Endoscopic laryngeal findings in patients undergoing thyroid and parathyroid surgery.

OBJECTIVES: This study aimed to report the pre- and post-operative laryngeal endoscopic findings in patients referred by non-otolaryngologists who are undergoing thyroid and/or parathyroid surgery, and to determine the number and nature of referrals before and after the release of the clinical practice guideline for improving voice outcomes after thyroid surgery. METHODS: This retrospective cohort study, conducted at a tertiary care academic hospital, comprised adult patients referred by the endocrine surgery service for laryngoscopy from 2007 to 2018 (n = 166). Data regarding patient demographics, reason for referral and endoscopic findings were recorded. RESULTS: The number of referrals increased significantly after the release of the practice guideline. The most common indication for referral pre- and post-operatively was voice change. The most common finding during laryngoscopy was normal examination findings (pre-operatively) and unilateral vocal fold immobility (post-operatively). CONCLUSION: Peri-operative thyroid and/or parathyroid patients have laryngoscopic findings other than vocal fold immobility. Laryngoscopy to detect structural and functional pathology is warranted.

Two-dimensional metal NaCu6.3Sb3 and solid-state transformations of sodium copper antimonides.

A novel layered compound, NaCu6.3Sb3, has been successfully synthesized from elements. This unique structure crystallizes in the hexagonal space group P63/mmc and has lattice constants of a = 4.2166(2) Å and c = 24.041(1) Å. The structure consists of complex Cu/Sb 2D blocks separated by Na ions. These blocks contain graphene-like hexagonal layers of either Cu or CuSb. The solid-state transformations in the Na-Cu-Sb system between Cu2Sb-NaCu6.3Sb3-NaCu4Sb2 were explored using annealing at different partial vapor pressures of Na, differential scanning calorimetry, and in situ synchrotron powder X-ray diffraction. Full reversibility of the transformation was observed, indicating that the bulk 3D Cu2Sb phase is capable of reversible intercalation of Na ions, forming layered intercalated phases similar to intercalated graphite. The characterization of the transport properties shows that the metallic nature of the electrical conductivity is preserved, even for the Na-rich phase of NaCu4Sb2. Electronic structure calculations support metallic properties in the Cu-Sb layers and predict that no bands cross the Fermi level across the layers, supporting NaCu6.3Sb3 as a two-dimensional metal.

Determination of lapachol in the presence of other naphthoquinones using 3MPA-CdTe quantum dots fluorescent probe.

3MPA-CdTe QDs in aqueous dispersion was used as a fluorescent probe for the determination of lapachol, a natural naphthoquinone found in plants of the Bignoniaceae family genus Tabebuia. Working QDs dispersions (4.5×10(-8) mol L(-1) of QDs) was prepared in aqueous media containing Tris-HCl buffer pH 7.4 and methanol (10% in volume). The excitation was made at 380 nm with signal measurement at 540 nm. To establish a relationship between fluorescence (corrected to inner filter effect) and concentration of lapachol, a Stern-Volmer model was used. The linear range obtained was from 1.0×10(-5) to 1.0×10(-4) mol L(-1). The limit of detection (x(b)-3s(b)) was 8.0×10(-6) mol L(-1). The 3MPA-CdTe QDs probe was tested in the determination of lapachol in urine, previously cleansed in an acrylic polymer. The average recovery was satisfactory.

Serum alkaline phosphatase and mortality in hemodialysis patients.

