tracts.
Inhal Toxicol
PUBLISHED: 02-21-2013
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Hexamethylene diisocyanate (HDI) is a reactive chemical used in the commercial production of polyurethanes. Toxic effects in rodents exposed to HDI vapor primarily occur in the nasal passages, yet some individuals exposed occupationally to concentrations exceeding current regulatory limits may experience temporary reduction in lung function and asthma-like symptoms. Knowledge of interspecies differences in respiratory tract dosimetry of inhaled HDI would improve our understanding of human health risks to this compound. HDI uptake was measured in the upper respiratory tract of anesthetized Fischer-344 rats. Nasal uptake of HDI was >90% in rats at unidirectional flow rates of 150 and 300 ml/min and a target air concentration of 200 ppb. Uptake data was used to calibrate nasal and lung dosimetry models of HDI absorption in rats and humans. Computational fluid dynamics (CFD) models of the nasal passages were used to simulate inspiratory airflow and HDI absorption. Transport of HDI through lung airways was simulated using convection-diffusion based mass transport models. HDI nasal uptake of 90% and 78% was predicted using the rat and human nasal CFD models, respectively. Total respiratory tract uptake was estimated to be 99% in rats and 97% in humans under nasal breathing. Predicted human respiratory uptake decreased to 87% under oral breathing conditions. Absorption rates of inhaled HDI in human lung airways were estimated to be higher than the rat due to lower uptake in head airways. Model predictions demonstrated significant penetration of HDI to human bronchial airways, although absorption rates were sensitive to breathing style.
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Identifying ideal brow vector position: empirical analysis of three brow archetypes.
Facial Plast Surg
PUBLISHED: 02-20-2013
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Surgical browlifts counteract the effects of aging, correct ptosis, and optimize forehead aesthetics. While surgeons have control over brow shape, the metrics defining ideal brow shape are subjective.
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Development of indole/indazole-aminopyrimidines as inhibitors of c-Jun N-terminal kinase (JNK): optimization for JNK potency and physicochemical properties.
Bioorg. Med. Chem. Lett.
PUBLISHED: 02-19-2013
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A novel series of indole/indazole-aminopyrimidines was designed and synthesized with an aim to achieve optimal potency and selectivity for the c-Jun kinase family or JNKs. Structure guided design was used to optimize the series resulting in a significant potency improvement. The best compound (17) has IC50 of 3 nM for JNK1 and 20 nM for JNK2, with greater than 40-fold selectivity against other kinases with good physicochemical and pharmacokinetic properties.
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Educational impact of using smartphones for clinical communication on general medicine: more global, less local.
J Hosp Med
PUBLISHED: 02-13-2013
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Medical trainees increasingly use smartphones in their clinical work. Similar to other information technology implementations, smartphone use can result in unintended consequences. This study aimed to examine the impact of smartphone use for clinical communication on medical trainees educational experiences.
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Teaching dermatology to internal medicine residents: needs assessment survey and possible directions.
J Cutan Med Surg
PUBLISHED: 02-01-2013
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Internal medicine trainees receive limited teaching and training in dermatology and may feel inadequately prepared to assess and manage patients with dermatologic complaints. No study to date has assessed the needs of internal medicine trainees in Canada with regard to dermatology teaching.
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Dorsal Nasal Mucocele: A Delayed Complication of Rhinoplasty.
Aesthetic Plast Surg
PUBLISHED: 01-25-2013
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Mucocele formation is a very rare complication of rhinoplasty surgery, with only 26 incidences documented in the medical literature. Postrhinoplasty nasal mucoceles are believed to result from the growth of ectopic nasal respiratory epithelium displaced during the rhinoplasty procedure. Although most cases of nasal mucocele present within weeks of rhinoplasty surgery, exceptional accounts describe nasal mucoceles presenting years after rhinoplasty. This case report describes an extremely delayed case of dorsal nasal mucocele that presented 21 years after the patient underwent a septorhinoplasty. The aesthetically bothersome mucocele was successfully removed with an open rhinoplasty approach, and the histopathologic analysis was consistent with a simple benign mucous retention cyst. The history, etiology, and prevention of mucocele formation in rhinoplasty surgery also are discussed.
