Autologous Fat Grafting for Treating Blepharoplasty-induced Lower Eyelid Retraction

Summary: Autologous fat grafting for blepharoplasty-induced lower eyelid retraction offers potential for a long-term solution while avoiding the morbidity associated with posterior lamellar spacer grafts. By combining traditional methods of lifting the retracted lower eyelid with autologous fat grafting, both functional and aesthetic concerns can be successfully addressed in these patients.

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Functional and Quantitative MRI Mapping of Somatomotor Representations of Human Supralaryngeal Vocal Tract

<span class="paragraphSection"><div class="boxTitle">Abstract</div>Speech articulation requires precise control of and coordination between the effectors of the vocal tract (e.g., lips, tongue, soft palate, and larynx). However, it is unclear how the cortex represents movements of and contact between these effectors during speech, or how these cortical responses relate to inter-regional anatomical borders. Here, we used phase-encoded fMRI to map somatomotor representations of speech articulations. Phonetically trained participants produced speech phones, progressing from front (bilabial) to back (glottal) place of articulation. Maps of cortical myelin proxies (R₁= 1/T₁) further allowed us to situate functional maps with respect to anatomical borders of motor and somatosensory regions. Across participants, we found a consistent topological map of place of articulation, spanning the central sulcus and primary motor and somatosensory areas, that moved from lateral to inferior as place of articulation progressed from front to back. Phones produced at velar and glottal places of articulation activated the inferior aspect of the central sulcus, but with considerable across-subject variability. R₁ maps for a subset of participants revealed that articulator maps extended posteriorly into secondary somatosensory regions. These results show consistent topological organization of cortical representations of the vocal apparatus in the context of speech behavior.</span>

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Neural Representations of Belief Concepts: A Representational Similarity Approach to Social Semantics

<span class="paragraphSection"><div class="boxTitle">Abstract</div>The present experiment identified neural regions that represent a class of concepts that are independent of perceptual or sensory attributes. During functional magnetic resonance imaging scanning, participants viewed names of social groups (e.g. Atheists, Evangelicals, and Economists) and performed a one-back similarity judgment according to 1 of 2 dimensions of belief attributes: political orientation (Liberal to Conservative) or spiritualism (Spiritualist to Materialist). By generalizing across a wide variety of social groups that possess these beliefs, these attribute concepts did not coincide with any specific sensory quality, allowing us to target conceptual, rather than perceptual, representations. Multi-voxel pattern searchlight analysis was used to identify regions in which activation patterns distinguished the 2 ends of both dimensions: Conservative from Liberal social groups when participants focused on the political orientation dimension, and spiritual from Materialist groups when participants focused on the spiritualism dimension. A cluster in right precuneus exhibited such a pattern, indicating that it carries information about belief-attribute concepts and forms part of semantic memory—perhaps a component particularly concerned with psychological traits. This region did not overlap with the theory of mind network, which engaged nearby, but distinct, parts of precuneus. These findings have implications for the neural organization of conceptual knowledge, especially the understanding of social groups.</span>

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Online Palliative Care and Oncology Patient Education Resources Through Google: Do They Meet National Health Literacy Recommendations?

Publication date: Available online 27 January 2017
Source:Practical Radiation Oncology
Author(s): Arpan V. Prabhu, Tudor Crihalmeanu, David R. Hansberry, Nitin Agarwal, Christine Glaser, David A. Clump, Dwight E. Heron, Sushil Beriwal
PurposeThe Google search engine is a common resource used by patients to access health-related patient education information. The American Medical Association and National Institutes of Health recommend that patient education resources be written between the third and seventh grade reading levels. We assessed the readability levels of online palliative care patient education resources using ten readability algorithms widely accepted in the medical literature.MethodsIn October 2016, ten terms pertaining to palliative care and oncology were individually searched for using the Google search engine, and the first ten articles written for the public for each term were downloaded for a total of 100 articles. The terms included: palliative care, hospice, advance directive, cancer pain management, treatment of metastatic disease, treatment of brain metastasis, treatment of bone metastasis, palliative radiation therapy, palliative chemotherapy, and end-of-life care. We determined the average reading level of the articles by readability scale and website domain.ResultsNine readability assessments with scores equivalent to academic grade level found that the 100 palliative care education articles were collectively written at a 12.1 reading level (SD 2.1; Range 7.6–17.3). Zero articles were written below a 7th grade level. Exactly 49 (49%) articles were written above a high school graduate reading level. The Flesch Reading Ease scale classified the articles as 'difficult' to read with a score of 45.6 out of 100. The articles were collected from 62 different website domains. Seven domains were accessed 3 or more times, of which www.mskcc.org had the highest average article reading level at a 14.5 grade level (SD 1.4; Range 13.4–16.1).ConclusionMost palliative care education articles readily available on Google are written above national health literacy recommendations. There is need for revision of these resources to allow patients and their families to derive the most benefit from these materials.



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Identification and analysis of intermediate-size noncoding RNAs in the rhesus macaque fetal brain

Publication date: Available online 27 January 2017
Source:Journal of Genetics and Genomics
Author(s): Liyuan Zhu, Xiaochao Tan, Wei Liu, Fengbiao Mao, Chao Wu, Junjie Zhou, Xiao Liu, Shuaiyao Lu, Kaili Ma, Bin Yin, Jianjun Luo, Jiangang Yuan, Boqin Qiang, Runsheng Chen, Xiaozhong Peng




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Regulators of alternative polyadenylation operate at the transition from mitosis to meiosis

Publication date: Available online 27 January 2017
Source:Journal of Genetics and Genomics
Author(s): Lingjuan Shan, Chan Wu, Di Chen, Lei Hou, Xin Li, Lixia Wang, Xiao Chu, Yifeng Hou, Zhaohui Wang
In the sexually reproductive organisms, gametes are produced by meiosis following a limited mitotic amplification. However, the intrinsic program switching cells from mitotic to meiotic cycle is unclear. Alternative polyadenylation (APA) is a highly conserved means of gene regulation and is achieved by RNA 3′-processing machinery to generate diverse 3′UTR profiles. In Drosophila spermatogenesis, we observed distinct profiles of transcriptome-wide 3′UTR between mitotic and meiotic cells. In mutant germ cells stuck in mitosis, 3′UTRs of hundreds genes were consistently shifted. Remarkably, altering the levels of multiple 3′-processing factors disrupted germline's progression to meiosis, indicative of APA's active role in this transition. An RNA-binding protein (RBP) Tut could directly bind 3′UTRs of 3′-processing factors whose expressions were repressed in the presence of Tut-containing complex. Further, we demonstrated that this RBP complex could execute the repression post-transcriptionally by recruiting CCR4/Twin of deadenylation complex. Thus, we propose that an RBP complex regulates the dynamic APA profile to promote the mitosis-to-meiosis transition.



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lncRInter: A database of experimentally validated long non-coding RNA interaction

Publication date: Available online 27 January 2017
Source:Journal of Genetics and Genomics
Author(s): Chun-Jie Liu, Changhan Gao, Zhaowu Ma, Renhuai Cong, Qiong Zhang, An-Yuan Guo




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Beyond the concepts of nanocomposite and 3D printing: PVA and nanodiamonds for layer-by-layer additive manufacturing

Publication date: 5 April 2017
Source:Materials & Design, Volume 119
Author(s): Mariglen Angjellari, Emanuela Tamburri, Luca Montaina, Marco Natali, Daniele Passeri, Marco Rossi, Maria Letizia Terranova
The use of dispersions of poly(vinyl alcohol) PVA and detonation nanodiamond (DND) as novel inks for 3D printing of variously shaped objects using a layer-by-layer additive manufacturing method is reported. In parallel with the nanocomposites preparation, we designed a 3D printing apparatus and settled protocols for the shaping of hybrid materials, choosing PVA-DND inks as a model system to test the performances of the 3D apparatus. Along with material design and preparation, we discuss the main factors influencing the quality of the final printed objects and enlighten the importance of the matching between the chemical/physical properties of the materials to be extruded and the characteristics of the 3D printer. The thermal and mechanical properties of the printed systems have been tested by Differential Scanning Calorimetry and Contact Resonance Atomic Force Microscopy. The analysis of the mechanical properties of the 3D printed objects evidenced, for 0.5%w/w, 1%w and 5%w DND-loaded nanocomposites, values of mean indentation modulus that are 22%, 44% and 200% higher, respectively, than that of the unloaded PVA. The results of the present research, indicate that an appropriate methodology is able to print PVA-DND nanocomposites in well-defined and shaped structures, suitable for a variety of possible applications.

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The effects of electrochemical polarization condition and applied potential on tribocorrosion behaviors of Inconel 690 alloys in water environment

Publication date: 5 April 2017
Source:Materials & Design, Volume 119
Author(s): J. Li, B.B. Yang, Y.H. Lu, L. Xin, Z.H. Wang, T. Shoji
The fretting corrosion behaviors of Inconel 690 in cathodic condition (CC) and anodic condition (AC) in water environment were investigated. The results indicated that fretting wear behavior, wear mechanism and the microstructure evolution mechanisms in the subsurface strongly depended on polarization condition. There was a thin wear debris layer (WDL) and a thick tribologically transformed structure (TTS) without oxidation in CC; while a thick oxidized WDL and a thin complex TTS consisting of nanocrystalline Ni-rich and Cr-rich oxide zones was observed in AC. The micro-cracks formed at the interface of WDL/TTS in CC, while they formed at the interfaces of Ni-rich/Cr-rich oxide zones and TTS/GDL in AC.

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Synthesis of 3D architecture CuO micro balls and nano hexagons and its electrochemical capacitive behavior

Publication date: 5 April 2017
Source:Materials & Design, Volume 119
Author(s): P. Subalakshmi, M. Ganesan, A. Sivashanmugam
CuO micro balls and nano hexagons have been synthesized by time, cost effective rapid hydrothermal and precipitation methods respectively. Physical characterization is explained through various analytical techniques. Electrochemical performance of CuO as an active material for super capacitor application in 6M KOH solution is illustrated. CuO micro balls exhibit specific capacitance of about 470Fg⁻¹ where as CuO nano hexagons exhibit only 103Fg⁻¹ at current density of 0.5Ag⁻¹. The superior electrochemical performance of CuO micro balls is attributed to 3D micro structure assembled from nano sheets eventually possess more active sites as evident from larger surface area observed in BET analysis. Further, co-existence of Cu2O phase enhances the electrochemical performance by reversible redox couple CuO/Cu2O and the entrapped hydroxyl group in micro balls increases the conductivity and accelerates the electrode kinetics in alkaline medium.

