ASGE Technology Committee systematic review and meta-analysis assessing the ASGE Preservation and Incorp oration of Valuable Endoscopic Innovations thresholds for adopting real-time imaging–assisted endoscopic targeted biopsy during endoscopic surveillance of Barrett’s esophagus

Publication date: Available online 11 February 2016
Source:Gastrointestinal Endoscopy
Author(s): Nirav Thosani, Barham K. Abu Dayyeh, Prateek Sharma, Harry R. Aslanian, Brintha K. Enestvedt, Sri Komanduri, Michael Manfredi, Udayakumar Navaneethan, John T. Maple, Rahul Pannala, Mansour A. Parsi, Zachary L. Smith, Shelby A. Sullivan, Subhas Banerjee
Background and AimsEndoscopic real-time imaging of Barrett's esophagus (BE) with advanced imaging technologies enables targeted biopsies and may eliminate the need for random biopsies to detect dysplasia during endoscopic surveillance of BE. This systematic review and meta-analysis was performed by the American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee to specifically assess whether acceptable performance thresholds outlined by the ASGE Preservation and Incorporation of Valuable Endoscopic Innovations (PIVI) document for clinical adoption of these technologies have been met.MethodsWe conducted meta-analyses calculating the pooled sensitivity, negative predictive value (NPV), and specificity for chromoendoscopy by using acetic acid and methylene blue, electronic chromoendoscopy by using narrow-band imaging, and confocal laser endomicroscopy (CLE) for the detection of dysplasia. Random effects meta-analysis models were used. Statistical heterogeneity was evaluated by means of I2 statistics.ResultsThe pooled sensitivity, NPV, and specificity for acetic acid chromoendoscopy were 96.6% (95% confidence interval [CI], 95-98), 98.3% (95% CI, 94.8-99.4), and 84.6% (95% CI, 68.5-93.2), respectively. The pooled sensitivity, NPV, and specificity for electronic chromoendoscopy by using narrow-band imaging were 94.2% (95% CI, 82.6-98.2), 97.5% (95% CI, 95.1-98.7), and 94.4% (95% CI, 80.5-98.6), respectively. The pooled sensitivity, NPV, and specificity for endoscope-based CLE were 90.4% (95% CI, 71.9-97.2), 98.3% (95% CI, 94.2-99.5), and 92.7% (95% CI, 87-96), respectively.ConclusionsOur meta-analysis indicates that targeted biopsies with acetic acid chromoendoscopy, electronic chromoendoscopy by using narrow-band imaging, and endoscope-based CLE meet the thresholds set by the ASGE PIVI, at least when performed by endoscopists with expertise in advanced imaging techniques. The ASGE Technology Committee therefore endorses using these advanced imaging modalities to guide targeted biopsies for the detection of dysplasia during surveillance of patients with previously nondysplastic BE, thereby replacing the currently used random biopsy protocols.

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Lack of Dystrophin Affects Bronchial Epithelium in mdx Mice

Abstract

Mild exercise training may positively affect the course of Duchenne Muscular Dystrophy (DMD). Training causes mild bronchial epithelial injury in both humans and mice, but no study assessed the effects of exercise in mdx mice, a well known model of DMD. The airway epithelium was examined in mdx (C57BL/10ScSn-Dmdmdx) mice, and in wild type (WT, C57BL/10ScSc) mice either under sedentary conditions (mdx-SD, WT-SD) or during mild exercise training (mdx-EX, WT-EX). At baseline, and after 30 and 45 days of training (5 d/wk for 6 weeks), epithelial morphology and markers of regeneration, apoptosis, and cellular stress were assessed. The number of goblet cells in bronchial epithelium was much lower in mdx than in WT mice under all conditions. At 30 days, epithelial regeneration (PCNA positive cells) was higher in EX than SD animals in both groups; however, at 45 days, epithelial regeneration decreased in mdx mice irrespective of training, and the percentage of apoptotic (TUNEL positive) cells was higher in mdx-EX than in WT-EX mice. Epithelial expression of HSP60 (marker of stress) progressively decreased, and inversely correlated with epithelial apoptosis (r = -0.66, p = 0.01) only in mdx mice. Lack of dystrophin in mdx mice appears associated with defective epithelial differentiation, and transient epithelial regeneration during mild exercise training. Hence, lack of dystrophin might impair repair in bronchial epithelium, with potential clinical consequences in DMD patients. This article is protected by copyright. All rights reserved

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Phosphorylation Regulates Functions of ZEB1 Transcription Factor

SUMMARY

ZEB1 transcription factor is important in both development and disease, including many TGFβ-induced responses, and the epithelial-to-mesenchymal transition (EMT) by which many tumors undergo metastasis. ZEB1 is differentially phosphorylated in different cell types; however the role of phosphorylation in ZEB1 activity is unknown. Luciferase reporter studies and electrophoresis mobility shift assays (EMSA) show that a decrease in phosphorylation of ZEB1 increases both DNA-binding and transcriptional repression of ZEB1 target genes. Functional analysis of ZEB1 phosphorylation site mutants near the second zinc finger domain (termed ZD2) show that increased phosphorylation (due to either PMA plus ionomycin, or IGF-1) can inhibit transcriptional repression by either a ZEB1-ZD2 domain clone, or full-length ZEB1. This approach identifies phosphosites that have a substantial effect regulating the transcriptional and DNA-binding activity of ZEB1. Immunoprecipitation with anti-ZEB1 antibodies followed by western analysis with a phospho-Threonine-Proline-specific antibody indicates that the ERK consensus site at Thr-867 is phosphorylated in ZEB1. In addition to disrupting in vitro DNA-binding measured by EMSA, IGF-1-induced MEK/ERK phosphorylation is sufficient to disrupt nuclear localization of GFP-ZEB1 fusion clones. These data suggest that phosphorylation of ZEB1 integrates TGFβ signaling with other signaling pathways such as IGF-1. This article is protected by copyright. All rights reserved

