Δευτέρα 18 Απριλίου 2016

quality of care; +21 new citations

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quality of care

These pubmed results were generated on 2016/04/18

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IJMS, Vol. 17, Pages 586: Chromosome 9p21 and ABCA1 Genetic Variants and Their Interactions on Coronary Heart Disease and Ischemic Stroke in a Chinese Han Population

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The single nucleotide polymorphisms (SNPs) related to both coronary heart disease (CHD) and ischemic stroke (IS) in Chinese individuals have not been identified definitely. This study was developed to evaluate the genetic susceptibility to CHD and IS on the chromosome 9p21 and the adenosine triphosphate (ATP)-binding cassette transporter A1 genes (ABCA1) in a Chinese Han population. Genotypes of the rs1333040, rs1333042, rs4977574, rs2066715 and rs2740483 SNPs were determined in 1134 unrelated patients (CHD, 565 and IS, 569) and 541 controls. The frequencies of the rs4977574 genotypes and alleles between CHD and control groups, and the rs2740483 genotypes and alleles between IS and control groups were different (p = 0.006–0.001). The subjects with rs1333042GG genotype and the carriers of the rs4977574G allele were associated with increased risk of CHD. The carriers of the rs4977574G allele were associated with increased risk of IS. However, the carriers of the rs2740483C allele had lower risk of IS than the non-carriers of the rs2740483C allele after controlling for potential confounders. The rs4977574GG-age (>60 year) interaction increased the risk of CHD (p = 0.022), whereas the rs2740483CG/CC-body mass index (>24 kg/m2) interaction decreased the risk of IS (p = 0.035). The interactions of rs1333040-rs1333042 on the risk of CHD and IS were relatively strong, whereas the interactions of rs1333040-rs1333042-rs2066715 and rs1333040-rs1333042-rs2066715-rs2740483 on the risk of CHD, and rs1333040-rs1333042-rs4977574 and rs1333040-rs1333042-rs4977574-rs2740483 on the risk of IS were relatively weak. These findings suggest that some common variants on the chromosome 9p21 and ABCA1 and their interactions may significantly modify the risk of CHD and IS independent of effects on serum lipid levels.

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Panniculectomy and Cystectomy: An Approach to the Morbidly Obese Patient

The obese patient undergoing radical cystectomy faces a unique set of challenges. We present the case of a 68-year-old gentleman who presented to our institution with Bacillus Calmette-Guerin refractory disease, a body mass index of 38.5, and a large pannus. The present paper describes our technique for performing radical cystectomy with ileal conduit urinary diversion and concomitant panniculectomy. We discuss the impact of obesity on patients undergoing radical cystectomy and how this may be mitigated by panniculectomy.

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Gigantomastia and Macroprolactinemia Responding to Cabergoline Treatment: A Case Report and Minireview of the Literature

Background. Macroprolactinemia is defined as predominance of high molecular weight prolactin forms in the circulation. Although macroprolactin is considered as a biologically inactive molecule, some authorities suggest treatment in symptomatic cases. Gigantomastia is defined as excess breast tissue and most cases in the literature were treated by surgical intervention. Case. A 44-year-old woman was admitted to our clinic with gigantomastia and galactorrhea. The patient had a demand for surgical therapy. In laboratory examination, she had hyperprolactinemia and macroprolactinemia. Pituitary imaging revealed 6 mm microadenoma in right side of the hypophysis. Since she was symptomatic, cabergolin treatment was started. Macroprolactin became negative, breast circumference decreased significantly, and galactorrhea resolved after treatment. Conclusion. Gigantomastia might be the presenting symptom in patients with macroprolactinemia. In these patients medical treatment with cabergoline may be used initially as an alternative to surgical approach.

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Effect of Alkaloids Isolated from Phyllodium pulchellum on Monoamine Levels and Monoamine Oxidase Activity in Rat Brain

Phyllodium pulchellum (P. pulchellum) is a folk medicine with a significant number of bioactivities. The aim of this study was to investigate the effects displayed by alkaloids fractions, isolated from the roots of P. pulchellum, on neurotransmitters monoamine levels and on monoamine oxidase (MAO) activity. Six alkaloids, which had indolealkylamine or β-carboline skeleton, were obtained by chromatographic technologies and identified by spectroscopic methods such as NMR and MS. After treatment with alkaloids of P. pulchellum, the reduction of DA levels (54.55%) and 5-HT levels (35.01%) in rat brain was observed by HPLC-FLD. The effect of alkaloids on the monoamines metabolism was mainly related to MAO inhibition, characterized by IC50 values of and  μg/mL for MAO-A and MAO-B, respectively. The acute toxicity indicated that P. pulchellum extract was nontoxic.

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Ultra-High and Near-Zero Refractive Indices of Magnetron Sputtered Thin-Film Metamaterials Based on TixOy

Metamaterials based on with ultra-high and near-zero refractive indices were obtained by DC magnetron sputtering. The data on refractive indices, extinction coefficients, film thickness, and band gaps, obtained by spectroscopic ellipsometry, showed very high potential of these materials as metamaterials. Phase analysis performed by XRD revealed the presence of titanium phases with lower titanium oxidation states resulting from high concentration of oxygen vacancies, which are crucial for such extraordinary jumps and drops of refractive indices. Numerous band gaps for direct and indirect electron transitions additionally confirmed unique properties of these materials.

