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Objective: To determine whether patients would have equivalent or improved outcomes when receiving non-surgical management versus surgical removal for vocal process granulomas. Methods: A chart review was performed for 53 adults with vocal process granulomas. All patients received baseline anti-reflux treatment consisting of twice-daily proton pump inhibitors and vocal hygiene education. Further treatment approaches were divided into non-surgical (i.e. inhaled corticosteroids, voice therapy, botulinum toxin injections) and surgical groups. Subjective parameters (Voice Handicap Index 10 and Reflux Symptom Index) and outcomes were tabulated and statistically compared. Cause of granuloma was also analysed to determine if this influenced outcomes. Results: Of 53 patients, 47 (89 per cent) experienced reduction in granuloma size, while 37 (70 per cent) experienced complete resolution. The rate of complete granuloma resolution after initial treatment strategy alone was significantly higher in non-surgical compared to surgical patients (67 and 30 per cent, respectively; p = 0.039). No difference in outcome was seen between iatrogenic and idiopathic granulomas. Conclusion: Non-surgical patients were more likely to experience initial treatment success than those who underwent surgical removal. Continued emphasis should be placed on conservative treatment options prior to surgery for patients with this condition. [ABSTRACT FROM AUTHOR]

Gender affirmation surgeries in male-to-female patient transitioning include breast augmentation, genital construction, and facial feminization surgery (FFS). FFS improves mental health and quality of life in transgender patients. The nose and forehead are critical in facial attractiveness and gender identity; thus, frontal brow reduction and rhinoplasty are a mainstay of FFS. The open approach to reduction of the frontal brow is very successful in the feminization of the face; however, risks include alopecia and scarring. Endoscopic brow reduction, in properly selected patients, is minimally invasive with excellent outcomes avoiding these risks. Since both reduction rhinoplasty and frontal brow reduction are routinely performed in FFS, a combined approach provides superior control over the nasal radix and profile when performing surgery on the frontal bone region first followed by nose reduction. We present a case series of four transwomen undergoing frontal bone reduction in combination with a reduction rhinoplasty. All had excellent results with one DVT that resolved with treatment. Transgender patients frequently require multiple operations during their transition increasing their hospital stay and costs. This combined approach offers superior control over the nasofrontal angle and is not only safe but reduces hospitalizations and costs and is a novel indication to reduce gender dysphoria. [ABSTRACT FROM AUTHOR]

Commercial cultivation of the button mushroomAgaricus bisporusis performed through the inoculation of a semipasteurized composted material. Pasteurization of the compost material prior to inoculation results in a substrate with a fungal community that becomes dominated byA. bisporus. However, little is known about the composition and activity in the wider fungal community beyond the presence ofA. bisporusin compost throughout the mushroom cropping process. In this study, the fungal cropping compost community was characterized by sequencing nuc rDNA ITS1-5.8S-ITS2 amplified from extractable DNA and RNA. The fungal community generated from DNA extracts identified a diverse community containing 211 unique species, although only 51 were identified from cDNA.Agaricus bisporuswas found to dominate in the DNA-derived fungal community for the duration of the cropping process. However, analysis of cDNA extracts foundA. bisporusto dominate only up to the first crop flush, after which activity decreased sharply and a much broader fungal community became active. This study has highlighted the diverse fungal community that is present in mushroom compost during cropping. [ABSTRACT FROM PUBLISHER]

