Editorial Board

Publication date: January 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 104





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Long-term follow-up with mention of complications in pediatric microvascular mandibular reconstruction

Publication date: February 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 105
Author(s): Kenneth Akakpo, Christopher Iobst, Matthew Old, Jonathan Grischkan
The fibular free flap has become the gold standard for mandibular reconstruction. Despite its vast array of benefits, this procedure has the potential for several complications. In the pediatric setting, the immature skeleton sets the stage for an increased risk of future skeletal abnormalities, both in the jaw, and in the donor site. Herein we describe the case of a toddler who underwent mandibular reconstruction using a fibula free flap and, years later, subsequently developed ankle instability as a result of residual fibula migration. This indicates the need for careful consideration of long-term issues in the growing pediatric skeleton prior to surgery.



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The impact of a resident-run review curriculum and USMLE scores on the Otolaryngology in-service exam

Publication date: January 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 104
Author(s): Andrew J. Redmann, Kareem O. Tawfik, Charles M. Myer
ObjectiveDescribe the association of USMLE Step 1 scores and the institution of a dedicated board review curriculum with resident performance on the Otolaryngology training examination.Study designRetrospective cross sectional study.MethodsWe reviewed American Board of Otolaryngology Training Examination (OTE) scores for an otolaryngology residency program between 2005 and 2016. USMLE Step 1 scores were collected. In 2011 a resident-run OTE review curriculum was instituted with the goal of improving test preparation. Scores were compared before and after curriculum institution. Linear regression was performed to identify predictors of OTE scores.Results47 residents were evaluated, 24 before and 23 after instituting the curriculum. There was a moderate correlation between USMLE step 1 scores and OTE scores for all years. For PGY-2 residents, mean OTE scores improved from 25th percentile to 41st percentile after institution of the review curriculum (p = 0.05). PGY 3–5 residents demonstrated no significant improvement. On multivariate linear regression, after controlling for USMLE step 1 scores, a dedicated board review curriculum predicted a 23-point percentile improvement in OTE scores for PGY-2 residents (p = 0.003). For other post-graduate years, the review curriculum did not predict score improvement.ConclusionUSMLE step 1 scores are moderately correlated with OTE performance. A dedicated OTE review curriculum may improve OTE scores for PGY-2 residents, but such a curriculum may have less benefit for intermediate- and senior-level residents.Level of evidence4.



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Maternal knowledge and attitudes to universal newborn hearing screening: Reviewing an established program

Publication date: February 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 105
Author(s): Maggie Yee Yan Lam, Eddie Chi Ming Wong, Chi Wai Law, Helena Hui Ling Lee, Bradley McPherson
ObjectivesTo facilitate early diagnosis of infants with hearing loss, a universal newborn hearing screening program (UNHS) has been implemented in Hong Kong's public hospitals for over a decade. However, there have been no known studies investigating parent attitudes to, and satisfaction with, UNHS since its launch in Hong Kong. The present study aimed to investigate knowledge of UNHS as well as infant hearing development, and attitudes and satisfaction with UNHS, in Hong Kong mothers with newborns. The study was designed to help evaluate and improve an established UNHS public hospital program, based on the perspectives of service users.MethodsA researcher-developed questionnaire was administered to 102 mothers whose newborn had received UNHS in the postnatal wards of a large public hospital in Hong Kong. The questionnaire considered parental knowledge of UNHS and infant hearing development, attitudes and satisfaction toward public hospital UNHS. In the knowledge dimension, parents' preferred time and location for pre-test information delivery, interpretation of screening results, and knowledge of hearing developmental milestones were surveyed. In addition, maternal attitudes to and satisfaction with UNHS screening services, the potential impact of UNHS on parent emotions and parent-baby bonding, attitudes toward informed consent, and willingness to comply with diagnostic assessment referral were also be surveyed.ResultsMean participant scores on knowledge of infant hearing development were relatively low (M = 2.59/6.0, SD = 0.90). Many mothers also underestimated the potential ongoing risks of hearing impairment in babies. Around 80% of mothers thought an infant could not have hearing impairment after passing the screening. In addition, one-third of mothers thought a baby could not later develop hearing impairment in infancy or childhood. In terms of attitudes and satisfaction, participants gave somewhat negative ratings for questions regarding receiving sufficient information about the screening (M = 2.90/5.0, SD = 1.27), screening procedure (M = 2.20/5.0, SD = 1.08), and sufficiency of information about results (M = 2.87/5.0, SD = 1.14). Nonetheless, participants gave positive ratings concerning whether screening could lead to early diagnosis (M = 4.61/5.0, SD = 0.57) and over 95% of mothers supported UNHS despite potential for false positive results. Mothers reported a high willingness to bring their baby to follow-up assessments if required (M = 4.53/5.0, SD = 0.56). Participants gave positive ratings for their level of satisfaction with the time and location of first UNHS information provision (M = 4.34/5.0, SD = 0.80) and the way permission was asked for screening the baby (M = 4.04/5.0, SD = 0.97) but alternative procedures were also recommended. Most recommendations focused on providing more information about the test and a more detailed explanation of screening results.ConclusionsThe survey results highlighted the need to provide more information to parents about infant hearing development to support home monitoring for signs of hearing loss after UNHS, as well as more detailed explanation and information regarding hearing screening and the implications of results to parents. Regardless of location, surveys of this type may provide valuable support for UNHS program quality assurance.



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Ring a ring o'roses, a patient with Kaposi's? Pazopanib, pazopanib, it might go away. Mediterranean (classic) Kaposi sarcoma responds to the tyrosine kinase inhibitor pazopanib after multiple lines of standard therapy

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Psychometric assessment of the marijuana adolescent problem inventory

Publication date: April 2018
Source:Addictive Behaviors, Volume 79
Author(s): Ashley A. Knapp, Steven F. Babbin, Alan J. Budney, Denise D. Walker, Robert S. Stephens, Emily A. Scherer, Catherine Stanger
Cannabis is one of the most commonly used psychoactive substances among adolescents in the United States. Adolescent cannabis use has multiple consequences including academic, health, and psychiatric problems. The Marijuana Adolescent Problem Inventory (MAPI) is a 23-item scale adapted from the Rutgers Alcohol Problem Index and used in the current literature to assess cannabis use problem severity. Psychometric testing for the MAPI has yet to be reported. The current investigation assessed the psychometric characteristics of the MAPI with cannabis-using adolescents (n=727) from school and outpatient settings who enrolled in five separate randomized clinical trials focused on treatment of substance use. Findings suggested that the MAPI is internally consistent and reliable. Factor structure analyses suggested that the MAPI measures one latent construct, with no differences in factor structure between the outpatient and school settings, supporting a one-factor model. External validity of the MAPI was also demonstrated as evidenced by significant relations with concurrent diagnosis of cannabis dependence and abuse, longitudinal frequency of cannabis use, and mean times used per day. Overall, this initial test of the psychometric characteristics of the MAPI suggests that it can be considered a reliable and valid measure of problems associated with cannabis use among adolescents. Future work is now needed to replicate these findings by testing the psychometric properties of the MAPI in more diverse samples and developing a short version to be used as a brief assessment tool.



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Guilt-proneness is associated with the use of protective behavioral strategies during episodes of alcohol use

Publication date: April 2018
Source:Addictive Behaviors, Volume 79
Author(s): Matt S. Treeby, Simon M. Rice, Fiona Cocker, Amy Peacock, Raimondo Bruno
IntroductionShame and guilt are closely related emotions with diverging implications for the development, and potential treatment, of substance use disorders. Accumulating research indicates that a guilt-prone affect style buffers individuals against the development of problematic alcohol use, while shame-proneness appears to offer no protective function. However, little is known about the manner in which guilt-prone individuals avoid the experience of alcohol use-related harms. The present study aimed to extend the shame, guilt, and substance use literature by examining whether these two self-conscious affect styles are differentially related to the use of protective behavioral strategies which reduce the risk of harms during drinking episodes.MethodsParticipants (N=281; female n=207) completed pen-and-paper measures of shame and guilt-proneness, level of alcohol use, and the habitual use of protective behavioral strategies during drinking episodes. Part-correlation analysis isolated shame-free guilt and guilt-free shame residuals in exploring relationships between self-conscious affect style and the use of protective behavioral strategies during drinking episodes.ResultsGuilt-proneness was consistently associated with the routine use of protective behavioral strategies during episodes of alcohol intake. In contrast, shame-proneness was unrelated to the use of such protective and harm avoidance strategies when drinking.ConclusionFindings provide additional support for the argument that guilt and shame need to be considered separately in both research and substance use treatment settings.



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Tubular variant of mammary adenomyoepithelioma: Diagnostic challenges and cytomorphological correlation in two cases

Aneeta Jassar, Kunjan Pathania

CytoJournal 2017 14(1):29-29

The authors describe the cytomorphologic features of two cases of tubular variant of adenomyoepithelioma of the breast that were first examined by fine-needle aspiration cytology (FNAC) and diagnosed as fibroadenoma. On retrospective review of the cytology, subtle features such as less cohesive epithelial clusters, intimate association of clusters of stromal cells with epithelial elements, a dominant population of plump-epithelioid naked (myoepithelial) cells, and occasional cells with intranuclear inclusions, were noted. Thus, these lesions can be diagnostically challenging and cannot be conclusively differentiated from either fibroadenoma or tubular adenoma cytologically and the pathologist may only be able to give a differential on FNAC. Recognition of the biphasic nature and the characteristic overall architecture of the tumors in combination with immunohistochemistry are essential to establish the correct diagnosis on biopsy. Although most tumors have a benign clinical course, rare instances of local recurrence, malignant transformation, and distant metastases have been reported. A complete excision with adequate margins would lower the chance of local recurrence.