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Photocatalystic degradation of RhB over highly visible-light-active Ag3PO4-Bi2MoO6 heterojunction using H2O2 electron capturer

Publication date: 5 April 2017
Source:Materials & Design, Volume 119
Author(s): Xiao Du, Jun Wan, Jia Jia, Chao Pan, Xiaoyun Hu, Jun Fan, Enzhou Liu
Ag3PO4-Bi2MoO6 heterojunctions with visible-light photocatalytic activity were successfully fabricated via a deposition-precipitation method. The investigation shows that Ag3PO4-Bi2MoO6 composites exhibit enhanced visible light harvesting ability and better degradation efficiency for RhB compared with Bi2MoO6 and Ag3PO4 under visible light irradiation (λ>420nm). What's more, we found that the activity and the stability of Ag3PO4-Bi2MoO6 heterojunction could be further improved by adding of H2O2 in the RhB reaction solution. The enhanced photocatalytic performance and structure stability are primarily attributed to the efficient charge carrier separation of the heterojunction formed by Ag3PO4 and Bi2MoO6, and the electron capturing property of H2O2 on the surface of Ag3PO4-Bi2MoO6 composites, leading to a highly efficient removal of RhB using the Ag3PO4-Bi2MoO6-H2O2 system. In addition, the active species trapping experiments indicate that h⁺ and •O2^– play important roles during the photocatalytic degradation process. This work suggests that the H2O2 assisted Ag3PO4-Bi2MoO6 heterojunction system could be a potential promising photocatalyst for environmental remediation.

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Effect of processing conditions on the thermal and electrical conductivity of poly (butylene terephthalate) nanocomposites prepared via ring-opening polymerization

Publication date: 5 April 2017
Source:Materials & Design, Volume 119
Author(s): S. Colonna, M.M. Bernal, G. Gavoci, J. Gomez, C. Novara, G. Saracco, A. Fina
Successful preparation of polymer nanocomposites, exploiting graphene-related materials, via melt mixing technology requires precise design, optimization and control of processing. In the present work, the effect of different processing parameters during the preparation of poly (butylene terephthalate) nanocomposites, through ring-opening polymerization of cyclic butylene terephthalate in presence of graphite nanoplatelets (GNP), was thoroughly addressed. Processing temperature (240°C or 260°C), extrusion time (5 or 10min) and shear rate (50 or 100rpm) were varied by means of a full factorial design of experiment approach, leading to the preparation of polybutylene terephthalate/GNP nanocomposite in 8 different processing conditions. Morphology and quality of GNP were investigated by means of electron microscopy, X-ray photoelectron spectroscopy, thermogravimetry and Raman spectroscopy. Molecular weight of the polymer matrix in nanocomposites and nanoflake dispersion were experimentally determined as a function of the different processing conditions. The effect of transformation parameters on electrical and thermal properties was studied by means of electrical and thermal conductivity measurement. Heat and charge transport performance evidenced a clear correlation with the dispersion and fragmentation of the GNP nanoflakes; in particular, gentle processing conditions (low shear rate, short mixing time) turned out to be the most favourable condition to obtain high conductivity values.

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The effects of antimony additions on microstructures, thermal and mechanical properties of Sn-8Zn-3Bi alloys

Publication date: 5 April 2017
Source:Materials & Design, Volume 119
Author(s): Guang Ren, Maurice N. Collins
In this paper, the effect Sb on the microstructure, thermal and mechanical properties of Sn-8Zn-3Bi alloys was studied. With addition of 0.5–1.5wt.% Sb, melting temperature and undercooling is slightly increased compared with Sn-8Zn-3Bi alloy, while the pasty range remains unchanged. It was found that the addition of Sb refined the microstructure, resulting in a smaller α-Zn phase, and enlarged the Sn-Zn eutectic area, without intermetallic compound (IMC) formation. Mechanical properties are significantly improved by micro-alloying and this is attributed to solid solution strengthening. With the addition of 1.5wt.% Sb, tensile strength, yield stress and Young's modulus was improved by 14.5%, 87% and 116.2% respectively, compared with the Sn-8Zn-3Bi solder alloy. Elongation was increased by 28%, due to a more ductile fracture mechanism. The relatively low melting temperature, superior mechanical properties, along with narrow pasty range and undercooling, makes Sn-8Zn-3Bi-xSb alloy system a potential low temperature lead-free alloy for temperature sensitive applications such as optoelectronics, crystal oscillators, MEMS devices, and internet-of-things (IoT) devices.

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Microstructure and mechanical properties of Ni1,5Co1,5CrFeTi0,5 high entropy alloy fabricated by mechanical alloying and spark plasma sintering

Publication date: 5 April 2017
Source:Materials & Design, Volume 119
Author(s): Igor Moravcik, Jan Cizek, Jozef Zapletal, Zuzana Kovacova, Jozef Vesely, Peter Minarik, Michael Kitzmantel, Erich Neubauer, Ivo Dlouhy
The present work is focused on synthesis and mechanical properties evaluation of non-equiatomic Ni1,5Co1,5CrFeTi0,5, ductile single phase high entropy alloy (HEA) with excellent mechanical properties (bend strength Rmb=2593MPa, tensile strength Rm=1384MPa, tensile elongation to fracture of 4.01%, and elastic modulus of 216GPa) surpassing those of traditional as-cast HEA. For the alloy production, a combination of mechanical alloying (MA) process in a planetary ball mill and spark plasma sintering (SPS) for powder densification was utilized. The tensile properties of a bulk material produced by a combination of MA+SPS are characterized for the first time. The feedstock powder and corresponding bulk material microstructure, elemental and phase composition, and mechanical properties were investigated by scanning (SEM) and transmission (TEM) electron microscopy, energy-dispersive X-ray spectroscopy (EDX), electron backscatter diffraction (EBSD), X-ray diffraction (XRD), as well as impulse excitation of vibration, Vickers microhardness and tensile and bend strength tests, respectively. The structure of the samples consisted of single-phase FCC high entropy solid solution of extremely fine-twinned grains and oxide inclusions inherited from the original powder feedstock. Dimple-like morphology corresponding to ductile fracture mode has been observed on the fracture surfaces, with crack initiation sites on the inclusions phases.

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Growth assessment of (002)-oriented AlN thin films on Ti bottom electrode deposited on silicon and kapton substrates

Publication date: 5 April 2017
Source:Materials & Design, Volume 119
Author(s): M.A. Signore, A. Taurino, M. Catalano, M. Kim, Z. Che, F. Quaranta, P. Siciliano
In the present work, the sputtering deposition conditions allowing the achievement of (002)-oriented aluminum nitride (AlN) thin films on titanium (Ti) bottom electrode were assessed on both silicon and kapton substrates. The AlN grain orientation was enhanced by tuning the conditions used for the Ti deposition, particularly the radiofrequency (RF) power applied to Ti target and the total pressure in the deposition chamber. Sputtered species energy and their flux towards the substrate were identified as key parameters to interpret Ti structure and morphology on both substrates, and to understand how they drive the AlN crystallization process. The evolution of morphology and structure of single Ti films and of the AlN/Ti system was characterized by X-ray Diffraction, Scanning Electron Microscopy and Transmission Electron Microscopy. Highly oriented AlN films were obtained on both substrates when the underneath Ti layer was mainly (002)-oriented; the presence in the Ti films of grains with (100) orientation produced a degree of misorientation in the following AlN growth, also resulting in a significant change of the surface morphology, on both substrates. The successful deposition of AlN/Ti on kapton substrate represents a promising result for the integration of this material in flexible piezoelectric electronics.

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Modelling of the buckling of a diaphragm–spine structure for a wave energy converter

Publication date: 5 April 2017
Source:Materials & Design, Volume 119
Author(s): K.M. Collins, M. Meng, H.R. Le, D. Greaves, N.W. Bellamy
A wide range of wave energy converter (WEC) designs exists, and the SeaWave WEC uses an unstable buckled spine mode of operation. The SeaWave consists of a hose and buckled spine-diaphragm, which pumps air along the device under wave action. A physical model and finite element analysis (FEA) is compared to a previous theoretical model in this paper. The FE model was developed in ABAQUS 6.14 using shell, solid and contact elements and the analysis was done with a quasi-static approach to reduce the computational costs. The physical model was a scale version of the novel arrangement of the spine and diaphragm made from steel, polycarbonate and latex rubber. Geometry of the deformed device was investigated results showed an increase in transverse and longitudinal curvature as the compression rate increased. The FEA tended to overestimate the bending stiffness of the model, and hence the transverse curvature, because certain behaviours of the physical model were not captured. The force required to switch from one buckled state to another was measured both in the physical and FEA models and the potential energy storage was estimated to be 0.5J/m of device at a compression rate of 0.1%.

Graphical abstract

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Synthesis and characterization of helium-charged titanium hydride films deposited by direct current magnetron sputtering with mixed gas

Publication date: 5 April 2017
Source:Materials & Design, Volume 119
Author(s): Zhibin Han, Chunjie Wang, Liqun Shi
Controllable helium-containing TiH2 phase films were prepared on Si (100) substances by magnetron sputtering with hydrogen-helium-argon mixed gas, in order to investigate the helium behavior in titanium tritide. The TiHxHe films were characterized by ion beam analysis (IBA) in which elastic recoil detection (ERD) and Rutherford backscattering spectrometry (RBS) methods are included, X-ray diffraction (XRD) and scanning electron microscope (SEM). It is found that with the increase in the relative hydrogen flow rate (QH: QAr) under the fixed helium flow and sputtering pressure, the hydrogen concentration in TiHxHe films increases at first, and then decreases. Though the hydrogen concentration in TiHxHe films can be greatly increased by increasing the total sputtering pressure, excessive sputtering pressure will deteriorate the crystallization quality. Although the helium concentration mainly relies on the relative helium flow rate of mixed gas during sputtering, the increase of the relative helium flow rate will reduce the concentration of hydrogen in films at fixed sputtering pressure dramatically. Fortunately, suitable relative hydrogen flow and sputtering pressure can maintain a high concentration of hydrogen in the films. Thus TiHxHe films with controllable hydrogen and helium content can be achieved.

Graphical abstract

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Transition from LDR to HDR brachytherapy for cervical cancer: Evaluation of tumor control, survival, and toxicity

Publication date: Available online 27 January 2017
Source:Brachytherapy
Author(s): K.D. Romano, K.J. Pugh, D.M. Trifiletti, B. Libby, T.N. Showalter
PurposeIn 2012, our institution transitioned from low-dose-rate (LDR) brachytherapy to high dose-rate (HDR) brachytherapy. We report clinical outcomes after brachytherapy for cervical cancer at our institution over a continuous 10-year period.Methods and MaterialsFrom 2004 to 2014, 258 women (184 LDR and 74 HDR) were treated with tandem and ovoid brachytherapy in the multidisciplinary management of International Federation of Gynecology and Obstetrics Stages IA–IVB cervical cancer. Clinical and treatment-related prognostic factors including age, stage, smoking status, relevant doses, and toxicity data were recorded.ResultsMedian followup for the LDR and HDR groups was 46 months and 12 months, respectively. The majority of patients (92%) received external beam radiotherapy as well as concurrent chemotherapy (83%) before the start of brachytherapy. For all stages, the 1-year local control and overall survival (OS) rates were comparable between the LDR and HDR groups (87% vs. 81%, p = 0.12; and 75% vs. 85%, p = 0.16), respectively. Factors associated with OS on multivariate analysis include age, stage, and nodal involvement. On multivariate analysis, severe toxicity (acute or chronic) was higher with HDR than LDR (24% vs. 10%, p = 0.04). Additional prognostic factors associated with increased severe toxicity include former/current smokers and total dose to lymph nodes.ConclusionsThis comparative retrospective analysis of a large cohort of women treated with brachytherapy demonstrates no significant difference in OS or local control between the LDR and HDR. Acute and chronic toxicity increased shortly after the implementation of HDR, highlighting the importance of continued refinement of HDR methods, including integrating advanced imaging.