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Th17 Cell Response in Mice following Motor Nerve Injury

An increased risk of ALS has been reported for veterans, varsity athletes, and professional football players. The mechanism underlying the increased risk in these populations has not been identified; however, it has been proposed that motor nerve injury may trigger immune responses which, in turn, can accelerate the progression of ALS. Accumulating evidence indicates that abnormal immune reactions and inflammation are involved in the pathogenesis of ALS, but the specific immune cells involved have not been clearly defined. To understand how nerve injury and immune responses may contribute to ALS development, we investigated responses of CD4+ T cell after facial motor nerve axotomy (FNA) at a presymptomatic stage in a transgenic mouse model of ALS (B6SJL ). mice, compared with WT mice, displayed an increase in the basal activation state of CD4+ T cells and higher frequency of Th17 cells, which were further enhanced by FNA. In conclusion, mice exhibit abnormal CD4+ T cell activation with increased levels of Th17 cells prior to the onset of neurological symptoms. Motor nerve injury exacerbates Th17 cell responses and may contribute to the development of ALS, especially in those who carry genetic susceptibility to this disease.

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Hyoid bone displacement as parameter for swallowing impairment in patients treated for advanced head and neck cancer.

Hyoid bone displacement as parameter for swallowing impairment in patients treated for advanced head and neck cancer.

Eur Arch Otorhinolaryngol. 2016 Apr 16;

Authors: Kraaijenga SA, van der Molen L, Heemsbergen WD, Remmerswaal GB, Hilgers FJ, van den Brekel MW

Abstract
Reduced hyoid displacement is thought to contribute to aspiration and pharyngeal residues in head and neck cancer (HNC) patients with dysphagia. To further study hyoid elevation and anterior excursion in HNC patients, this study reports on temporal/kinematic measures of hyoid displacement, with the additional goal to investigate correlations with clinical swallowing impairment. A single-blind analysis of data collected as part of a larger prospective study was performed at three time points before and after chemoradiotherapy. Twenty-five patients had undergone clinical swallowing assessments at baseline, 10-weeks, and 1-year post-treatment. Analysis of videofluoroscopic studies was done on different swallowing consistencies of varying amounts. The studies were independently reviewed frame-by-frame by two clinicians to assess temporal (onset and duration) and kinematic (anterior/superior movement) measures of hyoid displacement (ImageJ), laryngeal penetration/aspiration, and presence of vallecula/pyriform sinus residues. Patient-reported oral intake and swallowing function were also evaluated. Mean maximum hyoid displacement ranged from 9.4 mm (23 % of C2-4 distance) to 12.6 mm (27 %) anteriorly, and from 18.9 mm (41 %) to 24.9 mm (54 %) superiorly, depending on bolus volume and consistency. Patients with reduced superior hyoid displacement perceived significantly more swallowing impairment. No correlation between delayed or reduced hyoid excursion and aspiration or residue scores could be demonstrated. Hyoid displacement is subject to variability from a number of sources. Based on the results, this parameter seems not very valuable for clinical use in HNC patients with dysphagia.

PMID: 27086361 [PubMed - as supplied by publisher]



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Post traumatic deafness: a pictorial review of CT and MRI findings.

Post traumatic deafness: a pictorial review of CT and MRI findings.

Insights Imaging. 2016 Apr 16;

Authors: Maillot O, Attyé A, Boyer E, Heck O, Kastler A, Grand S, Schmerber S, Krainik A

Abstract
Hearing loss is a common functional disorder after trauma, and radiologists should be aware of the ossicular, labyrinthine or brain lesions that may be responsible. After a trauma, use of a systematic approach to explore the main functional components of auditory pathways is essential. Conductive hearing loss is caused by the disruption of the conductive chain, which may be due to ossicular luxation or fracture. This pictorial review firstly describes the normal 2-D and 3-D anatomy of the ossicular chain, including the incudo-malleolar and incudo-stapedial joints. The role of 3-D CT in the post-traumatic evaluation of injury to the temporal bone is then evaluated. In the case of sensorineural hearing loss, CT can detect pneumolabyrinth and signs of perilymphatic fistulae but fails to detect subtle lesions within the inner ear, such as labyrinthine haemorrhage or localized brain axonal damage along central auditory pathways. The role that MRI with 3-D-FLAIR acquisition plays in the detection of inner ear haemorrhage and post-traumatic lesions of the brain parenchyma that may lead to auditory agnosia is also discussed.
KEY POINTS: • The most common middle ear injuries are incudo-malleolar and incudo-stapedial joint luxation. • In patients with SNHL, CT can detect pneumolabyrinth or perilymphatic fistula • 3-D-FLAIR MRI appears the best sequence to highlight labyrinthine haemorrhage • Axonal damage and brain hematoma may lead to deafness.

PMID: 27085885 [PubMed - as supplied by publisher]



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Treatment of large tracheal defects after resection: Laryngotracheal release and tracheal replacement.

Treatment of large tracheal defects after resection: Laryngotracheal release and tracheal replacement.

Auris Nasus Larynx. 2016 Apr 14;

Authors: Kirschbaum A, Teymoortash A, Suárez C, Shah JP, Silver CE, Nixon I, Rinaldo A, Kowalski LP, Robbins KT, Ferlito A

Abstract
OBJECTIVE: Resection with direct tracheal or laryngotracheal anastomosis is the standard procedure employed for treatment of benign stenosis or occasionally primary or secondary tracheal malignancy.
DATA SOURCES: Literature review.
RESULTS: A tracheal anastomosis usually heals without complications provided that the ends being joined are adequately supplied with blood, an atraumatic suturing technique is used, and the anastomosis does not become infected. It is especially important that the anastomosis is not subjected to tension.
CONCLUSION: Various techniques of laryngeal and tracheal release serve to reduce the tension on the anastomosis by mobilizing and reducing the distance between the two segments to be approximated. These techniques can be used in different combinations depending on situation encountered during surgery. In cases where more than 50% of the tracheal length must be excised, prosthetic replacements, autologous tissue transfer and allografts are required. All present various problems. The use of tissue-engineering techniques utilizing autologous stem cells has opened new perspectives for tracheal replacement. Such procedures are still in an experimental state.

PMID: 27085818 [PubMed - as supplied by publisher]



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[HPV DNA genotyping: A study of anogenital, head and neck and skin cancers in a population from west Algerian. HPV detection in different cancers from an Algerian population].