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Comparative evaluation of six parametric Robinson and three parametric Howell's modification of Scarf-BloomRichardson grading method on breast aspirates with histopathology: A prospective study

Vaishali A Walke, Gajanan Gunjkar

CytoJournal 2017 14(1):31-31

Background: Fine needle aspiration cytology (FNAC) is a quick method to assess the tumor grade before its removal which will help clinicians to decide on the appropriate neo adjuvant therapy. This is essentially true in developing countries where core needle biopsy still is not used as a standard practice to sample breast carcinoma. Assessment of biological aggressiveness by cytological grading (CG) without removing the would be of immense value. The National Cancer Institute, Bethesda, sponsored conference had recommended that tumor grading on FNA material should be incorporated in cytology reports for prognostication. Aim: The present study was carried out to evaluate which among the two, five parametric Robinson or three parametric Scarf–BloomRichardson (SBR) cytology grading method corresponds better with the histological grading (HG) in breast carcinoma. Materials and Methods: FNAC of 150 cases of ductal carcinoma breast with subsequent histological confirmation was studied to assess the tumor grade on cytology by two distinct methods Robinson and Howell's modification of SBRmethod and then correlated with histologic grade. Results: Comparative analysis revealed concordance of 76% by Robinson and 68% by SBR with Kappa value of 0.6683 and 0.4505 and diagnostic accuracy of 86.7% and 78.7%, respectively. Conclusions: We conclude that Robinson method showed a better correlation and higher kappa value of agreement in comparison with SBR method. Robinson method of CG is simpler, objective, and easily reproducible for grading breast carcinomas.

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Fine-needle aspiration of a right neck mass in a 10-year-old boy: Diagnostic clues and workup for tumors with small round blue cells

Sue Chang, Sharon Hirschowitz, David Y Lu, Rose C Montoya, Maria Vergara-Lluri, Neda A Moatamed

CytoJournal 2017 14(1):30-30



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Influenza B virus infection and Stevens–Johnson syndrome

Abstract

A 2-year-old boy with influenza B infection and rapidly worsening targetoid skin lesions with mucosal involvement was diagnosed with Stevens–Johnson syndrome (SJS) and treated with oseltamivir and intravenous immunoglobulin, with resolution of illness. Subsequent quadrivalent inactivated influenza vaccine was well tolerated. This case highlights the rarity of SJS in the setting of influenza B infection and addresses the safety of administering subsequent influenza vaccines to such individuals.

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Triptolide-induced hepatotoxicity can be alleviated when combined with Panax notoginseng saponins and Catapol

Publication date: 25 March 2018
Source:Journal of Ethnopharmacology, Volume 214
Author(s): Lingling Zhou, Cong Zhou, Zhe Feng, Zhangpu Liu, Huaxu Zhu, Xueping Zhou
Ethnopharmacological relevanceThe hepatotoxicity of Tripterygium wilfordii Hook. f. (TW), due to the presence of triptolide (TP), limits its therapeutic potential. Based on the traditional Chinese medicine theory, the theory of "Yi lei xiang zhi" was proposed that Chinese herbs with different efficacy can restrict each other to achieve the least adverse reactions.Aim of the studyTo observe the effects of Catapol (CAT) and Panax notoginseng saponins (PNS), active ingredients in Rehmannia glutinosa (RG) and Panax notoginseng (PN) respectively, on reducing TP-induced hepatotoxicity, and further to explore the mechanisms.Materials and methodsThe human hepatic cell line L-02 was cultured and treated with CAT, PNS or Combinations, and then treated with TP. The cytotoxic assay, the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH), apoptosis, mitochondrial membrane potential and the expressions of NF-E2-related factor 1 (Nrf1) and its downstream targets were detected. Rats were treated with TP, TP + CAT, TP + PNS, or the combinations for 4 weeks. The levels of ALT, AST and LDH in serum, apoptosis of liver cells, mitochondria injury and the protein expressions of Caspase 3 and Nrf1 were investigated.ResultsCAT, PNS or CAT+PNS pre-treatment inhibited TP-induced toxicity in L-02 cells, distinctly decreased the apoptosis, alleviated the reduction of mitochondrial membrane potential, and modulated the expressions of Nrf1 and its downstream target, the mitochondrial transcription factor A (TFAM) and cytochrome C (Cyt-C). CAT, PNS or CAT+PNS inhibited the TP-induced hepatotoxicity in SD rats by reducing the mitochondria injury, decreasing the cells apoptosis and increasing the Nrf1 protein expression. Noticeably, TP + PNS + CAT combinations exhibited more effective than any single ingredient alone.ConclusionPNS and CAT were able to effectively attenuate TP-induced hepatotoxicity. The efficiency benefits from their modulating Nrf1 and its downstream genes TFAM and Cyt-C, and further influencing mitochondrial functions and cells apoptosis. The combination is more effective than single ingredient alone.

Graphical abstract

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Effects of mastic oleoresin on wound healing and episiotomy pain: A mixed methods study

Publication date: 25 March 2018
Source:Journal of Ethnopharmacology, Volume 214
Author(s): Zahra Moudi, Mojgan Edozahi, Seyyed Ahmad Emami, Javad Asili, Mahnaz Shahraki Pour
IntroductionMastic (Pistacia lentiscus) oleoresin (MO is used by traditional Baluch healers to precipitate wound healing and relieve episiotomy pain.Objective(s)To investigate the effects of MO on wound healing and episiotomy pain intensity in nulliparous Baluch women.Materials and methodsThis study had a mixed methods design. In the qualitative phase, we interviewed 9 traditional healers and 13 women to understand how the indigenous people use MO for wound healing. In the quantitative phase, a randomized controlled trial was performed on primiparous women during July 23-November 22 in 2016. One hundred and forty-seven women were randomly assigned to intervention (n=73) and control (n=74) groups. At 48h postpartum, 15g of MO was provided to the women to be administered for three days (through smoking the episiotomy wound). Pain and wound healing were measured at 3, 7, and 10 days postpartum using the visual analogue scale and REEDA scale, respectively.ResultsMO had no significant effect on episiotomy pain intensity at 3, 7, and 10 days postpartum (p=0.61, p=0.76, and p=0.45, respectively). In addition, healing rates of the episiotomy wounds treated by MO (mean: 0.11±0.45, 0.15±0.51, and 0.15±0.57, respectively) were higher than those in the control group (mean: 0.21±0.70, 0.16±0.63, and 0.49±0.28, respectively) at 3, 7, and 10 days postpartum; however, the difference between the two groups was not significant (p=0.27, p=0.76, and p=0.23, respectively).ConclusionIn the current study, healing rates in the MO group were higher than those in the control group; however, further studies should be undertaken to identify the effects of MO.



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Controlling nanoparticle crystallinity and surface enrichment in polymer (P3HT)/Nanoparticle(PCBM) blend films with tunable soft confinement

Publication date: 31 January 2018
Source:Polymer, Volume 136
Author(s): Abul F. Huq, Irina Zvonkina, Abdullah M. Al-Enizi, Alamgir Karim
Light absorbing semi-crystalline polymers are often blended with crystallizing conductive nanoparticles for enhanced electrical properties in thin film photovoltaics. Here we develop a general strategy to control nanoparticles degree of crystallinity and relative surface segregation at the air boundary, important for flexible organic electronics. While SAM modified silicon surface has been extensively studied to control substrate segregation in OPV blend films, controlling the same at the air surface has not been explored significantly. Semi-crystalline polymers have high surface energy much like nanoparticles, so that the surface energy differential can be low, allowing for tunability of the lower surface energy component by a soft confinement strategy. Soft confinement can also be used to control the degree of crystallization of the surface segregating component. To this end, we study effect of soft confinement on P3HT:PCBM blend films, a model semi-crystalline polymer/nanoparticle system, in which both components crystallize with P3HT migrating to free air surface. We present a novel UVO treated fluorosilicone elastomer transient capping layer with controlled surface energy, γ, that can induce PCBM migration to the elastomer capped blend film interface. The transition of P3HT crystalline structure from face-on to edge-on with annealing is largely unaffected in the process. Effects of the casting solvent on the crystallization kinetics of thin P3HT:PCBM blend films under wide range of fluoroelastomer surface energy values γ (29–70 mJ/m²) was explored with differing outcomes. A notable result is that PCBM crystallization cast from o-dichlorobenzene (DCB) is suppressed without diffusing into the fluorosilicone layer. Our tunable surface energy soft-confinement strategy should be extendable to other polymer/nanoparticle thin film systems for broader impact in the scientific community.

Graphical abstract

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Thermodynamic characterization of polymers

Publication date: 31 January 2018
Source:Polymer, Volume 136
Author(s): Costas Panayiotou
The central objective of this work is the presentation of a novel simple method for the characterization of polymers as regards their thermodynamic behavior in bulk phases and interfaces. For this purpose, LSER (Linear Solvation Energy Relationships) type molecular descriptors and polymer surface energies are derived, primarily, from Inverse Gas Chromatography (IGC) and contact angle measurements for a number of common polymers. The interconnection of these descriptors with the more familiar equation-of-state scaling constants from PVT measurements is explored. The characteristic LSER descriptors are used for the prediction of polymer – polymer miscibility as well as for handling IGC data for multicomponent systems. Emphasis is given on hydrogen-bonded polymer systems. As shown by a variety of examples, the efficiency and versatility of the method are particularly promising. The broader perspectives of this unified approach to solution thermodynamics are discussed.