Soil microorganisms are key contributors to nutrient cycling and are essential for the maintenance of healthy soils and sustainable agriculture. Although the antimicrobial effects of a broad range of nanoparticulate substances have been characterised in vitro , little is known about the impact of these compounds on microbial communities in environments such as soil. In this study, the effect of three widely used nanoparticulates (silver, silicon dioxide and aluminium oxide) on bacterial and fungal communities in an agricultural pastureland soil was examined in a microcosm-based experiment using a combination of enzyme analysis, molecular fingerprinting and amplicon sequencing. A relatively low concentration of silver nanoparticles (AgNPs) significantly reduced total soil dehydrogenase and urease activity, while AlO and SiO nanoparticles had no effect. Amplicon sequencing revealed substantial shifts in bacterial community composition in soils amended with AgNPs, with significant decreases in the relative abundance of Acidobacteria and Verrucomicrobia and an increase in Proteobacteria. In particular, the relative abundance of the Proteobacterial genus Dyella significantly increased in AgNP amended soil. The effects of AlO and SiO NPs on bacterial community composition were less pronounced. AgNPs significantly reduced bacterial and archaeal amoA gene abundance in soil, with the archaea more susceptible than bacteria. AgNPs also significantly impacted soil fungal community structure, while AlO and SiO NPs had no effect. Several fungal ribotypes increased in soil amended with AgNPs, compared to control soil. This study highlights the need to consider the effects of individual nanoparticles on soil microbial communities when assessing their environmental impact. [ABSTRACT FROM AUTHOR]

The article focuses on the English entertainment and theatrical devices produced for the French ambassadors in 1564. Based on the letter of William Honing to Sir John Thynne, Queen Elizabeth I ensured a honorable welcome for French nobleman Artus de Cossé at Dover and escorted to London by many gentlemen of Kent. Masques is an entertainment produced to celebrate the Treaty of Troyes in April 1564. French ambassadors in horseback with the help of dogs and footmen, chased and slew the deer in a yard at the queen's gallery.

Aims: The absence of standardized methods for quantifying faecal indicator bacteria (FIB) in sand hinders comparison of results across studies. The purpose of the study was to compare methods for extraction of faecal bacteria from sands and recommend a standardized extraction technique. Methods and Results: Twenty-two methods of extracting enterococci and Escherichia coli from sand were evaluated, including multiple permutations of hand shaking, mechanical shaking, blending, sonication, number of rinses, settling time, eluant-to-sand ratio, eluant composition, prefiltration and type of decantation. Tests were performed on sands from California, Florida and Lake Michigan. Most extraction parameters did not significantly affect bacterial enumeration.anova revealed significant effects of eluant composition and blending; with both sodium metaphosphate buffer and blending producing reduced counts. Conclusions: The simplest extraction method that produced the highest FIB recoveries consisted of 2 min of hand shaking in phosphate-buffered saline or deionized water, a 30-s settling time, one-rinse step and a 10 : 1 eluant volume to sand weight ratio. This result was consistent across the sand compositions tested in this study but could vary for other sand types. Significance and Impact of the Study: Method standardization will improve the understanding of how sands affect surface water quality. [ABSTRACT FROM AUTHOR]

Aims: The species identification and antimicrobial resistance profiles were determined for enterococci isolated from Southern California surface and ocean waters. Methods and Results: Species identification was determined for 1413 presumptive Enterococcus isolates from urban runoff, bay, ocean and sewage water samples. The most frequently isolated species were Enterococcus faecalis, Enterococcus faecium, Enterococcus hirae, Enterococcus casseliflavus and Enterococcus mundtii. All five of these species were isolated from ocean and bay water with a frequency ranging from 7% to 36%. Enterococcus casseliflavus was the most frequently isolated species in urban runoff making up 36–65% of isolates while E. faecium was the most frequently isolated species in sewage making up 53–78% of isolates. The similar distribution of species in urban runoff and receiving water suggests that urban runoff may be the source of Enterococcus. No vancomycin or high level gentamycin resistance was detected in E. faecalis and E. faecium isolates. Conclusions: Enterococcus faecalis, E. faecium, E. casseliflavus and E. mundtii are the most commonly isolated Enterococcus species from urban runoff and receiving waters in Southern California. Significance and Impact of the Study: Determination of the Enterococcus species isolated from receiving waters and potential pollution sources may assist in determining the sources of pollution. [ABSTRACT FROM AUTHOR]