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INTERVENTIONAL MOLECULAR IMAGING

While Molecular Imaging has had a dramatic impact on Diagnostic Imaging, it has only recently begun to be integrated into interventional procedures. Its significant impact is attributed to its ability to provide non-invasive, physiologic information that has supplemented conventional morphologic imaging. The four major interventional opportunities for Molecular Imaging are to first, provide guidance to localize a target; second, provide tissue analysis to confirm that the target has been reached; third, provide in-room, post-therapy assessment; and fourth, deliver targeted therapeutics. With improved understanding and application of ¹⁸F-FDG, as well as, the addition of new molecular probes beyond ¹⁸F-FDG, the future holds significant promise for the expansion of Molecular Imaging into the realm of interventional procedures.

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microPET Imaging of Tau Pathology with [18F]-THK5117 in two Transgenic Mouse Models

Abnormal accumulation of tau aggregates in brain is one of the hallmarks of Alzheimer's disease neuropathology. We visualized tau deposition in vivo with the previously developed 2-arylquinoline derivative ¹⁸F-THK5117 using small animal positron-emission-tomography (µPET) in conjunction with autoradiography and immunohistochemistry gold standard assessment in two transgenic mouse models expressing hyperphosphorylated tau. µPET recordings were obtained in groups of P301S (N = 11) and biGT mice (N = 16) of different ages, with age-matched wild-type (WT) serving as controls. After i.v. administration of 16±2 MBq ¹⁸F-THK5117, a dynamic 90 min emission recording was initiated for P301S mice and during 20-50 min p.i. for biGT mice, followed by a 15 min transmission scan (Siemens Inveon DPET). After co-registration to the MRI atlas and scaling to the cerebellum, we performed volume-of-interest based analysis (standard-uptake-value-ratio, SUVR) and statistical parametric mapping (SPM). µPET results were compared with autoradiography ex vivo and in vitro, and further validated with AT8 staining for neurofibrillary tangles. SUVRs calculated from static recordings during the interval of 20–50 min after tracer injection correlated highly with estimates of BPND based on the entire dynamic emission recordings (R=0.85). SUVR increases were detected in brainstem of aged P301S mice (+11%; p<0.001), and in entorhinal/amygdaloidal areas (+15%; p<0.001) of biGT mice when compared to WT, whereas aged WT mice did not show increased tracer uptake. Immunohistochemical tau loads correlated with µPET-SUVR for both P301S (R=0.8; p<0.001) and biGT (R=0.7; p<0.001) mice, and distribution patterns of AT8 positive neurons matched voxel-wise SPM analysis. Saturable binding of the tracer was verified by autoradiographic blocking studies. In the first dedicated µPET study in two different transgenic tauopathy mouse models using the novel tau tracer ¹⁸F-THK5117, the temporal and spatial progression could be visualized in good correlation with gold standard assessments of tau accumulation. Serial µPET method could afford the means for preclinical testing of novel therapeutic approaches by accommodating inter-animal variability at baseline, while detection thresholds in young animals have to be considered.

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Pretreatment 18FDG-PET Textural Features in Locally Advanced Non-Small Cell Lung Cancer: Secondary Analysis of ACRIN 6668/RTOG 0235

Background: In a secondary analysis of ACRIN 6668/RTOG 0235, high pretreatment metabolic tumor volume (MTV) on positron emission tomography with ¹⁸F-fluorodeoxyglucose (FDG-PET) was found to be a poor prognostic factor for patients treated with chemoradiotherapy for locally advanced non-small cell lung cancer (NSCLC). Here we utilize the same dataset to explore whether heterogeneity metrics based on PET textural features can provide additional prognostic information. Methods: Patients with locally advanced NSCLC underwent ¹⁸FDG-PET prior to treatment. A gradient-based segmentation tool was used to contour each patient's primary tumor. MTV, maximum standardized uptake value (SUV), and 43 textural features were extracted for each tumor. To address overfitting and high collinearity among PET features, the Least Absolute Shrinkage and Selection Operator (LASSO) method was applied to identify features that were independent predictors of overall survival (OS) after adjusting for MTV. Recursive binary partitioning in a conditional inference framework was utilized to identify optimal thresholds. Kaplan-Meier curves and log-rank testing were used to compare outcomes among patient groups. Results: 201 patients met inclusion criteria. The LASSO procedure identified one textural feature (SumMean) as an independent predictor of OS. The optimal cutpoint for MTV was 93.3 cm3, and the optimal SumMean cutpoint for tumors above 93.3 cm3 was 0.018. This grouped patients into three categories: low tumor MTV (n = 155, median OS 22.6 months), high tumor MTV and high SumMean (n = 23, median OS 20.0 months), and high tumor MTV and low SumMean (n = 23, median OS 6.2 months; logrank P < 0.001). Conclusion: We have described an appropriate methodology to evaluate the prognostic value of textural PET features in the context of established prognostic factors. We have also identified a promising feature that may have prognostic value in locally advanced NSCLC patients with large tumors who are treated with chemoradiotherapy. Validation studies are warranted.