BACKGROUND: Alkaline phosphatase is typically considered as an innocent by-stander, but emerging data suggest that alkaline phosphatase might play a pathogenic role in vascular calcification and thus contribute to increased mortality in hemodialysis patients. STUDY DESIGN: Longitudinal analyses of the existing HEMO Study database. SETTING AND PARTICIPANTS: 1,827 HEMO Study participants. PREDICTOR: Serum alkaline phosphatase level. OUTCOME AND MEASUREMENTS: All-cause and cardiovascular mortality. RESULTS: Based on the median serum alkaline phosphatase of 97 IU/l, participants were divided into low (< 97 IU/l) and high (> or = 97 IU/l) serum alkaline phosphatase groups. The lower serum alkaline phosphatase group was associated with older age, male gender, non-black race and shorter dialysis years as well as higher serum calcium, higher serum calcium-phosphorus product and lower parathyroid hormone levels. Mean serum liver enzyme values were in the normal range in both groups, but the high alkaline phosphatase group had slightly higher values. In a multivariate time-dependent Cox model using baseline and follow-up values of serum alkaline phosphatase levels, adjusted for demographics, HEMO Study groups, comorbidity, bone metabolism parameters and liver enzymes, each doubling of serum alkaline phosphatase was significantly associated with increased hazard of all-cause (hazard ratio 1.44, 95% CI 1.30 - 1.59) and cardiovascular mortality (hazard ratio 1.35, 95% CI 1.16 - 1.57). LIMITATIONS: Nonstandardized measurements of alkaline phosphatase. CONCLUSIONS: Serum alkaline phosphatase is associated with increased mortality in hemodialysis patients, independent of bone metabolism parameters and liver enzymes. Alkaline phosphatase might be a potential therapeutic target in hemodialysis patients.

Effect of pioglitazone on survival and renal function in a mouse model of polycystic kidney disease.

BACKGROUND/AIMS: Cystic epithelia in polycystic kidney disease display features similar to malignant cells. Thiazolidinediones have been shown to have anti-neoplastic properties, therefore we tested the hypothesis that pioglitazone reduces cyst formation, improves renal function, and prolongs survival in a mouse model of polycystic kidney disease. METHODS: PC-Pkd1-KO mice, which have homozygous mutations of the Pkd1 gene in principal cells, were used. On the day after giving birth, mothers were fed standard mouse chow with or without pioglitazone (30 mg/kg chow). After weaning, the assigned diet was continued. At 1 month of age, blood pressure was measured and animals were sacrificed to determine kidney weight, body weight, and serum urea. Kidneys were evaluated for proliferation using Ki-67, apoptosis using TUNEL analysis, and cyst number using MRI. Survival was observed. RESULTS: Pioglitazone did not alter renal function, cell proliferation, apoptosis, or cyst formation in animals with polycystic kidney disease, however it did increase survival. Pioglitazone reduced blood pressure in PC-Pkd1-KO, but not in controls. CONCLUSION: These findings suggest that pioglitazone may have a unique antihypertensive effect in polycystic kidney disease, and that such an effect may promote improved survival.

The effects of practice on speed of information processing using the Adjusting-Paced Serial Addition Test (Adjusting-PSAT) and the Computerized Tests of Information Processing (CTIP).

Three experiments were conducted to determine the effects of practice on the Adjusting-Paced Serial Addition Task (Adjusting-PSAT) (Tombaugh, 1999) and the Computerized Tests of Information Processing (CTIP) (Tombaugh & Rees, 2000). The Adjusting-PSAT is a computerized modification of the Paced Auditory Serial Addition Test (PASAT) (Gronwall, 1977) that makes the interval between digits contingent on the correctness of the response. This titration procedure permits a threshold value to be derived that represents the shortest presentation interval in which a person can process the digits to produce the correct sum. The CTIP consists of three reaction time tests that are progressively more difficult. Results showed that robust practice effects occurred with the Adjusting-PSAT, with the greatest increase in performance occurring on the first retest trial. Practice effects were equally prominent regardless of whether the first retest trial occurred 20A min, 1 week, or 3 months after the first administration. These gains were maintained for periods up to 6 months and were independent of modality of presentation (visual or auditory) and type of number list (easy or hard). In contrast to the findings with the Adjusting-PSAT, only minimal practice effects were observed with the CTIP. The major clinical implication of the study is that the high reliability coefficients for the CTIP, the lack of anxiety associated with its administration, and its insensitivity to variables such as numerical and verbal ability make the CTIP ideally suited for the serial evaluation of cognitive status. These characteristics also make the CTIP a viable alternative to the Adjusting-PSAT or PASAT for measuring speed of information processing. If the Adjusting-PSAT is administered repeatedly in clinical evaluations, a "dual baseline" or "run in" procedure should be used, with the second administration serving as the baseline measurement.