Graphical abstract

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Uranium time series analysis: A new methodological approach for event screening categorisation

Publication date: March 2018
Source:Journal of Environmental Radioactivity, Volume 183
Author(s): Stefano Bianchi, Wolfango Plastino
Uranium (U) groundwater anomalies, detected before the L'Aquila earthquake (April 6th, 2009), represent a key geochemical signal of a progressive increase of deep fluids fluxes at middle–lower crustal levels associated with the geodynamics of the earthquake. Although the analyses performed in association with the seismic pattern around Gran Sasso National Laboratory and the geophysical and geochemical patterns of the Gran Sasso aquifer supported this hypothesis, a new approach for time series analysis has been developed for event screening categorisation and to highlight U as possible strain meter in geodynamical processes, particularly those which characterise active normal faulting.



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Heparin-induced haemorrhagic bullous dermatosis

Summary

Background

Heparin-induced haemorrhagic bullous dermatosis (HBD) is a rare but probably underdiagnosed reaction to heparin, with 26 cases reported in the English literature. Currently, there is no consensus regarding the treatment.

Aim

To assess our new cases of HBD and review the previously reported cases, in order to draw conclusions about this adverse skin reaction to heparin.

Methods

A PubMed search was performed for articles containing the terms '(heparin-induced AND (blister OR bulla OR bullae)) OR (hemorrhagic bullous dermatosis AND heparin) OR heparin bullous dermatosis'. Descriptive statistical data analysis was performed using Microsoft Excel.

Results

We assessed five new cases of HBD. In addition, our literature search revealed 26 previously reported patients. Combining these, we found that the mean ± SD age of patients with HBD was 71.4 ± 14 years. HBD affects men more commonly than women (men 22/31; P = 0.02). Patients develop tense bullae most frequently on the extremities, approximately 8 days (mean ± SD 7.5 ± 6.4 days) after starting treatment with a heparin product, usually enoxaparin.

Conclusions

The typical clinical course is spontaneous resolution within days to weeks irrespective of continuation of heparin therapy. Because of its self-limiting nature, interruption of heparin therapy may not be required.

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An erythematous raised dermatofibroma-like nodule

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Arterial thrombosis and anti-PD-1 blockade

Publication date: Available online 27 December 2017
Source:European Journal of Cancer
Author(s): Céline Boutros, Jean-Yves Scoazec, Christine Mateus, Emilie Routier, Séverine Roy, Caroline Robert




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Targeting renal fibrosis: Mechanisms and drug delivery systems

Publication date: Available online 27 December 2017
Source:Advanced Drug Delivery Reviews
Author(s): Madalina V. Nastase, Jinyang Zeng-Brouwers, Malgorzata Wygrecka, Liliana Schaefer
Renal fibrosis is the common outcome of many chronic kidney diseases (CKD) independent of the underlying etiology. Despite a host of promising experimental data, currently available strategies only ameliorate or delay the progression of CKD but do not reverse fibrosis. One of the major impediments of translating novel antifibrotic strategies from bench to bedside is due to the intricacies of the drug delivery process. In this review, we briefly describe mechanisms of renal fibrosis and methods of drug transfer into the kidney. Various tools used in gene therapy to administer nucleic acids in vivo are discussed. Furthermore, we review the modes of action of protein- or peptide-based drugs with target-specific antibodies and cytokines incorporated in hydrogels. Additionally, we assess an intriguing new method to deliver drugs specifically to tubular epithelial cells via conjugation with ligands binding to the megalin receptor. Finally, plant-derived compounds with antifibrotic properties are also summarized.

Graphical abstract

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Ophthalmic gels: Past, present and future

Publication date: Available online 27 December 2017
Source:Advanced Drug Delivery Reviews
Author(s): Ali A. Al-Kinani, Ghada Zidan, Naba Elsaid, Ali Seyfoddin, Adam W.G. Alani, Raid G. Alany
Aqueous gels formulated using hydrophilic polymers (hydrogels) along with those based on stimuli responsive polymers (in situ gelling or gel forming systems) continue to attract increasing interest for various eye health-related applications. They allow the incorporation of a variety of ophthalmic pharmaceuticals to achieve sustained and therapeutic levels of drugs and bioactives at target ocular sites. The integration of sophisticated drug delivery technologies such as nanotechnology-based, intelligent and environment responsive systems can extend current treatment duration to provide more clinically relevant time courses (weeks and months instead of hours and days) which will inevitably reduce dose frequency, increase patient compliance and improve clinical outcomes. Novel applications and design of contact lenses and intracanalicular delivery devices along with the movement towards integrating gels into various drug delivery devices like intraocular pumps, injections and implants has the potential to reduce comorbidities caused by glaucoma, corneal keratopathy, cataract, diabetic retinopathies and age-related macular degeneration. This review describes ophthalmic gelling systems with emphasis on mechanism of gel formation and application in ophthalmology. It provides a critical appraisal of the techniques and methodologies used in the characterization of ophthalmic preformed gels and in situ gelling systems along with a thorough insight into the safety and biocompatibility of these systems. Newly developed ophthalmic gels, hydrogels, preformed gels and in situ gelling systems including the latest in the area of stimuli responsive gels, molecularly imprinted gels, nanogels, 3D printed hydrogels; 3D printed devices comprising ophthalmic gels are covered. Finally, new applications of gels in the production of artificial corneas, corneal wound healing and hydrogel contact lenses are described.

Graphical abstract

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Implantable, wireless device platforms for neuroscience research

Publication date: June 2018
Source:Current Opinion in Neurobiology, Volume 50
Author(s): Philipp Gutruf, John A Rogers
Recently developed classes of ultraminiaturized wireless devices provide powerful capabilities in neuroscience research, as implantable light sources for simulation/inhibition via optogenetics, as integrated microfluidic systems for programmed pharmacological delivery and as multimodal sensors for physiological measurements. These platforms leverage basic advances in biocompatible materials, semiconductor device designs and systems engineering concepts to afford modes of operation that are qualitatively distinct from those of conventional approaches that tether animals to external hardware by means of optical fibers, electrical cables and/or fluidic tubing. Neuroscience studies that exploit the unique features of these technologies enable insights into neural function through targeted stimulation, inhibition and recording, with spatially and genetically precise manipulation of neural circuit activity. Experimental possibilities include studies in naturalistic, three dimensional environments, investigations of pair-wise or group related social interactions and many other scenarios of interest that cannot be addressed using traditional hardware.



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Improving learning and confidence through small group, structured otoscopy teaching: a prospective interventional study

Abstract

Background

Otologic diseases are common and associated with significant health care costs. While accurate diagnosis relies on physical exam, existing studies have highlighted a lack of comfort among trainees with regards to otoscopy. As such, dedicated otoscopy teaching time was incorporated into the undergraduate medical curriculum in the form of a small group teaching session. In this study, we aimed to examine the effect of a small-group, structured teaching session on medical students' confidence with and learning of otoscopic examination.

Methods

Using a prospective study design, an otolaryngologist delivered an one-hour, small group workshop to medical learners. The workshop included introduction and demonstration of otoscopy and pneumatic otoscopy followed by practice with peer feedback. A survey exploring students' confidence with otoscopy and recall of anatomical landmarks was distributed before(T1), immediately after(T2), and 1 month following the session(T3).

Results

One hundred and twenty five learners participated from February 2016 to February 2017. Forty nine participants with complete data over T1-T3 demonstrated significant improvement over time in confidence (Wilk's lambda = .09, F(2,48) = 253.31 p < .001, η ²  = .91) and learning (Wilk's lambda = 0.34, F(2,47) = 24.87 p < .001, η ²  = .66).

Conclusions

A small-group, structured teaching session had positive effects on students' confidence with otoscopy and identification of otologic landmarks. Dedicated otoscopy teaching sessions may be a beneficial addition to the undergraduate medical curriculum.

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Inflammatory and infectious pathology of the gastrointestinal tract: an introduction

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Impact of heavy metal bioaccumulation on antioxidant activities and DNA profile in two earthworm species and freshwater prawn from Ogun River

Publication date: 15 May 2018
Source:Science of The Total Environment, Volume 624
Author(s): G.A. Dedeke, P.O. Iwuchukwu, A.A. Aladesida, T.A. Afolabi, I.O. Ayanda
The use of freshwater invertebrates as bioindicator of heavy metal pollution is an important tool for environmental biomonitoring. This study investigated antioxidant activities and DNA profile in two limicolous earthworms (Alma millsoni and Libyodrilus violaceus) and freshwater prawns (Macrobrachium vollenhovenii) at selected points of Ogun River, Abeokuta. Heavy metal concentrations and DNA profile in the earthworms and prawn tissues were measured using standard procedures. Zn concentration was higher than other heavy metals in A. millsoni (685.83±114.42mg/kg), L. violaceus (1913.3±1098.7mg/kg) and M. vollenhovenii (134.7±13.61mg/kg). Superoxide dismutase activity ranged from 62.44±7.16–79.82±11.18U/g tissues, 60.26±11.18–71.07±7.54U/g tissues and 74.07±16.69–87.79±8.50U/g tissues in A. millsoni, L. violaceus and M. vollenhovenii respectively. RAPD-PCR revealed varying DNA profile among the earthworms samples; the UPGMA dendrogram formed two distinct clusters at genetic similarity coefficient of 0.15–0.2 with one cluster consisting of Alma millsoni and Libyodrilus violaceus from Sokori, Enugada and Iberekodo sampling points and the second cluster forming two distinct sub-clusters comprising Arakanga and Ago-ika's L. violaceus in one and A. millsoni in the other. High genetic variability was recorded among the earthworm species while the freshwater prawn showed no variability. Antioxidant activities and genetic variability in earthworms could serve as biomarkers of heavy metal pollution in freshwater environment.