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The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals.
J Am Med Inform Assoc
PUBLISHED: 01-25-2013
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Effective clinical communication is critical to providing high-quality patient care. Hospitals have used different types of interventions to improve communication between care teams, but there have been few studies of their effectiveness.
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Its not about pager replacement: an in-depth look at the interprofessional nature of communication in healthcare.
J Hosp Med
PUBLISHED: 01-18-2013
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Institutions have tried to replace the use of numeric pagers for clinical communication by implementing health information technology (HIT) solutions. However, failing to account for the sociotechnical aspects of HIT or the interplay of technology with existing clinical workflow, culture, and social interactions may create other unintended consequences.
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Ex vivo investigations of laser auricular cartilage reshaping with carbon dioxide spray cooling in a rabbit model.
Lasers Med Sci
PUBLISHED: 01-10-2013
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Laser cartilage reshaping (LCR) with cryogen spray cooling is a promising modality for producing cartilage shape change while reducing cutaneous thermal injury. However, LCR in thicker tissues, such as auricular cartilage, requires higher laser power, thus increasing cooling requirements. To eliminate the risks of freeze injury characteristic of high cryogen spray pulse rates, a carbon dioxide (CO2) spray, which evaporates rapidly from the skin, has been proposed as the cooling medium. This study aims to identify parameter sets which produce clinically significant reshaping while producing minimal skin thermal injury in LCR with CO2 spray cooling in ex vivo rabbit auricular cartilage. Excised whole rabbit ears were mechanically deformed around a cylindrical jig and irradiated with a 1.45-?m wavelength diode laser (fluence 12-14 J/cm(2) per pulse, four to six pulse cycles per irradiation site, five to six irradiation sites per row for four rows on each sample) with concomitant application of CO2 spray (pulse duration 33-85 ms) to the skin surface. Bend angle measurements were performed before and after irradiation, and the change quantified. Surface temperature distributions were measured during irradiation/cooling. Maximum skin surface temperature ranged between 49.0 to 97.6 °C following four heating/cooling cycles. Significant reshaping was achieved with all laser dosimetry values with a 50-70 °C difference noted between controls (no cooling) and irradiated ears. Increasing cooling pulse duration yielded progressively improved gross skin protection during irradiation. CO2 spray cooling may potentially serve as an alternative to traditional cryogen spray cooling in LCR and may be the preferred cooling medium for thicker tissues. Future studies evaluating preclinical efficacy in an in vivo rabbit model are in progress.
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Nasal epithelial lesions in F344 rats following a 90-day inhalation exposure to naphthalene.
Inhal Toxicol
PUBLISHED: 12-19-2011
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Naphthalene (NA) was shown to be carcinogenic, causing respiratory epithelial adenoma in the nasal cavity of male F344 rats and olfactory epithelial neuroblastoma in female F344 rats at exposure concentrations of 10-60?ppm in a 2-year inhalation study conducted by the National Toxicology Program. To explore the exposure-response relationship and threshold for nasal epithelial effects in F344 rats, a 90-day (6?h/d, 5?d/wk) inhalation study was conducted at 0, 0.1, 1, 10 and 30?ppm NA vapor. Group size for nasal cavity histopathology was 10/sex with an additional 10/sex evaluated 4?wk post-exposure. NA exposure concentrations were measured by GC/MS, and aerosol testing verified that solid NA particles were not present. There were no NA exposure-related clinical observations and mild decreases in body weight (<10%) and food/water consumption were observed primarily in the 30?ppm rats. Rat heads were cross-sectioned at six levels for microscopic examination. There were no nasal cavity lesions related to NA exposure in rats of the 0.1?ppm group. Minimal hyperplasia was observed in the transitional/respiratory epithelium of rats exposed to 1?ppm. Mild hyperplasia and minimal squamous metaplasia were observed in the respiratory epithelium of rats exposed to 10 or 30?ppm. Lesions in the olfactory epithelium were observed only in rats of the 10 or 30?ppm groups and consisted of degeneration, necrosis, areas of re-epithelialization and basal cell hyperplasia. There was remarkable recovery of effects after 4 weeks, but residual olfactory epithelial degeneration and basal cell hyperplasia were still evident.