Objective We investigated effects of both vecuronium bromide, a nicotinic cholinergic antagonist, and atropine, a muscarinic cholinergic antagonist, on the pupil of the turtle to determine whether responses to light are controlled by parasympathetic innervations acting on the iris. Animal studied Three red-eared slider turtles, Pseudemys scripta elegans. Procedure Turtles were secured to immobilize their head movements and then inserted into a light-integrating sphere. Both pupils were monitored through small apertures by digital video cameras. Pupil diameters were measured manually with a digital caliper. During each trial, drugs (0.4%) were topically applied, four times at 15 min intervals, to the corneas of each eye. One eye was randomly selected for treatment of the drug while the other, treated with saline (0.9% NaCl), was used as control. Pupil sizes under adaptation to light were tracked after drug or saline applications. Results Mean pupillary diameters of eyes treated with vercuronium bromide increased by 28%, reaching peak size in 90 min. Onset of response occurred 20 min after drug application and then increased at a rate having a time constant of 26 min. Recovery began at 120 min after initial application. Atropine had no effect on pupil size. No systemic side effects by drugs were observed in turtles. Conclusions Although atropine does not cause mydriasis, vecuronium bromide does. These results suggest that the parasympathetic system in turtles acts through acetylcholine onto nicotinic receptors to stimulate pupillary light constriction. [ABSTRACT FROM AUTHOR]

Aims: To compare accuracy of genus and species level identification of presumptive enterococci isolates from the marine environment using conventional biochemical testing, four commercial identification systems and 16S rRNA sequence analysis. Methods and Results: Ninety-seven environmental bacterial isolates identified as presumptive enterococci on mEI media were tested using conventional and Enterococcus genus screen biochemical tests, four commercial testing systems and 16S rRNA sequencing. Conventional and Enterococcus genus screen biochemical testing, 16S rRNA sequencing and two commercial test systems achieved an accuracy of ≥94% for Enterococcus genus confirmation. Conventional biochemical testing and 16S rRNA sequencing achieved an accuracy of ≥90% for species level identification. Conclusions: For confirmation of Enterococcus genus from mEI media, conventional or genus screen biochemical testing, 16S rRNA sequencing and the four commercial systems were correct 79–100% of the time. For speciation to an accuracy of 90% or better, either conventional biochemical testing or 16S rRNA sequencing is required. Significance and Impact of the Study: Accurate identification of presumptive environmental Enterococcus isolates to genus and species level is an integral part of laboratory quality assurance and further characterization of Enterococcus species from pollution incidents. This investigation determines the ability of six different methods to correctly identify environmental isolates. [ABSTRACT FROM AUTHOR]

The article presents an analysis of the ballad "The Ferret and the Coney: An Oddity of Editorial Annotation," by Ben Jonson. It explores the anthologies of English renaissance drama that include both "Bartholmew Fair" and "Tis Pity She's a Whore." It examines the poem "Robert Salter Hunting the Cony and Doc" which tells the story of hunting a coney with the help of a ferret.

This paper presents a comparison of values of wildlife held by stakeholder groups and public samples in Victoria, Australia, with a sample of wildlife managers' beliefs about these groups. It also examines the managers' views of the importance of utilizing human dimensions information in their decision-making. In-depth interviews were conducted with wildlife/environmental managers in a sample of state and local government agencies and members of wildlife management stakeholder groups. Questionnaires were used to explore values of wildlife held by stakeholder group members and the Victorian public. There are several instances of interviewed managers misunderstanding the values held by stakeholder groups and subsets of the Victorian public. Such discrepancies can be reduced by incorporating systematically obtained human dimensions information into management decisions. Interviewed wildlife managers appear to appreciate the importance of human dimensions information; however, there was some uncertainty about how it could be applied. [ABSTRACT FROM AUTHOR]