National beef tenderness survey - 2006: Assessment of Warner-Bratzler shear and sensory panel ratings for beef from US retail and foodservice establishments.

Beef from retail and foodservice establishments in 11 US cities was evaluated using Warner-Bratzler shear (WBS) and consumer evaluation panels. Postmortem aging times ranged from 3 to 83d for retail and 7 to 136d for foodservice with mean aging times of 22.6d and 30.1d, respectively. For retail, the three cuts from the round - top round, bottom round, and eye of round - had the highest (P<0.05) WBS values compared to cuts from the chuck, rib, and loin. Top loin steaks had the lowest (P<0.05) WBS value compared to ribeye and top sirloin foodservice steaks. Retail bone-in top loin, top loin, ribeye, T-bone, and porterhouse received the highest (P<0.05) ratings by consumers for overall like and like tenderness. Quality grade had little or no effect on foodservice sensory evaluations. Improvements in round tenderness are needed to increase consumer acceptability.

Comment on "Post-wildfire logging hinders regeneration and increases fire risk".

Based on limited sampling 2 years after the 2002 Biscuit Fire in Oregon, Donato et al. (Brevia, 20 January 2006, p. 352) concluded that postfire logging reduced seedling regeneration by 71%. Analysis of the study methodology and raw data suggest that this estimate is statistically flawed and misleading and says nothing about the impacts of more prompt postfire harvest.

Gamma-ray imaging with a Si/CsI(Tl) Compton detector.

We present results from Compton imaging of gamma-ray sources using an instrument constructed from thin silicon scattering detectors and CsI(Tl) absorbing detectors. We have successfully imaged single and double point sources for several common radioactive isotopes ((137)Cs, (60)Co, (22)Na, (54)Mn). The measured angular resolution is 11.6( composite function) FWHM at 662keV. In parallel with the hardware effort, a GEANT4-based simulation code was developed. Comparisons between real and simulated data are discussed.

Physical, chemical, and histological characteristics of 18 lamb muscles.

Muscles (n=18) were dissected from each side of 20 lamb carcasses to characterize physical, chemical, and histological traits. Muscles from the right sides were used to measure color values, expressible moisture, pH, total collagen content, and sarcomere length. Muscles from the left sides were aged for 7d and used to determine Warner-Bratzler shear (WBS) force values. The M. adductor and M. semimembranosus had the darkest colored lean (lowest L(∗) values), whereas the M. latissimus dorsi and M. tensor fasciae latae had the lightest colored lean (highest L(∗) values). The M. triceps brachii, M. pectoralis profundus, and M. latissimus dorsi had among the lowest numerical expressible moistures whereas the M. adductor and the M. longissimus lumborum had among the highest. The M. infraspinatus was found to have the highest collagen content (9.0mg/g) and the M. psoas major had the longest sarcomere length (3.1µm). Of the muscles sampled, the M. serratus ventralis had one the lowest WBS values (21.8N) and the M. semimembranosus the highest (42.6N). On average, the largest muscles identified were the M. gluteobiceps, M. gluteus medius, M. longissimus lumborum, M. longissimus thoracis, and M. semimembranosus, which would likely be suitable in terms of physical dimensions for used in a variety of individual muscle applications. Other muscles, however, such as the M. teres major and M. tensor fasciae latae, may be too small in size and dimension to be used for individual application.

Retail cutting characteristics for US Choice and US Select beef subprimals.