[HPV DNA genotyping: A study of anogenital, head and neck and skin cancers in a population from west Algerian. HPV detection in different cancers from an Algerian population].

Bull Cancer. 2016 Apr 13;

Authors: Nahet A, Boublenza L, Hassaine H, Masdoua N, Prétet JL, Belglaiaa E, Mougin C

Abstract
OBJECTIVES: To investigate the prevalence of human papillomaviruses (HPV) in cancers located at different sites in patients from west Algerian and collected between 2010 and 2014.
MATERIAL AND METHODS: Extracted DNA from archival formaldehyde-fixed and paraffin-embedded tissues was provided from 39 anogenital cancers, 10 head and neck cancers and 36 skin cancers. The viral DNA was detected using the INNO-LiPA HPV Genotyping Extra(®) kit.
RESULTS: The prevalence of HPV was 100% in cervical cancers, 40% in vaginal cancers, 17% in vulvar cancers, 33% in anal cancers, 0% in tonsil and larynx cancers and 6.4% in skin squamous cell carcinoma. In cervical cancers, the most prevalent genotypes were HPV16 (52%) and HPV18 (12%) as single infection.
CONCLUSION: The overall results agree partially with literature. Extensive research is necessary to promote HPV vaccine to reduce in particular the burden of cervical cancer in Algeria.

PMID: 27085765 [PubMed - as supplied by publisher]



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Erratum to "Jaw osteoradionecrosis and dental extraction after head and neck radiotherapy: A nationwide population-based retrospective study in Taiwan" [Oral Oncology 56 (2016) 71-77].

Erratum to "Jaw osteoradionecrosis and dental extraction after head and neck radiotherapy: A nationwide population-based retrospective study in Taiwan" [Oral Oncology 56 (2016) 71-77].

Oral Oncol. 2016 Apr 13;

Authors: Kuo TJ, Leung CM, Chang HS, Wu CN, Chen WL, Chen GJ, Lai YC, Huang WC

PMID: 27085636 [PubMed - as supplied by publisher]



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Corrigendum to "Cetuximab activity in dysplastic lesions of the upper aerodigestive tract" [Oral Oncol. 53 (2016) 60-66].

Corrigendum to "Cetuximab activity in dysplastic lesions of the upper aerodigestive tract" [Oral Oncol. 53 (2016) 60-66].

Oral Oncol. 2016 Apr 13;

Authors: Khan Z, Epstein JB, Marur S, Boyd Gillespie M, Feldman L, Tsai HL, Zhang Z, Wang H, Sciubba J, Ferris RL, Grandis JR, Gibson M, Koch W, Tufano R, Westra W, Tsottles N, Ozawa H, Chung CH, Califano JA

PMID: 27085635 [PubMed - as supplied by publisher]



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Short-term culture of tumour slices reveals the heterogeneous sensitivity of human head and neck squamous cell carcinoma to targeted therapies.

Short-term culture of tumour slices reveals the heterogeneous sensitivity of human head and neck squamous cell carcinoma to targeted therapies.

BMC Cancer. 2016;16(1):273

Authors: Donnadieu J, Lachaier E, Peria M, Saidak Z, Dakpe S, Ikoli JF, Chauffert B, Page C, Galmiche A

Abstract
BACKGROUND: Despite recent progress, investigating the impact of targeted therapies on Head and Neck Squamous Cell Carcinoma (HNSCC) remains a challenge. We investigated whether short-term culture of tumour fragments would permit the evaluation of tumour sensitivity to targeted therapies at the individual level.
METHODS: We cultivated tumour slices prepared from 18 HNSCC tumour samples obtained during surgical resection. The samples were treated for 48 h with a panel of 8 targeted therapies directed against selected oncogenic transduction pathways. We analysed the cell proliferation index (CPI) of tumour cells using Ki67 labelling and the activation status of the RAF-MEK-ERK cascade through ERK phosphorylation analysis.
RESULTS: Fourteen tumours were successfully analysed after short-term culture of tumour samples, revealing a striking individual heterogeneity of HNSCC in terms of tumour cell sensitivity to targeted therapies. Using 50 % inhibition of CPI as threshold, sorafenib was shown to be active in 5/14 tumours. Cetuximab, the only approved targeted drug against HNSCC, was active in only 2/14 tumours. A more than 50 % inhibition was observed with at least one drug out of the eight tested in 10/14 tumours. Cluster analysis was carried out in order to examine the effect of the drugs on cell proliferation and the RAF-MEK-ERK cascade.
CONCLUSIONS: In vitro culture of tumour fragments allows for the evaluation of the effects of targeted therapies on freshly resected human tumours, and might be of value as a possible guide for the design of clinical trials and for the personalization of the medical treatment of HNSCC.

PMID: 27085492 [PubMed - as supplied by publisher]



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Sam Glover

Sam Glover grew up in a working class Jewish immigrant family in Belfast. He joined the merchant navy after qualifying from Queens University and travelled the world as a ship's doctor. He started...
recent?d=yIl2AUoC8zA recent?d=dnMXMwOfBR0 recent?i=Jiam3kmhdbE:BX0VQP-kREE:V_sGLiP recent?d=qj6IDK7rITs recent?i=Jiam3kmhdbE:BX0VQP-kREE:gIN9vFw recent?d=l6gmwiTKsz0 recent?d=7Q72WNTAKBA recent?i=Jiam3kmhdbE:BX0VQP-kREE:F7zBnMy recent?i=Jiam3kmhdbE:BX0VQP-kREE:-BTjWOF


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Charles Roger Wood

The youngest of five siblings, Roger Wood grew up in Buckinghamshire, where his father was a rural GP. He qualified at a time when all students helped in the blitz. After war service aboard a Royal...
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Ethel Mary Reddie

Ethel Mary Reddie’s fellow students at UCL included John Wing and Robin Skynner. At that time she does not seem to have considered a future in psychiatry, but she recalled having lectures in...
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24. Jahrestagung der FG “Innere Medizin und klinische Labordiagnostik” der DVG (InnLab),...



