Plated-rich plasma for androgenetic alopecia: Does it work? Evidence from meta analysis

Summary

Introduction

The use of plated-rich plasma (PRP) has increased among different surgical specialities for the treatment of various conditions. Androgenetic alopecia is a common condition, with severe attendant psychosocial implications. PRP injections for hair restoration have become a popular practice among plastic surgeons. We performed a meta-analysis comparing local injection of plated-rich plasma versus control to evaluate this issue in order to investigate the effectiveness of PRP local injections for androgenetic alopecia.

Methods

A systematic literature search was performed. Primary outcome was the increase in number of hairs. Secondary outcomes were the increase in hair thickness and the percentage increase in hair number and thickness. We performed random-effect analysis.

Results

Six studies involving 177 patients were retrieved and included in the present analysis. A significantly locally increased hair number per cm² was observed after PRP injections versus control (mean difference (MD) 17.90, 95%CI 5.84-29.95, P=.004). Similarly, a significantly increased hair thickness cross section per 10⁻⁴ mm² (MD 0.22, 95%CI 0.07-0.38, P=.005) favoring PRP group. The pooled results did not show statistically significant differences in percentage increase in hair number (MD 24.12%, 95%CI −12.76-60.99, P=.20) and hair thickness (MD 32.63%, 95%CI −16.23-81.48, P=0.19) among patients treated with PRP.

Conclusions

Local injection of PRP for androgenic alopecia might be associated with an increased number of hairs and some hair thickness improvement in the treated areas with minimal morbidity. The results of this meta-analysis should be interpreted with caution as it consists of pooling many small studies. Larger randomized studies can verify this perception.

http://ift.tt/2n3GxSG

Simvastatin-associated dermatomyositis

http://ift.tt/2nyRHLX

Adverse effects of isotretinoin: A large, retrospective review

Abstract

Acne is a very common and disfiguring disease that affects mostly adolescents and, to some extent, adults. The objective of our study was to estimate the adverse effects after isotretinoin by treatment of 3,525 patients due to acne vulgaris in a 5-year observation. Retrospective, comparative study was carried out in Poland and Romania from January 2012 to August 2016. Inclusion criteria into this study were moderate, severe, and nodulocystic inflammatory acne vulgaris. Exclusion criteria were mild acne, pregnant, and lactating women. Statistical analysis was carried out using T test and Chi square. All patients were treated with oral isotretinoin. Patient age ranged from 13-35 years. Dry lips was the most commonly reported adverse effect, affecting 100% of users, followed by xerosis (94.97%) and facial erythema (66.21%). Of all adverse effects, psychiatric symptoms accounted for 25.16%; eye lesions accounted for 8.96%. In lab investigations an increase in the level of total cholesterol and serum triglycerides was observed. This study documents the adverse effect profile of isotretinoin in a large number of patients collected over a period of 4 years. Side effects were mild and well tolerated and did not necessitate stopping the treatment. However, it is important to educate patients about this potential consequence.

http://ift.tt/2n3K9Ea

Successful treatment to a tretinoin/clindamycin gel in a late onset of nevus comedonicus

http://ift.tt/2nyJ0kG

Plated-rich plasma for androgenetic alopecia: Does it work? Evidence from meta analysis

Summary

Introduction

The use of plated-rich plasma (PRP) has increased among different surgical specialities for the treatment of various conditions. Androgenetic alopecia is a common condition, with severe attendant psychosocial implications. PRP injections for hair restoration have become a popular practice among plastic surgeons. We performed a meta-analysis comparing local injection of plated-rich plasma versus control to evaluate this issue in order to investigate the effectiveness of PRP local injections for androgenetic alopecia.

Methods

A systematic literature search was performed. Primary outcome was the increase in number of hairs. Secondary outcomes were the increase in hair thickness and the percentage increase in hair number and thickness. We performed random-effect analysis.