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Smaller agents for larger therapeutic indices: nanoscale brachytherapy with 177Lu-labeled gold nanoparticles

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PET Imaging of Mitochondrial Complex I with 18F-BCPP-EF in Brain of Parkinsons Disease Model Monkey

¹⁸F-BCPP-EF was applied to assess mitochondrial complex I (MC-I) activity in the brains of Parkinson's disease (PD) model monkeys prepared by MPTP and also presynaptic dopamine parameters. Methods: ¹¹C-β-CFT for the dopamine transporter (DAT), β-¹¹C-L-DOPA, ¹⁸F-FDOPA, or 6-¹¹C-methyl-m-tyrosine (¹¹C-6MemTyr) for dopamine synthesis, or ¹⁸F-BCPP-EF for MC-1 was intravenously injected into normal and MPTP monkeys in order to analyze their uptakes in the striatum. Results: Significant reductions in presynaptic dopamine parameters and MC-I activity were detected in the striatum of MPTP monkeys. Correlations were observed between MC-I activity and DAT as well as between MC-I activity and dopamine synthesis in the striatum. The order of detectability of impaired MC-I activity was ¹¹C-6MemTyr >> β-¹¹C-L-DOPA > ¹⁸F-FDOPA. Conclusion: ¹⁸F-BCPP-EF has potential as a PET probe for the quantitative imaging of MC-1 damage in the living brains of PD model monkeys using PET.

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Ultrasound imaging of the joint damage in the patient with long-standing Rheumatoid Arthritis

LETTER

Hippokratia 2015, 19(3):281

Kakavouli GG1, Siagkri C1, Zivanovic S2
1Rheumatologist in private practice, Greece, 2Rheumatology Department, University of Kragujevac, Kragujevac, Serbia

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The role of Apigenin in testicular damage in experimental ischemia-reperfusion injury in rats

ORIGINAL ARTICLE

Hippokratia 2015, 19(3):225-230

Skondras I1, Lambropoulou M2, Tsaroucha A3, Gardikis S1, Tripsianis G4, Simopoulos C3, Vaos G1
1Department of Pediatric Surgery, 2Laboratory of Histology, 32nd Department of Surgery and Laboratory of Experimental Surgery, 4Laboratory of Medical Statistics Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece

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Evaluation of transient vision loss

Pula JH, Kwan K, Yuen CA, Kattah JC

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Spontaneous regression and complete disappearance of the vein of Galen aneurysmal malformation

Abstract

Introduction

Thrombosis is frequently observed in Galen malformation, but propagation of thrombosis resulting in the disappearance of the aneurysmal malformation is a very rare clinical condition.

Case report

A rare case of spontaneous regression and disappearance of the vein of Galen aneurysmal malformation (VoGAM) in a pediatric patient with repeated generalized seizure, increased head circumference, and congestive heart failure is recorded. The course of regression from infancy to 8 years of age has been depicted. Radiological studies initially demonstrated VoGAM complicated by an intra-cerebral hemorrhage and hydrocephalus, which later underwent spontaneous regression. Long-term clinical and radiological follow-up is presented.

Discussion

Different conditions including hemodynamic alteration, compression of adjacent hematoma, and narrowing of related vascular structures have been described to cause thrombosis of VoGAM. The relevant literature to address possible mechanism is reviewed.

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Erratum zu: Sollen bei Prodromalstadien der Schizophrenie Antipsychotika zur Psychoseprävention eingesetzt werden? Pro

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Comparison of heart rate changes with ictal tachycardia seizures in adults and children

Abstract

Purpose

Lower heart rate variability (HRV) is known to make patients more susceptible to tachycardia and possibly sudden unexpected death in epilepsy (SUDEP). The heart rate (HR) at which tachycardia is present may vary by age. To date, no study has been done comparing adult and child seizures at different time points. The purpose of this study was to compare the frequency of HR changes with ictal tachycardia (IT) seizures at different time points in adults versus children.

Methods

We retrospectively assessed the changes in the HR of 99 IT seizures in children and 96 IT seizures in adults. The difference between adults and children in gender, hemispheric lateralization or sleep/wakefulness, or seizure type on the HR changes and the difference between children and adults during 10 s preictal, ictal onset, and ictal and 60 s postictal were separately assessed.

Results

The HR difference and maximum HR increase with aging in children. The seizure duration in adults lasted longer as compared with that in children. There are higher HR at different points and HR difference at 10 s preictal as compared to baseline in children.

Conclusions

The study illustrates that age and duration were respectively related to HR differences distinguishing children from adults. There may be an age-related effect of HR changes associated with seizures, with higher HR at different times and HR difference at 10 s before seizure onset as compared to baseline in children, which might explain that children are more likely to predict epileptic seizures than adults, contributing to subclinical seizures and treatment efficiency in refractory patients.

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Legal tussle delays launch of huge toxicity database

Health risks of nearly 10,000 chemicals charted to help predict toxicity of untested substances.

Nature News doi: 10.1038/nature.2016.19365

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LIGO announces gravitational-wave detection — in pictures

Scenes from the historic announcement in Washington DC.

Nature News doi: 10.1038/nature.2016.19368

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Eckpunkte für die Regelung der öffentlich-rechtlichen Unterbringung in psychi atrischen Krankenhäusern – mit Erläuterungen

Zusammenfassung

Während die Vorgaben der höchsten Gerichte für betreuungsrechtliche Unterbringung und Behandlung einwilligungsunfähiger Patienten in psychiatrischen Krankenhäusern umgesetzt sind, stehen entsprechende Anpassungen der Regeln zur öffentlich-rechtlichen Unterbringung nach den Psychisch-Kranken-Gesetzen und Unterbringungsgesetzen in vielen Bundesländern noch aus. Wo es bereits Neuregelungen gibt, bestehen nach Meinung juristischer Experten Zweifel an deren Konformität mit der Verfassung und der UN-Behindertenrechtskonvention. Die DGPPN hat aus fachlicher Sicht Eckpunkte für die öffentlich-rechtliche Unterbringung formuliert, die bei den Neuregelungen der einzelnen Länder Berücksichtigung finden sollten.

