Role of corticosteroids in Functional Endoscopic Sinus Surgery - a systematic review and meta-analysis

Background: The aim of our study is to systematically review the existing evidence on the role of corticosteroids in patients undergoing functional endoscopic sinus surgery (FESS).  Methodology: Systematic search of MEDLINE (1950- 2014), EMBASE (1980-2014), metaRegister, Cochrane Library and ISI conference proceedings was carried out.  Results: Eighteen randomised controlled trials with 1309 patients were included. Use of local and/or systemic corticosteroids with FESS was reported in four categories; operative, anaesthesia related, post-operative outcomes and risk of recurrence. Metaanalysis for operative outcomes demonstrated that, mean operative time (MD -10.70 minutes; 95% CI -15.86, -5.55; P <0.0001) and mean estimated blood loss (MD -28.32 mls; 95% CI -40.93, -15.72; P <0.0001) was significantly lower; and surgical field quality (MD -0.81; 95% CI -1.32, -0.30; P = 0.002) was significantly better in corticosteroid group. Meta-analysis showed that post-operative endoscopic scores (SMD -0.39; 95% CI -0.60, -0.17; P = 0.0004) were significantly better in corticosteroid group compared to no corticosteroid group. There was no increase in risk of sinusitis (RR 0.64; 95% CI 0.32, 1.30; P = 0.22) between use of corticosteroids and no corticosteroids; There was no significant difference in recurrence risk of chronic rhinosinusitis (CRS) in mixed population studies (RR 0.77; 95% CI 0.35, 1.70; P = 0.52) between the two groups but analysis of studies reporting on chronic rhinosinusitis with nasal polyps (CRSwNP) (RR 0.64;95% CI 0.45,0.91;P=0.01) showed significant difference in favour of the corticosteroid group.  Conclusion: Pre-operative use of local and/or systemic corticosteroids in FESS, results in significantly reduced blood loss, shorter operative time and improved surgical field quality. Studies are limited on the intra-operative use of corticosteroids to reduce postoperative pain. Postoperative corticosteroids improve postoperative endoscopic scores in CRS and recurrence rates in cases of CRSwNP

Nanoscale LiZnN - luminescent half-Heusler quantum dots

Colloidal semiconductor quantum dots are a well-established technology, with numerous materials available either commercially or through the vast body of literature. The prevalent materials are cadmium-based and are unlikely to find general acceptance in most applications. While the III-V family of materials is a likely substitute, issues remain about its long-term suitability, and other earth-abundant materials are being explored. In this report, we highlight a nanoscale half-Heusler semiconductor, LiZnN, composed of readily available elements as a potential alternative system to luminescent II-VI and III-V nanoparticle quantum dots

Growth hormone action predicts age-related white adipose tissue dysfunction and senescent cell burden in mice

The aging process is associated with the development of several chronic diseases. White adipose tissue (WAT) may play a central role in age-related disease onset and progression due to declines in adipogenesis with advancing age. Recent reports indicate that the accumulation of senescent progenitor cells may be involved in age-related WAT dysfunction. Growth hormone (GH) action has profound effects on adiposity and metabolism and is known to influence lifespan. In the present study we tested the hypothesis that GH activity would predict age-related WAT dysfunction and accumulation of senescent cells. We found that long-lived GH-deficient and -resistant mice have reduced age-related lipid redistribution. Primary preadipocytes from GH-resistant mice also were found to have greater differentiation capacity at 20 months of age when compared to controls. GH activity was also found to be positively associated with senescent cell accumulation in WAT. Our results demonstrate an association between GH activity, age-related WAT dysfunction, and WAT senescent cell accumulation in mice. Further studies are needed to determine if GH is directly inducing cellular senescence in WAT or if GH actions on other target organs or alternative downstream alterations in insulin-like growth factor-1, insulin or glucose levels are responsible

Hypogene Calcitization: Evaporite Diagenesis in the Western Delaware Basin

Evaporite calcitization within the Castile Formation of the Delaware Basin is more widespread and diverse than originally recognized. Coupled field and GIS studies have identified more than 1000 individual occurrences of calcitization within the Castile Formation outcrop area, which includes both calcitized masses (limestone buttes) and laterally extensive calcitized horizons (limestone sheets). Both limestone buttes and sheets commonly contain a central brecciated zone that we attribute to hypogene dissolution. Lithologic fabric of calcitized zones ranges from little alteration of original varved laminae to fabrics showing extensive laminae distortion as well as extensive vuggy and open cavernous porosity. Calcitization is most abundant in the western portion of the Castile outcrop region where surface denudation has been greatest. Calcitization often forms linear trends, indicating fluid migration along fractures, but also occurs as dense clusters indicating focused, ascending, hydrocarbon-rich fluids. Native sulfur, secondary tabular gypsum (i.e. selenite) and hypogene caves are commonly associated with clusters of calcitization. This assemblage suggests that calcium sulfate diagenesis within the Castile Formation is dominated by hypogene speleogemesis

A novel, integrated in vitro carcinogenicity test to identify genotoxic and non-genotoxic carcinogens using human lymphoblastoid cells