Results

Six studies involving 177 patients were retrieved and included in the present analysis. A significantly locally increased hair number per cm² was observed after PRP injections versus control (mean difference (MD) 17.90, 95%CI 5.84-29.95, P=.004). Similarly, a significantly increased hair thickness cross section per 10⁻⁴ mm² (MD 0.22, 95%CI 0.07-0.38, P=.005) favoring PRP group. The pooled results did not show statistically significant differences in percentage increase in hair number (MD 24.12%, 95%CI −12.76-60.99, P=.20) and hair thickness (MD 32.63%, 95%CI −16.23-81.48, P=0.19) among patients treated with PRP.

Conclusions

Local injection of PRP for androgenic alopecia might be associated with an increased number of hairs and some hair thickness improvement in the treated areas with minimal morbidity. The results of this meta-analysis should be interpreted with caution as it consists of pooling many small studies. Larger randomized studies can verify this perception.

http://ift.tt/2n3GxSG

Simvastatin-associated dermatomyositis

http://ift.tt/2nyRHLX

Adverse effects of isotretinoin: A large, retrospective review

Abstract

Acne is a very common and disfiguring disease that affects mostly adolescents and, to some extent, adults. The objective of our study was to estimate the adverse effects after isotretinoin by treatment of 3,525 patients due to acne vulgaris in a 5-year observation. Retrospective, comparative study was carried out in Poland and Romania from January 2012 to August 2016. Inclusion criteria into this study were moderate, severe, and nodulocystic inflammatory acne vulgaris. Exclusion criteria were mild acne, pregnant, and lactating women. Statistical analysis was carried out using T test and Chi square. All patients were treated with oral isotretinoin. Patient age ranged from 13-35 years. Dry lips was the most commonly reported adverse effect, affecting 100% of users, followed by xerosis (94.97%) and facial erythema (66.21%). Of all adverse effects, psychiatric symptoms accounted for 25.16%; eye lesions accounted for 8.96%. In lab investigations an increase in the level of total cholesterol and serum triglycerides was observed. This study documents the adverse effect profile of isotretinoin in a large number of patients collected over a period of 4 years. Side effects were mild and well tolerated and did not necessitate stopping the treatment. However, it is important to educate patients about this potential consequence.

http://ift.tt/2n3K9Ea

Successful treatment to a tretinoin/clindamycin gel in a late onset of nevus comedonicus

http://ift.tt/2nyJ0kG

Therapeutic Potential, Challenges and Future Perspective of Cancer Stem Cells in Translational Oncology: A Critical Review

Stem cell research is a rapidly developing field that offers effective treatment for a variety of malignant and non-malignant diseases. Stem cell is a regenerative medicine associated with the replacement, repair, and restoration of injured tissue. Stem cell research is a promising field having maximum therapeutic potential. Cancer stem cells (CSCs) are the cells within the tumor that posses capacity of selfrenewal and have a root cause for the failure of traditional therapies leading to re-occurrence of cancer. CSCs have been identified in blood, breast, brain, and colon cancer. Traditional therapies target only fast growing tumor mass, but not slow-dividing cancer stem cells. It has been shown that embryonic pathways such as Wnt, Hedgehog and Notch, control self-renewal capacity and involved in cancer stem cell maintenance. Targeting of these pathways may be effective in eradicating cancer stem cells and preventing chemotherapy and radiotherapy resistance. Targeting CSCs has become one of the most effective approaches to improve the cancer survival by eradicating the main root cause of cancer. The present review will address, in brief, the importance of cancer stem cells in targeting cancer as better and effective treatment along with a concluding outlook on the scope and challenges in the implication of cancer stem cells in translational oncology.