Graphical abstract

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Evaluation of environmental and anthropogenic influences on ambient background metal and metalloid concentrations in soil

Publication date: 15 May 2018
Source:Science of The Total Environment, Volume 624
Author(s): Hannah G. Mikkonen, Raghava Dasika, Jessica A. Drake, Christian J. Wallis, Bradley O. Clarke, Suzie M. Reichman
There has been a global shift in environmental risk assessment towards quantifying ambient background concentrations of metals/metalloids in soil. Whilst bedrock has been shown to be a key driver of metal/metalloid variability in soil, few researchers have assessed controls of ambient background concentrations in soils of similar bedrock. A soil survey was undertaken ofGreater Melbourne, Greater Geelong, Ballarat and Mitchell in Victoria, Australia for elements of potential environmental concern: As, Cd, Cr, Cu, Ni, Hg, Pb and Zn. Samples (n=622) were collected from surface (0 to 0.1m) and sub-surface (0.3 to 0.6m) soils, overlying Tertiary-Quaternary basalt, Tertiary sediments and Silurian siltstone and sandstone. In addition, background soil data from open-source environmental assessment reports (n=5512) were collated to support the understanding of natural enrichment, particularly at depths >0.6m. Factor analysis, supported by correlation analysis and auxiliary geo-spatial data, provided an improved understanding of where and how background metal/metalloid enrichment occurs in the environment. Weathering during paleoclimates was the predominant influence of background metal/metalloid variability in soils overlying similar bedrock. Other key influences of metal/metalloid variability in soil included hydraulic leaching of alkali elements, biological cycling, topography and alluvial transfer of silt and sand from mineralised regions. In addition, urbanisation positively correlated with Pb and Zn concentrations in surface soils suggesting that anthropogenic activities may have resulted in diffuse Pb and Zn contamination of urban soil.

Graphical abstract

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Simulated nitrogen deposition affects stoichiometry of multiple elements in resource-acquiring plant organs in a seasonally dry subtropical forest

Publication date: 15 May 2018
Source:Science of The Total Environment, Volume 624
Author(s): Liang Kou, Weiwei Chen, Lei Jiang, Xiaoqin Dai, Xiaoli Fu, Huimin Wang, Shenggong Li
Increase of anthropogenic atmospheric nitrogen (N) deposition markedly influences biogeochemical cycles of elements in a wide range of ecosystems. However, our knowledge of how N deposition affects stoichiometry of plants in forests experiencing regular seasonal droughts remains limited. Using a 3-year (2013–2015) N-manipulative experiment, we examined the stoichiometric responses of ten mineral elements, including the most limiting elements (N and P) to plant growth, base cations (K, Ca, and Mg), and trace metal cations (Mn, Zn, Cu, Al, and Fe) in resource-acquiring organs (foliage vs. absorptive roots) of Pinus elliottii to N additions in both wet and dry seasons in a seasonally dry subtropical forest. Stoichiometric responses of both organs depended on rate of N addition (generally stronger under high rate) and season. N additions increased foliar [N] and decreased foliar [P] only in dry season and the relative changes in foliar N:P ratio were twice higher in dry than wet seasons, suggesting an aggravated P limitation in dry season. The stoichiometry of absorptive roots was more responsive to N additions than that of foliage, especially for the base cations. N additions increased [Mn] and decreased Fe:Mn ratio in both organs, indicating increased risk of Mn²⁺ toxicity to this tree species. Our results have implications for understanding the N-induced changes in nutrient limitation of forests influenced by seasonal drought, and highlight the contrasting stoichiometric responses of above- and below-ground resource-acquiring plant organs to N loading.

Graphical abstract

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Unraveling the impact of chronic exposure to metal pollution through human gallstones

Publication date: 15 May 2018
Source:Science of The Total Environment, Volume 624
Author(s): Annika Parviainen, Claudio Marchesi, Juan Manuel Suárez-Grau, Carlos J. Garrido, Rafael Pérez-López, José Miguel Nieto, Gema Cobo-Cárdenas
This study aims to explore the impact of chronic metal exposure derived from persistent pollution from mining activity using human gallstones as proxies. The samples were obtained from patients residing in geologically and environmentally contrasting areas in the Province of Huelva, SW Spain, allowing for the evaluation of the regional effect of metal pollution. The study group resides in the Iberian Pyrite Belt characterized by natural and anthropogenic metal pollution from mining activities, whereas the control group resides in the Ossa Morena Zone famous for its natural parks. A total of 68 gallstones were first classified based on their phase composition and structure and subsequently their chemical composition was studied using solution Inductively Coupled Plasma-Mass Spectrometry. The metal concentrations increased in the cholesterol-rich gallstones from pure, to mixed and composite cholesterol stones along with the increasing amount of minor phases, such as bilirubinate, carbonate, and phosphate. These cholesterol stones did not show an evident enrichment tendency. On the contrary, pigment stones, composed of bilirubinate, carbonate, and phosphate phases, were rich in a variety of elements and the regional comparison showed that the pigment stones from the study area were enriched in sulfide-associated metal(loid)s, Mn, Fe, Cu, Zn, Sr, As, Ag, Sb, and Pb with respect to the control group. Inhalation of polluted airborne particulate matter is considered as one of the main exposure routes among the residents of the study area. Additionally, consumption of local water and locally produced food products such as fruit and vegetables and dermal contact may be possible sources of exposure, but no direct connection was observed.

Graphical abstract

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Biochar affects the dissolved and colloidal concentrations of Cd, Cu, Ni, and Zn and their phytoavailability and potential mobility in a mining soil under dynamic redox-conditions

Publication date: 15 May 2018
Source:Science of The Total Environment, Volume 624
Author(s): Ali El-Naggar, Sabry M. Shaheen, Yong Sik Ok, Jörg Rinklebe
There is a lack of knowledge on the effects of biochar (BC) on the release dynamics of potentially toxic elements (PTEs) in different phases of soil under systematic change of redox potential (EH). We aimed to elucidate the impact of pre-definite EH on the release dynamics of dissolved and colloidal concentrations of Cd, Cu, Ni, and Zn as well as their phytoavailability and potential mobility in the solid-phase of a mining soil treated with rice hull biochar (S+BC) compared to non-treated soil (S). The influence of EH-dependent changes of soil pH, dissolved organic carbon (DOC), dissolved aromatic carbon (DAC), Fe, Mn, SO4²⁻, and Cl⁻ on the elements release was also determined. The experiment was conducted stepwise from reducing (−30mV in S and −12mV in S+BC) to oxidizing (+218mV in S and +333mV in S+BC) conditions using an automated biogeochemical microcosm system.Biochar-treated soil exhibited a wider range of EH and a lower pH than the non-treated soil. Dissolved concentrations of Cd, Cu, Ni, Zn, Fe, Mn, SO4²⁻, and DAC increased under oxic conditions in the non-treated and biochar-treated-soils, which might be due to the decline of pH, and/or sulfide oxidation. Cadmium was more abundant in the colloidal fraction, while Cu, Mn, and DOC were more abundant in the dissolved fraction. Nickel, Zn, and Fe distributed almost equally in both fractions. Biochar increased the dissolved concentration of Cd, Ni, Zn and in particular Cu under oxic conditions. However, the biochar did not significantly affect the colloidal fraction of Cd, Cu, Ni, and Zn. The phytoavailability of the studied elements was higher than the potential mobility. We conclude that increasing the dissolved concentrations of the elements under oxic conditions might increase their release and transfer into the groundwater and the food chain which should be harmful for the environment.

Graphical abstract

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Effects of dissolved oxygen, pH, salinity and humic acid on the release of metal ions from PbS, CuS and ZnS during a simulated storm event

Publication date: 15 May 2018
Source:Science of The Total Environment, Volume 624
Author(s): Ping-I Chou, Ding-Quan Ng, I-Chia Li, Yi-Pin Lin
Metal sulfides serve as the sinks of toxic heavy metals in anoxic sediments. Once exposed to fluctuations in environmental conditions, dissolution of metal sulfides can occur and release toxic heavy metal ions into water column. In this study, we investigated the effects of dissolved oxygen (DO), pH, salinity and humic acid (HA) on the dissolution of CuS, PbS and ZnS using batch experiments with continuous aeration to simulate the re-suspension of these metal sulfides during a storm event. Experimental results indicated that oxidative dissolution of CuS, PbS and ZnS occurred in the presence of DO. The rate was the fastest for PbS, followed by CuS and ZnS. Soluble metal concentrations also increased with decreasing pH under oxic conditions. Compared to metal sulfides dissolution rates in freshwater without HA, the presence of saline conditions and HA generally accelerated the dissolution of CuS but inhibited the dissolution of PbS and ZnS. A higher saline or HA concentration, however, did not always lead to a stronger enhanced or inhibited dissolution rate, which could be a collective effect resulting from ligand-enhanced dissolution, complexation, and decreased oxygen and proton attacks due to HA adsorption on the metal sulfide surfaces.