Human exposure to carcinogens occurs via a plethora of environmental sources, with 70–90% of cancers caused by extrinsic factors. Aberrant phenotypes induced by such carcinogenic agents may provide universal biomarkers for cancer causation. Both current in vitro genotoxicity tests and the animal-testing paradigm in human cancer risk assessment fail to accurately represent and predict whether a chemical causes human carcinogenesis. The study aimed to establish whether the integrated analysis of multiple cellular endpoints related to the Hallmarks of Cancer could advance in vitro carcinogenicity assessment. Human lymphoblastoid cells (TK6, MCL-5) were treated for either 4 or 23 h with 8 known in vivo carcinogens, with doses up to 50% Relative Population Doubling (maximum 66.6 mM). The adverse effects of carcinogens on wide-ranging aspects of cellular health were quantified using several approaches; these included chromosome damage, cell signalling, cell morphology, cell-cycle dynamics and bioenergetic perturbations. Cell morphology and gene expression alterations proved particularly sensitive for environmental carcinogen identification. Composite scores for the carcinogens’ adverse effects revealed that this approach could identify both DNA-reactive and non-DNA reactive carcinogens in vitro. The richer datasets generated proved that the holistic evaluation of integrated phenotypic alterations is valuable for effective in vitro risk assessment, while also supporting animal test replacement. Crucially, the study offers valuable insights into the mechanisms of human carcinogenesis resulting from exposure to chemicals that humans are likely to encounter in their environment. Such an understanding of cancer induction via environmental agents is essential for cancer prevention

BEST PRACTICES IN FAMILY CENTERED CARE IN THE NEONATAL INTENSIVE CARE UNIT

The purpose of this thesis is to determine best practice recommendations for family centered care (FCC) in the neonatal intensive care unit (NICU). The care received in the NICU has an impact on the outcomes of the neonates as well as their parents who have to endure the stress and bear the financial cost of having a baby in the NICU. A literature review was conducted to identify evidenced based recommendations for FCC that would positively impact patient outcomes and parental stress. These recommendations provide hospitals and nurses with guidelines for implementing FCC in their own NICUs. The best practice recommendations for family centered care in the NICU include high parental involvement in the neonates’ care through education on bathing, changing diapers, checking temperature, infant development, hand hygiene, feeding methods, skin to skin contact and infection control. Additionally, adequate space and staffing need to be available for nurses to provide education and families to spend sufficient time in the NICU. Finally, virtual visitation must be available for families who cannot be present in the NICU. The final chapter proposes an implementation and evaluation plan using the Plan-Do-Study-Act framework

THE EFFECT OF MODELED RULE VIOLATION ON OBSERVER RESPONSE

This research investigated the effect of modeled rule violation behavior on observer response within a small group setting. Students decided whether or not they would engage in a modeled behavior that was in conflict with instructions that were given prior to the beginning of a task. Bandura (1965) described the acquisition of new responses from observing others as vicarious learning, a central concept within social learning theory. Model and observer characteristics as well as moral reasoning levels were identified as being important variables in influencing observer response to modeled behavior. One hundred and thirty-one students attending an urban, midwestern university participated in this study. Students were randomly placed in one of six experimental conditions (low, medium, high DIT/model/control). They were asked to view a series of eighty slides of human faces and write the first descriptive word that came to mind. Candy was available after completion of the task. Students in the model condition were exposed to a model who took candy prior to the completion of the task. The model observed the response of the students and noted any rule violations. Students in the control condition were requested to complete the task without a model present. Students were asked to complete an eighteen item questionnaire which provided an opportunity for them to express their feelings about the experimental and control group experiences. Eight one-way, eight two-factor ANOVAS and ten chi-square tests were performed, utilizing self reported rule violation, confrontive behavior, comfort level, performance satisfaction, judgment of model behavior, and model attribution responses as dependent variables. The chi-square revealed significant relationships between model sex, subject sex, DIT level and self reported rule violation responses. There was a significant relationship between experimental grouping (model/control) and self reported rule violation. ANOVA revealed no main effects for moral reasoning level, experimental condition, model or subject sex on any of the dependent measures, nor any significant interactions on any of the dependent measures. This study suggests the need to examine more fully the types of modeled behaviors in which students are willing to engage and whether moral reasoning level and model and observer characteristics will play a role in determining observer resistance or yielding to the modeled behavior. The implications of this study may assist educators in understanding some of the factors that influence behavior of contemporary college students

Better Together?: Intimate Partner Effects on Offending Women

The role of marriage has been extensively studied for its positive impacts on male desistance. However, the role of romantic partners for women is less understood. Do partners exert a prosocial “protective” effect or are they criminogenic? The present study empirically drills down on this question. Specifically, we assess the character and quality of romantic relationships on substance use and illegitimate income using a sample of incarcerated women. Drawing from social control, social learning, and strain theory, we hypothesize that the effects of both being in and breaking up from a relationship on illicit behavior are conditional on the quality of the relationship and behavior/characteristics of the partner. Using data from the Women’s Experience of Violence (WEV) project, consisting of a custodial sample of criminal justice-involved women (N = 770), we examine how relationship status and quality, as well as partner offending, influence drug use and illicit earnings. A series of multi-level random effects models are estimated to explore how within-person changes in relationship/breakup status are related to changes in the two dependent variables. Contrary to expectations, we find that romantic dissolution (of either a high- or low-quality relationship) does not negatively impact this sample of women and that being in a high-quality relationship is not a protective factor, as has been found often in male samples. Findings suggest partner behavior may be more important than the quality of the relationship with the partner. Our results link drug use and participation in the illicit economy to factors mostly outside of a woman’s relationship status and quality, thereby challenging some commonly understood mechanisms of desistance