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Fragen zum Artikel: R. M. Heilmann: „Minimal-invasive interventionelle Verfahren am Urogenitaltrakt...



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L'epatite C aumenta il rischio tumori, ma ora esiste una cura - Tiscali.it


Tiscali.it

L'epatite C aumenta il rischio tumori, ma ora esiste una cura
Tiscali.it
I ricercatori sanno da tempo che l'epatite C può aumentare il rischio di cancro al fegato e linfoma non-Hodgkin. Una nuova ricerca evidenzia tuttavia che il virus può aumentare anche il rischio di alcuni tumori della testa e del collo, tra cui quelli ...

and more »


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Detecting and Mitigating Smart Insider Jamming Attacks in MANETs Using Reputation-Based Coalition Game

Security in mobile ad hoc networks (MANETs) is challenging due to the ability of adversaries to gather necessary intelligence to launch insider jamming attacks. The solutions to prevent external attacks on MANET are not applicable for defense against insider jamming attacks. There is a need for a formal framework to characterize the information required by adversaries to launch insider jamming attacks. In this paper, we propose a novel reputation-based coalition game in MANETs to detect and mitigate insider jamming attacks. Since there is no centralized controller in MANETs, the nodes rely heavily on availability of transmission rates and a reputation for each individual node in the coalition to detect the presence of internal jamming node. The nodes will form a stable grand coalition in order to make a strategic security defense decision, maintain the grand coalition based on node reputation, and exclude any malicious node based on reputation value. Simulation results show that our approach provides a framework to quantify information needed by adversaries to launch insider attacks. The proposed approach will improve MANET’s defense against insider attacks, while also reducing incorrect classification of legitimate nodes as jammers.

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Skeletal Muscle Remodelling as a Function of Disease Progression in Amyotrophic Lateral Sclerosis

Muscle weakness is considered the pivotal sign of amyotrophic lateral sclerosis (ALS). Knowledge about the skeletal muscle degeneration/regeneration process and the myogenic potential is limited in ALS patients. Therefore, we investigate these processes in a time course perspective by analysing skeletal muscle biopsies from ALS patients collected before and after a 12-week period of normal daily activities and compare these with healthy age-matched control tissue. We do this by evaluating mRNA and protein (immunohistochemical) markers of regeneration, neurodegeneration, myogenesis, cell cycle regulation, and inflammation. Our results show morphological changes indicative of active denervation and reinnervation and an increase in small atrophic fibres. We demonstrate differences between ALS and controls in pathways controlling skeletal muscle homeostasis, cytoskeletal and regenerative markers, neurodegenerative factors, myogenic factors, cell cycle determinants, and inflammatory markers. Our results on Pax7 and MyoD protein expression suggest that proliferation and differentiation of skeletal muscle stem cells are affected in ALS patients, and the myogenic processes cannot overcome the denervation-induced wasting.

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Intrastromal Injection of China Painting Ink in Corneas of Male Rabbits: Clinical and Histological Study

Background. Many patients with corneal opacity or complicated cataract in blind eye ask for cosmoses. In this study we tried to investigate the staining of corneas of male rabbits by Rotring China painting ink and to study the histological changes. Method. 10 eyes of 10 male Baladi Egyptian rabbits were injected (0.1 mL) intrastromally in the cornea by the use of China painting ink (Rotring Tinta China) through insulin syringe (27-gauge needle) by single injection; clinical follow-up is for 6 months and lastly the rabbits were scarified and the stained eyes were enucleated for histological analysis. Results. Clinically the stain was stable in color and distribution in corneas with no major complications. Histological results of the stained rabbit corneas showed blackish pigmentation in the corneal stroma without any inflammatory cellular infiltration. Some fibroblast cells had pigment granules in their cytoplasm in the adjacent layers. Conclusion. Corneal staining by China painting ink is effective and safe in staining of male rabbits cornea; however further study in human corneas with longer follow-up period is advisable.

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Learning how to make routinely available data useful in guiding regulatory oversight of hospital care

Though the past 20 years have seen a series of changes to the independent regulation of healthcare,1 there is surprisingly little empirical work that evaluates the effectiveness of different approaches. Even in the related area of accreditation, where there are more studies of impact, the literature is ‘limited’.2 There is no shortage of strongly held opinions on the best approach. Though most agree about the need for some form of regulation to offer an independent review of the quality of healthcare, there is less agreement about the best style and methods to be adopted. In England, the situation is further complicated in that national healthcare regulators have been subject to periodic regime changes and regularly review and revise their approaches.

Systems of government-funded but independent regulation of healthcare providers have been created in a number of countries as recognition of the limitations of both pure healthcare markets, on...



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Intelligent Monitoring? Assessing the ability of the Care Quality Commission's statistical surveillance tool to predict quality and prioritise NHS hospital inspections

Background

The Care Quality Commission (CQC) is responsible for ensuring the quality of the health and social care delivered by more than 30 000 registered providers in England. With only limited resources for conducting on-site inspections, the CQC has used statistical surveillance tools to help it identify which providers it should prioritise for inspection. In the face of planned funding cuts, the CQC plans to put more reliance on statistical surveillance tools to assess risks to quality and prioritise inspections accordingly.

Objective

To evaluate the ability of the CQC's latest surveillance tool, Intelligent Monitoring (IM), to predict the quality of care provided by National Health Service (NHS) hospital trusts so that those at greatest risk of providing poor-quality care can be identified and targeted for inspection.

Methods

The predictive ability of the IM tool is evaluated through regression analyses and 2 testing of the relationship between the quantitative risk score generated by the IM tool and the subsequent quality rating awarded following detailed on-site inspection by large expert teams of inspectors.