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Getting the message: a quality improvement initiative to reduce pages sent to the wrong physician.
BMJ Qual Saf
PUBLISHED: 11-07-2011
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One in seven pages are sent to the wrong physician and may result in unnecessary delays that potentially threaten patient safety. The authors aimed to implement a new team-based paging process to reduce pages sent to the wrong physician.
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Changes in the tangent modulus of rabbit septal and auricular cartilage following electromechanical reshaping.
J Biomech Eng
PUBLISHED: 10-21-2011
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Transforming decades old methodology, electromechanical reshaping (EMR) may someday replace traditionally destructive surgical techniques with a less invasive means of cartilage reshaping for reconstructive and esthetic facial surgery. Electromechanical reshaping is essentially accomplished through the application of voltage to a mechanically deformed cartilage specimen. While the capacity of the method for effective reshaping has been consistently shown, its associated effects on cartilage mechanical properties are not fully comprehended. To begin to explore the mechanical effect of EMR on cartilage, the tangent moduli of EMR-treated rabbit septal and auricular cartilage were calculated and compared to matched control values. Between the two main EMR parameters, voltage and application time, the former was varied from 2-8 V and the latter held constant at 2 min for septal cartilage, 3 min for auricular cartilage. Flat platinum electrodes were used to apply voltage, maintaining the flatness of the specimens for more precise mechanical testing through a uniaxial tension test of constant strain rate 0.01 mm/s. Above 2 V, both septal and auricular cartilage demonstrated a slight reduction in stiffness, quantified by the tangent modulus. A thermal effect was observed above 5 V, a newly identified EMR application threshold to avoid the dangers associated with thermoforming cartilage. Optimizing EMR application parameters and understanding various side effects bridge the gap between EMR laboratory research and clinical use, and the knowledge acquired through this mechanical study may be one additional support for that bridge.
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Use of lasers in acute management of surgical and traumatic incisions on the face.
Facial Plast Surg Clin North Am
PUBLISHED: 08-23-2011
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This article is a clinically practical review structured around the specific applications of laser technologies used in acute management of soft tissue injuries in surgical incisions and trauma. Surgical and traumatic incisions and injuries provide the clinician with the unique opportunity to follow the progression and maturation of the wound healing response from a very early stage. There has been a recent interest in early cosmetic optimization of surgical and traumatic wounds on the face using optical technologies. Early clinical results for acute laser intervention starting immediately after suture removal or the first several weeks after repair have been very promising.
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The future of medical diagnostics: review paper.
Head Neck Oncol
PUBLISHED: 08-13-2011
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While histopathology of excised tissue remains the gold standard for diagnosis, several new, non-invasive diagnostic techniques are being developed. They rely on physical and biochemical changes that precede and mirror malignant change within tissue. The basic principle involves simple optical techniques of tissue interrogation. Their accuracy, expressed as sensitivity and specificity, are reported in a number of studies suggests that they have a potential for cost effective, real-time, in situ diagnosis.We review the Third Scientific Meeting of the Head and Neck Optical Diagnostics Society held in Congress Innsbruck, Innsbruck, Austria on the 11th May 2011. For the first time the HNODS Annual Scientific Meeting was held in association with the International Photodynamic Association (IPA) and the European Platform for Photodynamic Medicine (EPPM). The aim was to enhance the interdisciplinary aspects of optical diagnostics and other photodynamic applications. The meeting included 2 sections: oral communication sessions running in parallel to the IPA programme and poster presentation sessions combined with the IPA and EPPM posters sessions.
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An evaluation of the use of smartphones to communicate between clinicians: a mixed-methods study.
J. Med. Internet Res.
PUBLISHED: 07-21-2011
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Communication between clinicians is critical to providing quality patient care but is often hampered by limitations of current systems. Smartphones such as BlackBerrys may improve communication, but studies of these technologies have been limited to date.
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Porcine cartilage model for simulation of nasal tip aesthetics and mechanics.