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Stellenwert des Elektroenzephalogramms in der Psychiatrie

Zusammenfassung

Die Ableitung eines Elektroenzephalogramms (EEG) ist eine sensitive, nichtinvasive und kostengünstige Methode zur Untersuchung der Hirnfunktion. Der vorliegende Artikel beleuchtet kritisch den Stellenwert von EEG-Untersuchungen in der psychiatrischen Praxis und beschreibt relevante Einsatzmöglichkeiten und Limitationen. Nach einer Zusammenfassung von Grundlagen zur Entstehung und Ableitung des EEG werden der EEG-Normalbefund und pathologische EEG-Veränderungen vorgestellt. Mit Blick auf die psychiatrische Diagnostik werden im Weiteren Möglichkeiten des EEG in der Diagnostik und Differenzialdiagnostik der Alzheimer-Erkrankung und des Delirs und in der Abgrenzung psychiatrischer Erkrankungen zum nichtkonvulsiven Status epilepticus berichtet. Im Monitoring der Psychopharmakotherapie bietet das EEG vor allem hinsichtlich der Diagnostik und der Verlaufsbeobachtung bei Lithium- und anderen Intoxikationen relevante Informationen für die klinische Praxis. Der Artikel gibt schließlich einen kurzen Einblick in vielversprechende Forschungsansätze, die aktuell in der Psychiatrie mit dem EEG verfolgt werden.

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Description of 3 Cases in Vietnam of Aspirin Desensitization in Patients With Coronary Artery Disease and Coexisting Aspirin Hypersensitivity

Aspirin (ASA) hypersensitivity comprises types I to III (Cox-1 mediated) and types IV and V (IgE antibody mediated). Rapid, low-dose (81-325 mg/day) ASA desensitization regimens are known to be useful in estab…

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GlideScope Video Laryngoscopes

No abstract available (Source: Biomedical Safety and Standards)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.

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We Call for iCAALL: International Collaboration in Asthma, Allergy and Immunology

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Allergen Immunotherapy: A Centenary Celebration

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Critical Documents on Cow’s Milk Allergy and Anaphylaxis: Two Recent WAO Position Papers

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Effects of a Novel GA2LEN Training Program on Urticaria on the Knowledge of General Practitioners in Saudi-Arabia

Continued education in allergology of both general practitioners and specialists can be achieved by various measures including publications, online tools, and lectures. GA2LEN, the Global Allergy and Asthma Europ…

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Unintended Effects of a Smoking Cessation Intervention on Latino Fathers’ Binge Drinking In Early Postpartum

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Overactive Thyroid Linked to Breast Cancer Risk – U.S. News & World Report

Daily Mail

Overactive Thyroid Linked to Breast Cancer Risk U.S. News & World Report THURSDAY, Feb. 11, 2016 (HealthDay News) — Women who have an overactive thyroid gland might be at greater risk for breast cancer, a new study suggests. A team of Danish researchers found that women with the condition — called hyperthyroidism … Women with an overactive thyroid are 'at greater risk of breast cancer'Daily Mail Breast cancer risk linked to overactive thyroidWebMD.Boots.com Breast cancer link to overactive thyroidIndependent Online Stuff.co.nz –Nursing in Practice all 17 news articles »

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Prolonged Hoarseness Caused by Arytenoid Dislocation After Anterior Cervical Corpectomy and Fusion

Conclusion. Arytenoid dislocation should never be ignored in the differential diagnosis of prolonged postoperative hoarseness after ACCF. This situation can be confirmed by CT scan, vocal cord electromyography (EMG), fiberoptic laryngoscopy, or strobovideolaryngoscopy. Once the diagnosis is established, appropriate treatment should be considered immediately. Level of Evidence: 3 (Source: Spine)

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What Are My Hiccups Telling Me? – Newswise (press release)

What Are My Hiccups Telling Me? Newswise (press release) This spasm is usually followed by the closure of the glottis (the slit-like opening between the vocal cords and larynx) and a characteristic sound like that of a cough. Persistent hiccups are … "This may also point to a tumor in the neck or goiter …

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The Use of Anatomical Information for Molecular Image Reconstruction Algorithms: Attenuation/Scatter Correction, Motion Compensation, and Noise Reduction

Abstract

PET and SPECT are important tools for providing valuable molecular information about patients to clinicians. Advances in nuclear medicine hardware technologies and statistical image reconstruction algorithms enabled significantly improved image quality. Sequentially or simultaneously acquired anatomical images such as CT and MRI from hybrid scanners are also important ingredients for improving the image quality of PET or SPECT further. High-quality anatomical information has been used and investigated for attenuation and scatter corrections, motion compensation, and noise reduction via post-reconstruction filtering and regularization in inverse problems. In this article, we will review works using anatomical information for molecular image reconstruction algorithms for better image quality by describing mathematical models, discussing sources of anatomical information for different cases, and showing some examples.

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Radiological challenges in distinguishing keratocystic odontogenic tumor from ameloblastoma: an extraordinary occurrence in the same patient

Publication date: Available online 11 February 2016
Source:American Journal of Otolaryngology
Author(s): Sami P. Moubayed, Azita Khorsandi, Mark L. Urken
ObjectivesTo describe the radiological appearance of two common odontogenic lesions (keratocystic odontogenic tumor and ameloblastoma) arising in the same patient simultaneously with their radiological differences and histological correlates, and to describe challenges in radiological diagnosis.DesignSingle case reportSettingTertiary referral centerParticipantsForty-one year-old African-American male patientMain outcome measureLesion appearance on Computed Tomography (CT) scan and pathological correlatesResultsA 41 year-old African-American male presented with asymptomatic right maxillary swelling. A CT scan of the maxillofacial skeleton showed and expansile and cystic lesion of the right hemimaxilla with trabecular osseous expansion, and a left cystic lesion in the left hemimaxilla expanding into the pterygopalatine fossa. Biopsy confirmed the suspected diagnoses of right ameloblastoma and left keratocystic odontogenic tumor.ConclusionAlthough they are among the most common odontogenic tumors, the presence of concurrent ameloblastoma and KOT is an exceedingly rare occurrence in the same patient. The appearance on CT scan may help in distinguishing ameloblastoma from KOT by looking at bone expansion and high density areas, although the gold standard diagnostic test remains open biopsy.