Graphical abstract

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Beyond the mean: A comparison of trace- and macroelement correlation profiles of two lacustrine populations of the crayfish Procambarus clarkii

Publication date: 15 May 2018
Source:Science of The Total Environment, Volume 624
Author(s): Giorgio Mancinelli, Paride Papadia, Alessandro Ludovisi, Danilo Migoni, Roberta Bardelli, Francesco Paolo Fanizzi, Salvatrice Vizzini
In invertebrate biomonitors of chemical pollution, emphasis has been generally given to mean accumulation patterns and how they reflect varying environmental levels of contamination. Intra-population variability, and how it relates with individual phenotypic traits, has received less attention. Here, a set of analytes including trace elements (B, Ba, Cd, Cr, Cu, Fe, Li, Mn, Ni, Pb, Sr, V, and Zn), macroelements (C, Ca, K, Mg, N, Na), and carbon and nitrogen stable isotopes (δ¹³C and δ¹⁵N) was measured in two populations of the crayfish Procambarus clarkii from Lake Trasimeno and Lake Bolsena (Central Italy). The influence of location, sex, body size, and condition factor was assessed; in addition, the analyte correlation profiles of the two populations were compared to verify their congruence. In general, significant inter-lake differences were observed in the concentration of both trace- and macroelements in crayfish tissues, generally mirroring the local chemistry of water and of benthic non-living matrices (sediment and plant detritus). Crayfish CN isotopic signatures excluded the occurrence of inter-lake variations in their omnivorous trophic habits. Correlation profiles varied considerably between the two populations in the nature and strength of bivariate relationships. However, Mantel tests and procrustean analyses indicated a general, significant congruence; C, N, and, to a lesser extent K, Li, Ni, Pb, and δ¹³C showed the highest procrustean residuals, suggesting that their associations with other analytes may be partially influenced by inter-population differences in growing phases. Our study indicates that the local geochemistry of the lacustrine environment influences the elemental fingerprint of Procambarus clarkii; the considerable inter-individual variability in the concentration of analytes, however, does not significantly reflect on their association, thus corroborating its effectiveness as an indicator species.

Graphical abstract

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Changes in metal speciation and mobility during electrokinetic treatment of industrial wastes: Implications for remediation and resource recovery

Publication date: 15 May 2018
Source:Science of The Total Environment, Volume 624
Author(s): Claudia Peppicelli, Peter Cleall, Devin Sapsford, Michael Harbottle
Industrial waste deposits contain substantial quantities of valuable metals and other resources, although often in a recalcitrant form that hinders their recovery. This paper reports an experimental programme on the application of electrokinetic (EK) processing to two different waste materials (a mine tailings deposit and a metallurgical furnace dust), with the aim of exploring the effect of EK on metal speciation and extractability, with a focus on Pb and Zn due to their prevalence in these materials. The speciation of metals within the waste was determined based on a selective sequential extraction (SSE) procedure which was applied to the materials before, during and after the application of the EK treatment. The results demonstrate the generation of an acidic front in the mine tailings, which enhanced the transport of ions associated with the more labile fractions, a behaviour typical of materials characterized by a lower buffering capacity. The application of the EK in the furnace dust showed much less effect due to a very high starting pH (10) with the higher buffering capacity posing an obstacle to transport. It is shown that EK has altered the geochemical speciation of the metals in both materials, typically redistributing them from less available SSE fractions to the more labile fractions. Zn was redistributed with the SSE fractions and mobilised to a greater extent than Pb in both samples. The changes in pH and redox potential arising as a result of the application of an electric field are likely to be the main causes of the changes in speciation of both Zn and Pb. The considerable changes in metal fractionation, including removal from more recalcitrant fractions, suggest that EK may facilitate metal recovery processes. This, combined with its applicability to fine grained materials and heterogeneous environments, demonstrates that the technique may be particularly suited to both remediation of, and in-situ resource recovery from, such materials.

Graphical abstract

http://ift.tt/2E2ADGV

Association between human exposure to heavy metals/metalloid and occurrences of respiratory diseases, lipid peroxidation and DNA damage in Kumasi, Ghana

Publication date: April 2018
Source:Environmental Pollution, Volume 235
Author(s): Nesta Bortey-Sam, Yoshinori Ikenaka, Osei Akoto, Shouta M.M. Nakayama, Kwadwo A. Asante, Elvis Baidoo, Christian Obirikorang, Hazuki Mizukawa, Mayumi Ishizuka
Heavy metals and metalloids contamination in soils, water, food and livers of wild rats have been studied in Kumasi, Ghana and despite the estimated risks to residents, there is no epidemiological study to ascertain these projections. In addition, the World Health Organization and International Agency for Research on Cancer have reported an increase in respiratory diseases and cancers, in Ghana. The study's purpose was therefore to explore the potential associations between metal exposure and occurrences of respiratory diseases, lipid peroxidation and/or DNA damage to different age groups and sexes in Kumasi. Human urine was collected from the general population in urban and control sites in Kumasi and nine metals were measured in each sample. Results showed that although Zn was the most abundant total urinary As concentration was higher in 83% of samples compared to reference values. Urinary concentrations of metals, malondialdehyde (MDA) and 8-hydroxy-2-deoxy-guanosine (8-OHdG) were higher in urban sites compared to the control site. Based on the results obtained, there was no significant correlation between urinary metals and age. However, urinary Cd and MDA were highest in age groups 61–85 and 3–20 years, respectively. Significantly higher levels of urinary Co, As and Cd were detected in female participants. The study revealed that exposure to As was significantly associated with increased odds of asthma (odds ratio (OR) = 2.76; CI: 1.11–6.83) and tachycardia (OR = 3.93; CI: 1.01–15.4). Significant association was observed between urinary metals and MDA and 8-OHdG indicating possibility of lipid peroxidation and/or DNA damage in Kumasi residents.

Graphical abstract

Teaser

Human exposure to metals/metalloid increased the occurrences of lipid peroxidation, DNA damage and was also associated with increased odds of asthma and tachycardia.


http://ift.tt/2E2qoCy

l-Thyroxine-responsive drop attacks in childhood benign hereditary chorea: A case report

Publication date: Available online 27 December 2017
Source:Brain and Development
Author(s): Tadashi Shiohama, Hirofumi Ohashi, Kenji Shimizu, Katsunori Fujii, Daiju Oba, Tomozumi Takatani, Mitsuhiro Kato, Naoki Shimojo
Benign hereditary chorea (BHC) is a rare autosomal dominant disease that is characterized by non-progressive chorea with early-childhood-onset, congenital hypothyroidism, and neonatal respiratory distress. Although tetrabenazine and levodopa are partly effective for chorea and drop attacks in some patients, there is no standard treatment option. We herein describe a childhood case of BHC that presented with l-thyroxine-responsive drop attacks. A genetic analysis revealed an interstitial deletion that included two enhancer regions of NKX2-1, providing genetic confirmation of BHC. This is the first report to inform the connection between thyroid function and drop attacks in BHC. Moreover, our findings identify l-thyroxine as a therapeutic option for the management of drop attacks in BHC.



http://ift.tt/2E4KfRN

TUBB3 E410K syndrome with osteoporosis and cough syncope in a patient previously diagnosed with atypical Moebius syndrome

Publication date: Available online 27 December 2017
Source:Brain and Development
Author(s): Yasuko Nakamura, Hiroshi Matsumoto, Kiyotaka Zaha, Kenji Uematsu, Shigeaki Nonoyama
BackgroundA heterozygous c.1228G > A p.E410K mutation in TUBB3 encoding neuronal-specific β-tubulin isotype 3 causes TUBB3 E410K syndrome, which exhibits a wide range of neurological and endocrinological abnormalities.Case descriptionThe patient is a 31-year-old Japanese woman who was diagnosed with atypical Moebius syndrome because of congenital facial weakness and extraocular ophthalmoplegia sparing abduction. She suffered a femoral neck fracture at 23 years of age, and radiological and endocrinological studies revealed osteoporosis because of hypogonadotropic hypogonadism. She also had borderline intellectual disability, cyclic vomiting, syncope with cough, and decreased sense of smell since childhood. Brain magnetic resonance imaging revealed abnormal morphology of the corpus callosum and pontine. Hypoplastic bilateral oculomotor and facial nerves were evident. Based on these symptoms, we analyzed the TUBB3 gene and identified a heterozygous c.1228G > A (p.E410K) mutation that confirmed the diagnosis of TUBB3 E410K syndrome.ConclusionTUBB3 E410K syndrome may be diagnosed as atypical Moebius syndrome because of overlapping clinical symptoms. Genetic analysis of c.1228G > A in TUBB3 is useful to differentiate TUBB3 E410K syndrome from other disorders presenting congenital external ophthalmoplegia and facial nerve palsy.



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Does vagus nerve stimulation influence pregnancy outcomes?