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The utilization of MRI in the operating room

Publication date: Available online 27 January 2017
Source:Brachytherapy
Author(s): C. Ménard, J.-F. Pambrun, S. Kadoury
Online image guidance in the operating room using ultrasound imaging led to the resurgence of prostate brachytherapy in the 1980s. Here we describe the evolution of integrating MRI technology in the brachytherapy suite or operating room. Given the complexity, cost, and inherent safety issues associated with MRI system integration, first steps focused on the computational integration of images rather than systems. This approach has broad appeal given minimal infrastructure costs and efficiencies comparable with standard care workflows. However, many concerns remain regarding accuracy of registration through the course of a brachytherapy procedure. In selected academic institutions, MRI systems have been integrated in or near the brachytherapy suite in varied configurations to improve the precision and quality of treatments. Navigation toolsets specifically adapted to prostate brachytherapy are in development and are reviewed.



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Brachytherapy improves outcomes in young men (≤60 years) with prostate cancer: A SEER analysis

Publication date: Available online 27 January 2017
Source:Brachytherapy
Author(s): Hani Ashamalla, Adel Guirguis, Kyle McCool, Shauna McVorran, Malcolm Mattes, Daniel Metzger, Clara Oromendia, Karla V. Ballman, Bahaa Mokhtar, Mounzer Tchelebi, Evangelia Katsoulakis, Sameer Rafla
PurposeThe aim of the study was to compare prostate cancer–specific mortality (PCSM) in young men with clinically localized prostate cancer treated by either external beam radiation (EBRT) alone or brachytherapy with or without external beam radiation.Methods and MaterialsUtilizing the Surveillance, Epidemiology and End Results database, 15,505 patients ≤60 years of age diagnosed with prostate cancer between 2004 and 2009 and treated with radiation therapy alone were identified. Incidence of PCSM was determined for both groups and compared using competing risk models.ResultsThe overall 8-year PCSM for the study population was 1.9% (95% confidence interval [CI]: 1.6–2.2). For patients treated with EBRT or brachytherapy with or without external beam, the 8-year PCSM was found to be 2.8% (CI: 2.2–3.4) and 1.2% (CI: 0.9–1.6), respectively (p < 0.001). Univariable analysis demonstrated that brachytherapy was associated with lower PCSM risk (hazard ratio = 0.40; CI: 0.30–0.54; p < 0.001). High Gleason risk category, black race, higher Tumor (T) stage, and higher grade were all associated with greater mortality risk (p < 0.01). On multivariable analysis, brachytherapy continued to be associated with a significantly lower mortality risk (hazard ratio = 0.65; CI: 0.47–0.89; p = 0.008). Subgroup analyses found that among those with Gleason score ≥8, younger patients had increased risk of PCSM (p = 0.001).ConclusionsIn men ≤60 years of age with prostate cancer, radiation therapy continues to offer excellent outcomes. After adjusting for relevant variables, the use of brachytherapy was associated with reduced PCSM compared to treatment with EBRT alone.



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Outpatient template-guided permanent interstitial brachytherapy using 131Cs in gynecologic malignancies: Initial report

Publication date: Available online 27 January 2017
Source:Brachytherapy
Author(s): Jonathan Feddock, Prakash Aryal, Cole Steber, Jason Edwards, Dennis Cheek, Marcus Randall
PurposeOptimal curative intent brachytherapy for certain gynecologic cancers requires interstitial brachytherapy, often using template-guided techniques such as a Syed–Neblett implant. Whether high or low dose rate (LDR), these procedures pose significant risks to patients, partly attributable to the prolonged period of bed rest. Published results of free-handed permanent interstitial brachytherapy (PIB) with ¹³¹Cs demonstrate it to be an effective modality for the management of small volume gynecologic cancers. This report is the first to describe a permanent template-guided interstitial technique using ¹³¹Cs for gynecologic cancers, performed as an LDR outpatient procedure.Methods and MaterialsFive sequential patients with recurrent or primary gynecologic malignancies underwent template-guided PIB using ¹³¹Cs. A posttreatment planning CT was obtained immediately after the procedure and again 3–4 weeks later. Both CT data sets were fused and the relative positions compared to assess for migration in the x, y, and z planes. Seed positions as well as dosimetric parameters including D90, D100, V100, and the dose to 2 cc of rectum and bladder were compared to quantify migration of sources and the resulting effect, if any, on the treatment.ResultsThe median age was 69 years (range 64–85). All patients received a template-guided ¹³¹Cs PIB implant to treat gross disease. All 5 patients had significant medical comorbidities that limited treatment options. Considering all 5 patients, a total of 40 interstitial needles were placed. Ten needles carried only Vicryl-stranded sources, and 30 needles carried a combination of stranded ¹³¹Cs seeds and free seeds. Needle count was between 6 and 10 needles per patient, with active lengths of 4–10 cm. The median dose was 30 Gy (range 25–55 Gy) to permanent decay, enabling a cumulative median biological effective dose 91.5 Gy (range 60.9–92.1 Gy) and equivalent dose at 2 Gy per fraction 75.9 Gy (range 50.7–76.8 Gy). All implants were performed as outpatient procedures with only the first patient admitted for 23-hour observation. All calculated median migration distances were less than 1 cm in the axial, sagittal, or coronal planes. In 69.2% cases, the individual seed migration was <5 mm. Strand migration appeared directly related to peripheral placement and the use of stranded sources. The median D90, D100, and V100 were compared between study sets, and no significant differences were identified. No Grade 3 or higher complications occurred.ConclusionsPermanent LDR template-guided PIB using ¹³¹Cs can be safely performed on an outpatient basis. Compared to currently used template-guided techniques, the use of ¹³¹Cs avoids prolonged bed rest and hospitalization, significantly lowers cost, and enables a higher cumulative dose. Seed migration is minimal with this technique. Early experience suggests that the technique is safe and merits further study.



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Prostate MRI for brachytherapists: Diagnosis, imaging pitfalls, and post-therapy assessment

Publication date: Available online 27 January 2017
Source:Brachytherapy
Author(s): A.M. Venkatesan, R.J. Stafford, C. Duran, P.D. Soni, A. Berlin, P.W. McLaughlin
Optimal integration of multiparametric MRI (mp MRI) into prostate brachytherapy practice necessitates an understanding of imaging findings pertinent to prostate cancer detection and staging. This review will summarize prostate cancer imaging findings and tumor staging on mp MRI, including an overview of the Prostate Imaging Reporting and Data System (PIRADS)–structured reporting schema, mp MRI findings observed in the post-therapy setting including cases of post-treatment recurrence, and MRI concepts integral to successful salvage brachytherapy.



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Postoperative single-dose interstitial high–dose-rate brachytherapy in therapy-resistant keloids

Publication date: Available online 27 January 2017
Source:Brachytherapy
Author(s): C.J.H. Hafkamp, O. Lapid, R. Dávila Fajardo, A.L. van de Kar, C. Koedooder, L.J. Stalpers, B.R. Pieters
PurposePatients with keloids complain of the cosmetic aspect, pain, and pruritus. Many different therapies are being used for keloids. The aim of this study was to evaluate the recurrence rate and outcome after resection followed by a single-dose brachytherapy.Methods and materialsPatients treated by resection of the keloid plus a single dose of 13 Gy high–dose-rate brachytherapy were evaluated at least 1 year after treatment. Clinical response and cosmesis were assessed by a plastic surgeon and by the patients using the Patient and Observer Scar Assessment Scale.ResultsOnly 24 of the 61 invited patients responded to participate with the study; 29 keloids were evaluated. The recurrence rate was 24.1% after a median followup of 53 months (19–95 months). Patients scored on average 24.3 for their total Patient and Observer Scar Assessment Scale score (range 6–52), whereas the observer scored on average 14.6 (range 6–42).ConclusionsThis treatment has a higher recurrence rate than that reported in most other studies. This may be explained by differences in recurrence definition, differences in followup time among studies, and selection bias because of not contributing to the study. The cosmetic outcome for evaluated patients is relatively good. This treatment policy has the advantage that patients are treated in a single day.



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Salvage of locally recurrent prostate cancer after external beam radiation using reduced-dose brachytherapy with neoadjuvant plus adjuvant androgen deprivation

Publication date: Available online 27 January 2017
Source:Brachytherapy
Author(s): Brian C. Baumann, John C. Baumann, John P. Christodouleas, Edward Soffen
PurposeLocal recurrence (LR) of prostate cancer after external beam radiotherapy (EBRT) is a serious problem. Our purpose was to determine if reduced-dose salvage brachytherapy could achieve high rates of biochemical control with acceptable toxicity if combined with androgen deprivation therapy (ADT).Methods and MaterialsThirty-three consecutive patients with LR after EBRT were treated with salvage brachytherapy plus ADT from 1998 to 2013. All had pathologically confirmed LR, disease-free interval ≥18 months after EBRT, no distant/nodal metastasis, and International Prostate Symptom Score ≤15. Whole-gland salvage treatment was delivered using low-dose-rate (median 100 Gy with ¹⁰³Pd, n = 25) or high-dose-rate brachytherapy (30 Gy in 6 fractions over 4 weeks, n = 8) plus 4–6 months of neoadjuvant plus adjuvant ADT.ResultsFifty-five percent had high-risk disease at diagnosis. Median EBRT dose was 70.2 Gy; median prostate-specific antigen nadir was 0.8 ng/mL. Median time to recurrence was 56 months; median presalvage prostate-specific antigen was 5.0 ng/mL. Median postbrachytherapy followup was 61 months (range 7–150 months). Five and 7-year relapse-free survival, distant metastasis-free survival, and overall survival were 79% and 67%; 93% and 86%; and 94% and 85%, respectively. Freedom from late Grade 3 GU toxicity at 5 years was 85%. There were no late Grade ≥2 GI toxicities.ConclusionsThis is the largest series of salvage brachytherapy combined with neoadjuvant plus adjuvant ADT and uses reduced-dose brachytherapy. Results suggest that reduced-dose salvage brachytherapy is feasible and reasonably well tolerated when combined with ADT. Compared to prior series, this approach was associated with favorable relapse-free survival. Prospective studies of reduced-dose salvage brachytherapy plus ADT are warranted.



http://ift.tt/2k2rFzW

Mitochondrial Omi/HtrA2 Promotes Caspase Activation Through Cleavage of HAX-1 in Aging Heart

Rejuvenation Research , Vol. 0, No. 0.


http://ift.tt/2jfCCRv

MRI follow-up is unnecessary in patients with macroprolactinomas and long-term normal prolactin levels on dopamine agonist treatment

Objective

Both antitumor and antisecretory efficacies of dopamine agonists (DA) make them the first-line treatment of macroprolactinomas. However, there is no guideline for MRI follow-up once prolactin is controlled. The aim of our study was to determine whether a regular MRI follow-up was necessary in patients with long-term normal prolactin levels under DA.