Aesthet Surg J
PUBLISHED: 07-02-2011
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The aesthetics of the human nose is highly dependent on the complex structure of the lower lateral cartilages (LLC). Understanding optimum shape and mechanical properties of the LLC is pivotal to achieving satisfactory results in nasal tip rhinoplasty.
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Real-time automated paging and decision support for critical laboratory abnormalities.
BMJ Qual Saf
PUBLISHED: 07-01-2011
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For patients with critical laboratory abnormalities, timely clinical alerts with decision support could improve management and reduce adverse events.
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Imaging vibrating vocal folds with a high speed 1050 nm swept source OCT and ODT.
Opt Express
PUBLISHED: 07-01-2011
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Vocal fold vibration is vital in voice production and the correct pitch of speech. We have developed a high speed functional optical coherence tomography (OCT) system with a center wavelength of 1050 nm and an imaging speed of 100,000 A-lines per second. We imaged the vibration of an ex-vivo swine vocal fold. At an imaging speed of 100 frames per second, we demonstrated high quality vocal fold images during vibration. Functional information, such as vibration frequency and vibration amplitude, was obtained by analyzing the tissue surface during vibration. The axial direction velocity distribution in the cross-sectional images of the vibrating vocal folds was obtained with the Doppler OCT. The quantitative transverse direction velocity distribution in the cross-sectional images was obtained with the Doppler variance images.
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Needle electrode-based electromechanical reshaping of rabbit septal cartilage: a systematic evaluation.
IEEE Trans Biomed Eng
PUBLISHED: 05-25-2011
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Electromechanical reshaping (EMR) provides a means of producing shape change in cartilage by initiating oxidation-reduction reactions in mechanically deformed specimens. This study evaluates the effect of voltage and application time on specimen shape change using needle electrodes. Rabbit septal cartilage specimens (20 x 8 x 1 mm, n = 200) were bent 90 degrees in a precision-machined plastic jig. Optimal electrode placement and the range of applied voltages were estimated using numerical modeling of the initial electric field within the cartilage sample. A geometric configuration of three platinum needle electrodes 2 mm apart from each other and inserted 6 mm from the bend axis on opposite ends was selected. One row of electrodes served as the anode and the other as the cathode. Constant voltage was applied at 1, 2, 4, 6, and 8 V for 1, 2, and 4 minutes, followed by rehydration in phosphate buffered saline. Samples were then removed from the jig and bend angle was measured. In accordance with previous studies, bend angle increased with increasing voltage and application time. Below a voltage threshold of 4 V, 4 minutes, no clinically significant reshaping was observed. The maximum bend angle obtained was 35.7 ± 1.7 º at 8 V, 4 minutes.
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Discovery of 6-(2,4-difluorophenoxy)-2-[3-hydroxy-1-(2-hydroxyethyl)propylamino]-8-methyl-8H-pyrido[2,3-d]pyrimidin-7-one (pamapimod) and 6-(2,4-difluorophenoxy)-8-methyl-2-(tetrahydro-2H-pyran-4-ylamino)pyrido[2,3-d]pyrimidin-7(8H)-one (R1487) as orally
J. Med. Chem.
PUBLISHED: 03-04-2011
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The development of a new series of p38? inhibitors resulted in the identification of two clinical candidates, one of which was advanced into a phase 2 clinical study for rheumatoid arthritis. The original lead, an lck inhibitor that also potently inhibited p38?, was a screening hit from our kinase inhibitor library. This manuscript describes the optimization of the lead to p38-selective examples with good pharmacokinetic properties.
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3-Amino-pyrazolo[3,4-d]pyrimidines as p38? kinase inhibitors: design and development to a highly selective lead.
Bioorg. Med. Chem. Lett.
PUBLISHED: 02-28-2011
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Learnings from previous Roche p38-selective inhibitors were applied to a new fragment hit, which was optimized to a potent, exquisitely selective preclinical lead with a good pharmacokinetic profile.
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Practical device for precise cutting of costal cartilage grafts to uniform thickness.
Arch Facial Plast Surg
PUBLISHED: 02-21-2011
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Costal cartilage is becoming increasingly popular as a graft source for facial reconstruction. However, carving methods have not changed in decades and continue to primarily rely on detailed maneuvers with a scalpel. There are few reports of mechanical devices for shaping costal cartilage, and to our knowledge their accuracy and precision have not been reported. We describe a simple costal cartilage slicing device that facilitates the production of sections having uniform, user-defined thicknesses.