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Quality of life in functional rhinoplasty: rhinoplasty outcomes evaluation German version (ROE-D)

Abstract

The aim of this study was to validate a German version of the rhinoplasty outcomes evaluation (ROE) questionnaire. A prospective study was conducted and a German translated ROE (ROE-D) questionnaire administered to 100 patients preoperatively, 6 and 12 months postoperatively. The translation was performed according to internationally accepted guidelines. To validate this instrument, we evaluated its reliability, validity and sensitivity. ROE-D was completed by 54 patients after 6 months and by 69 patients 1 year after functional rhinoplasty. Cronbach's α indicated good internal consistency. Reliability was tested with a split-half-reliability, showing significant correlation. Discrimination validity was demonstrated by a comparison with healthy controls. Sensitivity to change showed medium to large effects. ROE-D is a reliable, validated and sensitive German instrument for measuring health-related quality of life in patients after rhinoplasty. The ROE-D focuses mainly on the aesthetic aspects of the rhinoplasty surgery.

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The effect of fluctuating maskers on speech understanding of high-performing cochlear implant users

10.3109/14992027.2015.1128124<br/>Stefan Zirn

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An experimental application of aeroacoustic time-reversal to the Aeolian tone

This paper presents an experimental application of the aeroacoustic time-reversal (TR) source localization technique for studying flow-induced noise problems and compares the TR results with those obtained using conventional beamforming (CB). Experiments were conducted in an anechoic wind tunnel for the benchmark test-case of a full-span circular cylinder located in subsonic cross-flow wherein the far-field acoustic pressure was sampled using two line arrays (LAs) of microphones located above and below the cylinder. The source map obtained using the signals recorded at the two LAs without modeling the reflective surfaces of the contraction-outlet and cylinder during TR simulations revealed the lift-dipole nature of aeroacousticsourcegenerated at the Aeolian tone; however, it indicates an error of 3/20 of Aeolian tone wavelength in the predicted location. Modeling the reflective contraction-outlet during TR was shown to improve the focal-resolution of the source and reduce side-lobe levels, especially in the low-frequency range. The experimental TR results were shown to be comparable to (a) the simulation results of an idealized dipole at the cylinder location in wind-tunnel flow and (b) that obtained by monopole and dipole CB, thereby demonstrating the suitability of TR method as a diagnostic tool to analyze flow-induced noise generation mechanism.

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Separation of non-stationary sound fields with single layer pressure-velocity measurementsa)

This paper examines the feasibility of extracting the non-stationary sound fieldgenerated by a target source in the presence of disturbing source from single layer pressure-velocity measurements. Unlike the method described in a previous paper [Bi, Geng, and Zhang, J. Acoust. Soc. Am. 135(6), 3474–3482 (2014)], the proposed method allows measurements of pressure and particle velocity signals on a single plane instead of pressure signals on two planes, and the time-dependent pressure generated by the target source is extracted by a simple superposition of the measured pressure and the convolution between the measuredparticle velocity and the corresponding impulse response function. Because the particle velocity here is measured directly, the error caused by the finite difference approximation can be avoided, which makes it possible to perform the separation better than the previous method. In this paper, a Microflown pressure-velocity probe is used to perform the experimental measurements, and the calibration procedure of the probe in the time domain is given. The experimental results demonstrate that the proposed method is effective in extracting the desired non-stationary sound fieldgenerated by the target source from the mixed one in both time and space domains, and it obtains more accurate results than the previous method.

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Fano resonance scatterings in waveguides with impedance boundary conditions

The resonancescattering theory is used to study the sound propagation in a waveguide with a portion of its wall lined by a locally reacting material. The objective is to understand the effects of the mode coupling in the lined portion on the transmission. It is shown that a zero in the transmission is present when a real resonance frequency of the open system, i.e., the lined portion of the waveguide that is coupled to the two semi-infinite rigid ducts, is equal to the incident frequency. This transmission zero occurs as a Fano resonance—due to the excitation of a trapped mode in the open system. The trapped mode is formed by the interferences of two neighbored modes with complex resonance frequencies. It is also linked to the avoided crossing of eigenvalues of these two modes that occurs near an exceptional point (a subject that has attracted much attention in recent years in different physical domains). The real and complex resonance frequencies of the open system are determined by an equivalent eigenvalue problem of matrix , which describes the eigenvalue problem defined in the finite lined portion (scattering region). With the aid of the eigenvalues and eigenfunctions of matrix , the usual acoustic resonancescattering formula can be extended to describe the coupling effects between the scattering region and the rigid parts of the waveguide.

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Assessment of the biomechanical stability of a dental implant with quantitative ultrasound: A three-dimensional finite element study

Dental implant stability is an important determinant of the surgical success. Quantitative ultrasound (QUS) techniques can be used to assess such properties using the implant acting as a waveguide. However, the interaction between an ultrasonicwave and the implant remains poorly understood. The aim of this study is to investigate the sensitivity of the ultrasonic response to the quality and quantity of bone tissue in contact with the implant surface. The 10 MHz ultrasonic response of an implant used in clinical practice was simulated using an axisymmetric three-dimensional finite element model, which was validated experimentally. The amplitude of the echographic response of the implant increases when the depth of a liquid layer located at the implant interface increases. The results show the sensitivity of the QUS technique to the amount of bone in contact with the implant. The quality of bone tissue around the implant is varied by modifying the bone biomechanicalproperties by 20%. The amplitude of the implant echographic response decreases when bone quality increases, which corresponds to bone healing. In all cases, the amplitude of the implant response decreased when the dental implant stability increased, which is consistent with the experimental results.