Patients and methods

We conducted a retrospective multicenter study (Marseille, Paris La Pitie Salpetriere and Nancy, France; Liege, Belgium) including patients with macroprolactinomas (largest diameter: >10 mm and baseline prolactin level: >100 ng/mL) treated by dopamine agonists, and regularly followed (pituitary MRI and prolactin levels) during at least 48 months once normal prolactin level was obtained.

Results

In total, 115 patients were included (63 men and 52 women; mean age at diagnosis: 36.3 years). Mean baseline prolactin level was 2224 ± 6839 ng/mL. No significant increase of tumor volume was observed during the follow-up. Of the 21 patients (18%) who presented asymptomatic hemorrhagic changes of the macroprolactinoma on MRI, 2 had a tumor increase (2 and 7 mm in the largest size). Both were treated by cabergoline (1 mg/week) with normal prolactin levels obtained for 6 and 24 months. For both patients, no further growth was observed on MRI during follow-up at the same dose of cabergoline.

Conclusion

No significant increase of tumor size was observed in our patients with controlled prolactin levels on DA. MRI follow-up thus appears unnecessary in patients with biologically controlled macroprolactinomas.

http://ift.tt/2jfrSTv

Bone material strength index as measured by impact microindentation is altered in patients with acromegaly

Objective

Acromegaly is a rare disease caused by excess growth hormone (GH) production by the pituitary adenoma. The skeletal complications of GH and IGF-1 excess include increased bone turnover, increased cortical bone mass and deteriorated microarchitecture of trabecular bone, associated with a high risk of vertebral fractures in the presence of relatively normal bone mineral density (BMD). We aimed to evaluate tissue-level properties of bone using impact microindentation (IMI) in well-controlled patients with acromegaly aged ≥18 years compared to 44 controls from the outpatient clinic of the Centre for Bone Quality.

Design and methods

In this cross-sectional study, bone material strength index (BMSi) was measured in 48 acromegaly patients and 44 controls with impact microindentation using the osteoprobe.

Results

Mean age of acromegaly patients (54% male) was 60.2 years (range 37.9–76.5), and 60.5 years (range 39.8–78.6) in controls (50% male). Patients with acromegaly and control patients had comparable BMI (28.2 kg/m² ± 4.7 vs 26.6 kg/m² ± 4.3, P = 0.087) and comparable BMD at the lumbar spine (1.04 g/cm² ± 0.21 vs 1.03 g/cm² ± 0.13, P = 0.850) and at the femoral neck (0.84 g/cm² ± 0.16 vs 0.80 g/cm² ± 0.09, P = 0.246). BMSi was significantly lower in acromegaly patients than that in controls (79.4 ± 0.7 vs 83.2 ± 0.7; P < 0.001).

Conclusion

Our data indicates that tissue-level properties of cortical bone are significantly altered in patients with controlled acromegaly after reversal of long-term exposure to pathologically high GH and IGF-1 levels. Our findings also suggest that methods other than DXA should be considered to evaluate bone fragility in patients with acromegaly.

http://ift.tt/2k2hU51

Clinical features and practice patterns of treatment for adrenal crisis: a nationwide cross-sectional study in Japan

Context

Adrenal crisis is an endocrine emergency that requires prompt diagnosis and treatment. However, the clinical features and practice patterns of treatment for adrenal crisis are not completely understood.

Objective

To investigate patient characteristics, comorbidities and treatments of adrenal crisis.

Methods

We conducted a cross-sectional study of patients who received intravenous glucocorticoids for adrenal crisis at admission from 1 July 2007 to 31 March 2014, using a national inpatient database in Japan.

Results

Among approximately 34 million inpatients in the database, we identified 799 patients diagnosed with adrenal crisis and coexisting primary or secondary adrenal insufficiency at admission. The median (interquartile range) age was 58 (28–73) years, and the overall in-hospital mortality was 2.4% (19 of 799 patients). The most common comorbidity at admission was infections excluding pneumonia and gastroenteritis (15.0%). There were 68 (8.5%) patients with gastroenteritis, and no deaths occurred among these patients. The patients with secondary adrenal insufficiency showed significantly higher proportions of admission to ICU, extracellular fluid resuscitation, insulin therapy and catecholamine use than the patients with primary adrenal insufficiency. There were no significant between-group differences in mortality rate and variation in intravenous glucocorticoids (short-acting glucocorticoid, hydrocortisone; moderate-acting glucocorticoid, prednisolone or methylprednisolone; long-acting glucocorticoid, dexamethasone or betamethasone). Of the 19 dead patients, 15 were aged above 60 years, 12 had impaired consciousness at admission and 13 received insulin therapy.

Conclusions

Clinicians should be aware that older patients with impaired consciousness and diabetes mellitus are at relatively high risk of death from adrenal crisis.

http://ift.tt/2jfx9dx

Pancreatic Carcinosarcoma: A Case Report Highlighting CT Characteristics

Publication date: Available online 27 January 2017
Source:Current Problems in Diagnostic Radiology
Author(s): Steven Mszyco, Leslie Teng, Joseph Annunziata, Matthew S. Hartman
Primary pancreatic carcinosarcoma is a rare and malignant neoplasm arising within the pancreas. With fewer than a dozen cases ever reported, the recognition and treatment of this rare phenomenon can be difficult. We describe the case of an 85-year-old man who presented with vague RUQ and epigastric abdominal pain and was found to have a pancreatic mass on ultrasound and computed tomography. The patient underwent open pancreaticoduodenectomy and was found to have pancreatic carcinosarcoma on microscopic evaluation. While specific radiologic diagnosis of this entity is not possible, bringing the possibility of primary pancreatic carcinosarcoma to the ordering clinician′s attention has the potential to hasten treatment and improve patient outcomes. We review the current literature on this rare type of neoplasia, considering histopathological and clinical features. This case highlights the importance of radiologist awareness of this rare neoplasm and to consider carcinosarcoma in the differential when presented with a mixed solid and cystic pancreatic mass.



http://ift.tt/2k2ebUS

Is That a Human? Categorization (Dis)Fluency Drives Evaluations of Agents Ambiguous on Human-Likeness.

Author: Carr, Evan W.; Hofree, Galit; Sheldon, Kayla; Saygin, Ayse P.; Winkielman, Piotr

DOI: 10.1037/xhp0000304

Publication Date: POST AUTHOR CORRECTIONS, 26 January 2017

http://ift.tt/2kwsZeb

Heme oxygenase/carbon monoxide in the female reproductive system: an overlooked signalling pathway.

Related Articles

Heme oxygenase/carbon monoxide in the female reproductive system: an overlooked signalling pathway.

Int J Biochem Mol Biol. 2017;8(1):1-12

Authors: Němeček D, Dvořáková M, Sedmíková M

Abstract
For a long time, carbon monoxide (CO) was known for its toxic effect on organisms. But there are still many things left to discover on that molecule. CO is formed directly in the body by the enzymatic activity of heme oxygenase (HO). CO plays an important role in many physiological processes, such as cell protections (against various stress factors), and the regulation of metabolic processes. Recent research proves that CO also operates in the female reproductive system. At the centre of interest is the importance of CO for gestation. During the gestation period, CO is an important element affecting the proper function of the feto-placental unit and generally affects fetal survivability rates. Gestation is one of the most important processes of successful reproduction, although there are more relevant processes that need to be researched. While already proven that CO influences steroidogenesis and the corpus luteum survivability rate, our knowledge concerning the function and importance of CO in the reproductive system is still relatively limited. As an example, our knowledge of CO function in an oocyte, the most important cell for reproduction, is almost non-existent. The aim of this review is to summarize our current knowledge concerning the function of CO in the female reproductive system.

PMID: 28123837 [PubMed - in process]

http://ift.tt/2kw5zWl

Acknowledgment of Reviewers 2016

Photomedicine and Laser Surgery Feb 2017, Vol. 35, No. 2: 122-123.


http://ift.tt/2kD9Iab

Scar Remodeling with the Association of Monopolar Capacitive Radiofrequency, Electric Stimulation, and Negative Pressure

Photomedicine and Laser Surgery , Vol. 0, No. 0.


http://ift.tt/2kd5Iki

Transcervical ultrasonographic examination of palatine tonsil size and its correlation with age, gender and body-mass index in healthy children

Our aim was to assess the palatine tonsil size with transcervical ultrasonography in healthy children and to analyze whether the palatine tonsil size is correlated with age, gender and body-mass index (BMI).

http://ift.tt/2jyWPjN

Free Dermal Fat Graft Reconstruction of the Head and Neck: An Alternate Reconstructive Option

Ablative procedures of the head and neck often result in significant facial and cervical irregularities and cosmetic asymmetry. The deformity resulting from ablative procedures of the head and neck is a significant source of cosmetic morbidity and postoperative dissatisfaction. Reconstruction of post-ablative defects in the head and neck can employ a broad range of techniques, ranging from primary closure to free tissue transfer. The free dermal fat graft (FDFG) is one such option and has been used to repair volume defects of varying sizes after common head and neck procedures such as parotidectomy.

http://ift.tt/2kCYUsG

Free Dermal Fat Graft Reconstruction of the Head and Neck: An Alternate Reconstructive Option

Ablative procedures of the head and neck often result in significant facial and cervical irregularities and cosmetic asymmetry. The deformity resulting from ablative procedures of the head and neck is a significant source of cosmetic morbidity and postoperative dissatisfaction. Reconstruction of post-ablative defects in the head and neck can employ a broad range of techniques, ranging from primary closure to free tissue transfer. The free dermal fat graft (FDFG) is one such option and has been used to repair volume defects of varying sizes after common head and neck procedures such as parotidectomy.

http://ift.tt/2kCYUsG

Histologic and histomorphometric evaluation of bone regeneration using nanocrystalline hydroxyapatite and human freeze-dried bone graft

Abstract

Purpose

Bone regeneration is an important concern in periodontal treatment and implant dentistry. Different biomaterials and surgical techniques have been used for this purpose. The aim of the present study was to compare the effect of nanocrystalline hydroxyapatite and human freeze-dried bone graft (FDBG) in regeneration of rabbit calvarium bony defects by histologic and histomorphometric evaluation.

