Evaluating the incidence, clinical significance and predictors for vocal cord palsy and incidental laryngopharyngeal conditions before elective thyroidectomy: is there a case for routine laryngoscopic examination?

Background: Routine preoperative laryngeal examination remains controversial. We aimed to assess the utility of preoperative routine flexible laryngoscopy (FL) by looking at the incidence, clinical significance and predictors for preoperative vocal cord paresis (VCP) and incidental laryngopharyngeal conditions (LPC) in our consecutive cohort. Methods: A total of 302 patients underwent laryngeal examination by an independent otorhinolaryngologist and were specifically asked about voice/swallowing symptoms suggestive of VCP 1 day before surgery. As well as vocal cord (VC) mobility, the naso-pharynx and larynx were examined using FL. Any VCP and/or LPC was recorded. VCP was defined as reduced or absent movement in one or more VC. An LPC was considered clinically significant if the ensuing thyroidectomy was changed or deferred. Results: Seven (2.3 %) patients had preoperative VCP, while an additional seven patients had an incidental LPC. Of the seven VCPs, five were caused by previous thyroidectomy, while two were caused by a benign goitre. The incidence of asymptomatic VCP in a previously non-operated cohort was 1/245 (0.41 %). Voice/swallowing symptoms (p = 0.033) and previous thyroidectomy (p < 0.001) were the two significant predictors for VCP. The seven incidental LPCs were vallecular cyst (n = 1), VC scar and polyp (n = 2), nasopharyngeal cyst and polyp (n = 3) and redundant arytenoid mucosa (n = 1); however, as they were benign, all seven patients proceeded to thyroidectomy as planned. Conclusions: Given the low incidence (0.41 %) of asymptomatic VCP in a previously non-operated cohort and that none of the seven LPCs were considered clinically significant, routine preoperative laryngoscopic examination should be reserved for those with previous thyroidectomy and/or voice/swallowing symptoms. © 2013 Société Internationale de Chirurgie.postprin

Randomized Clinical Trial on Preventing Root Caries among Community-Dwelling Elders

Dental root caries is a common disease among elders. More efforts on preventing this disease are needed. Silver diammine fluoride (SDF) is known to prevent dental caries in primary teeth. However, clinical evidence of its efficacy in preventing root surface caries is limited. This clinical trial aimed to compare the effectiveness of SDF in preventing root caries among elders in a water fluoridated area. A total of 323 elders who had at least 5 teeth with exposed root surfaces and who had self-care ability were randomly allocated into 3 intervention groups: group 1 (placebo control), annual application of tonic water; group 2, annual application of SDF solution; group 3, annual application of SDF solution, immediately followed by potassium iodide (KI) solution. Oral hygiene instructions and fluoride toothpaste were provided to all subjects. Status of dental root surface was assessed every 6 mo by the same independent examiner. After 30 mo, 257 (79.6%) elders were reviewed. The mean numbers of root surface with new caries experience in the control, SDF, and SDF/KI groups were 1.1, 0.4, and 0.5, respectively (analysis of variance, P 0.05). Moreover, elders who had higher visible plaque index scores at 30-mo examination (analysis of covariance, P < 0.001) and those who had higher baseline DMFT scores (analysis of covariance, P = 0.005) developed more new root caries. It is concluded that annual application of SDF or SDF/KI solution is effective in preventing root caries among community-dwelling elders in a fluoridated area (ClinicalTrials.gov NCT02360124).postprin

Interpretations of J/ψJ/\psi suppression

We review the two main interpretations of $J/\psi$ suppression proposed in the literature. The phase transition (or deconfining) scenario assumes that below some critical value of the local energy density (or of some other geometrical quantity which depends both on the colliding systems and on the centrality of the collision), there is only nuclear absorption. Above this critical value the absorptive cross-section is taken to be infinite, i.e. no $J/\psi$ can survive in this hot region. In the hadronic scenario the $J/\psi$ dissociates due both to nuclear absorption and to its interactions with co-moving hadrons produced in the collision. No discontinuity exists in physical observables. We show that an equally good description of the present data is possible in either scenario.Comment: 12 pages, LaTeX, uses epsfig and ioplppt; review talk given by A. Capella at the International Symposium on Strangness in Quark Matter, Santorini (Greece), April 1997; Figs. 1 and 2 not available but can be found in Refs. 13 and 6 respectivel

Quasi-Elliptic Bandpass Frequency Selective Surface Based on Coupled Stubs-Loaded Ring Resonators

© 2013 IEEE. In this paper, a novel design of frequency-selective surface (FSS) based on coupled stubs-loaded ring resonators (SLRRs) is proposed. The proposed FSS exhibits quasi-elliptic bandpass filtering characteristic at C-band. And each unit cell of the structure is composed of two SLRRs coupled by a circular aperture. A novel method of transmission line (TL) model is proposed to investigate the operating principle of a single SLRR under normal incidence plane wave. Moreover, the operating mechanism of the proposed FSS is further researched with the aid of the equivalent circuit model (ECM) analysis method. Due to the symmetric and low-profile physical structure, the FSS keeps stable frequency response under oblique incident plane wave for both transverse electric (TE) and transverse magnetic (TM) polarizations. Finally, the designed FSS is fabricated and measured. The measured results agree well with the simulated results. The measured results indicate that the proposed FSS exhibits a dual-polarized and stable bandpass frequency response with two transmission zeros (TZs) at around 5.71 and 6.87 GHz under different incident angles up to 40°

Testing and comparing two self-care-related instruments among older Chinese adults