US Choice (Ch) and US Select (Se) beef subprimals from the rib, chuck, plate, loin, and round were obtained to conduct retail cutting tests. Subprimals were merchandised into bone-in or boneless retail cuts and associated components by experienced retail meat merchandisers. These Se subprimals had less (P<0.05) trimmable fat than their Ch counterparts: ball tip, top sirloin, outside round, inside round, and ribeye. Se inside rounds, outside rounds, eye of rounds, boneless striploins, and ball tips had greater (P<0.05) purge losses than the same cuts from Ch. The only subprimals where grade impacted total saleable yield were the top (inside) rounds (Ch=80.13%, Se=87.34%; P=0.004) and outside rounds cut into roasts, steaks, and cubed steaks (Ch=87.61%, Se=90.28%; P=0.05). Methods to increase retail yields from beef subprimals should consider minimizing purge and increasing cutting efficiencies in addition to reducing fat trim.

Beef hide antimicrobial interventions as a means of reducing bacterial contamination.

This project was designed to evaluate interventions capable of reducing bacterial counts on the hide prior to opening. In Trial I, fresh beef hides (n=12) were cut into sections and assigned to serve as either clipped (hair trimmed) or non-clipped sections. Sections were inoculated with a bovine fecal slurry and sampled following a water wash. Treatments (distilled water, isopropyl alcohol, 3% hydrogen peroxide, 2% l-lactic acid, 10% povidone-iodine, and 1% cetylpyridinium chloride (CPC)) were then applied to each section and the sections were sampled for enumeration of aerobic plate counts (APCs), coliforms, and Escherichia coli. Within clipped samples, 1% CPC and 3% hydrogen peroxide caused the greatest reductions in APCs (4.6 and 4.4 log(10)CFU/100-cm(2), respectively), and 1% CPC, 2% l-lactic acid, and 3% hydrogen peroxide caused the greatest reductions in coliform counts (4.5, 4.1, and 3.9 log(10)CFU/100-cm(2), respectively). In Trial II, beef carcasses with hides on were sampled initially and clipped, and then 2% l-lactic acid, 3% hydrogen peroxide, or 1% CPC were applied before sampling. For APCs, 1% CPC produced the greatest reduction on the hide surface (3.8 log(10)CFU/100-cm(2)). Selective application of these antimicrobials to clipped hide opening sites reduced bacterial counts on hide surfaces, and therefore could reduce final carcass counts in these areas by decreasing the bacterial load before opening.

Factors influencing the variation in tenderness of seven major beef muscles from three Angus and Brahman breed crosses.

Beef carcasses (n=30) from 3/4 Angus (A)×1/4 Brahman (B), 1/4A×3/4B, and 1/2A×1/2B F(1) crosses were used to evaluate breed type, electrical stimulation, and postmortem aging on the M. semimembranosus (SM), M. semitendinosus (ST), M. biceps femoris (BF), M. vastus lateralis (VL), M. gluteus medius (GM), M. longissimus dorsi lumborum (LD), and M. triceps brachii (TB). Shear force values decreased with increased postmortem aging to a greater extent in steaks from 3/4A×1/4B than steaks from the other breed types. Shear force values for steaks from the round (SM, ST, BF, VL) were higher than steaks from the loin (LD, GM) and chuck (TB) for both electrically stimulated and non-electrically stimulated muscles. In the LD muscle, calpastatin activities were similar among breed types. Muscle type played the greatest role in determining tenderness.

In-home consumer evaluations of individual muscles from beef rounds subjected to tenderization treatments.

In-home evaluations of the M. vastus lateralis, M. rectus femoris, M. semimembranosus, and M. adductor (n=266) muscles that were either blade tenderized, enhanced with a salt and phosphate solution, or served as a control (no tenderization or enhancement treatment) were conducted. Consumers (n=261) cooked these steaks and were asked to document cooking method and degree of doneness, and provide palatability ratings for each steak. Enhancing round muscles with a salt and phosphate solution improved most palatability traits compared to blade tenderized or control steaks. For M. semimembranosus and M. vastus lateralis, the enhanced steaks received higher (P<0.05) ratings for all palatability traits. Cooking method and degree of doneness had little influence on consumer palatability ratings, and where differences occurred, they were muscle specific. This may allow limited recommendations for the most appropriate cooking method and degree of doneness for specific beef round muscles.