Methods

In this experimental study, three similar defects, measuring 8 mm in diameter, were created in the calvaria of 16 white New Zealand rabbits. Two defects were filled with FDBG and nanocrystalline hydroxyapatite silica gel, while the other one remained unfilled to be considered as control. All the defects were covered with collagen membranes. During the healing period, two animals perished; so 14 rabbits were divided into two groups: half of them were euthanized after 6 weeks of healing and the other half after 12 weeks. The specimens were subjected to histologic and histomorphometric examinations for assessment of the following variables: percentage of bone formation and residual graft material, inflammation scores, patterns of bone formation and type of newly formed bone.

Results

The percentages of new bone formation after 6 weeks were 14.22 ± 7.85, 21.57 ± 6.91, and 20.54 ± 10.07% in FDBG, NanoBone, and control defects. These values were 27.54 ± 20.19, 23.86 ± 6.27, and 26.48 ± 14.18% in 12-week specimens, respectively. No significant differences were found in the amount of bone formation between the groups. With regard to inflammation, the control and NanoBone groups showed significantly less inflammation compared to FDBG at the 6-week healing phase (P = 0.04); this difference was not significant in the 12-week specimens.

Conclusions

Based on the results of this experimental study, both NanoBone and FDBG exhibited a similar effect on bone formation.

http://ift.tt/2jojqw4

Physical activity after a hip fracture: effect of a multicomponent home-based rehabilitation program − a secondary analysis of a randomized controlled trial

Publication date: Available online 27 January 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Katri Turunen, Anu Salpakoski, Johanna Edgren, Timo Törmäkangas, Marja Arkela, Mauri Kallinen, Maija Pesola, Sirpa Hartikainen, Riku Nikander, Sarianna Sipilä
ObjectivesTo investigate the effect of a yearlong multicomponent rehabilitation program on the level of physical activity (PA) and the maintenance of the level of PA over one year follow-up among older people recovering from a recent hip fracture.DesignSecondary analysis of a randomized, controlled, parallel-group trial.SettingHome-based rehabilitation; measurements in university laboratory.ParticipantsCommunity-dwelling people aged 60+ recovering from a hip fracture. Participants were randomly assigned into an intervention (n=40) or control (n=41) group on average 42±23 days after discharge from hospital.MeasurementsThe outcome was the level of PA, which was assessed with the questionnaire (a modified Grimby scale) at baseline, and 3, 6, 12 and 24 months after baseline. Three PA categories were defined: inactivity, light PA and moderate to heavy PA. Physical function was assessed using the short physical performance battery (SPPB) at baseline. The effects of the intervention were analyzed with generalized estimation equations.InterventionA yearlong intervention included evaluation and modification of environmental hazards, guidance for safe walking, non-pharmacological pain management, a progressive home exercise program, PA counseling and Standard Care.ResultsIn the intervention group, a significant increase was observed in the level of PA after the intervention (interaction p=0.005) and after one-year follow-up (0.021) compared to the standard care only. The benefit was particularly evident among the participants with a baseline SPPB score seven or above (interaction p<0.001).ConclusionThe 12-month individualized multicomponent rehabilitation program increased PA among older hip fracture patients. The increase was found to be maintained at the one-year follow-up.



http://ift.tt/2jomsRh

Establishing the Minimal Clinical Important Difference and Minimal Detectable Change for the Cumberland Ankle Instability Tool

Publication date: Available online 27 January 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Cynthia J. Wright, Shelley W. Linens, M. Spencer Cain
ObjectiveThe objective was to establish the minimal detectable change (MDC) and minimal clinically important different (MCID) for the Cumberland Ankle Instability Tool (CAIT) in a population with chronic ankle instability (CAI).DesignExperimental cohort.SettingLaboratory.ParticipantsA convenience sample of fifty participants with CAI participated (12 males, 38 females, monthly giving-way=5.84±12.54). CAI inclusion criteria included a history of an ankle sprain, recurrent episodes of giving way, and a CAIT score ≤ 25.InterventionsParticipants completed an injury history and demographic data then the CAIT. Participants then either participated in 4 weeks of wobble board balance training, resistance tubing strength training, or no intervention. After 4 weeks, participants re-completed the CAIT and recorded their global rating of change (GRC).Main Outcome MeasuresDependent variables were pre- and post-intervention score on the CAIT, and post-intervention GRC. MDC with 95% confidence was calculated. A receiver operating characteristic curve (ROC) identified the optimal CAIT cut-point (MCID) between improved and unimproved individuals based on their GRC. Area under the curve (AUC) was used to identify a significant ROC curve (alpha = 0.05).ResultsThe average CAIT score pre-intervention was 16.8±5.6, and post-intervention was 20.0±5.2. Thirty-one participants (62%) rated themselves as improved on the GRC, whereas 19 (38%) were not improved. The ROC was significant (AUC = 0.797, p=0.001), indicating that CAIT change score significantly predicted clinical status. The MDC was 3.08, the MCID was ≥3 points.ConclusionsThe CAIT has a MDC and MCID of ≥3 points. When CAIT scores are utilized to assess patient change over time, these scores should be used as a minimum threshold to indicate detectable and clinically meaningful improvement.



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Predictive validity of a screening instrument for the risk of non-return-to-work in patients with internal diseases

Publication date: Available online 27 January 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Marco Streibelt, Matthias Bethge, Thomas Gross, Klaus Herrmann, Ferman Ustaoglu, Christoph Reichel
ObjectivesA screening instrument (SIMBO, 0-100 points) to predict return-to-work (RTW) problems was developed in a pilot study. We tested the predictive validity of the SIMBO in patients with internal diseases.DesignA prospective multicenter study was conducted. Data were obtained from questionnaires at admission and 3 months after rehabilitation.Setting12 inpatient rehabilitation centers.ParticipantsPatients aged 18 to 65 years with internal diagnoses were included.InterventionsMultimodal rehabilitation programs.Main Outcome MeasureThe primary outcome was occurrence of a critical RTW event during the follow-up. Receiver operating characteristic (ROC) analyses were performed. Sensitivity, specificity and positive predictive values were calculated for each disease group using the cut-off score of 27 points.Results1,366 patients with neoplasms (n=203), endocrine, nutritional and metabolic diseases (n=355), diseases of the circulatory (n=470), respiratory (n=255) and digestive systems (n=83) were included. Between 9.9% and 40.6% of the patients reported critical RTW events during the 3-month follow-up. The AUC was between .849 (.754-.923) and .903 (.846-.959). Sensitivity and specificity ranged from 65.6% to 92.9% and 80.4% to 89.9%, respectively. The positive predictive values were between 40.4% and 77.8%.ConclusionThe risk score SIMBO predicts short-term RTW problems after rehabilitation in patients with internal diseases. The cut-off of 27 points was confirmed as a reasonable threshold.



http://ift.tt/2jodC5O

A novel postal-based approach to diagnosing obstructive sleep apnoea in a high-risk population

More than 50% of patients with diabetic macular oedema (DMO) have obstructive sleep apnoea (OSA), but the majority remain undiagnosed. We used a 4-channel device (ApneaLink [AL], ResMed, UK) to establish a remote postal-based diagnostic service for patients with DMO. Here we describe our experience.

http://ift.tt/2jGTGfx

Treating sleep apnea in Parkinson’s Disease with C-PAP: feasibility concerns and effects on cognition and alertness

Obstructive sleep apnea (OSA) is highly prevalent in Parkinson disease (PD) and is known to contribute to cognitive impairment and daytime sleepiness. We investigated feasibility of continuous positive airway pressure treatment (CPAP) and its effects on subjective daytime sleepiness and cognitive profile in PD plus OSA subjects in a longitudinal three months follow up study.

http://ift.tt/2kd63DE

Head drops: Electromyography may give the way

Intermittent head drops are episodic and usually brief (lasting seconds) head flexion movements occurring in a wide spectrum of conditions, including epileptic syndromes and movement and sleep disorders [1]. Here, we report episodes of intermittent head drops with similar clinical features but different neurophysiological correlates occurring in two patients with two different diseases.

http://ift.tt/2jGSrNl

Video-Polysomnographic Aspects of Painful Legs and Moving Toes Syndrome

Painful legs and moving toes (PLMT) syndrome is a rare chronic disorder (1) characterized by pain and repetitive stereotyped toe movements that may resemble restless legs syndrome (RLS) (2). PLMT is idiopathic or associated with other conditions (3). No effective therapy is available for PLMT. A video-polysomnography of PLMT has never been carried out.

http://ift.tt/2kdiC1x

Sex Differences in Mental Rotation Tasks: Not Just in the Mental Rotation Process!

Author: Boone, Alexander P.; Hegarty, Mary

DOI: 10.1037/xlm0000370

Publication Date: POST AUTHOR CORRECTIONS, 26 January 2017

http://ift.tt/2kcfkeR

Factors Influencing the Food Purchases of Early Care and Education Providers

Publication date: Available online 27 January 2017
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Jennifer J. Otten, Tad Hirsch, Catherine Lim
BackgroundWith the majority of US children enrolled in some form of early care and education, the settings for early care and education represent a valuable opportunity to positively impact young children's diets and their interactions with food. Little evidence exists on how early care and education providers make food purchasing and service decisions for this population of young children.ObjectiveOur aim was to explore the factors that influence early care and education providers' food purchasing and service decisions.DesignA qualitative design consisting of individual, in-person, and semi-structured interviews with providers and on-site observations was used.Participants/settingSixteen early care and education providers—selected across a variety of characteristics that might affect food selection (eg, size of site, participation in reimbursement programs, presence of staff assigned to foodservice) using maximum variation purposive sampling—based in the Puget Sound region, Washington, were interviewed from June to September 2014.Main outcome measureProvider perspectives on food purchasing and service decisions.Statistical analyses performedInductive analysis of transcribed interviews using TAMS Analyzer software (GPL version 2, 2012) to identify themes.ResultsTen main influencers emerged from the data. These were grouped into four categories based on an ecological framework: macro-level environments (ie, regulations; suppliers and vendors, including stores); physical environment and settings (ie, organizational mission, budget, and structure; the facility itself); social environments (ie, professional networks; peers; the site-specific parent and child community); and individual factors at both a provider and child-level (ie, providers' skills, behaviors, motivations, attitudes, knowledge, and values; child food preferences; and, child allergies). A model was then developed to identify potential pathways of intervention and underscore the need for a comprehensive approach to improve early care and education nutrition.ConclusionsThis study suggests that a more system-based understanding and approach—one that accounts for an array of influencers and their interactions—is necessary to take advantage of opportunities and address barriers to improving early care and education-based nutrition.