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At the frontiers of surgery: review.
Head Neck Oncol
PUBLISHED: 02-07-2011
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The complete surgical removal of disease is a desirable outcome particularly in oncology. Unfortunately much disease is microscopic and difficult to detect causing a liability to recurrence and worsened overall prognosis with attendant costs in terms of morbidity and mortality. It is hoped that by advances in optical diagnostic technology we could better define our surgical margin and so increase the rate of truly negative margins on the one hand and on the other hand to take out only the necessary amount of tissue and leave more unaffected non-diseased areas so preserving function of vital structures. The task has not been easy but progress is being made as exemplified by the presentations at the 2nd Scientific Meeting of the Head and Neck Optical Diagnostics Society (HNODS) in San Francisco in January 2010. We review the salient advances in the field and propose further directions of investigation.
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p53 codon 271 CGT to CAT mutant fraction does not increase in nasal respiratory and olfactory epithelia of rats exposed to inhaled naphthalene.
Mutat. Res.
PUBLISHED: 02-04-2011
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A 2-year rat tumor bioassay testing whole body exposure to naphthalene (NA) vapor found a significant increase in nasal respiratory epithelial adenomas in male rats and in olfactory epithelial neuroblastomas in female rats. To obtain mechanistic insight into NA-induced nasal carcinogenesis, NA dose-response was characterized in nasal epithelium using a tumor-relevant endpoint. Specifically, levels of p53 codon 271 CGT to CAT mutation were measured in nasal respiratory and olfactory epithelium of NA-exposed male and female rats by allele-specific competitive blocker-PCR (ACB-PCR). Male and female, 8-9 week-old F344 rats (5 rats/group) were exposed to 0, 0.1, 1.0, 10, and 30ppm NA vapor for 13 weeks (6h/day, 5 days/week). The geometric mean p53 mutant fraction (MF) levels in nasal epithelium of control treatment groups ranged between 2.05 × 10(-5) and 3.05 × 10(-5). No significant dose-related changes in p53 mutant fraction (MF) were observed in the olfactory or respiratory epithelia of female rats. However, statistically significant treatment-related differences were observed in male respiratory and olfactory epithelium, with the p53 MF in the respiratory epithelium of male rats exposed to 30ppm NA significantly lower than that in controls. Further, a significant trend of decreasing p53 MF with increasing dose was observed in the male respiratory epithelium. Of the tissue types analyzed, respiratory epithelium is the most sensitive to the cytotoxic effects of NA, suggesting cytotoxicity may be responsible for the loss of p53 mutation. Because ACB-PCR has been used successfully to detect the effects of known mutagenic carcinogens, the absence of any significant increases in p53 MF associated with NA exposure adds to the weight of evidence that NA does not operate through a directly mutagenic mode of action.
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Electromechanical reshaping of costal cartilage grafts: a new surgical treatment modality.
Laryngoscope
PUBLISHED: 01-21-2011
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Needle electrode-based electromechanical reshaping (EMR) is a novel, ultra-low-cost nascent surgical technology to reshape cartilage with low morbidity. EMR uses direct current to induce mechanical relaxation in cartilage that is first deformed into a required geometry, which in turn leads to permanent shape change. The objective of this study was to determine the effect of EMR voltage and time on the shape change of costal cartilage grafts.
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Vascular endothelial growth factor-D is overexpressed in human cardiac allograft vasculopathy and diabetic atherosclerosis and induces endothelial permeability to low-density lipoproteins in vitro.
J. Heart Lung Transplant.
PUBLISHED: 01-21-2011
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Vascular endothelial growth factor (VEGF)-D is a member of the VEGF family, which can induce angiogenesis and lymphangiogenesis. We have previously demonstrated a role for VEGF-A in cardiac allograft vasculopathy (CAV). Our experiments profile the expression and localization of VEGF-D in human native atherosclerosis (NA), diabetes mellitus with atherosclerosis (DM) and CAV, and we investigate its ability to induce low-density lipoprotein (LDL) permeability in human cardiac microvascular endothelial cells (HCMEC).