Influence of animal temperament and stress responsiveness on the carcass quality and beef tenderness of feedlot cattle.

Three groups of steers (A, B, C) were used to study the effect of temperament (Calm, Intermediate, and Excitable) on meat quality. Temperament was based on exit velocity, pen scores, and chute scores. Temperament traits were consistent across evaluations, and values decreased (P<0.05) in magnitude over time. Increasing excitability was associated with higher (P<0.05) serum cortisol concentrations. Carcasses from cattle with calm temperaments had higher (P<0.05) 0.5h postmortem pH values than those from Intermediate and Excitable cattle (0.1 and 0.2 units, respectively). Group C Excitable steers had higher (P<0.05) WBS values than the calmer Group C steers. This trend was observed in Group A steers, although the values were not statistically different. Correlations were highest between temperament values and tenderness after 21d. Temperament influences tenderness, although the mechanism is not clear.

Crosslinking a lipid raft component triggers liquid ordered-liquid disordered phase separation in model plasma membranes.

The mechanisms by which a cell uses and adapts its functional membrane organization are poorly understood and are the subject of ongoing investigation and discussion. Here, we study one proposed mechanism: the crosslinking of membrane components. In immune cell signaling (and other membrane-associated processes), a small change in the clustering of specific membrane proteins can lead to large-scale reorganizations that involve numerous other membrane components. We have investigated the large-scale physical effect of crosslinking a minor membrane component, the ganglioside GM1, in simple lipid models of the plasma membrane containing sphingomyelin, cholesterol, and phosphatidylcholine. We observe that crosslinking GM1 can cause uniform membranes to phase-separate into large, coexistent liquid ordered and liquid disordered membrane domains. We also find that this lipid separation causes a dramatic redistribution of a transmembrane peptide, consistent with a raft model of membrane organization. These experiments demonstrate a mechanism that could contribute to the effects of crosslinking observed in cellular processes: Domains induced by clustering a small number of proteins or lipids might rapidly reorganize many other membrane proteins.

The chilling of carcasses.

Biochemical processes and structural changes that occur in muscle during the first 24h postmortem play a great role in the ultimate quality and palatability of meat and are influenced by the chilling processes that carcasses are subjected to after slaughter. For beef and lamb, employing chilling parameters that minimize cold shortening is of greatest importance and can be best addressed by ensuring that muscle temperatures are not below 10°C before pH reaches 6.2. For pork, because of the impact of high muscle temperatures and low pH on the development of pale, soft, and exudative (PSE) pork, a more rapid chilling process is needed to reduce PSE with the recommended internal muscle temperature of 10°C at 12h and 2-4°C at 24h. Spray chilling, a system whereby chilled water is applied to carcasses during the early part of postmortem cooling, is used to control carcass shrinkage and to improve chilling rates through evaporative cooling. Delayed chilling can be used to reduce or prevent the negative effects of cold shortening; however, production constraints in high-volume facilities and food safety concerns make this method less useful in commercial settings. Electrical stimulation and alternative carcass suspension programs offer processors the opportunity to negate most or all of the effects of cold shortening while still using traditional chilling systems. Rapid or blast chilling can be an effective method to reduce the incidence of PSE in pork but extreme chilling systems may cause quality problems because of the differential between the cold temperatures on the outside of the carcass compared to the warm muscle temperatures within the carcass (i.e., muscles that are darker in color externally and lighter in color internally).

Biochemical and physical factors affecting discoloration characteristics of 19 bovine muscles.