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Spectral contrast enhancement improves speech intelligibility in noise for cochlear implants

Spectral smearing causes, at least partially, that cochlear implant(CI) users require a higher signal-to-noise ratio to obtain the same speech intelligibility as normal hearing listeners. A spectral contrast enhancement (SCE) algorithm has been designed and evaluated as an additional feature for a standard CI strategy. The algorithm keeps the most prominent peaks within a speech signal constant while attenuating valleys in the spectrum. The goal is to partly compensate for the spectral smearing produced by the limited number of stimulation electrodes and the overlap of electrical fields produced in CIs. Twelve CI users were tested for their speech reception threshold(SRT) using the standard CI coding strategy with and without SCE. No significant differences in SRT were observed between conditions. However, an analysis of the electrical stimulation patterns shows a reduction in stimulation current when using SCE. In a second evaluation, 12 CI users were tested in a similar configuration of the SCE strategy with the stimulation being balanced between the SCE and the non-SCE variants such that the loudness perception delivered by the strategies was the same. Results show a significant improvement in SRT of 0.57 dB (p 

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Defining the medial-lateral axis of an anatomical femur coordinate system using freehand 3D ultrasound imaging

Publication date: Available online 10 February 2016
Source:Gait & Posture
Author(s): Elyse Passmore, Morgan Sangeux
Hip rotation from gait analysis informs clinical decisions regarding correct of femoral torsional deformities. However, it is among the least repeatable due to discrepancies in determining the medial-lateral axis of the femur. Conventional or functional calibration methods may be used to define the axis but there is no benchmark to evaluate these methods. Freehand 3D ultrasound, the coupling of ultrasound with 3D motion capture, may provide such a benchmark.We measured the accuracy in vitro and repeatability in vivo of determining the femur condylar axis from freehand 3D ultrasound. The condylar axis provided the reference medial-lateral axis of the femur and was used to evaluate one conventional method and three functional calibration methods, applied to three calibration movements. Ten healthy subjects (20 limbs) underwent 3D gait analysis and freehand 3D ultrasound. The functional calibration methods were a transformation technique, a geometrical method and a method that minimises variance of knee varus-valgus kinematics (DynaKAD). The conventional method used markers over the femoral epicondyles.The condylar axis determined by ultrasound showed good accuracy in vitro, 1.6° (SD: 0.3°) and good repeatability in vivo, 0.2° (RSMD: 2.3°). The DynaKAD method applied to the walking calibration movement determined the medial-lateral axis closest to the ultrasound reference. The average angular difference in the transverse plane was 3.1° (SD: 6.1°).Freehand 3D ultrasound offers an accurate, non-invasive and relatively fast method to locate the medial-lateral axis of the femur for gait analysis.



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Age-independent and age-dependent sex differences in gait pattern determined by principal component analysis

Publication date: Available online 11 February 2016
Source:Gait & Posture
Author(s): Yoshiyuki Kobayashi, Hiroaki Hobara, Thijs A. Heldoorn, Makiko Kouchi, Masaaki Mochimaru
Although various studies have reported significant sex differences in pelvic and/or hip-joint motion during normal walking in healthy adults, it is still unclear whether such differences are among the most dominant age-independent sex differences. This study was conducted to analyze the whole waveform of lower-extremity joint kinematics obtained from 191 healthy adults using a 1212□principal component analysis (PCA). The PCA was conducted using a 955 input matrix constructed from the participants' time-normalized pelvic and right-lower-limb-joint angles along three axes (five trials of 191 participants sex) analyses of□3 axes). Two-way (age□4 angles□101 data points□variance were conducted on the principal component scores (PCSs) of principal component vectors (PCVs) 1 through 6, each of which explained more than 5% of the variance. We identified a PCV that exhibits a significant age–sex interaction (PCV 1). The characteristics of sex differences reported in previous studies could be observed in the reconstructed waveforms of this PCV. Thus, we can conclude that the sex differences in the gaits reported in previous studies are not consistent across age groups. Furthermore, we also found a PCV that exhibited only a significant sex difference (PCV 6). This PCV was the first and only PCV to exhibit a sex difference without any age-related effect or age–sex interaction. Therefore, we concluded that the movement related to this PCV is age-independent and is the most dominant sex difference in the gaits observed during normal walking.



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Measurement of dispersion curves of circumferential guided waves radiating from curved shells: Theory and numerical validation

A method is proposed to evaluate in a non-contact way the phase velocity dispersion curves of circumferential waves around a shell of arbitrary shape immersed in a fluid. No assumptions are made about the thickness or the material of the shell. A geometrical model is derived to describe the shape of the radiated wavefronts in the surrounding fluid, and predict the positions of its centers of curvature. Then the time-reversal principle is applied to recover these positions and to calculate the phase velocity of the circumferential waves. Numerical finite-difference simulations are performed to evaluate the method on a circular and on an elliptic thin shell. Different dispersion curves can be recovered with an error of less than 10%.

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The effect of fluctuating maskers on speech understanding of high-performing cochlear implant users

10.3109/14992027.2015.1128124<br/>Stefan Zirn

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Book review.

Book review.