http://ift.tt/2jojoVj

Autopsy after transcatheter aortic valve implantation

Abstract

Autopsy after transcatheter aortic valve implantation (TAVI) is a new field of interest in cardiovascular pathology. To identify the cause of death, it is important to be familiar with specific findings related to the time interval between the procedure and death. We aimed to provide an overview of the autopsy findings in patients with TAVI in their medical history divided by the timing of death with specific interest in the added value of autopsy over a solely clinically determined cause of death. In 8 European centres, 72 cases with autopsy reports were available. Autopsies were divided according to the time interval of death and reports were analysed. In 32 patients who died ≤72 h postprocedure, mortality resulted from cardiogenic or haemorrhagic shock in 62.5 and 34.4%, respectively. In 31 patients with mortality >72 h to ≤30 days, cardiogenic shock was the cause of death in 51.6% followed by sepsis (22.6%) and respiratory failure (9.7%). Of the nine patients with death >30 days, 88.9% died of sepsis, caused by infective endocarditis in half of them. At total of 12 patients revealed cerebrovascular complications. Autopsy revealed unexpected findings in 61.1% and resulted in a partly or completely different cause of death as was clinically determined. Autopsy on patients who underwent TAVI reveals specific patterns of cardiovascular pathology that clearly relate to the time interval between TAVI and death and significantly adds to the clinical diagnosis. Our data support the role of autopsy including investigation of the cerebrum in the quickly evolving era of cardiac device technology.

http://ift.tt/2jfoh7Q

DNA profiling of tumor buds in colorectal cancer indicates that they have the same mutation profile as the tumor from which they derive

http://ift.tt/2k27K44

Response of spontaneous plants from an ex-mining site of Elba island (Tuscany, Italy) to metal(loid) contamination

Abstract

The release of large amounts of toxic metals in the neighboring sites of abandoned mine areas represents an important environmental risk for the ecosystem, because it adversely affects soil, water, and plant growth. The aim of the present study was to investigate the metal(loid) (As, Cr, Cu, Ni, Pb, and Zn) contents of native Mediterranean plants grown on the ex-mining area of Elba island (Italy), with the prospective of its recovery by further phytoremediation technology. Soil samples were collected and characterized for metal(loid) content in total and potentially available (EDTA-extractable) fractions. Arsenic was particularly high, being 338 and 2.1 mg kg⁻¹ as total and available fractions, respectively. Predominant native species, namely Dittrichia viscosa L. Greuter, Cistus salviifolius L., Lavandula stoechas L., and Bituminaria bituminosa L., were analyzed for metal content in the different plant organs. D. viscosa exhibited the highest metal(loid) content in the leaves and the singular behavior of translocating arsenic to the leaves (transfer factor about 2.06 and mean bioconcentration factor about 12.48). To assess the healthy status of D. viscosa plants, the leaves were investigated further. The activities of the main antioxidant enzymes and the levels of secondary metabolites linked to oxidative stress in plants from the ex-mining area were not significantly different from those of control plants, except for a lower content of carotenoids, indicating that native plants were adapted to grow in these polluted soils. These results indicate that D. viscosa can be suitable for the revegetation of highly metal-contaminated areas.

http://ift.tt/2kc4wNB

Solar-assisted photodegradation of isoproturon over easily recoverable titania catalysts

Abstract

An easily recoverable homemade TiO₂ catalyst (GICA-1) has been evaluated during the overall photodegradation process, understood as photocatalytic efficiency and catalyst recovery step, in the solar light-assisted photodegradation of isoproturon and its reuse in two consecutive cycles. The global feasibility has been compared to the commercial TiO₂ P25. The homemade GICA-1 catalyst presented better sedimentation efficiency than TiO₂ P25 at all studied pHs, which could be explained by its higher average hydrodynamic particle size (3 μm) and other physicochemical surface properties. The evaluation of the overall process (isoproturon photo-oxidation + catalyst recovery) revealed GICA-1 homemade titania catalyst strengths: total removal of isoproturon in less than 60 min, easy recovery by sedimentation, and reusability in two consecutive cycles, without any loss of photocatalytic efficiency. Therefore, considering the whole photocatalytic cycle (good performance in photodegradation plus catalyst recovery step), the homemade GICA-1 photocatalyst resulted in more affordability than commercial TiO₂ P25.

Graphical abstract

http://ift.tt/2jH1q0X

A comprehensive performance evaluation of heterogeneous Bi 2 Fe 4 O 9 /peroxymonosulfate system for sulfamethoxazole degradation

Abstract

In this study, a Bi₂Fe₄O₉ catalyst with nanoplate morphology was fabricated using a facile hydrothermal method. It was used as a catalyst to activate peroxymonosulfate (PMS) for aqueous sulfamethoxazole (SMX) removal. A comprehensive performance evaluation of the Bi₂Fe₄O₉/PMS system was conducted by investigating the effects of pH, PMS dosage, catalyst loading, SMX concentration, temperature, and halides (Cl⁻ and Br⁻) on the degradation of SMX. The Bi₂Fe₄O₉/PMS system demonstrated a remarkable catalytic activity with >95% SMX removal within 30 min (conditions: pH 3.8, [Bi₂Fe₄O₉] = 0.1 g L⁻¹, [SMX]:[PMS] mol ratio =1:20). It was found that both Cl⁻ and Br⁻ can lead to the formation of PMS–induced reactive halide species (i.e. HClO, HBrO, and Br₂) which can also react with SMX forming halogenated SMX byproducts. Based on the detected degradation byproducts, the major SMX degradation pathway in the Bi₂Fe₄O₉/PMS system is proposed. The SMX degradation by Bi₂Fe₄O₉/PMS system in the wastewater secondary effluent (SE) was also investigated. The results showed that SMX degradation rate in the SE was relatively slower than in the deionized water due to (i) reactive radical scavenging by water matrix species found in SE (e.g.: dissolved organic matters (DOCs), etc.), and (ii) partial deactivation of the catalyst by DOCs. Nevertheless, the selectivity of the SO₄^•− towards SMX degradation was evidenced from the rapid SMX degradation despite the high background DOCs in the SE. At least four times the dosage of PMS is required for SMX degradation in the SE to achieve a similar SMX removal efficiency to that of the deionized water matrix.

http://ift.tt/2jGBYbY

Histologic and histomorphometric evaluation of bone regeneration using nanocrystalline hydroxyapatite and human freeze-dried bone graft

Abstract

Purpose

Bone regeneration is an important concern in periodontal treatment and implant dentistry. Different biomaterials and surgical techniques have been used for this purpose. The aim of the present study was to compare the effect of nanocrystalline hydroxyapatite and human freeze-dried bone graft (FDBG) in regeneration of rabbit calvarium bony defects by histologic and histomorphometric evaluation.

Methods

In this experimental study, three similar defects, measuring 8 mm in diameter, were created in the calvaria of 16 white New Zealand rabbits. Two defects were filled with FDBG and nanocrystalline hydroxyapatite silica gel, while the other one remained unfilled to be considered as control. All the defects were covered with collagen membranes. During the healing period, two animals perished; so 14 rabbits were divided into two groups: half of them were euthanized after 6 weeks of healing and the other half after 12 weeks. The specimens were subjected to histologic and histomorphometric examinations for assessment of the following variables: percentage of bone formation and residual graft material, inflammation scores, patterns of bone formation and type of newly formed bone.

Results

The percentages of new bone formation after 6 weeks were 14.22 ± 7.85, 21.57 ± 6.91, and 20.54 ± 10.07% in FDBG, NanoBone, and control defects. These values were 27.54 ± 20.19, 23.86 ± 6.27, and 26.48 ± 14.18% in 12-week specimens, respectively. No significant differences were found in the amount of bone formation between the groups. With regard to inflammation, the control and NanoBone groups showed significantly less inflammation compared to FDBG at the 6-week healing phase (P = 0.04); this difference was not significant in the 12-week specimens.

Conclusions

Based on the results of this experimental study, both NanoBone and FDBG exhibited a similar effect on bone formation.

http://ift.tt/2jojqw4

Fiber Encapsulation Additive Manufacturing: Technology and Applications Update

3D Printing and Additive Manufacturing , Vol. 0, No. 0.


http://ift.tt/2kDbsAo

Surgical treatment of thyroid follicular neoplasms: results of a retrospective analysis of a large clinical series

Abstract

The most appropriate surgical management of "follicular neoplasm/suspicious for follicular neoplasm" lesions (FN), considering their low definitive malignancy rate and the limited predictive power of preoperative clinic-diagnostic factors, is still controversial. On behalf of the Italian Association of Endocrine Surgery Units (U.E.C. CLUB), we collected and analyzed the experience of 26 endocrine centers by computerized questionnaire. 1379 patients, surgically treated after a FN diagnosis from January 2012 and December 2103, were evaluated. Histological features, surgical complications, and medium-term outcomes were reported. Total thyroidectomy (TT) was performed in 1055/1379 patients (76.5 %), while hemithyroidectomy (HT) was carried out in 324/1379 cases (23.5 %). Malignancy rate was higher in TT than in HT groups (36.4 vs. 26.2 %), whereas the rates of transient and definitive hypoparathyroidism following TT were higher than after HT. Consensual thyroiditis (16.8 vs. 9.9 %) and patient age (50.9 vs. 47.9 %) also differed between groups. A cytological FN diagnosis was associated to a not negligible malignancy rate (469/1379 patients; 34 %), that was higher in TT than in HT groups. However, a lower morbidity rate was observed in HT, which should be considered the standard of care in solitary lesions in absence of specific risk factors. Malignancy could not be preoperatively assessed and clinical decision-making is still controversial. Further efforts should be spent to more accurately preoperatively classify FN thyroid nodules.

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Low vitamin D status is associated with advanced liver fibrosis in patients with nonalcoholic fatty liver disease

Abstract

Several studies explored the association between vitamin D status and nonalcoholic fatty liver disease with contradictory results. We aimed to investigate the association between vitamin D status, inflammatory cytokines and liver fibrosis in nonalcoholic fatty liver disease patients. Two hundred nineteen nonalcoholic fatty liver disease patients and 166 age- and gender- matched healthy controls were recruited for this study. Serum 25(OH)D was measured by radioimmunoassay. Serum interleukin-8 and transforming growth factor-β1 were measured using ELISA. Serum 25(OH)D was only marginally decreased in nonalcoholic fatty liver disease patients. Interestingly, serum 25(OH)D was markedly reduced in nonalcoholic fatty liver disease patients with advanced liver fibrosis compared to nonalcoholic fatty liver disease patients with indeterminate liver fibrosis and no advanced fibrosis. Logistic regression analysis showed that there was an inverse association between serum 25(OH)D and severity of liver fibrosis in nonalcoholic fatty liver disease patients. Further analysis showed that serum interleukin-8 was elevated in nonalcoholic fatty liver disease patients, the highest interleukin-8 in patients with advanced fibrosis. An inverse correlation between serum 25(OH)D and interleukin-8 was observed in nonalcoholic fatty liver disease patients with and without liver fibrosis. Although serum transforming growth factor-β1 was slightly elevated in nonalcoholic fatty liver disease patients, serum transforming growth factor-β1 was reduced in nonalcoholic fatty liver disease patients with advanced fibrosis. Unexpectedly, a positive correlation between serum 25(OH)D and transforming growth factor-β1 was observed in nonalcoholic fatty liver disease patients with advanced fibrosis. In conclusion, low vitamin D status is associated with advanced liver fibrosis in nonalcoholic fatty liver disease patients. Interleukin-8 may be an important mediator for hepatic fibrosis in nonalcoholic fatty liver disease patients with low vitamin D status.