Results

First, the continuous risk scores generated by the CQC's IM statistical surveillance tool cannot predict inspection-based quality ratings of NHS hospital trusts (OR 0.38 (0.14 to 1.05) for Outstanding/Good, OR 0.94 (0.80 to –1.10) for Good/Requires improvement, and OR 0.90 (0.76 to 1.07) for Requires improvement/Inadequate). Second, the risk scores cannot be used more simply to distinguish the trusts performing poorly—those subsequently rated either ‘Requires improvement’ or ‘Inadequate’—from the trusts performing well—those subsequently rated either ‘Good’ or ‘Outstanding’ (OR 1.07 (0.91 to 1.26)). Classifying CQC's risk bandings 1-3 as high risk and 4-6 as low risk, 11 of the high risk trusts were performing well and 43 of the low risk trusts were performing poorly, resulting in an overall accuracy rate of 47.6%. Third, the risk scores cannot be used even more simply to distinguish the worst performing trusts—those subsequently rated ‘Inadequate’—from the remaining, better performing trusts (OR 1.11 (0.94 to 1.32)). Classifying CQC's risk banding 1 as high risk and 2-6 as low risk, the highest overall accuracy rate of 72.8% was achieved, but still only 6 of the 13 Inadequate trusts were correctly classified as being high risk.

Conclusions

Since the IM statistical surveillance tool cannot predict the outcome of NHS hospital trust inspections, it cannot be used for prioritisation. A new approach to inspection planning is therefore required.



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Abbreviated breast MR rivals standard protocol

2016_02_25_09_22_50_142_MRI_abstract_200An abbreviated breast MR protocol represents a time-saving method with the...


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U.K. launches massive scanning project

A U.K. research organization said it has launched a large study across the...


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RT @Missus_Bennett : Our research with @CityUniLondon featured on @ecancer today https://t.co/iIAFrfGIgV

RT @Missus_Bennett : Our research with @CityUniLondon featured on @ecancer today https://t.co/iIAFrfGIgV

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@BluePriyaramesh Thanks for contacting us, @ecancer_espanol will get in touch with you this week.

@BluePriyaramesh Thanks for contacting us, @ecancer_espanol will get in touch with you this week.

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Buckling Instability Behavior of Steel Bridge under Fire Hazard

Failure of buckling instability will most likely occur before the displacement reaches the allowable value of the code when a tanker burns under the steel bridge. This research focuses on critical buckling stress of bridge under fire hazard and a thermal analysis model of a steel bridge is established by FDS (Fire Dynamics Simulator). Thermal parameters of the steel are determined by the polynomial fitting method. Temperature field and elastic modulus of the bridge changing with time are calculated by determining the heat release rate function of tanker. Critical buckling stress of the bridge web and bottom floor changing with time is calculated according to steel floor buckling theory. Finite element software ANSYS is used to verify the result. Results show that when a tanker is burning for 17 minutes, critical buckling stress of steel web will be reduced to = 19.1 MPa and = 38.8 MPa, which is less than the web stress ( = 19.6 MPa, = 39.8 MPa) caused by dead and live load. So steel web will be the first to show shear flexural bending buckling failure. Displacement in the midspan will reach 35.4 mm at this time, which was less than the allowable displacement (50 mm) set by standard. The best rescue time of the bridge under fire hazard is within 15 minutes.

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Robotic Compartment-Based Radical Surgery in Early-Stage Cervical Cancer

A radical hysterectomy with pelvic lymphadenectomy is the recommended treatment option in patients with early-stage cervical cancer. Although various classifications were developed in order to define the resection margins of this operation, no clear standardization could be achieved both in the nomenclature and in the extent of the surgery. Total mesometrial resection (TMMR) is a novel procedure which aims to remove all components of the compartment formed by Müllerian duct in which female reproductive organs develop. TMMR differs from the conventional radical hysterectomy techniques in that its surgical philosophy, terminology, and partly resection borders are different. In this paper, a TMMR with therapeutic pelvic lymphadenectomy operation that we performed for the first time with robot-assisted laparoscopic (robotic) approach in an early-stage cervical cancer patient was presented. This procedure has already been described in open surgery by Michael Höckel and translated to the robotic surgery by Rainer Kimmig. Our report is the second paper, to our knowledge, to present the initial experience regarding robotic TMMR in the English literature.

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Tricellular Tight Junctions in the Inner Ear

Tight junctions (TJs) are structures that seal the space between the epithelial cell sheets. In the inner ear, the barrier function of TJs is indispensable for the separation of the endolymphatic and perilymphatic spaces, which is essential for the generation and maintenance of the endocochlear potential (EP). TJs are formed by the intercellular binding of membrane proteins, known as claudins, and mutations in these proteins cause deafness in humans and mice. Within the epithelial cell sheet, however, a bound structure is present at the site where the corners of three cells meet (tricellular tight junctions (tTJs)), and the maintenance of the barrier function at this location cannot be explained by the claudins alone. Tricellulin and the angulin family of proteins (angulin-1/LSR, angulin-2/ILDR1, and angulin-3/ILDR2) have been identified as tTJ-associated proteins. Tricellulin and ILDR1 are localized at the tTJ and alterations in these proteins have been reported to be involved in deafness. In this review, we will present the current state of knowledge for tTJs.