Publication date: Available online 27 December 2017
Source:Brain Stimulation
Author(s): Anne Sabers, Line Buchgreitz, Winfried Neuhuber




http://ift.tt/2E1U4zE

Chronic deep brain stimulation normalizes scalp EEG activity in isolated dystonia

Publication date: February 2018
Source:Clinical Neurophysiology, Volume 129, Issue 2
Author(s): Svjetlana Miocinovic, Andrew Miller, Nicole C. Swann, Jill L. Ostrem, Philip A. Starr
ObjectiveTo investigate cortical activity using scalp EEG in patients with isolated dystonia treated with chronic deep brain stimulation (DBS), on and off stimulation.MethodsWe analyzed 64-channel scalp EEG in 12 isolated dystonia patients treated with chronic DBS (7 generalized, 5 cervical/segmental; 7 globus pallidus (GP), 5 subthalamic nucleus (STN)), and 20 healthy age-matched controls. Recordings during rest and movement task, and clinical motor scores, were collected with DBS-on and during a 90-min DBS washout.ResultsResting state alpha power in the dominant (or contralateral to more dystonic side) motor cortex channel during DBS was comparable to healthy controls, but it increased when DBS was stopped. Resting state and movement-related alpha coherence between bilateral motor cortex channels was increased off DBS.ConclusionsChronic DBS reduces exaggerated alpha oscillations and interhemispheric alpha coherence in the motor cortex of patients with isolated dystonia.SignificanceThese findings complement related studies in Parkinson's disease and support the view that network desynchronization is a prominent mechanism of DBS in movement disorders.



http://ift.tt/2BYPPaK

The effect of increased intracranial EEG sampling rates in clinical practice

Publication date: February 2018
Source:Clinical Neurophysiology, Volume 129, Issue 2
Author(s): Kathryn A. Davis, Seth P. Devries, Abba Krieger, Temenuzhka Mihaylova, Daniela Minecan, Brian Litt, Joost B. Wagenaar, William C. Stacey
ObjectiveRecent research suggests that high frequency intracranial EEG (iEEG) may improve localization of epileptic networks. This study aims to determine whether recording macroelectrode iEEG with higher sampling rates improves seizure localization in clinical practice.Methods14 iEEG seizures from 10 patients recorded with >2000 Hz sampling rate were downsampled to four sampling rates: 100, 200, 500, 1000 Hz. In the 56 seizures, seizure onset time and location was marked by 5 independent, blinded EEG experts.ResultsWhen reading iEEG under clinical conditions, there was no consistent difference in time or localization of seizure onset or number of electrodes involved in the seizure onset zone with sampling rates varying from 100 to 1000 Hz. Stratification of patients by outcome did not improve with higher sampling rate.ConclusionWhen utilizing standard clinical protocols, there was no benefit to acquiring iEEGs with sampling rate >100 Hz. Significant variability was noted in EEG marking both within and between individual expert EEG readers.SignificanceAlthough commercial equipment is capable of sampling much faster than 100 Hz, tools allowing visualization of subtle high frequency activity such as HFOs will be required to improve patient care. Quantitative methods may decrease reader variability, and potentially improve patient outcomes.



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Fasciculation potentials and decremental responses in amyotrophic lateral sclerosis

Publication date: February 2018
Source:Clinical Neurophysiology, Volume 129, Issue 2
Author(s): Yosuke Miyaji, Yuki Hatanaka, Mana Higashihara, Takamichi Kanbayashi, Fumiaki Tanaka, Masahiro Sonoo
ObjectiveThe positive correlation between fasciculation potentials (FPs) and decremental responses in repetitive nerve stimulation test (RNS) in amyotrophic lateral sclerosis (ALS) patients has been described based on only one past study. We revisited this issue.MethodsSubjects consisted of 30 prospectively-enrolled ALS patients on whom both needle EMG and RNS were conducted in the same trapezius muscle. Fasciculation potentials (FPs) were identified off-line from the restored 3-min signal. Firing rate of FPs (FR-FP) per minute was calculated from the total count of FPs of different origins. Correlations between FR-FP, decremental percentage (Decr%) and the amplitude of the initial compound muscle action potential (CMAPamp) in RNS were investigated.ResultsThere was no correlation between FR-FP and Decr% (r = 0.03) or between FR-FP and CMAPamp (r = 0.04). A significant negative correlation was observed between CMAPamp and Decr% (r = −0.56, P < .005).ConclusionFPs are not correlated with the decremental response in RNS.SignificanceThe underlying mechanism for FPs and decremental responses in ALS must be different and unrelated to each other.



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Nerve ultrasound in neurofibromatosis type 1: A follow-up study

Publication date: February 2018
Source:Clinical Neurophysiology, Volume 129, Issue 2
Author(s): Johan A. Telleman, Menno D. Stellingwerff, Geert J. Brekelmans, Leo H. Visser
ObjectiveTo investigate development of sonographic abnormalities and applications of high-resolution ultrasonography (HRUS) in neurofibromatosis type 1 (NF1).MethodsSixteen asymptomatic or minimally symptomatic NF1 patients underwent HRUS at inclusion and 1 year follow-up. Upper and lower extremity nerves were investigated. Peripheral nerve involvement was graded.ResultsPlexiform neurofibromas (PNFs) were found in 7 patients (43.8%) at inclusion and 10 (62.5%) at follow-up. All initially identified PNFs were also found at follow-up; additional PNFs were found by extended longitudinal assessment at follow-up. All 3 patients with minor and 7 patients with severe peripheral nerve involvement had similar involvement at follow-up. Mean nerve size change was −0.2 mm² (±1.6) and 0.3 mm² (±6.2) in patients with minor and severe involvement. Mean PNF size change was −0.1 mm² (±9.9).ConclusionsHRUS allows qualitative assessment of peripheral nerves, which makes it advantageous as initial imaging technique in suspected neuropathy. Patients with minimal nerve involvement remained so, and might therefore require less follow-up for malignant peripheral nerve sheath tumor (MPNSTs) development. Measured change in PNF size was highly variable. Repeating an extensive standardized HRUS protocol during follow-up thus seems less useful to screen for MPNSTs.SignificanceHRUS has potential applications as diagnostic and screening tool in NF1.



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Correlations between MUNIX and adapted multiple point stimulation MUNE methods

Publication date: February 2018
Source:Clinical Neurophysiology, Volume 129, Issue 2
Author(s): Karim Benmouna, Christophe Milants, François Charles Wang
ObjectiveThe aim of this study was to evaluate how the motor unit number index (MUNIX) is related to the adapted multiple point stimulation (AMPS) technique.MethodsMUNIX and AMPS technique were prospectively performed on thenar muscles in 20 consecutive patients referred to our neurophysiological laboratory with the clinical diagnosis of a possible motoneurone disorder (MND). The clinical and paraclinical assessment confirmed the diagnosis of MND in 13 out of 20 patients, amyotrophic lateral sclerosis (ALS) in 9 (with MND group). In the other 7 patients, there were neither evidence of MND, nor of any peripheral nervous system disease (without MND group).ResultsAMPS and MUNIX data were significantly (p < 0.001) lower in patients with MND than in patients without MND. There was a strong significant positive linear correlation between AMPS and MUNIX values (n = 20; R = 0.83; p < 0.01).ConclusionBoth MUNIX and AMPS methods could serve as a reliable marker to document the motor unit loss.SignificanceThe present paper constitutes one more clue of MUNIX reliability.



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Detecting sub-second changes in brain activation patterns during interictal epileptic spike using simultaneous EEG-fMRI

Publication date: February 2018
Source:Clinical Neurophysiology, Volume 129, Issue 2
Author(s): Epifanio Bagarinao, Satoshi Maesawa, Yuji Ito, Naotaka Usui, Jun Natsume, Hirohisa Watanabe, Minoru Hoshiyama, Toshihiko Wakabayashi, Gen Sobue, Shinji Naganawa, Haruo Isoda
ObjectiveEpileptic spikes are associated with rapidly changing brain activation involving the epileptic foci and other brain regions in the "epileptic network". We aim to resolve these activation changes using simultaneous electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) recordings.MethodsSimultaneous EEG-fMRI recordings from 9 patients with epilepsy were used in the analysis. Our method employed the whole scalp EEG data to generate regressors for the analysis of fMRI data using the general linear model.ResultsWe were able to resolve, with milliseconds temporal resolution, changes in activation patterns involving suspected epileptic foci and other brain regions in the epileptic network during spike and slow wave. Using summary maps (called SSWAS maps) which show the activation frequency of voxels, we found that suspected epileptic foci tend to be significantly active during this interval. SSWAS maps also enabled the detection of the epileptic foci in 4 of 5 patients where the conventional event-timing-based analysis failed to identify.ConclusionThese findings demonstrated the efficacy of the method and the potential application of SSWAS maps to identify epileptic foci.SignificanceThe method could help resolve activation changes during epileptic spike and could provide insights into the underlying pathophysiology of these changes.



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17β-estradiol (E2) promotes growth and stability of new dendritic spines via estrogen receptor β pathway in intact mouse cortex

Publication date: Available online 27 December 2017
Source:Brain Research Bulletin
Author(s): Shaofang Wang, Jun Zhu, Tonghui Xu
The steroid hormone 17β-estradiol (E2) remodels neural circuits at the synaptic level in the mammalian hippocampus and cortex. However, the underlying mechanism of synapse dynamics remains unclear. To elucidate the mechanism, we traced individual dendritic spines on layer V pyramidal neurons of the primary sensory cortex in adult female mice under E2 intervention using two-photon in vivo imaging microscopy. We confirmed the increase of the spine density upon E2 treatment in the intact mouse cortex. Furthermore, we found that this increase is due to the promotion of spine formation and the stability of newly formed spines. E2 treatment doesn't alter the elimination rate of pre-existing spines. Our results also indicate that the activation of the estrogen receptor β (ERβ) mimics the effects of E2 administration on spine dynamics. Taken together, our findings suggest that estrogen promotes growth and stability of new dendritic spines via the ERβ pathway in the intact cortex of female mice.