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Reply

Publication date: Available online 27 January 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Jennifer Koplin, Katrina J. Allen




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Ruxolitinib reverses dysregulated T helper cell responses and controls autoimmunity caused by a novel signal transducer and activator of transcription 1 (STAT1) gain-of-function mutation

Publication date: Available online 27 January 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Katja G. Weinacht, Louis-Marie Charbonnier, Fayhan Alroqi, Ashley Plant, Qi Qiao, Hao Wu, Clement Ma, Troy R. Torgerson, Sergio D. Rosenzweig, Thomas A. Fleisher, Luigi D. Notarangelo, Imelda C. Hanson, Lisa R. Forbes, Talal A. Chatila
BackgroundGain-of-function (GOF) mutations in the human signal transducer and activator of transcription 1 (STAT1) manifest in immunodeficiency and autoimmunity with impaired TH17 cell differentiation and exaggerated responsiveness to type I and II interferons. Allogeneic bone marrow transplantation has been attempted in severely affected patients, but outcomes have been poor.ObjectiveWe sought to define the effect of increased STAT1 activity on T helper cell polarization and to investigate the therapeutic potential of ruxolitinib in treating autoimmunity secondary to STAT1 GOF mutations.MethodsWe used in vitro polarization assays, as well as phenotypic and functional analysis of STAT1-mutated patient cells.ResultsWe report a child with a novel mutation in the linker domain of STAT1 who had life-threatening autoimmune cytopenias and chronic mucocutaneous candidiasis. Naive lymphocytes from the affected patient displayed increased TH1 and follicular T helper cell and suppressed TH17 cell responses. The mutation augmented cytokine-induced STAT1 phosphorylation without affecting dephosphorylation kinetics. Treatment with the Janus kinase 1/2 inhibitor ruxolitinib reduced hyperresponsiveness to type I and II interferons, normalized TH1 and follicular T helper cell responses, improved TH17 differentiation, cured mucocutaneous candidiasis, and maintained remission of immune-mediated cytopenias.ConclusionsAutoimmunity and infection caused by STAT1 GOF mutations are the result of dysregulated T helper cell responses. Janus kinase inhibitor therapy could represent an effective targeted treatment for long-term disease control in severely affected patients for whom hematopoietic stem cell transplantation is not available.

Graphical abstract

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Reply

Publication date: Available online 27 January 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Mary Feeney, George Du Toit, Gideon Lack




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Role of TGF-β in anti-rhinovirus immune responses in asthmatic patients

Publication date: Available online 27 January 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Carina Bielor, Nina Sopel, Anja Maier, Ashley Blau, Himanshu Sharma, Tytti Vuorinen, Bettina Kroß, Susanne Mittler, Anna Graser, Stephanie Mousset, Volker O. Melichar, Alexander Kiefer, Theodor Zimmermann, Rebekka Springel, Corinna Holzinger, Sonja Trump, Stella Taka, Nikolaos G. Papadopoulos, Scott T. Weiss, Susetta Finotto




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Early or delayed introduction of food? Misunderstanding is in the air

Publication date: Available online 27 January 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Simona Di Mario, Vittorio Basevi, Costantino Panza, Sergio Conti Nibali, Adriano Cattaneo




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Effectiveness of technologies in the treatment of post-stroke anomia: A systematic review

Publication date: Available online 27 January 2017
Source:Journal of Communication Disorders
Author(s): Monica Lavoie, Joël Macoir, Nathalie Bier
BackgroundTechnologies are becoming increasingly popular in the treatment of language disorders and offer numerous possibilities, but little is known about their effectiveness and limitations.AimThe aim of this systematic review was to investigate the effectiveness of treatments delivered by technology in the management of post-stroke anomia.MethodsAs a guideline for conducting this review, we used the PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions. We conducted a systematic search of publications in PubMed, PsycInfo and Current Contents. We also consulted Google Scholar. Without any limitations as to publication date, we selected studies designed to assess the effectiveness of an intervention delivered by a technology, namely computer or smart tablet, to specifically improve anomia in post-stroke participants. The main outcomes studied were improvement in naming skills and generalisation to untreated items and daily communication.ResultsWe examined 23 studies in this review. To date, computers constitute the most popular technology by far; only a few studies explored the effectiveness of smart tablets. In some studies, technology was used as a therapy tool in a clinical setting, in the presence of the clinician, while in others, therapy with technology was self-administeredat home, without the clinician. All studies confirmed the effectiveness of therapy provided by technology to improve naming of trained items. However, generalisation to untrained items is unclear and assessment of generalisation to daily communication is rare.DiscussionThe results of this systematic review confirm that technology is an efficient approach in the management of post-stroke anomia. In future studies, ecological tasks aimed at evaluating therapy's effectiveness with word retrieval in real-life situations should be added since the ultimate goal of improving anomia is to increase the ability toretrieve words more easily in everyday life.



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Oral Contraceptive Okay for Acne as Last Resort, Says EMA

EU regulators said the available evidence for drugs combining dienogest and ethinylestradiol does not raise new safety concerns.
Medscape Medical News

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An automated hand hygiene compliance system is associated with improved monitoring of hand hygiene

Publication date: Available online 27 January 2017
Source:American Journal of Infection Control
Author(s): Saungi McCalla, Maggie Reilly, Rowena Thomas, Dawn McSpedon-Rai
BackgroundConsistent hand hygiene is key to reducing health care-associated infections (HAIs) and assessing compliance with hand hygiene protocols is vital for hospital infection control staff. A new automated hand hygiene compliance system (HHCS) was trialed as an alternative to human observers in an intensive care unit and an intensive care stepdown unit at a hospital facility in the northeastern United States.MethodsUsing a retrospective cohort design, researchers investigated whether implementation of the HHCS resulted in improved hand hygiene compliance and a reduction in common HAI rates. Pearson χ² tests were used to assess changes in compliance, and incidence rate ratios were used to test for significant differences in infection rates.ResultsDuring the study period, the HHCS collected many more hand hygiene events compared with human observers (632,404 vs 480) and ensured that the hospital met its compliance goals (95%+). Although decreases in multidrug-resistant organisms, central line-associated bloodstream infections, and catheter-associated urinary tract infection rates were observed, they represented nonsignificant differences.Discussion and conclusionsHuman hand hygiene observers may not report accurate measures of compliance. The HHCS is a promising new tool for fine-grained assessment of hand hygiene compliance. Further study is needed to examine the association between the HHCS and HAI rate reduction.



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Assessment With Children Who Need Augmentative and Alternative Communication (AAC): Clinical Decisions of AAC Specialists

Purpose

The purpose of this study was to explore how speech-language pathologists (SLPs) who are augmentative and alternative communication (AAC) specialists approach the assessment process for 2 case studies, 1 child with cerebral palsy and 1 with autism spectrum disorder. The aim of the study was to answer the following questions: (a) How do clinicians with expertise approach the AAC assessment process for children with developmental disabilities? (b) Can any initial hypothesis be drawn about how SLPs approach the assessment of children with motor versus social interactive deficits?

Method

This study used a phenomenological qualitative design. The researchers conducted 2 in-depth, semistructured interviews with 8 SLPs who specialized in AAC and self-identified as primarily working with children.

Results

Four major themes emerged from the data: area of assessment, method of assessment, evaluation preparation, and parent education. Each major theme contained multiple subthemes and categories within those subthemes.

Conclusions

Participants discussed similar areas of assessment for both cases, indicating that some aspects of AAC assessment are universal. However, the specific aspects of what they were assessing and how they went about assessing them differed between the 2 cases. The results of the current study provide an outline of an assessment protocol for children with complex communication needs.

http://ift.tt/2iYfEfX

Bilingual Language Assessment: Contemporary Versus Recommended Practice in American Schools

Purpose

The purpose of this study was to identify current practices of school-based speech-language pathologists (SLPs) in the United States for bilingual language assessment and compare them to American Speech-Language-Hearing Association (ASHA) best practice guidelines and mandates of the Individuals with Disabilities Education Act (IDEA, 2004).

Method

The study was modeled to replicate portions of Caesar and Kohler's (2007) study and expanded to include a nationally representative sample. A total of 166 respondents completed an electronic survey.

Results

Results indicated that the majority of respondents have performed bilingual language assessments. Furthermore, the most frequently used informal and standardized assessments were identified. SLPs identified supports, and barriers to assessment, as well as their perceptions of graduate preparation.

Conclusion

The findings of this study demonstrated that although SLPs have become more compliant to ASHA and IDEA guidelines, there is room for improvement in terms of adequate training in bilingual language assessment.

http://ift.tt/2hqC85H

Interactive Book Reading to Accelerate Word Learning by Kindergarten Children With Specific Language Impairment: Identifying an Adequate Intensity and Variation in Treatment Response

Purpose

This study sought to identify an adequate intensity of interactive book reading for new word learning by children with specific language impairment (SLI) and to examine variability in treatment response.

Method

An escalation design adapted from nontoxic drug trials (Hunsberger, Rubinstein, Dancey, & Korn, 2005) was used in this Phase I/II preliminary clinical trial. A total of 27 kindergarten children with SLI were randomized to 1 of 4 intensities of interactive book reading: 12, 24, 36, or 48 exposures. Word learning was monitored through a definition task and a naming task. An intensity response curve was examined to identify the adequate intensity. Correlations and classification accuracy were used to examine variation in response to treatment relative to pretreatment and early treatment measures.

Results

Response to treatment improved as intensity increased from 12 to 24 to 36 exposures, and then no further improvements were observed as intensity increased to 48 exposures. There was variability in treatment response: Children with poor phonological awareness, low vocabulary, and/or poor nonword repetition were less likely to respond to treatment.

Conclusion

The adequate intensity for this version of interactive book reading was 36 exposures, but further development of the treatment is needed to increase the benefit for children with SLI.

http://ift.tt/2igQeKB

Synthesizing Information From Language Samples and Standardized Tests in School-Age Bilingual Assessment

Purpose

Although language samples and standardized tests are regularly used in assessment, few studies provide clinical guidance on how to synthesize information from these testing tools. This study extends previous work on the relations between tests and language samples to a new population—school-age bilingual speakers with primary language impairment—and considers the clinical implications for bilingual assessment.

Method

Fifty-one bilingual children with primary language impairment completed narrative language samples and standardized language tests in English and Spanish. Children were separated into younger (ages 5;6 [years;months]–8;11) and older (ages 9;0–11;2) groups. Analysis included correlations with age and partial correlations between language sample measures and test scores in each language.

Results

Within the younger group, positive correlations with large effect sizes indicated convergence between test scores and microstructural language sample measures in both Spanish and English. There were minimal correlations in the older group for either language. Age related to English but not Spanish measures.