The longterm outlook after Helicobacter pylori ( H. pylori) eradication in peptic ulcer disease is unclear. This study documents H. pylori recurrence, dyspeptic symptoms and anti-secretory therapy in peptic ulcer patients six years or more after H. pylori eradication. Peptic ulcer patients with H. pylori eradication between 1990 and 1992 were included. Infection recurrence was diagnosed by 13-carbon urea breath test (UBT). Dyspeptic symptoms and anti-secretory therapy use were assessed by questionnaire. Sixty-one patients completed the study protocol. Mean follow-up after eradication was 6.1 years (range 4.8–8.3). Four patients had a positive UBT. H. pylori recurrence rate was 6.6% or 0.02% per patient per year. Forty-two patients (69%) had dyspeptic symptoms. Heartburn and belching were more common than pain (p<0.001). All four patients with H. pylori recurrence had symptoms compared with 38 of 57 H. pylori-negative patients (p>0.05). Ten of 61 patients (16.4%) were taking anti-secretory therapy and their dyspepsia scores were higher. Despite a low H. pylori recurrence rate, longterm dyspeptic symptoms were common in peptic ulcer patients after H. pylori eradication. The symptoms are mainly reflux in type and require anti-secretory therapy in only a minority of patients. [ABSTRACT FROM AUTHOR]

In a prospective protocol, plasma tocopherols, selenium (Se), Se-dependent glutathione peroxidase, platelet aggregation and erythrocyte hemolysis were measured in 23 control subjects, and 15 patients receiving total parenteral nutrition (TPN), before and after 2 wk of TPN unsupplemented with vitamin E and Se. The results indicate that short-term TPN did not alter status of these nutrients. However, TPN patients had significantly lower plasma levels of Se (p < 0.01) and α-tocopherol (p < 0.01) relative to control subjects. Low plasma levels, with no attendant decrease in function, suggest a marginal depletion. In view of this, and considering the low amount of vitamin E and Se supplied by the TPN solutions, supplementation with these nutrients is recommended. [ABSTRACT FROM AUTHOR]

As consumers are released from hospitalization as a result of the downsizing of inpatient psychiatric facilities, their ability to sustain themselves in the community becomes a concern to a number of constituencies. This article describes the development of a program for monitoring persons who were released from hospitals into the community as a result of the downsizing of state psychiatric hospitals. The program's uniqueness was the collaboration between the state mental health authority and the state Alliance for the Mentally Ill in developing and implementing the monitoring system. [ABSTRACT FROM AUTHOR]

Plasma and synovial fluid concentrations of biphenylacetic acid were determined following application of 3 g of 3% biphenylacetic acid gel to one knee of patients suffering from rheumatoid arthritis. The mean peak plasma concentration was 34 ng/ml. Synovial fluid concentrations tended to follow plasma concentrations but at a somewhat lower level, the mean peak synovial fluid concentration was 21 ng/ml. The average ratio of synovial fluid AUC (0-24 h) to plasma AUC (0-24 h) was 0.58, r=0.97. Where patients had bilateral effusions, the concentration in the ipsilateral knee at each time point examined was not significantly different to that in the contralateral knee, suggesting that absorption was initially into the plasma and subsequently into the synovium. [ABSTRACT FROM AUTHOR]

The article reports on civic pageantry and the earliest extant drama for most of the towns during the reign of Henry VII, King of England. From his victory at Bosworth until his victory at Stoke, Henry VII strove energetically to consolidate his new authority. The pomp of his coronation, the business of his first parliament, his marriage with Elizabeth of York and his first provincial progress were all steps towards political stability. At the same time, his visits invited civic pageants so that a city could create a privileged meeting place between itself and its king and define the real relationship between them in ways that transcended both the neutrality of convention and the tact of silence.

A study of the new phase, kettle wax, in the system sodium laurate, sodium chloride and water has been carried out using analytical and visual methods. The lower boundaries of kettle wax and its equilibria were established and when plotted occupy a highly dominant island region on the phase diagram. It occupies a portion between 60 and 70 wt. % soap and about 3 and 7 wt. % of salt. The effects of temperature on kettle wax in this system have also been studied. It was found that kettle wax existed above 75°C. and below 215°C. and has the same type of equilibria with lye throughout this temperature range. In the system sodium laurate, sodium chloride and water, curd is not formed, even by saturating the lye with salt at 90°C. Hence graining out results only in the formation of kettle wax and lye. [ABSTRACT FROM AUTHOR]

The article focuses on two stories of plays performed at Cambridge University, stories that illustrate the decisive role of the monarch as audience and critic, have been generally unnoticed. William Whiteway, a wealthy merchant, one of the fifteen capital burgesses of Dorchester, and its member of Parliament in 1626, was interested in drama with political significance. Whiteway judged production of two of the most controversial Cambridge University plays worthy of note. Both these plays were political in content, being part satires of lovers,scholars, clergymen, common lawyers, and civic officials.