Int J Audiol. 2016 Mar;55(3):196

Authors: Gilbert J

PMID: 26862923 [PubMed - as supplied by publisher]

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Defining the medial-lateral axis of an anatomical femur coordinate system using freehand 3D ultrasound imaging

Publication date: Available online 10 February 2016
Source:Gait & Posture
Author(s): Elyse Passmore, Morgan Sangeux
Hip rotation from gait analysis informs clinical decisions regarding correct of femoral torsional deformities. However, it is among the least repeatable due to discrepancies in determining the medial-lateral axis of the femur. Conventional or functional calibration methods may be used to define the axis but there is no benchmark to evaluate these methods. Freehand 3D ultrasound, the coupling of ultrasound with 3D motion capture, may provide such a benchmark.We measured the accuracy in vitro and repeatability in vivo of determining the femur condylar axis from freehand 3D ultrasound. The condylar axis provided the reference medial-lateral axis of the femur and was used to evaluate one conventional method and three functional calibration methods, applied to three calibration movements. Ten healthy subjects (20 limbs) underwent 3D gait analysis and freehand 3D ultrasound. The functional calibration methods were a transformation technique, a geometrical method and a method that minimises variance of knee varus-valgus kinematics (DynaKAD). The conventional method used markers over the femoral epicondyles.The condylar axis determined by ultrasound showed good accuracy in vitro, 1.6° (SD: 0.3°) and good repeatability in vivo, 0.2° (RSMD: 2.3°). The DynaKAD method applied to the walking calibration movement determined the medial-lateral axis closest to the ultrasound reference. The average angular difference in the transverse plane was 3.1° (SD: 6.1°).Freehand 3D ultrasound offers an accurate, non-invasive and relatively fast method to locate the medial-lateral axis of the femur for gait analysis.



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Book Review.

Book Review.

Int J Audiol. 2016 Mar;55(3):195

Authors: Marc B

PMID: 26862922 [PubMed - as supplied by publisher]

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Age-independent and age-dependent sex differences in gait pattern determined by principal component analysis

Publication date: Available online 11 February 2016
Source:Gait & Posture
Author(s): Yoshiyuki Kobayashi, Hiroaki Hobara, Thijs A. Heldoorn, Makiko Kouchi, Masaaki Mochimaru
Although various studies have reported significant sex differences in pelvic and/or hip-joint motion during normal walking in healthy adults, it is still unclear whether such differences are among the most dominant age-independent sex differences. This study was conducted to analyze the whole waveform of lower-extremity joint kinematics obtained from 191 healthy adults using a 1212□principal component analysis (PCA). The PCA was conducted using a 955 input matrix constructed from the participants' time-normalized pelvic and right-lower-limb-joint angles along three axes (five trials of 191 participants sex) analyses of□3 axes). Two-way (age□4 angles□101 data points□variance were conducted on the principal component scores (PCSs) of principal component vectors (PCVs) 1 through 6, each of which explained more than 5% of the variance. We identified a PCV that exhibits a significant age–sex interaction (PCV 1). The characteristics of sex differences reported in previous studies could be observed in the reconstructed waveforms of this PCV. Thus, we can conclude that the sex differences in the gaits reported in previous studies are not consistent across age groups. Furthermore, we also found a PCV that exhibited only a significant sex difference (PCV 6). This PCV was the first and only PCV to exhibit a sex difference without any age-related effect or age–sex interaction. Therefore, we concluded that the movement related to this PCV is age-independent and is the most dominant sex difference in the gaits observed during normal walking.



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The effect of fluctuating maskers on speech understanding of high-performing cochlear implant users

10.3109/14992027.2015.1128124<br/>Stefan Zirn

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Whole-brain grey matter density predicts balance stability irrespective of age and protects older adults from falling

Publication date: March 2016
Source:Gait & Posture, Volume 45
Author(s): Matthieu P. Boisgontier, Boris Cheval, Peter van Ruitenbeek, Oron Levin, Olivier Renaud, Julien Chanal, Stephan P. Swinnen
Functional and structural imaging studies have demonstrated the involvement of the brain in balance control. Nevertheless, how decisive grey matter density and white matter microstructural organisation are in predicting balance stability, and especially when linked to the effects of ageing, remains unclear. Standing balance was tested on a platform moving at different frequencies and amplitudes in 30 young and 30 older adults, with eyes open and with eyes closed. Centre of pressure variance was used as an indicator of balance instability. The mean density of grey matter and mean white matter microstructural organisation were measured using voxel-based morphometry and diffusion tensor imaging, respectively. Mixed-effects models were built to analyse the extent to which age, grey matter density, and white matter microstructural organisation predicted balance instability. Results showed that both grey matter density and age independently predicted balance instability. These predictions were reinforced when the level of difficulty of the conditions increased. Furthermore, grey matter predicted balance instability beyond age and at least as consistently as age across conditions. In other words, for balance stability, the level of whole-brain grey matter density is at least as decisive as being young or old. Finally, brain grey matter appeared to be protective against falls in older adults as age increased the probability of losing balance in older adults with low, but not moderate or high grey matter density. No such results were observed for white matter microstructural organisation, thereby reinforcing the specificity of our grey matter findings.