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Transcriptomic Analysis of Resistant and Susceptible Bombyx mori Strains Following BmNPV Infection Provides Insights into the Antiviral Mechanisms

Purpose. To decipher transcriptomic changes and related genes with potential functions against Bombyx mori nucleopolyhedrovirus infection and to increase the understanding of the enhanced virus resistance of silkworm on the transcriptomic level. Methods. We assembled and annotated transcriptomes of the Qiufeng (susceptible to infection) and QiufengN (resistant to infection) strains and performed comparative analysis in order to decipher transcriptomic changes and related genes with potential functions against BmNPV infection. Results. A total of 78,408 SNPs were identified in the Qiufeng strain of silkworm and 56,786 SNPs were identified in QiufengN strain. Besides, novel AS events were found in these 2 strains. In addition, 1,728 DEGs were identified in the QiufengN strain compared with Qiufeng strain. These DEGs were involved in GO terms related to membrane, metabolism, binding and catalytic activity, cellular processes, and organismal systems. The highest levels of gene representation were found in oxidative phosphorylation, phagosome, TCA cycle, arginine and proline metabolism, and pyruvate metabolism. Additionally, COG analysis indicated that DEGs were involved in “amino acid transport and metabolism” and “carbohydrate transport and metabolism.” Conclusion. We identified a series of major pathological changes in silkworm following infection and several functions were related to the antiviral mechanisms of silkworm.

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Morphology and Distribution of Antennal Sensilla of the Bean Bug Riptortus pedestris (Hemiptera: Alydidae)

ABSTRACT

The bean bug, Riptortus pedestris is a major pest of bean pods and some tree fruits in north-east Asian countries. Scanning electron microscopy was conducted to investigate the morphology and distribution of antennal sensilla of R. pedestris to help in understanding the sensory mechanisms of the bug. Average antennal lengths of male and female R. pedestris were 11.00 mm and 9.84 mm, respectively, consisting of four distinct segments, scape, pedicel, basiflagellum, and distiflagellum. Based on the gross appearance, the antennal sensilla were classified into four major types (trichodea, basiconica, chaetica, and coeloconica), which could be further classified into four trichoid, three basiconic, four chaotic, and two coeloconic subtypes, based on their size, tip shape, presence of socket, and surface structure. Among them, two subtypes of trichoid sensilla, all three subtypes of basiconic sensilla, four subtypes of chaetic sensilla and two subtypes of coeloconic sensilla had numerous pores along the surface, suggesting their olfactory function. Nine subtypes (2 trichoid, 1 basiconic, 4 chaetic, and 2 coeloconic subtypes) showed a distinct socket structure at the base. Among the four antennal segments, the distiflagellum possessed highest number of sensilla. Trichoid sensilla were most abundant, followed by basiconic, chaetic, and coeloconic sensilla. Each subtype of sensilla exhibited distinct distribution profile along the four antennal segments. Two subtypes of trichoid sensilla, one subtype of basiconic sensilla and one subtype of chaetica sensilla were distributed on scape, pedicel, and basiflagellum, whereas distribution of other subtypes of sensilla was confined to basiflagellum and distiflagellum. Microsc. Res. Tech., 2016. © 2016 Wiley Periodicals, Inc.



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Visualizing subsurface defects in graphite by acoustic atomic force microscopy

ABSTRACT

We describe a versatile platform, which combines atomic force acoustic microscopy, ultrasonic atomic force microscopy and heterodyne force microscopy. The AFM system can enable in-situ switching among these operation modes flexibly and thus benefit the discrimination of differences in mechanical properties and buried subsurface nanostructures. We demonstrate the potential of this platform for visualizing the subsurface defects of graphite. Our results show that tiny topographic edges are enhanced in acoustic oscillation signals whilst embedded defects and inhomogeneous in mechanical properties are made clearly distinguishable. The possibility of detecting subsurface defects in few-layer graphene is further discussed with first-principles calculations. Microsc. Res. Tech., 2016. © 2016 Wiley Periodicals, Inc.



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Ultrastructural study of mouse adipose-derived stromal cells induced towards osteogenic direction

ABSTRACT

We investigated the ultrastructural characteristics of mouse adipose-derived stem/stromal cells (ASCs) induced towards osteogenic lineage. ASCs were isolated from adipose tissue of FVB-Cg-Tg(GFPU)5Nagy/J mice and expanded in monolayer culture. Flow cytometry, histochemical staining, and electron microscopy techniques were used to characterize the ASCs with respect to their ability for osteogenic differentiation capacity. Immunophenotypically, ASCs were characterized by high expression of the CD44 and CD90 markers, while the relative content of cells expressing CD45, CD34 and CD117 markers was <2%. In assays of differentiation, the positive response to osteogenic differentiation factors was observed and characterized by deposition of calcium in the extracellular matrix and alkaline phosphatase production. Electron microscopy analysis revealed that undifferentiated ASCs had a rough endoplasmic reticulum with dilated cisterns and elongated mitochondria. At the end of the osteogenic differentiation, the ASCs transformed from their original fibroblast-like appearance to having a polygonal osteoblast-like morphology. Ultrastructurally, these cells were characterized by large euchromatic nucleus and numerous cytoplasm containing elongated mitochondria, a very prominent rough endoplasmic reticulum, Golgi apparatus and intermediate filament bundles. Extracellular matrix vesicles of variable size similar to the calcification nodules were observed among collagen fibrils. Our data provide the ultrastructural basis for further studies on the cellular mechanisms involved in osteogenic differentiation of mouse adipose-derived stem/stromal cells. Microsc. Res. Tech., 2016. © 2016 Wiley Periodicals, Inc.



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Dolphins have a language that helps them solve problems together

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When faced with a puzzle that two can solve better than one, bottlenose dolphins chatter away, suggesting that they have a specific vocalisation for working together

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Identification of the LCK mutation in an atypical epidermodysplasia verruciformis family with T cell defects and virus-induced squamous cell carcinoma

Summary

Background

Inherited epidermodysplasia verruciformis (EV) is a rare skin disorder characterized by susceptibility to specific types of human papilloma virus (HPVs) and is strongly associated with skin carcinomas. Inactivating mutations in EVER1/2 account for most EV patients. However, more phenotypes related to but distinct from EV have been reported with an immunodeficiency state but without EVER1/2 mutation, and the genetic basis for these atypical EV cases is poorly understood.

Objective

The aim of this study is to identify the causative gene responsible for three siblings affected by atypical EV but without EVER1/2 mutation.

