Cocaine use in sinonasal surgery: patients' perspective on its use and the need for pre-operative consent.

Objectives: Intranasal cocaine is commonly used in endoscopic sinus surgery due to its vasoconstrictive and anaesthetic properties. This study aimed to understand patients' perspectives and whether patients should have to give their consent for its use.

Methods: Prospective data were collected over a three-month period in ENT departments in the out-patient setting of two district general hospitals.

Homozygous HLA-DQB1*06:02 combined with T-cell receptor alpha polymorphism results in narcolepsy onset - A familial case report.

Narcolepsy is a life-long neurological disorder with well-established genetic risk factors. Human leukocyte antigen-DQB1*06:02 remains the strongest genetic predeterminant; however, polymorphisms in genes encoding the T-cell receptor alpha chain are also strongly linked. This case report shows the inheritance pathway of these genetic markers contributing to narcolepsy onset in a 17-year-old female.

Human leukocyte antigen epitope mismatch loads and the development of de novo donor-specific antibodies in cardiothoracic organ transplantation.

De novo donor-specific human leucocyte antigen (HLA) antibodies (dnDSA) are associated with increased risk of rejection and mortality in solid organ transplantation. Such dnDSA is produced in some recipients upon allorecognition of mismatched HLA post-transplant. HLA matching is not currently considered in the allocation of deceased donor hearts and lungs and pre-transplant immunological risk stratification is based entirely on the mean fluorescence intensity (MFI) of circulating donor-directed HLA antibodies.

Transmastoid Occlusion Surgery for Superior Semicircular Canal Dehiscence Syndrome Improves Patient-Reported Quality-of-Life Measures and corrects cVEMP Thresholds and Amplitudes.

Objective: To determine the pre- and postoperative clinical, audiological, vestibular, and patient-reported measures in patients undergoing transmastoid occlusion surgery for superior canal dehiscence syndrome (SCDS).

Study Design: Retrospective case review.

Setting: Tertiary referral centre, UK.

Variations in visceral leishmaniasis burden, mortality and the pathway to care within Bihar, India.

Background: Visceral leishmaniasis (VL) has been targeted by the WHO for elimination as a public health problem (< 1 case/10,000 people/year) in the Indian sub-continent (ISC) by 2020. Bihar State in India, which accounts for the majority of cases in the ISC, remains a major target for this elimination effort. However, there is considerable spatial, temporal and sub-population variation in occurrence of the disease and the pathway to care, which is largely unexplored and a threat to achieving the target.

Consumer Perception of Retail Pork Bacon Attributes Using Adaptive Choice-based Conjoint Analysis and Maximum Differential Scaling.

Unlabelled: Bacon is one of the most recognizable consumer pork products and is differentiated by appearance, flavor, thickness, and several possible product claims. The objective of this study was to explore the attributes of retail bacon that influence consumers to purchase and consume bacon. An Adaptive Choice-Based Conjoint (ACBC) survey was designed for attributes of raw American-style bacon.

Risks of Breast, Ovarian, and Contralateral Breast Cancer for BRCA1 and BRCA2 Mutation Carriers.

Importance: The clinical management of BRCA1 and BRCA2 mutation carriers requires accurate, prospective cancer risk estimates.

Objectives: To estimate age-specific risks of breast, ovarian, and contralateral breast cancer for mutation carriers and to evaluate risk modification by family cancer history and mutation location.

Design, Setting, And Participants: Prospective cohort study of 6036 BRCA1 and 3820 BRCA2 female carriers (5046 unaffected and 4810 with breast or ovarian cancer or both at baseline) recruited in 1997-2011 through the International BRCA1/2 Carrier Cohort Study, the Breast Cancer Family Registry and the Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer, with ascertainment through family clinics (94%) and population-based studies (6%).

Elimination of visceral leishmaniasis in the Indian subcontinent: a comparison of predictions from three transmission models.

We present three transmission models of visceral leishmaniasis (VL) in the Indian subcontinent (ISC) with structural differences regarding the disease stage that provides the main contribution to transmission, including models with a prominent role of asymptomatic infection, and fit them to recent case data from 8 endemic districts in Bihar, India. Following a geographical cross-validation of the models, we compare their predictions for achieving the WHO VL elimination targets with ongoing treatment and vector control strategies. All the transmission models suggest that the WHO elimination target (<1 new VL case per 10,000 capita per year at sub-district level) is likely to be met in Bihar, India, before or close to 2020 in sub-districts with a pre-control incidence of 10 VL cases per 10,000 people per year or less, when current intervention levels (60% coverage of indoor residual spraying (IRS) of insecticide and a delay of 40days from onset of symptoms to treatment (OT)) are maintained, given the accuracy and generalizability of the existing data regarding incidence and IRS coverage.

Screening for arteriovenous malformations in hereditary haemorrhagic telangiectasia.

Objective: To determine whether patients with hereditary haemorrhagic telangiectasia were being screened according to international guidelines, and to review recent evidence in order to provide up-to-date guidelines for the initial systemic management of hereditary haemorrhagic telangiectasia.

Methods: A retrospective case note analysis was conducted, assessing patients in terms of screening for: genetics, cerebral arteriovenous malformations, pulmonary and hepatic arteriovenous malformations, and gastrointestinal telangiectasia. Databases searched included Medline, the Cumulative Index to Nursing and Allied Health Literature, and Embase.