Graphical abstract

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Defining the medial-lateral axis of an anatomical femur coordinate system using freehand 3D ultrasound imaging

Publication date: Available online 10 February 2016
Source:Gait & Posture
Author(s): Elyse Passmore, Morgan Sangeux
Hip rotation from gait analysis informs clinical decisions regarding correct of femoral torsional deformities. However, it is among the least repeatable due to discrepancies in determining the medial-lateral axis of the femur. Conventional or functional calibration methods may be used to define the axis but there is no benchmark to evaluate these methods. Freehand 3D ultrasound, the coupling of ultrasound with 3D motion capture, may provide such a benchmark.We measured the accuracy in vitro and repeatability in vivo of determining the femur condylar axis from freehand 3D ultrasound. The condylar axis provided the reference medial-lateral axis of the femur and was used to evaluate one conventional method and three functional calibration methods, applied to three calibration movements. Ten healthy subjects (20 limbs) underwent 3D gait analysis and freehand 3D ultrasound. The functional calibration methods were a transformation technique, a geometrical method and a method that minimises variance of knee varus-valgus kinematics (DynaKAD). The conventional method used markers over the femoral epicondyles.The condylar axis determined by ultrasound showed good accuracy in vitro, 1.6° (SD: 0.3°) and good repeatability in vivo, 0.2° (RSMD: 2.3°). The DynaKAD method applied to the walking calibration movement determined the medial-lateral axis closest to the ultrasound reference. The average angular difference in the transverse plane was 3.1° (SD: 6.1°).Freehand 3D ultrasound offers an accurate, non-invasive and relatively fast method to locate the medial-lateral axis of the femur for gait analysis.



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Evaluation of udder health parameters and risk factors for clinical mastitis in Dutch dairy herds in the context of a restricted antimicrobial usage policy

Publication date: Available online 10 February 2016
Source:Journal of Dairy Science
Author(s): I.M.G.A. Santman-Berends, J.M. Swinkels, T.J.G.M. Lam, J. Keurentjes, G. van Schaik
Recently, many changes have been implemented in Dutch dairy herds. Herd sizes have increased and antimicrobial use has been reduced. Certain types of antimicrobials can only be used in specific circumstances, and the preventive use of antimicrobials in dry cows is prohibited. The aim of this study was to quantify clinical mastitis (CM), subclinical mastitis (SCM), and risk factors associated with CM in Dutch dairy herds in 2013, in the context of these changes. For this study, 240 dairy herds were randomly selected from farms that participated in test-day milk recording, used a conventional milking system, and agreed to participate in the study. Eventually, 233 Dutch dairy farmers had complete records of CM in their herds in 2013 and 224 of these farmers completed a questionnaire on management factors potentially associated with CM. All participating farmers gave consent to use their routinely collected herd data such as test-day records and cow identification and registration data. Clinical and subclinical mastitis incidence rate (CMI and SCMI, respectively) per 100 cows per year, subclinical mastitis prevalence, and average bulk tank milk somatic cell count were obtained for 2013. The risk factor analysis was conducted using a generalized linear model with a log link function and a negative binomial distribution on herd level in Stata 13.1. A median CMI of 28.6 per 100 cows at risk per year, SCMI of 70.1 per 100 cows at risk per year, SCM prevalence of 15.8%, and bulk tank milk somatic cell count of 171 × 103 cells/mL were observed in 2013. Factors that were significantly associated with a higher CMI were cleaning slatted floors only once per day compared with more than 4 times a day (i.e., mechanical), a higher percentage of Holstein Friesian cows present in the herd, treating less than 50% of the cows with CM with antimicrobials, postmilking teat disinfection, and treatment of cows with elevated somatic cell count with antimicrobials. The results of this study indicated that udder health had not deteriorated compared with udder health in previous Dutch studies where herd sizes were somewhat smaller and before the restrictions in antimicrobial use. Several of the risk factors that were found can be influenced by the farmer and can prevent the occurrence of CMI. Still, when cases of CM occur, treatment with antimicrobials might be necessary to cure the CM case and is beneficial for the overall udder health in the herd.

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Analysis of behavioral changes in dairy cows associated with claw horn lesions

Publication date: Available online 10 February 2016
Source:Journal of Dairy Science
Author(s): K. Nechanitzky, A. Starke, B. Vidondo, H. Müller, M. Reckardt, K. Friedli, A. Steiner
Detecting lame cows is important in improving animal welfare. Automated tools are potentially useful to enable identification and monitoring of lame cows. The goals of this study were to evaluate the suitability of various physiological and behavioral parameters to automatically detect lameness in dairy cows housed in a cubicle barn. Lame cows suffering from a claw horn lesion (sole ulcer or white line disease) of one claw of the same hind limb (n = 32; group L) and 10 nonlame healthy cows (group C) were included in this study. Lying and standing behavior at night by tridimensional accelerometers, weight distribution between hind limbs by the 4-scale weighing platform, feeding behavior at night by the nose band sensor, and heart activity by the Polar device (Polar Electro Oy, Kempele, Finland) were assessed. Either the entire data set or parts of the data collected over a 48-h period were used for statistical analysis, depending upon the parameter in question. The standing time at night over 12 h and the limb weight ratio (LWR) were significantly higher in group C as compared with group L, whereas the lying time at night over 12 h, the mean limb difference (Δweight), and the standard deviation (SD) of the weight applied on the limb taking less weight were significantly lower in group C as compared with group L. No significant difference was noted between the groups for the parameters of heart activity and feeding behavior at night. The locomotion score of cows in group L was positively correlated with the lying time and Δweight, whereas it was negatively correlated with LWR and SD. The highest sensitivity (0.97) for lameness detection was found for the parameter SD [specificity of 0.80 and an area under the curve (AUC) of 0.84]. The highest specificity (0.90) for lameness detection was present for Δweight (sensitivity = 0.78; AUC = 0.88) and LWR (sensitivity = 0.81; AUC = 0.87). The model considering the data of SD together with lying time at night was the best predictor of cows being lame, accounting for 40% of the variation in the likelihood of a cow being lame (sensitivity = 0.94; specificity = 0.80; AUC = 0.86). In conclusion, the data derived from the 4-scale-weighing platform, either alone or combined with the lying time at night over 12 h, represent the most valuable parameters for automated identification of lame cows suffering from a claw horn lesion of one individual hind limb.

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