Conclusions

Tests and language samples complement each other in assessment. Wordless picture-book narratives may be more appropriate for ages 5–8 than for older children. We discuss clinical implications, including a case example of a bilingual child with primary language impairment, to illustrate how to synthesize information from these tools in assessment.

http://ift.tt/2hTUqiW

Evaluating the Impact of a Multistrategy Inference Intervention for Middle-Grade Struggling Readers

Purpose

We examined the effectiveness of a multistrategy inference intervention designed to increase inference making and reading comprehension for middle-grade struggling readers.

Method

A total of 66 middle-grade struggling readers were randomized to treatment (n = 33) and comparison (n = 33) conditions. Students in the treatment group received explicit instruction in 4 inference strategies (i.e., clarification using text clues; activating and using prior knowledge; understanding character perspectives and author's purpose; answering inferential questions). In addition, narrative and informational texts were carefully chosen and sequenced to build requisite background knowledge to form inferences. Intervention was delivered in small groups of 3 students for 10 days of instruction.

Results

One-way analysis of covariance models on outcome measures with the respective pretest scores as a covariate revealed significant gains on a proximal measure of Egyptian-content knowledge (g = 1.37) and on a standardized measure of reading comprehension—i.e., Wechsler Individual Achievement Test–Third Edition Reading Comprehension (g = 0.46).

Conclusion

The moderate effect on a standardized measure of reading comprehension provides preliminary evidence for the effectiveness of this multistrategy inference intervention in improving reading comprehension of middle-grade struggling readers.

http://ift.tt/2h2pr4h

Masthead

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Common and differential brain abnormalities in gambling disorder subtypes based on risk attitude

Publication date: June 2017
Source:Addictive Behaviors, Volume 69
Author(s): Hideaki Takeuchi, Kosuke Tsurumi, Takuro Murao, Ariyoshi Takemura, Ryosaku Kawada, Shin-ichi Urayama, Toshihiko Aso, Gen-ichi Sugihara, Jun Miyata, Toshiya Murai, Hidehiko Takahashi
Studying brain abnormalities in behavioral addiction including GD enables us to exclude possible confounding effects of exposure to neurotoxic substances, which should provide important insight that can lead to a better understanding of addiction per se. There have been a few brain structural magnetic resonance imaging studies for GD, although the results have been inconsistent. On the other hand, GD was suggested to be a heterogeneous disorder in terms of risk attitude. We aimed to examine the heterogeneity of GD by combining a behavioral economics task and voxel-based morphometry. Thirty-six male GD patients and 36 healthy male control subjects underwent a task for estimation of loss aversion, which can assess risk attitude in real-life decision-making. The GD patients were divided into two groups based on their level of loss aversion, low and high. While both groups showed common gray matter volume reduction in the left supramarginal gyrus and bilateral posterior cerebellum, high loss-aversion GD showed pronounced reduction in the left posterior cerebellum and additional reduction in the bilateral medial orbitofrontal cortex. Our study suggests that the heterogeneity of GD is underpinned at the brain structural level. This result might be useful for understanding neurobiological mechanisms and for the establishment of precise treatment strategies for GD.



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Do romantic partners influence each other's heavy episodic drinking? Support for the partner influence hypothesis in a three-year longitudinal study

Publication date: June 2017
Source:Addictive Behaviors, Volume 69
Author(s): Sara J. Bartel, Simon B. Sherry, Danielle S. Molnar, Aislin R. Mushquash, Kenneth E. Leonard, Gordon L. Flett, Sherry H. Stewart
BackgroundApproximately one in five adults engage in heavy episodic drinking (HED), a behavior with serious health and social consequences. Environmental, intrapersonal, and interpersonal factors contribute to and perpetuate HED. Prior research supports the partner influence hypothesis where partners influence each other's HED.ObjectivesWe examined the partner influence hypothesis longitudinally over three years in heterosexual couples in serious romantic relationships, while exploring possible sex differences in the magnitude of partner influence.MethodsOne-hundred-and-seventy-nine heterosexual couples in serious relationships (38.5% married at baseline) completed a measure of HED at baseline and again three years later.ResultsUsing actor-partner interdependence modelling, results showed actor effects for both men and women, with HED remaining stable for each partner from baseline to follow-up. Significant partner effects were found for both men and women, who both positively influenced their partners' HED over the three-year follow-up.ConclusionsThe partner influence hypothesis was supported. Results indicated partner influences on HED occur over the longer term and apply to partners in varying stages of serious romantic relationships (e.g., cohabiting, engaged, married). Women were found to influence their partners' HED just as much as men influence their partners' HED. Findings suggest HED should be assessed and treated as a couples' issue rather than simply as an individual risky behavior.



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Distress tolerance dimensions and smoking behavior among Mexican daily smokers: A preliminary investigation

Publication date: June 2017
Source:Addictive Behaviors, Volume 69
Author(s): Brooke Y. Kauffman, Lorra Garey, Jafar Bakhshaie, Rubén Rodríguez, Samuel Jurado Cárdenas, Patricia Edith Campos Coy, Michael J. Zvolensk
IntroductionDistress intolerance has been implicated in various aspects of smoking maintenance and quit behavior, although past work has been conducted almost exclusively among European American samples.MethodThe present study sought to extend past work by exploring distinct subdimensions of distress tolerance (Tolerance, Appraisal, Regulation, and Absorption) among a sample of 113 (53.1% female; Mage=22.81, SD=2.13) adult daily smokers from Mexico City, Mexico in regard to multiple indices of problematic smoking.ResultsResults indicated that the Appraisal dimension of distress intolerance was associated with smoking more cigarettes per day, a greater number of (lifetime) failed quit attempts, and an increased likelihood of early smoking relapse. These findings remained significant after controlling for negative affectivity, gender, alcohol usage as well as the variance accounted for by other distress tolerance dimensions.ConclusionsSuch results provide novel preliminary empirical evidence that lesser perceived ability to tolerate distress because it is appraised as 'unacceptable' may be a particularly important element of the construct in terms of better understanding multiple public health relevant indicators of smoking for Mexican smokers. Overall, the present findings uniquely contribute to a growing body of research related to distress intolerance and its implications for explicating the nature of the maintenance of smoking behavior among a highly understudied segment of the smoking population (Mexican smokers).



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Fixated and Not Fixated Regions of Mammograms: A Higher-Order Statistical Analysis of Visual Search Behavior

Publication date: Available online 27 January 2017
Source:Academic Radiology
Author(s): Suneeta Mall, Patrick Brennan, Claudia Mello-Thoms
Rationale and ObjectivesVisual search is an inhomogeneous yet efficient sampling process accomplished by the saccades and the central (foveal) vision. Areas that attract the central vision have been studied for errors in interpretation of medical imaging. In this study, we extend existing visual search studies to understand what characterizes areas that receive direct visual attention and elicit a mark by the radiologist (True and False Positive decisions) from those that elicit a mark but were captured by the peripheral vision. We also investigate if there are any differences between these areas and those that are never fixated by radiologists.Materials and MethodsEight radiologists participated in this fully crossed multi-reader multi-case visual search study of digital mammography (DM) involving 120 two-view cases (59 cancers). From these DM images, 3 types of areas, namely Fixated Clusters (FC), Marked Peripherally Fixated Clusters (MPFC) and Never Fixated Clusters (NFC), were extracted and analysed using statistical information theory (in the form of third and fourth-order cumulants and polyspectrum [specifically bispectrum and trispectrum]) in addition to traditional second-order statistics (in the form of power spectrum) and other nonspectral features to characterize these types of areas.ResultsOur results suggest that energy profiles of FC, MPFC, and NFC areas are distinct. We found evidence that energy profiles and dwell time of these areas influence radiologists' decisions (and confidence in such decisions). We also noted that foveated areas are selected on the basis of being most informative.ConclusionWe show that properties of these areas influence radiologists' decisions and their confidence in the decisions made.



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Foxo3a inhibits mitochondrial fission and protects against doxorubicin-induced cardiotoxicity by suppressing MIEF2

Publication date: Available online 27 January 2017
Source:Free Radical Biology and Medicine
Author(s): Luyu Zhou, Ruibei Li, Cuiyun Liu, Teng Sun, Lynn Htet Htet Aung, Chao Chen, Jinning Gao, Yanfang Zhao, Kun Wang
Doxorubicin (DOX) as a chemotherapeutic drug is widely used to treat a variety of human tumors. However, a major factor limiting its clinical use is its cardiotoxicity. The molecular components and detailed mechanisms regulating DOX-induced cardiotoxicity remain largely unidentified. Here we report that Foxo3a is downregulated in cardiomyocytes and mouse heart in response to DOX treatment. Foxo3a attenuates DOX-induced mitochondrial fission and apoptosis in cardiomyocytes. Cardiac specific Foxo3a transgenic mice show reduced mitochondrial fission, apoptosis and cardiotoxicity upon DOX administration. Furthermore, Foxo3a directly targets mitochondrial dynamics protein of 49kDa (MIEF2) and suppresses its expression at transcriptional level. Knockdown of MIEF2 reduces DOX-induced mitochondrial fission and apoptosis in cardiomyocytes and in vivo. Also, knockdown of MIEF2 protects heart from DOX-induced cardiotoxicity. Our study identifies a novel pathway composed of Foxo3a and MIEF2 that mediates DOX cardiotoxicity. This discovery provides a promising therapeutic strategy for the treatment of cancer therapy and cardioprotection.



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Complementary and alternative medicine in radiation oncology

Abstract

Background

Complementary and alternative medicine (CAM) are gaining in importance, but objective data are mostly missing. However, in previous trials, methods such as acupuncture showed significant advantages compared to standard therapies. Thus, the aim was to evaluate most frequently used methods, their significance and the general acceptance amongst cancer patients undergoing radiotherapy (RT).

Methods

A questionnaire of 18 questions based on the categorical classification released by the National Centre for Complementary and Integrative Health was developed. From April to September 2015, all patients undergoing RT at the Department of Radiation Oncology, Technical University of Munich, completed the survey. Changes in attitude towards CAM were evaluated using the questionnaire after RT during the first follow-up visit (n = 31).

Results

Of 634 patients, 333 answered the questionnaire (52.5%). Of all participants, 26.4% used CAM parallel to RT. Before RT, a total of 39.3% had already used complementary medicine. The most frequently applied methods during therapy were vitamins/minerals, food supplements, physiotherapy/manual medicine, and homeopathy. The majority (71.5%) did not use any complementary treatment, mostly stating that CAM was not offered to them (73.5%). The most common reasons for use were to improve the immune system (48%), to reduce side effects (43.8%), and to not miss an opportunity (37.8%). Treatment integrated into the individual therapy concept, e.g. regular acupuncture, would be used by 63.7% of RT patients.

Conclusion

In comparison to other studies, usage of CAM parallel to RT in our department is considered to be low. Acceptance amongst patients is present, as treatment integrated into the individual oncology therapy would be used by about two-third of patients.

http://ift.tt/2kbSJPC