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The protective effect of 20(S)-protopanaxadiol (PPD) against chronic sleep deprivation (CSD)-induced memory impairments in mice

Publication date: Available online 27 December 2017
Source:Brain Research Bulletin
Author(s): Cong Lu, Liming Dong, Jingwei Lv, Yan Wang, Bei Fan, Fengzhong Wang, Xinmin Liu
Sleep deprivation (SD) is associated with oxidative stress that causes learning and memory impairment. 20(S)-Protopanaxadiol (PPD), one of the protopanaxadiol-type saponins, has antioxidant and neuroprotective effect. This study was designed to research the protective effect of PPD against cognitive deficits induced by chronic sleep deprivation (CSD) in mice. The CSD model was induced by subjecting the mice to our self-made Sleep Interruption Apparatus (SIA) continuously for 14 days. The memory enhancing effects of PPD were evaluated by behavioral tests and the related mechanism was further explored by observing the oxidative stress changes in the cortex and hippocampus of mice. The results revealed that PPD (20 and 40 μmol/kg, i.p.) administration significantly improved the cognitive performance of CSD model mice in object location recognition experiment, novel object recognition task and Morris water maze test. Furthermore, PPD effectively restored the levels/activities of antioxidant defense biomarkers in the cortex and hippocampus, including the superoxide dismutase (SOD) enzyme activity, catalase (CAT) enzyme activity, glutathione (GSH), and lipid peroxidation (LPO). In conclusion, PPD could attenuate cognitive deficits induced by CSD, and the neuroprotective effect of PPD might be mediated by alleviation of oxidative stress. It was assumed that PPD has the potential to be a neuroprotective substance for cognition dysfunction.



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Myelin changes at the early stage of 5XFAD mice

Publication date: Available online 28 December 2017
Source:Brain Research Bulletin
Author(s): Lihua Gu, Di Wu, Xiang Tang, Xinyang Qi, Xiaoli Li, Feng Bai, Xiaochun Chen, Qingguo Ren, Zhijun Zhang
Previous studies have demonstrated myelin deficits in Alzheimer's disease (AD). However, it is still unclear whether myelin deficits occur at early stage of AD. Our study aimed to investigate myelin deficits in 5XFAD mice dynamically in different cognition-associated brain regions at early stage of AD. Transmission electron microscopy (TEM) was applied to detect myelin changes in late-myelinating regions such as prelimbic area (PrL), retrosplenial granular cortex (Rsg), field CA1 of hippocampus (CA1) and entorhinal cortex (ERC) respectively at different stages (1, 2, 3 and 5 months of age) in 5XFAD mouse model. In addition, we assessed spatial learning and memory with Morris water maze (MWM) in 5XFAD mice. Myelin deficits in 5XFAD mice started from 1 month of age and this deterioration continued during ageing, whereas the same myelin abnormality could only be observed in 5-month-old wild-type mice. Additionally, the g-ratio (an index associated with myelin thickness) was increased in 1-month-old 5XFAD mice in the regions including PrL, CA1 and ERC, compared to wild-type mice. As animals aged, the increased g-ratio in 5XFAD appeared in more regions of the brain. Moreover, 5XFAD mice showed spatial memory deficits from 1 month of age and spatial learning deficits from 2 months of age. In conclusion, myelin deficits occurred at an early stage and progressed with ageing in 5XFAD mouse model. Notably, a sequential myelin change was detected in cognition-associated brain regions. Combined with cognitive examinations, this study suggests that myelin changes might contribute to cognitive dysfunction.



http://ift.tt/2BKMjgd

Inhalant allergen sensitization is an independent risk factor for the development of angioedema

The etiology and risk factors for angioedema remain poorly understood with causative triggers often going undiagnosed despite repeated reactions. The purpose of this study was to determine the relationship between inhalant allergen sensitization and angioedema.

http://ift.tt/2zEPtA0

Effects of human adipose-derived mesenchymal stem cells combined with estrogen on regulatory T cells in patients with premature ovarian insufficiency

Publication date: February 2018
Source:International Immunopharmacology, Volume 55
Author(s): Kaijing Song, Huihua Cai, Dongmei Zhang, Ruichun Huang, Donghua Sun, Yuanli He
ObjectiveTo investigate the effects of human adipose-derived mesenchymal stem cells (hADSCs) combined with estrogen on regulatory T cells (Tregs) in patients with premature ovarian insufficiency (POI).MethodshADSCs were isolated by enzymatic digestion and identified by flow cytometry. Peripheral blood mononuclear cells (PBMCs) were isolated from POI patients and healthy controls. PBMCs were cultured in the following experimental groups: the control group, hADSC group, estrogen group and combined group. The PBMCs in the hADSC group were co-cultured with hADSCs at concentrations of 1×10⁴, 2×10⁴, or 1×10⁵ cells/well, and the estrogen group was co-cultured with 10⁻⁹, 10⁻⁸, or 10⁻⁷mol/L 17β-estradiol. Cell proliferation was measured with the CCK-8 assay. The percentage of CD4⁺ CD25⁺ Foxp3⁺ Tregs was measured by flow cytometry. The expression levels of Foxp3, TGF-β1 and IFN-γ were measured by real-time PCR.ResultsTreatment with hADSCs, estrogen and their combination promoted Tregs differentiation of PBMCs from POI patients and healthy controls. An increase in the percentage of CD4⁺ CD25⁺ Foxp3⁺ Tregs was observed when PBMCs were co-cultured with hADSCs, 17β-estradiol and their combination. Foxp3 and TGF-β1 mRNA expression was higher and IFN-γ mRNA expression was lower in the hADSCs, estrogen and combined groups than in the control group.ConclusionCombined treatment with hADSCs and estrogen played an immunomodulatory role by promoting Tregs proliferation, thereby potentially improving impaired ovarian function.



http://ift.tt/2C0Asih

Quercetin in the experimental liver fibrosis induced by carbon tetrachloride (CCl4)

Publication date: February 2018
Source:International Immunopharmacology, Volume 55
Author(s): Salvatore Chirumbolo, Geir Bjørklund




http://ift.tt/2zFPcNy

EFhd2/swiprosin-1 regulates LPS-induced macrophage recruitment via enhancing actin polymerization and cell migration

Publication date: February 2018
Source:International Immunopharmacology, Volume 55
Author(s): Ye Tu, Lichao Zhang, Lingchang Tong, Yue Wang, Su Zhang, Rongmei Wang, Ling Li, Zhibin Wang
Macrophage motility is vital in innate immunity, which contributes strategically to the defensive inflammation process. During bacterial infection, lipopolysaccharide (LPS) potently activates the migration of macrophages via the NF-κB/iNOS/c-Src signaling pathway. However, the downstream region of c-Src that participates in macrophage migration is unclear. EFhd2, a novel actin bundling protein, was evaluated for its role in LPS-stimulated macrophage migration in this study. We found that LPS stimulated the up-regulation, tyrosine phosphorylation and membrane translocation of EFhd2 in macrophages. The absence of EFhd2 inhibited the recruitment of macrophages in the lungs of LPS-induced septic mice. LPS-induced macrophage migration was neutralized by the deletion of EFhd2. EFhd2-mediated up-regulation of NFPs (including Rac1/Cdc42, N-WASP/WAVE2 and Arp2/3 complex) induced by LPS could be used to explain the role of EFhd2 in promoting actin polymerization. Furthermore, the purified EFhd2 could directly promote actin polymerization in vitro. Dasatinib, a c-Src specific inhibitor, inhibited the up-regulation of EFhd2 stimulated by LPS. Therefore, our study demonstrated that EFhd2 might be involved in LPS-stimulated macrophage migration, which provides a potential target for LPS-activated c-Src during macrophage mobilization.



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VideoEndocrinology™ High-Impact Videos

VideoEndocrinology™
The Official Journal of: American Thyroid Association

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Bilateral Axillo-Breast Approach Robot-Assisted Endoscopic Modified Radical Neck Dissection
Hyunsuk Suh, Timo W. Hakkarainen, William B. Inabnet III

Subtotal Thyroidectomy with Local Cervical Block Anesthesia in Rural Uganda
Christine Deyholos, Thanyawat Sasanakietkul, Cathy Kilyewala, Jane O. Fualal, Tobias Carling

Retroperitoneoscopic Excision of Recurrent Paraganglioma
Mark Lansdown, Titus Cvasciuc, Sheila Fraser

 

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The Safety of Device Registries for Endovascular Abdominal Aortic Aneurysm Repair: Systematic Review and Meta-regression

Publication date: Available online 26 December 2017
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Fran Kent, Graeme K. Ambler, David C. Bosanquet, Christopher P. Twine
ObjectivesNew and re-designed stent grafts for endovascular aortic aneurysm repair (EVAR) are released regularly. Manufacturers use data from registries to assess stent graft performance, but little is known about the ability of such registries to detect rates of clinically relevant complications. The aim of this paper was to perform a systematic review and meta-analysis to determine pooled failure rates for EVAR stent grafts, to define an acceptable non-inferiority limit for these devices, and then to calculate the number of patients needed for a new device to achieve non-inferiority against published devices.Data sources and review methodsMEDLINE and EMBASE were searched for studies reporting outcomes of specific EVAR grafts being used for intact infrarenal abdominal aortic aneurysms, from inception to November 2016. Meta-regression was performed to pool data and calculate the patient numbers needed to detect non-inferiority of a future graft performance. An expert consensus was performed to define adequate standards for device safety.ResultsOne hundred and forty-seven moderate quality papers involving 27,058 patients were included. Multiple outcomes were pooled. Of these, the estimated rate (±standard error) of overall endoleak (excluding Type II) at 2 years was 5.7 ± 0.6%. The pooled re-intervention rate was 11.1 ± 0.7% at 2 years. There were differences in pooled endoleak rates between different stent graft types. Expert consensus defined non-inferiority as better performance than the worst performing 25% of stent grafts. The most popular outcome in the expert consensus was cumulative endoleak rate (excluding Type II). The number of patients who would need to be enrolled in a registry to demonstrate non-inferiority at this level was 525. Only two of 147 included studies achieved this. The second most popular choice in the expert consensus was re-intervention rate; 492 patients are required to demonstrate this.ConclusionsFive hundred and twenty-five patients need to be entered into a registry to demonstrate non-inferiority to previous stent grafts. Almost all previous publications have captured lower patient numbers. With performance varying between devices, and new devices being introduced regularly, there is an urgent need to capture higher quality long-term data on EVAR stent grafts.