The objective was to determine endometrial blood perfusion and hormone enzyme activity contralateral and ipsilateral to both the corpus luteum (CL) and developing dominant follicle (DF). Fourteen Angus cows were subjected to an Ovsynch + CIDR estrous synchronization protocol with d 0 corresponding to day of estrus. Equine AI rods were passed through the cervices, which provided a canal for the laser Doppler probe (PeriFlux 5000 LDPM, Perimed Inc., Ardmore, PA) to collect endometrial blood perfusion and microvascular flow of tissue surfaces without traumatizing the endometrium. Optimal perfusion was obtained by selecting 10 s of relatively constant perfusion for measurement, as measured by arbitrary Perfusion Units (PU) following calibration. After perfusion was collected, cattle were subjected to an endometrial biopsy utilizing a mare uterine biopsy punch with a sample collected from each horn and snap frozen. Perfusion and uterine biopsies were collected on d 12, 15, 18, and 21 of the estrous cycle. Data were analyzed using repeated measures ANOVA of the MIXED procedure of SAS (SAS Inst. Inc., Cary, NC), using the Wilcoxon rank sum test, and significance was declared at P ≤ 0.05. The model statement included day of estrous cycle, CL and DF location (respective to each uterine horn), the respective interactions with day, and CL and DF size with their respective interactions with day as covariants. Cattle were subjected to ultrasonography on d 11 and 19 of the estrous cycle to determine CL and follicular locations and size. Uterine biopsies were homogenized and activity of uridine 5'-diphospho-glucuronosyltransferase (UGT) was determined via luminogenic substrates (expressed per mg of protein). No differences (P ≥ 0.15) in endometrial perfusion were observed based on the location of the CL. However, endometrial perfusion was greater (P < 0.01) on the ipsilateral side to the DF. No differences (P ≥ 0.34) in endometrial perfusion were observed within day. Finally, no differences (P ≥ 0.38) were observed for UGT activity. In conclusion, endometrial perfusion relative to location of the DF were different whereas the CL location did not influence blood perfusion or UGT activity. This alteration in endometrial perfusion could be due to an increase in estrogen due to the presence of the DF. [ABSTRACT FROM AUTHOR]

Melatonin is a strong antioxidant that contributes to circadian rhythm in several mammalian species. Melatonin has been shown to influence uteroplacental hemodynamics in both sheep and cattle. The objective was to examine fetal liver and placental steroid and eicosanoid enzyme activity during maternal melatonin supplementation. Commercial beef heifers (n = 12) were bred via AI and delegated to receive two 24-mg subdermal melatonin implants (MEL; n = 6) or act as part of a nonimplant control group (CON; n = 6). All treatments were applied at d 180, 210, and 240 of gestation, and heifers underwent Caesarian removal of the fetus at 243 ± 2 d of gestation. Placental samples were collected and separated into maternal (caruncle [CAR]) and fetal (cotyledon [COT]) portions. Additionally, the fetal liver was harvested. Cytochrome P450 1A (CYP1A), 2C (CYP2C), and 3A (CYP3A) and uridine 5'-diphospho-glucuronosyltransferase (UGT) activities were determined via luminogenic substrates. Activities were expressed per milligram of protein, and data were analyzed, using the Wilcoxon rank sum test, within tissue using the MIXED procedure of SAS (SAS Inst. Inc., Cary, NC) with treatment, fetal sex, and the interaction thereof in the model. Statistical significance was declared at P = 0.05. Activity of CYP1A in CAR was decreased (P = 0.02) in male vs. female fetuses from CON dams. Activity of CYP1A was not different (P ≥ 0.25) in COT tissues; however, activity of CYP1A in the fetal liver was increased (P = 0.01) in male vs. female fetuses. Activity of CYP2C was observed only in CAR and was not different between treatments (P ≥ 0.59). Activity of CYP3A was observed only in the fetal liver and was not different between treatments (P ≥ 0.41). Activity of UGT in COT was decreased (P = 0.03) in male fetuses from MEL dams vs. female fetuses from MEL dams and male fetuses from CON dams. Activity of UGT was not different (P ≥ 0.34) between treatments in CAR; however, activity of UGT was increased (P = 0.002) in the fetal liver from MEL dams compared with the fetal liver from CON dams. In conclusion, melatonin supplementation did alter hormone metabolizing enzymes in fetal liver and placental tissues of gestating cattle. Moreover, the difference in activity of steroid and eicosanoid metabolizing enzymes in male and female fetuses may indicate a physiological adaptation to decrease excessive exposure. [ABSTRACT FROM AUTHOR]

