Background Regenerated oxidized cellulose (ROC) sheets have gained popularity as an adjunct to a vascularized nasoseptal flap for closure of dural defects after endoscopic endonasal skull‐base approaches (EESBS). However, evidence supporting its impact on the healing process is uncertain. This study was performed to evaluate the impact of ROC on the nasal mucosa and assess its effects on tissue pH, structure, and cell viability. Methods In 5 patients, a 1‐cm2 piece of ROC gauze was placed on the surface of the middle turbinate before it was resected as part of a standard EESBS. Mucosa treated with ROC was separated from untreated mucosa and a histologic examination of structural changes in the respiratory epithelium was performed. To assess the effect of ROC on pH, increasing amounts of ROC were added to culture medium. Nasal fibroblasts viability was assessed in the presence of ROC before and after the pH was neutralized. Results Compared with unexposed controls, treated mucosa exhibited a higher incidence of cell necrosis and epithelial cell detachment. When added to Dulbecco's modified Eagle medium, ROC caused a dose‐dependent decrease in pH of the medium. Only 1 ± 0.8% of cultured fibroblasts exposed to the ROC‐induced acidic medium were alive, whereas 98.25 ± 0.5% of the cells were viable when the pH was neutralized (p < 0.001). Conclusion ROC applied in vivo to nasal mucosa induced epithelial necrosis likely by diminishing the medium pH, because pH neutralization prevents its effect. The ultimate effect of this material on the healing process is yet to be determined.

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Action-based research is an approach used to design studies that seek to both inform and influence practice. The goal of this type of research in the academic arena centers on guiding school improvement to take informed actions. This chapter specifically focuses on action-based research, the process, and the effects the approach has in both P-12 and higher education through the use of two case studies. These case studies show that action-based research can be applied to various settings and age ranges. Theoretical frameworks are provided to endorse ways in which action-based research is an effective hands-on approach aimed towards getting results to improve practices.

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