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Nasal tip projection and facial attractiveness.
Laryngoscope
PUBLISHED: 01-18-2011
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Six nasal tip projection (NTP) ratios from Goode, Simons, Baum, Powell, and Crumley guide clinical and academic practice on quantifying NTP, but none have been empirically correlated with facial attractiveness. This studys objectives were to determine: 1) if there is a correlation between these ratios and facial attractiveness; and 2) which of the six ratios has the greatest linkage to overall facial attractiveness.
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Novel endoscopic management of penetrating intracranial trauma.
Ann. Otol. Rhinol. Laryngol.
PUBLISHED: 12-15-2010
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We report a unique case of minimally invasive endoscopic removal of a penetrating orbitocranial foreign body (POCFB), and present a review of the literature. A 12-year-old boy was impaled in the orbit with a gate latch. Neurosurgical consultation ascertained that removal via bifrontal craniotomy would necessitate extensive brain retraction and result in permanent anosmia. Attempting nasal endoscopic removal was deemed prudent, given this morbidity and a lack of brain parenchymal violation. The patient recovered without a cerebrospinal fluid leak or other neurologic sequelae. To date, craniotomy is the only reported management of POCFBs in the literature. We herein report the first nasal endoscopic removal of a POCFB.
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Stabilization of costal cartilage graft warping using infrared laser irradiation in a porcine model.
Arch Facial Plast Surg
PUBLISHED: 11-17-2010
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To develop a method to rapidly stabilize the shape change process in peripheral slices of costal cartilage by using infrared laser irradiation in a porcine model.
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Semi-resonant operation of a fiber-cantilever piezotube scanner for stable optical coherence tomography endoscope imaging.
Opt Express
PUBLISHED: 10-14-2010
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A forward-view optical coherence tomography (OCT) scanning catheter has been developed based on a fiber-cantilever piezotube scanner by using a semi-resonant scan strategy for a better scan performance. A compact endoscope catheter was fabricated by using a tubular piezoelectric actuator with quartered electrodes in combination with a resonant fiber cantilever. A cantilever weight was attached to the fiber cantilever to reduce the resonance frequency down to 63 Hz, well in the desirable range for Fourier-domain OCT. The resonant-cantilever scanner was driven at semi-resonance frequencies that were well out of the resonance peak but within a range of partial resonance. This driving strategy has been found to minimize the phase difference between the two scan axes for a better scan stability against environmental perturbations as well as for a driving simplicity. By driving the two axes at slightly different frequencies, a low-order Lissajous pattern has been obtained for a 2D area scan. 3D OCT images have been successfully acquired in an acquisition time of 1.56 seconds for a tomogram volume of 2.2 × 2.2 × 2.1 mm(3). They were reconstructed without any scan calibration by extracting the scan timing from the image data. In addition, it has been found that the Lissajous scan strategy provides a means to compensate the relative axial motion of a sample for a correct imaged morphology.
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Pairwise network mechanisms in the host signaling response to coxsackievirus B3 infection.
Proc. Natl. Acad. Sci. U.S.A.
PUBLISHED: 09-10-2010
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Signal transduction networks can be perturbed biochemically, genetically, and pharmacologically to unravel their functions. But at the systems level, it is not clear how such perturbations are best implemented to extract molecular mechanisms that underlie network function. Here, we combined pairwise perturbations with multiparameter phosphorylation measurements to reveal causal mechanisms within the signaling network response of cardiomyocytes to coxsackievirus B3 (CVB3) infection. Using all possible pairs of six kinase inhibitors, we assembled a dynamic nine-protein phosphorylation signature of perturbed CVB3 infectivity. Cluster analysis of the resulting dataset showed repeatedly that paired inhibitor data were required for accurate data-driven predictions of kinase substrate links in the host network. With pairwise data, we also derived a high-confidence network based on partial correlations, which identified phospho-I?B? as a central "hub" in the measured phosphorylation signature. The reconstructed network helped to connect phospho-I?B? with an autocrine feedback circuit in host cells involving the proinflammatory cytokines, TNF and IL-1. Autocrine blockade substantially inhibited CVB3 progeny release and improved host cell viability, implicating TNF and IL-1 as cell autonomous components of CVB3-induced myocardial damage. We conclude that pairwise perturbations, when combined with network-level intracellular measurements, enrich for mechanisms that would be overlooked by single perturbants.