Steaks from muscles (n=19 from nine beef carcasses) were evaluated over the course of retail display (0-, 1-, 2-, 3-, 4- or 5-d) for objective measures of discoloration (metmyoglobin, oxymyoglobin, L*-, a*-, and b*-values), reducing ability (metmyoglobin reductase activity (MRA), resistance to induced metmyoglobin formation (RIMF), and nitric oxide metmyoglobin reducing ability (NORA)), oxygen consumption rate (OCR), oxygen penetration depth, myoglobin content, oxidative rancidity, and pH. Muscles were grouped according to objective color measures of discoloration. M. longissimus lumborum, M. longissimus thoracis, M. semitendinosus, and M. tensor fasciae latae were grouped as "high" color stability muscles, M. semimembranosus, M. rectus femoris, and M. vastus lateralis were grouped as "moderate" color stability muscles, M. trapezius, M. gluteus medius, and M. latissimus dorsi were grouped as "intermediate" color stability muscles, M. triceps brachi - long head, M. biceps femoris, M. pectoralis profundus, M. adductor, M. triceps brachi - lateral head, and M. serratus ventralis were grouped as "low" color stability muscles, and M. supraspinatus, M. infraspinatus, and M. psoas major were grouped as "very low" color stability muscles. Generally, muscles of high color stability had high RIMF, nitric oxide reducing ability, and oxygen penetration depth and possessed low OCRs, myoglobin content, and oxidative rancidity. In contrast, muscles of low color stability had high MRA, OCRs, myoglobin content, and oxidative rancidity and low RIMF, NORA, and oxygen penetration depth. Data indicate that discoloration differences between muscles are related to the amount of reducing activity relative to the OCR.

The effects of list difficulty and modality of presentation on a computerized version of the Paced Serial Addition Test (PSAT).

The Paced Serial Addition Test (PSAT) presents a series of digits at different speeds with the requirement that the two most recent numbers be added together. Although the PSAT is a relatively difficult test, its level of difficulty may be decreased by changing the number list to make the answers simpler and by presenting the digits visually rather than aurally. In view of this, the present experiment varied both task difficulty (easy vs. hard) and mode of presentation (visual vs. auditory). Task difficulty was manipulated by using two different lists composed of single digits whose answers ranged between 2 and 10 (easy) or 2 and 18 (hard). All stimuli were presented by computer which permitted measurement of response latencies, as well as correctness of responding. The results showed that mode of presentation, but not task difficulty, produced highly significant effects. Additional evidence showed that the ability to compute answers to simple addition problems must be considered as a modulator variable. However, an individual's basic arithmetic ability is not as critical as the modality in which a stimulus is presented. The lower performance associated with the auditory version (i.e., PASAT) was interpreted as an interference effect caused by both the stimulus and the response occurring in a single auditory information processing channel. This interpretation suggests that the PASAT's well documented sensitivity to traumatic brain injury (TBI) may be due, at least in part, to an increased susceptibility to interference effects rather than attributable solely to a decreased rate of information processing.

Lamotrigine for HIV-associated painful sensory neuropathies: a placebo-controlled trial.

OBJECTIVE: To evaluate the efficacy and tolerability of lamotrigine (LTG) for the treatment of pain in HIV-associated sensory neuropathies. METHODS: In a randomized, double-blind study, patients with HIV-associated distal sensory polyneuropathy (DSP) received LTG or placebo during a 7-week dose escalation phase followed by a 4-week maintenance phase. Randomization was stratified according to whether or not patients were currently using neurotoxic antiretroviral therapy (ART). RESULTS: The number of patients randomized was 92 (62 LTG, 30 placebo) in the stratum receiving neurotoxic ART and 135 (88 LTG, 47 placebo) in the stratum not receiving neurotoxic ART. Mean change from baseline in Gracely Pain Scale score for average pain was not different between LTG and placebo at the end of the maintenance phase in either stratum, but the slope of the change in Gracely Pain Scale score for average pain reflected greater improvement with LTG than with placebo in the stratum receiving neurotoxic ART (p = 0.004), as did the mean change from baseline scores on the Visual Analogue Scale for Pain Intensity and the McGill Pain Assessment Scale and patient and clinician ratings of global impression of change in pain (p