Methods

Whole exome sequencing (WES) followed by Sanger sequencing was performed to identify the gene responsible for the atypical EV patients enrolled in our study.

Results

A homozygous splicing mutation was detected in the T lymphocyte-specific protein tyrosine kinase (LCK) gene (c.188-2A>G). And this mutation resulted in an exon 3-deletion LCK isoform, which further led to frameshift mutation and subsequent mRNA decay.

Conclusion

Our study demonstrates a novel mutation in LCK in an atypical EV-affected family with T cell defects, HPV infection and virus-induced malignancy, which provides new clues for the understanding of host defenses against HPV and better genetic counseling of patients with EV phenotype.

This article is protected by copyright. All rights reserved.



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Phenotyping of Leukocytes and Leukocyte-Derived Extracellular Vesicles

Extracellular vesicles (EVs) have a demonstrated involvement in modulating the immune system. It has been proposed that EVs could be used as biomarkers for detection of inflammatory and immunological disorders. Consequently, it is of great interest to investigate EVs in more detail with focus on immunological markers. In this study, five major leukocyte subpopulations and the corresponding leukocyte-derived EVs were phenotyped with focus on selected immunological lineage-specific markers and selected vesicle-related markers. The leukocyte-derived EVs displayed phenotypic differences in the 34 markers investigated. The majority of the lineage-specific markers used for identification of the parent cell types could not be detected on EVs released from monocultures of the associated cell types. In contrast, the vesicular presentation of CD9, CD63, and CD81 correlated to the cell surface expression of these markers, however, with few exceptions. Furthermore, the cellular expression of CD9, CD63, and CD81 varied between leukocytes present in whole blood and cultured leukocytes. In summary, these data demonstrate that the cellular and vesicular presentation of selected lineage-specific and vesicle-related markers may differ, supporting the accumulating observations that sorting of molecular cargo into EVs is tightly controlled.

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Association between Polymorphisms in Interleukins 4 and 13 Genes and Chronic Periodontitis in a Han Chinese Population

Chronic periodontitis (CP) is one of the most common chronic inflammatory diseases and cytokines play a pivotal role in the regulation of immune response. Interleukin-4 (IL-4) and interleukin-13 (IL-13) are anti-inflammatory cytokines and several polymorphisms of them have been proved involved in periodontal disease. This study aimed to evaluate whether three single nucleotide polymorphisms (SNPs), rs2070874 and rs2243248 from IL4 and rs1800925 from IL13, are associated with CP in a Han Chinese population consisting of 440 moderate or severe CP patients and 324 healthy controls. Genomic DNA extracted from buccal epithelial cells of the included participants were genotyped using a matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry method. No significant association between rs2070874 or rs1800925 and CP was found, while the frequencies of rs2243248 and two haplotypes C-G-T and C-T-T showed significant differences between the two groups. The results suggest that the polymorphism rs2243248 and haplotypes C-G-T and C-T-T may be associated with CP susceptibility in the present Han Chinese population.

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Onychomycosis due to Candida parapsilosis in a Child with Ventricular Septal Defect: An Unusual Predisposition

Candida parapsilosis is emerging as a potential pathogen for onychomycosis. A 4-year-old male child with perimembranous ventricular septal defect (VSD) was admitted with features of cystitis and was treated with broad spectrum antibiotics. Two weeks later, he developed yellowish discoloration of nails of both hands. The sloughed out nail, on microscopy, showed numerous yeast forms that were identified as Candida parapsilosis by both phenotypic and genotypic methods. Antifungal sensitivity testing of the isolate was performed by microbroth dilution method in accordance with CLSI guidelines. Patient was successfully treated with topical amphotericin B and oral fluconazole. Thus, one should have a high index of suspicion of C. parapsilosis onychomycosis, especially when the patient is in the paediatric age group, presenting with unusual predisposing condition like congenital heart disease, and is on broad spectrum antibiotics.

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Dynamic Performance Analysis of the Towers of a Long-Span Bridge Based on GPS Monitoring Technique

The present study investigates the parameter identification and the dynamic performance of a long-span bridge tower based on the output of a global positioning system (GPS) health monitoring system. The random decrement (RD) algorithm is used to estimate the tower displacement impulse response. Three methods are applied to extract the dynamic performance including least squares complex exponential (LSCE) method, Hilbert envelope method (HEM), and eigensystem realization algorithm (ERA). Results reveal that the HEM and LSCE method are more suitable to extract fundamental frequency and modal and damping ratios of the tower. Furthermore, the dynamic properties and statistical time series analysis of the GPS measurements illustrate that the traffic loads have a high significant impact on the semistatic and dynamic performances.

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Steroid Tumor Environment in Male and Female Mice Model of Canine and Human Inflammatory Breast Cancer

Canine inflammatory mammary cancer (IMC) shares clinical and histopathological characteristics with human inflammatory breast cancer (IBC) and has been proposed as a good model for studying the human disease. The aim of this study was to evaluate the capacity of female and male mice to reproduce IMC and IBC tumors and identify the hormonal tumor environment. To perform the study sixty 6–8-week-old male and female mice were inoculated subcutaneously with a suspension of 106 IPC-366 and SUM149 cells. Tumors and serum were collected and used for hormonal analysis. Results revealed that IPC-366 reproduced tumors in 90% of males inoculated after 2 weeks compared with 100% of females that reproduced tumor at the same time. SUM149 reproduced tumors in 40% of males instead of 80% of females that reproduced tumors after 4 weeks. Both cell lines produce distant metastasis in lungs being higher than the metastatic rates in females. EIA analysis revealed that male tumors had higher T and SO4E1 concentrations compared to female tumors. Serum steroid levels were lower than those found in tumors. In conclusion, IBC and IMC male mouse model is useful as a tool for IBC research and those circulating estrogens and intratumoral hormonal levels are crucial in the development and progression of tumors.