Understanding the transmission dynamics of Leishmania donovani to provide robust evidence for interventions to eliminate visceral leishmaniasis in Bihar, India.

Visceral Leishmaniasis (VL) is a neglected vector-borne disease. In India, it is transmitted to humans by Leishmania donovani-infected Phlebotomus argentipes sand flies. In 2005, VL was targeted for elimination by the governments of India, Nepal and Bangladesh by 2015.

Quantitative analyses and modelling to support achievement of the 2020 goals for nine neglected tropical diseases.

Quantitative analysis and mathematical models are useful tools in informing strategies to control or eliminate disease. Currently, there is an urgent need to develop these tools to inform policy to achieve the 2020 goals for neglected tropical diseases (NTDs). In this paper we give an overview of a collection of novel model-based analyses which aim to address key questions on the dynamics of transmission and control of nine NTDs: Chagas disease, visceral leishmaniasis, human African trypanosomiasis, leprosy, soil-transmitted helminths, schistosomiasis, lymphatic filariasis, onchocerciasis and trachoma.

The effect of extrinsic attributes on liking of cottage cheese.

Preference mapping studies with cottage cheese have demonstrated that cottage cheese liking is influenced by flavor, texture, curd size, and dressing content. However, extrinsic factors such as package, label claims, and brand name may also influence liking and have not been studied. The objective of this study was to evaluate the role of package attributes and brand on the liking of cottage cheese.

A risk prediction algorithm for ovarian cancer incorporating BRCA1, BRCA2, common alleles and other familial effects.

Background: Although BRCA1 and BRCA2 mutations account for only ∼27% of the familial aggregation of ovarian cancer (OvC), no OvC risk prediction model currently exists that considers the effects of BRCA1, BRCA2 and other familial factors. Therefore, a currently unresolved problem in clinical genetics is how to counsel women with family history of OvC but no identifiable BRCA1/2 mutations.

Methods: We used data from 1548 patients with OvC and their relatives from a population-based study, with known BRCA1/2 mutation status, to investigate OvC genetic susceptibility models, using segregation analysis methods.

Examining extrinsic factors that influence product acceptance: a review.

Drivers of liking (DOL) studies are useful for product development to formulate acceptable products; however, DOL alone are insufficient for understanding why a product is purchased and repurchased, which is ultimately the indication of a successful product. Ultimately sensory attributes drive product success (that is, repeat and continued purchase). However, ignoring the importance of extrinsic factors may neglect the vital product attributes responsible for the initial purchase, which may in turn, affect repeat purchase.

Consumer attitudes and preferences for fresh market tomatoes.

Unlabelled: This study established attractive attributes and consumer desires for fresh tomatoes. Three focus groups (n = 28 participants) were conducted to explore how consumers perceived tomatoes, including how they purchased and consumed them. Subsequently, an Adaptive Choice Based Conjoint (ACBC) survey was conducted to understand consumer preferences toward traditional tomatoes.

When is a neck lump not a neck lump? Initial presentation of a solitary sternocleidomastoid muscle in an adult.

A 70-year-old woman was referred to us for evaluation of a presumed left-sided neck mass. The referral was based on the visual appearance of subtle neck asymmetry. The patient reported no ENT symptoms.

Ovarian cancer familial relative risks by tumour subtypes and by known ovarian cancer genetic susceptibility variants.

Background: Family history is one of the most important risk factors for epithelial ovarian cancer (EOC). Little is known, however, on how EOC familial relative risks (FRRs) vary by factors such as tumour subtype or the combined effects of common EOC susceptibility alleles. In addition, no data currently exist on the FRRs associated with EOC after exclusion of BRCA1 or BRCA2 mutation carriers.

Influence of heating and acidification on the flavor of whey protein isolate.

Previous studies have established that whey protein manufacture unit operations influence the flavor of dried whey proteins. Additionally, manufacturers generally instantize whey protein isolate (WPI; ≥ 90% protein) by agglomeration with lecithin to increase solubility and wettability. Whey protein isolate is often subjected to additional postprocessing steps in beverage manufacturing, including acidification and heat treatment.

The impact of iron on the bleaching efficacy of hydrogen peroxide in liquid whey systems.

Unlabelled: Whey is a value-added product that is utilized in many food and beverage applications for its nutritional and functional properties. Whey and whey products are generally utilized in dried ingredient applications. One of the primary sources of whey is from colored Cheddar cheese manufacture that contains the pigment annatto resulting in a characteristic yellow colored Cheddar cheese.

Increased severity of acute graft versus host disease as a result of differential expression following a homozygous gene deletion.

Acute graft versus host disease (aGvHD) is a major cause of early morbidity post-haematopoietic stem cell transplantation with minor histocompatibility antigens being a contributing factor. One mHA encoded by the UDP glycosyltransferase 2 family polypeptide B17 (UGT2B17) gene has been shown to be immunogenic because of differential expression in the donor and recipient. We investigated the effects of a homozygous gene deletion of UGT2B17 on the severity of acute aGvHD post-HSCT in HLA-matched related donors.

Effect of bleaching whey on sensory and functional properties of 80% whey protein concentrate.

Whey is a highly functional food that has found widespread use in a variety of food and beverage applications. A large amount of the whey proteins produced in the United States is derived from annatto-colored Cheddar cheese. Color from annatto is undesirable in whey and must be bleached.