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Robotic single-incision transabdominal and transvaginal surgery: initial experience with intersecting robotic arms.
Int J Med Robot
PUBLISHED: 09-03-2010
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Single-incision laparoscopic and natural orifice translumenal endoscopic surgery (NOTES) are technically challenging methods. Robotics might have the potential to overcome such hurdles with computer technology.
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Optical coherence tomography of cholesteatoma.
Otol. Neurotol.
PUBLISHED: 08-05-2010
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To image cholesteatoma using optical coherence tomography (OCT) and correlate the results with clinical findings and conventional observations obtained using binocular microscopy and histology. OCT is a high-resolution optical imaging modality that generates cross-sectional images of turbid media, such as tissue with resolution approaching that of light microscopy. OCT relies on intrinsic differences in tissue optical properties for image contrast.
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Survival of chondrocytes in rabbit septal cartilage after electromechanical reshaping.
Ann Biomed Eng
PUBLISHED: 07-30-2010
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Electromechanical reshaping (EMR) has been recently described as an alternative method for reshaping facial cartilage without the need for incisions or sutures. This study focuses on determining the short- and long-term viability of chondrocytes following EMR in cartilage grafts maintained in tissue culture. Flat rabbit nasal septal cartilage specimens were bent into semi-cylindrical shapes by an aluminum jig while a constant electric voltage was applied across the concave and convex surfaces. After EMR, specimens were maintained in culture media for 64 days. Over this time period, specimens were serially biopsied and then stained with a fluorescent live-dead assay system and imaged using laser scanning confocal microscopy. In addition, the fraction of viable chondrocytes was measured, correlated with voltage, voltage application time, electric field configuration, and examined serially. The fraction of viable chondrocytes decreased with voltage and application time. High local electric field intensity and proximity to the positive electrode also focally reduced chondrocyte viability. The density of viable chondrocytes decreased over time and reached a steady state after 2-4 weeks. Viable cells were concentrated within the central region of the specimen. Approximately 20% of original chondrocytes remained viable after reshaping with optimal voltage and application time parameters and compared favorably with conventional surgical shape change techniques such as morselization.
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Near-infrared imaging of the sinuses: preliminary evaluation of a new technology for diagnosing maxillary sinusitis.
J Biomed Opt
PUBLISHED: 07-10-2010
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Diagnosing sinusitis remains a challenge for primary care physicians. There is a need for a simple, office-based technique to aid in the diagnosis of sinusitis without the cost and radiation risk of conventional radiologic imaging. We designed a low-cost near-infrared (NIR) device to transilluminate the maxillary sinuses. The use of NIR light allows for greater interrogation of deep-tissue structures as compared to visible light. NIR imaging of 21 patients was performed and compared with computed tomography (CT) scans. Individual maxillary sinuses were scored on a scale from 0 to 2 based on their degree of aeration present on CT and similarly based on the NIR signal penetration into the maxilla on NIR images. Our results showed that air-filled and fluid/tissue-filled spaces can be reasonably distinguished by their differing NIR signal penetration patterns, with average NIR imaging scores for fluid-filled maxillary sinuses (0.93+/-0.78, n=29) significantly lower than those for normal maxillary sinuses (1.62+/-0.57, n=13) (p=0.003). NIR imaging of the sinuses is a simple, safe, and cost-effective modality that can potentially aid in the diagnosis of sinusitis. Long-term, significant device refinement and large clinical trials will be needed to determine the diagnostic accuracy of this technique.
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Teaching quality improvement and patient safety to trainees: a systematic review.
Acad Med
PUBLISHED: 06-15-2010
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To systematically review published quality improvement (QI) and patient safety (PS) curricula for medical students and/or residents to (1) determine educational content and teaching methods, (2) assess learning outcomes achieved, and (3) identify factors promoting or hindering curricular implementation.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.