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ACTH-Independent Hypercorticism in Adrenal Tumors and Adrenocortical Hyperplasia

Cortisol production is normally under the regulation of adrenocorticotropic hormone (ACTH). Hypercortisolism or Cushing’s syndrome, characterized by excessive cortisol levels, may be caused by ACTH-independent mechanisms. The present work aims to review the current knowledge on ACTH-independent mechanisms through aberrant expression of hormone receptors in adrenal tumors and adrenocortical hyperplasia. In particular, the effects of epinephrine, norepinephrine, serotonin, arginine vasopressin, and gastric inhibitory polypeptide are discussed.

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Causes and outcomes of emergency presentation of rectal cancer

Summary

Emergency presentation of rectal cancer carries a relatively poor prognosis, but the roles and interactions of causative factors remain unclear. We describe an innovative statistical approach which distinguishes between direct and indirect effects of a number of contextual, patient and tumour factors on emergency presentation and outcome of rectal cancer.

All patients diagnosed with rectal cancer in Ireland 2004-2008 were included. Registry information, linked to hospital discharge data, provided data on patient demographics, comorbidity and health insurance; population density and deprivation of area of residence; tumour type, site, grade and stage; treatment type and optimality; and emergency presentation and hospital caseload. Data were modelled using a structural equation model with a discrete-time survival outcome, allowing us to estimate direct and mediated effects of the above factors on hazard, and their inter-relationships.

2,750 patients were included in the analysis. 12% had emergency presentations, which increased hazard by 80%. Affluence, private patient status and being married reduced hazard indirectly by reducing emergency presentation. Older patients had more emergency presentations, while married patients, private patients or those living in less deprived areas had fewer than expected. Patients presenting as an emergency were less likely to receive optimal treatment or to have this in a high caseload hospital.

Apart from stage, emergency admission was the strongest determinant of poor survival. The factors contributing to emergency admission in this study are similar to those associated with diagnostic delay. The socio-economic gradient found suggests that patient education and earlier access to endoscopic investigation for public patients could reduce emergency presentation. This article is protected by copyright. All rights reserved.



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Fine-scale mapping of 8q24 locus identifies multiple independent risk variants for breast cancer

Abstract

Previous genome-wide association studies among women of European ancestry identified two independent breast cancer susceptibility loci represented by single nucleotide polymorphisms (SNPs) rs13281615 and rs11780156 at 8q24. We conducted a fine-mapping study across 2.06 Mb (chr8:127,561,724 -129,624,067, hg19) in 55,540 breast cancer cases and 51,168 controls within the Breast Cancer Association Consortium. We found three additional independent association signals in women of European ancestry, represented by rs35961416 (OR = 0.95, 95% CI = 0.93-0.97, conditional P = 5.8 × 10−6), rs7815245 (OR = 0.94, 95% CI = 0.91-0.96, conditional P = 1.1 × 10−6), and rs2033101 (OR = 1.05, 95% CI = 1.02-1.07, conditional P = 1.1 × 10−4). Integrative analysis using functional genomic data from the Roadmap Epigenomics, the Encyclopedia of DNA Elements project, the Cancer Genome Atlas, and other public resources implied that SNPs rs7815245 in Signal 3, and rs1121948 in Signal 5 (in linkage disequilibrium with rs11780156, r2 = 0.77), were putatively functional variants for two of the five independent association signals. Our results highlight multiple 8q24 variants associated with breast cancer susceptibility in women of European ancestry. This article is protected by copyright. All rights reserved. © 2014 Wiley Periodicals, Inc.



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Lithography-Free, Low-Cost Method for Improving Photodiode Performance by Etching Silicon Nanocones as Antireflection Layer

A three-step process has been demonstrated to improve the performance of photodiode by creating nanocone forest on the surface of photodiode as an antireflection layer. This high-throughput, low-cost process has been shown to decrease the reflectivity by 66.1%, enhance the quantum efficiency by 27%, and increase the responsivity by 25.7%. This low-cost manufacture process can be applied to increase the responsivity of silicon based photonic devices.

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Thermal Condensate Structure and Cosmological Energy Density of the Universe

The aim of this paper is to study thermal vacuum condensate for scalar and fermion fields. We analyze the thermal states at the temperature of the cosmic microwave background (CMB) and we show that the vacuum expectation value of the energy momentum tensor density of photon fields reproduces the energy density and pressure of the CMB. We perform the computations in the formal framework of the Thermo Field Dynamics. We also consider the case of neutrinos and thermal states at the temperature of the neutrino cosmic background. Consistency with the estimated lower bound of the sum of the active neutrino masses is verified. In the boson sector, nontrivial contribution to the energy of the universe is given by particles of masses of the order of 10−4 eV compatible with the ones of the axion-like particles. The fractal self-similar structure of the thermal radiation is also discussed and related to the coherent structure of the thermal vacuum.

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Intraoral technique for locking reconstruction plate fixation using an implant handpiece with adapted drills

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Abstract

Background

Locking reconstruction plates are used in the treatment of jaw trauma and diseases if there is a need for surgical resection and to prevent pathologic fracture after tumor excision. Fixation is typically performed using an extraoral approach.

Methods

This article describes a technique for the intraoral fixation of locking reconstruction plates that uses prototyping to model the plate before the procedure as well as an implant handpiece with adapted drills for bone drilling and the insertion of screws into relatively inaccessible areas.

Conclusion

Intraoral fixation not only prevents nerve damage and facial scarring but also minimizes the plate's risk of extraoral exposure and reduces surgical morbidity. © 2016 Wiley Periodicals, Inc. Head Neck, 2016



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Teenagers at upper end of normal body weight have higher mortality in adult life, study shows

Adolescents at the upper end of the range for normal body weight have higher cardiovascular and all cause mortality in young adulthood or midlife, shows a large follow-up study that found an even...
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