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Silica-based nanoparticles are efficient delivery system for temoporfin

Publication date: Available online 27 December 2017
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Brezániová Ingrid, Záruba Kamil, Králová Jarmila, Sinica Alla, Adámková Hana, Ulbrich Pavel, Poučková Pavla, Hrubý Martin, Štěpánek Petr, Král Vladimír
BackgroundDrug targeting using functionalized nanoparticles to advance their transport to the dedicated site became a new standard in novel anticancer methods Anticancer photodynamic therapy also takes benefit from using nanoparticles by means of increasing targeting efficiency and decreased side effect. With this in mind, the silica-based nanoparticles, as drug delivery systems for the second-generation photosensitizer 5,10,15,20-tetrakis(m-hydroxyphenyl) chlorin (temoporfin) were development.MethodsIn order to determine the stability and therapeutic performance of the selected nanomaterials in physiological fluids, their physicochemical properties (i.e. size, polydispersity, zeta potential) were measured by dynamic light scattering technique and the diameter and the morphology of the individual particles were visualized by a transmission electron microscopy. Their efficacy was compared with commercial temoporfin formulation in terms of in vitro phototoxicity in 4T1 (murine mammary carcinoma) and of in vivo anticancer effect in Nu/Nu mice bearing MDA-MB-231 tumors.Results and conclusionsThe two types of silica nanoparticles, porous and non-porous and with different surface chemical modification, were involved and critically compared within the study. Their efficacy was successfully demonstrated and was shown to be superior in comparison with commercial temoporfin formulation in terms of in vitro phototoxicity and cellular uptake as well as in terms of in vivo anticancer effect on human breast cancer model. Temoporfin-loaded silica nanoparticles also passed through the blood-brain barrier showing potential for the treatment of brain metastases.

Graphical abstract

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New Combination Strategy of Photodynamic Therapy and Surgery in Treating Recurrent Basal Cell Carcinoma, a Case Report

Publication date: Available online 27 December 2017
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Zhang Shu, Yang Lifeng, Yu Ruichao
BackgroundThere are several options for BCC treatment. But sometimes, even Mohs surgery isn't desirable because of predicted aggressive surgery. Treatment of recurrent basal cell carcinoma can be a challenge for dermatologists.MethodsWe describe a case of a man with an invasive recurrent basal cell carcinoma on his face. The tumor was difficult to be removed completely by excision. Thus one-time photodynamic therapy was performed in the defect during surgery.ResultsNo recurrence has been found at 1-year follow-up and the cosmetic result was excellent. 
ConclusionsThe tumor was successfully treated by combing surgery with photodynamic therapy at same time. This new strategy of treatment can be an option for cases as ours.



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European Summit on the Prevention and Self-Management of Chronic Respiratory Diseases: report of the European Union Parliament Summit (29 March 2017)

On March 29, 2017, a European Summit on the Prevention and Self-Management of Chronic Respiratory Diseases (CRD) was organized by the European Forum for Research and Education in Allergy and Airway Diseases. ...

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Psychological stress level detection based on electrodermal activity

Publication date: 2 April 2018
Source:Behavioural Brain Research, Volume 341
Author(s): Yun Liu, Siqing Du
This paper presents a method for detecting psychological stress levels. It aims to explore the feasibility of using a single physiological signal to create a more practical alternative for detecting stress in people than current multiple physiological signals approaches involve. In particular, the approach explored uses linear discriminant analysis (LDA) based on the electrodermal activity (EDA) signal which aims at discriminating between three stress levels: low, medium and high. We used the MIT Media lab 'stress database' from which we selected eleven 'foot' based EDA data sets for our experiments. Using this eighteen EDA features were extracted from (sixty-six) five-minutes data segments equating to three driving conditions: at rest, on the open road (highway) and city driving. After that, Fisher projection and Linear discriminant analysis (LDA) were used to classify the stress levels with feature vectors, that included both leaving one out and test cross-validation strategy. The results showed that these methods achieved recognition rate of 81.82% which we argue, while less that multiple signal systems, may be a better balance between recognition performance and computational load, that could be a promising line of research for the development of practical personal stress monitors.



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January 2018:153(1)

Publication date: January 2018
Source:American Journal of Orthodontics and Dentofacial Orthopedics, Volume 153, Issue 1
Author(s): Allen H. Moffitt




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Editorial Board

Publication date: January 2018
Source:American Journal of Orthodontics and Dentofacial Orthopedics, Volume 153, Issue 1





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Information for readers

Publication date: January 2018
Source:American Journal of Orthodontics and Dentofacial Orthopedics, Volume 153, Issue 1





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Precision and trueness of dental models manufactured with different 3-dimensional printing techniques

Publication date: January 2018
Source:American Journal of Orthodontics and Dentofacial Orthopedics, Volume 153, Issue 1
Author(s): Soo-Yeon Kim, Yoo-Seok Shin, Hwi-Dong Jung, Chung-Ju Hwang, Hyoung-Seon Baik, Jung-Yul Cha
IntroductionIn this study, we assessed the precision and trueness of dental models printed with 3-dimensional (3D) printers via different printing techniques.MethodsDigital reference models were printed 5 times using stereolithography apparatus (SLA), digital light processing (DLP), fused filament fabrication (FFF), and the PolyJet technique. The 3D printed models were scanned and evaluated for tooth, arch, and occlusion measurements. Precision and trueness were analyzed with root mean squares (RMS) for the differences in each measurement. Differences in measurement variables among the 3D printing techniques were analyzed by 1-way analysis of variance (α = 0.05).ResultsExcept in trueness of occlusion measurements, there were significant differences in all measurements among the 4 techniques (P <0.001). For overall tooth measurements, the DLP (76 ± 14 μm) and PolyJet (68 ± 9 μm) techniques exhibited significantly different mean RMS values of precision than the SLA (88 ± 14 μm) and FFF (99 ± 14 μm) techniques (P <0.05). For overall arch measurements, the SLA (176 ± 73 μm) had significantly different RMS values than the DLP (74 ± 34 μm), FFF (89 ± 34 μm), and PolyJet (69 ± 18 μm) techniques (P <0.05). For overall occlusion measurements, the FFF (170 ± 55 μm) exhibited significantly different RMS values than the SLA (94 ± 33 μm), DLP (120 ± 28 μm), and PolyJet (96 ± 33 μm) techniques (P <0.05). There were significant differences in mean RMS values of trueness of overall tooth measurements among all 4 techniques: SLA (107 ± 11 μm), DLP (143 ± 8 μm), FFF (188 ± 14 μm), and PolyJet (78 ± 9 μm) (P <0.05). For overall arch measurements, the SLA (141 ± 35 μm) and PolyJet (86 ± 17 μm) techniques exhibited significantly different mean RMS values of trueness than DLP (469 ± 49 μm) and FFF (409 ± 36 μm) (P <0.05).ConclusionsThe 3D printing techniques showed significant differences in precision of all measurements and in trueness of tooth and arch measurements. The PolyJet and DLP techniques were more precise than the FFF and SLA techniques, with the PolyJet technique having the highest accuracy.



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Lifetime Achievement Award for Orthodontic Research, 2018

Publication date: January 2018
Source:American Journal of Orthodontics and Dentofacial Orthopedics, Volume 153, Issue 1
Author(s): Rolf G. Behrents




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Rapid canine retraction by dentoalveolar distraction osteogenesis

Publication date: January 2018
Source:American Journal of Orthodontics and Dentofacial Orthopedics, Volume 153, Issue 1
Author(s): T.P. Chaturvedi, Ajit V. Parihar, Ashish Agrawal, Sadhana Swaraj




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Authors' response

Publication date: January 2018
Source:American Journal of Orthodontics and Dentofacial Orthopedics, Volume 153, Issue 1
Author(s): Gökmen Kurt, Haluk İşeri, Reha Kişnişçi, Özkan Özkaynak




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Table of Contents

Publication date: January 2018
Source:American Journal of Orthodontics and Dentofacial Orthopedics, Volume 153, Issue 1





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Ordinal logistic regression

Publication date: January 2018
Source:American Journal of Orthodontics and Dentofacial Orthopedics, Volume 153, Issue 1
Author(s): Despina Koletsi, Nikolaos Pandis




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Authors' response

Publication date: January 2018
Source:American Journal of Orthodontics and Dentofacial Orthopedics, Volume 153, Issue 1
Author(s): Henry Ohiomoba, Andrew Sonis, Bernard Friedland




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Orthodontics: Current principles and techniques, 6th ed

Publication date: January 2018
Source:American Journal of Orthodontics and Dentofacial Orthopedics, Volume 153, Issue 1
Author(s): Ki Beom Kim




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External apical root resorption

Publication date: January 2018
Source:American Journal of Orthodontics and Dentofacial Orthopedics, Volume 153, Issue 1
Author(s): Naphtali Brezniak, Atalia Wasserstein




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