The article discusses sixteenth century Master of Revels Sir Thomas Benger, based on accounts of masques recounted in the correspondence written to Sir John Thynne, former Lord Protector of King Edward VI. Benger was appointed to the court of Queen Elizabeth I in 1560 and soon organized the marriage celebrations for William Brooke, Lord Cobham, and Frances Newton, one of Elizabeth's chamberers. In 1567, a Shrove Tuesday masque he oversaw resulted in his imprisonment in the Tower of London, England. Letters written by Richard Young, possibly a clerk of letters patent in 1571, to Thynne are detailed.

Introduction: The rate of implantation of cardiac rhythm management devices continues to rise and therefore the morbidity of revision procedures needs to be substantiated. Revision operations are acknowledged to be higher risk procedures than virgin implants but the evidence directly comparing complications is poor. We contrast the morbidity at 1-year for patients requiring standard device revision procedures, at a single UK centre.Methods: Contemporaneously maintained clinical health records were analysed by a single investigator, for complications and re-operations arising within 1 year after transvenous cardiac implantable electronic device (CIED) procedures (primary implant, generator (Bx) replacement, lead only, generator and lead (Bx and lead) replacement, system reburial), performed between April 2008–March 2011. Data was collated on the following complications/ re-operations; (1) radiographic evidence of a pneumothorax, (2) transthoracic echocardiographic evidence of a pericardial effusion and (3) re-operation relating to the CIED system or implant site. Complications and re-operations were analysed as discrete entities, according to the index procedure and mortality censoring adjusting for deaths within the follow-up year.Results: 3,713 procedures were performed. 35% female and 65% male patients. The median age was 72 years (range 15–100). Complications and re-operations are outlined in the table below.The most frequent reason for re-operation varied by index procedure. Lead re-interventions were frequent post primary implant (84; 3.2%) or lead revision (11, 8.0%). Generator manipulation increased reburial (20, 2.5% generator replacement; 7, 6.3% generator and lead) and explant/ extraction procedures (20, 2.5% generator replacement; 13, 17.6% reburial). Infection was the predominant reason for explant/extraction independent of the index procedure (49; 92.5%). Pneumothoraxes required aspiration or intercostal drainage in 0.2% virgin CIED operations, 0.7% lead only procedures and 2.7% generator and lead operations. 2 pericardial effusions were managed with pericardial drainage (1 primary implant, 1 lead only). Admission priority had 1-year survival implications after PPM generator, lead and generator and reburial operations (p < 0.05).Conclusion: There is a 5.0% complication rate within 1-year of a new CIED implant. Routine revision procedures confer escalating complication rates; 6.0%, 16.7%, 22.5% and 31.1% for generator replacement, lead only intervention, combined lead and generator replacement and reburials respectively.Complications and re-operations according to the index procedurePrimary implant n=2,585Bx n=805Lead n=138Bx and lead n=111Reburial n=74Pneumothorax16-15-Pericardial effusion3-12-Re-operation11048211823 Haematoma evacuation20010 Lead re-intervention8481152 System reburial1220778 Explant/extraction12203513Total129 (5.0%)48 (6.0%)23 (16.7%)25 (22.5%)23 (31.1%) [ABSTRACT FROM PUBLISHER]