Objectives The study aimed to test and compare the reliability and validity, including sensitivity and specificity of the two self-care-related instruments, the Self-care Ability Scale for the Elderly (SASE), and the Appraisal of Self-care Agency Scale-Revised (ASAS-R), among older adults in the Chinese context. Methods A cross-sectional design was used to conduct this study. The sample consisted of 1152 older adults. Data were collected by a questionnaire including the Chinese version of SASE (SASE-CHI), the Chinese version of ASAS-R (ASAS-R-CHI) and the Exercise of Self-Care Agency scale (ESCA). Homogeneity and stability, content, construct and concurrent validity, and sensitivity and specificity were assessed. Results The Cronbach's alpha (α) of SASE-CHI was 0.89, the item-to-total correlations ranged from r = 0.15 to r = 0.81, and the test-retest correlation coefficient (intra-class correlation coefficient, ICC) was 0.99 (95% CI, 0.99±1.00; P<0.001). The Cronbach's α of ASAS-R-CHI was 0.78, the item-to-total correlations ranged from r = 0.20 to r = 0.65, and the test-retest ICC was 0.95 (95% CI, 0.92±0.96; P<0.001). The content validity index (CVI) of SASE-CHI and ASAS-R-CHI was 0.96 and 0.97, respectively. The findings of exploratory and confirmatory factor analyses (EFA and CFA) confirmed a good construct validity of SASE-CHI and ASAS-R-CHI. The Pearson's rank correlation coefficients, as a measure of concurrent validity, between total score of SASE-CHI and ESCA and ASAS-R-CHI and ESCA were assessed to 0.65 (P<0.001) and 0.62 (P<0.001), respectively. Regarding ESCA as the criterion, the area under the receiver operator characteristic (ROC) curve for the cut-point of SASE-CHI and ASAS-R-CHI were 0.93 (95% CI, 0.91±0.94) and 0.83 (95% CI, 0.80±0.86), respectively. Conclusion There is no significant difference between the two instruments. Each has its own characteristics, but SASE-CHI is more suitable for older adults. The key point is that the users can choose the most appropriate scale according to the specific situation.publishedVersionNivå

Effect of telephone intervention on stoma self-care of colostomy patients

2010-2011 > Academic research: refereed > Publication in refereed journalVersion of RecordPublishe

Bezielle Selectively Targets Mitochondria of Cancer Cells to Inhibit Glycolysis and OXPHOS

Bezielle (BZL101) is a candidate oral drug that has shown promising efficacy and excellent safety in the early phase clinical trials for advanced breast cancer. Bezielle is an aqueous extract from the herb Scutellaria barbata. We have reported previously that Bezielle was selectively cytotoxic to cancer cells while sparing non-transformed cells. In tumor, but not in non-transformed cells, Bezielle induced generation of ROS and severe DNA damage followed by hyperactivation of PARP, depletion of the cellular ATP and NAD, and inhibition of glycolysis. We show here that tumor cells' mitochondria are the primary source of reactive oxygen species induced by Bezielle. Treatment with Bezielle induces progressively higher levels of mitochondrial superoxide as well as peroxide-type ROS. Inhibition of mitochondrial respiration prevents generation of both types of ROS and protects cells from Bezielle-induced death. In addition to glycolysis, Bezielle inhibits oxidative phosphorylation in tumor cells and depletes mitochondrial reserve capacity depriving cells of the ability to produce ATP. Tumor cells lacking functional mitochondria maintain glycolytic activity in presence of Bezielle thus supporting the hypothesis that mitochondria are the primary target of Bezielle. The metabolic effects of Bezielle towards normal cells are not significant, in agreement with the low levels of oxidative damage that Bezielle inflicts on them. Bezielle is therefore a drug that selectively targets cancer cell mitochondria, and is distinguished from other such drugs by its ability to induce not only inhibition of OXPHOS but also of glycolysis. This study provides a better understanding of the mechanism of Bezielle's cytotoxicity, and the basis of its selectivity towards cancer cells

A new species of Argyromys (Rodentia, Mammalia) from the oligocene of the valley of lakes (Mongolia): its importance for palaeobiogeographical homogeneity across Mongolia, China and Kazakhstan

We describe a new species of Rodentia (Mammalia), Argyromys cicigei sp. nov. from Toglorhoi (fossil bed TGW-A/2a) in Mongolia and Ulantatal (fossil beds UTL 1 and UTL 7) in China. Its tooth morphology differs from the type species Argyromys aralensis from Akespe in Kazakhstan by smaller size and simpler structures. Argyromys has been assigned in different families of Muroidea, such as Tachyoryctoididae and Spalacidae. However, the presence of common characters indicates a closer relationship of Argyromys with the genera of Cricetidae s.l. (subfamilies Eucricetodontinae; Cricetopinae; Cricetodontinae and Gobicricetodontinae among others) from Asia than with the earliest representatives of Spalacidae or the endemic Tachyoryctoididae. Argyromys cicigei sp. nov. possesses a simple anterocone and anteroconid in the upper and lower first molars, respectively, which is characteristic for Cricetidae s.l. It has a flat occlusal surface in worn specimens; weakly-developed posterolophs; an oblique protolophule and metaloph on the upper molars and it lacks a labial anterolophid on the m1. These traits are also typical of the Oligocene genera Aralocricetodon and Plesiodipus, included in the subfamilies Cricetodontinae and Gobicricetodontinae respectively. The cladistic analysis performed here supports this hypothesis. The clade formed by Argyromys species is grouped with other cricetid taxa (s.l). Spalacids, however, form a different clade, as do the tachyoryctoids. Previous authors state that the Aral Formation (Kazakhstan) should be dated to the Oligocene instead of the Miocene, based on the presence of several taxa. The finds of Argyromys in both regions supports the statement that they are closer in age than previously thought. The occurrence of Argyromys in Kazakhstan, Mongolia and China evidences the biogeographic unity of the Central Asian bioprovince during the Oligocene