http://ift.tt/2kwEW7p

Role of Imaging in Testicular Cancer

Testicular malignancy is the most common nonhematologic malignancy in young men. Around 95% of them are germ cell tumors (GCTs), and with correct assessment of the disease and application of chemotherapy and radiotherapy survival rates of more than 90% can be achieved. Imaging studies not only aid in the diagnosis of testicular cancer but also help determine the tumor extent and site of metastatic disease, in monitoring treatment response, surgical planning and detecting sites of relapse and residual disease. Scrotal sonography combined with clinical examination has a high sensitivity for diagnosing testicular cancer and thus is often the first imaging modality to be performed on patients presenting with testicular mass. Abdominal and pelvic CT and chest CT remain the preferred techniques for staging, monitoring of treatment response, and detecting relapse and residual disease in patients with testicular cancer but MRI, PET with 18F-FDG (fluorodeoxyglucose) and sonography also show promises in certain situations. This article reviews the literatures on the role of imaging in the management of testicular germ cell cancer.

http://ift.tt/2n3RMKL

Cancer Associated Thrombosis: Focus on Prevention and Treatment of Venous Thromboembolism

Cancer-associated thrombosis (CAT) accounts for about 20% of all thrombosis worldwide. It is the second leading cause of death in cancer patients. The risk of venous thromboembolism (VTE) is 4 -7 times higher and the risk of recurrent VTE three times higher in the cancer patients, compared to the non-cancer patients. The survival of cancer patients with VTE is lower than that of patients without VTE. In the last two decades, the incidence of CAT has risen in the ambulatory patients than in the inpatient setting. While the role of pharmacologic thromboprophylaxis (PTP) is established in the hospitalized cancer patients, ambulatory PTP is not, except in patients with multiple myeloma and myeloproliferative neoplasms. In the last decade, the low-molecular-weight heparin (LMWH) has emerged as the standard of care for the treatment of acute cancer-associated VTE. Many questions remain unanswered with regards to the optimal duration of LMWH therapy in the CAT, the role of direct oral anticoagulants (DOACs) in CAT, and the optimal anticoagulation management in thrombocytopenic cancer patients. Research trials are necessary to define a subset of ambulatory solid tumor patients who may benefit from PTP and to define the role of DOACs in the prevention and treatment of CAT.

http://ift.tt/2lBLCO9

Review: Circulating microRNAs in Predicting the Prognosis of Gastrointestinal Cancers

Gastrointestinal cancers remain a significant health problem worldwide. Resistance to treatment in a subset of patients is a major problem and personalized treatment is expected to improve prognosis in these individuals. Assessment of biomarkers, which are generally genes, proteins, phosphoproteins and/or microRNAs (miRNAs), and their levels in tumor or blood, leads to a view of the molecular characteristics (signature) of a given patient's tumor and thus provides information that will enable personalized treatment. miRNAs are short noncoding RNAs that regulate gene expression at the post-transcriptional level. Deregulation of miRNA expression has been demonstrated in various cancers, including gastrointestinal (GI) cancers. The high stability of miRNAs in the blood circulation offers enormous advantage for prognostic applications as blood samples can be easily procured noninvasively. Circulating miRNAs have been demonstrated to be valuable instruments in prognosis of GI cancers. Additionally, serial collection of blood samples is possible for monitoring the progress of cancer, something that cannot be done reasonably with tumor tissue. We review previous reports that used circulating miRNAs as biomarkers in the prognosis of GI cancers, and also highlight the fascinating possibility of using the gathered information to identify new therapeutic targets.

http://ift.tt/2n3JiU0

Different trajectories of decline for global form and global motion processing in ageing, Mild Cognitive Impairment and Alzheimer’s disease

Publication date: Available online 14 March 2017
Source:Neurobiology of Aging
Author(s): Gillian Porter, John Wattam-Bell, Antony Bayer, Judy Haworth, Oliver Braddick, Janette Atkinson, Andrea Tales
The visual processing of complex motion is impaired in Alzheimer's disease (AD). However, it is unclear whether these impairments are biased towards the motion stream or part of a general disruption of global visual processing, given some reports of impaired static form processing in AD. Here, for the first time, we directly compared the relative preservation of motion and form systems in AD, Mild Cognitive Impairment (MCI) and healthy ageing, by measuring coherence thresholds for well-established global rotational motion and static form stimuli known to be of equivalent complexity. Our data confirm a marked motion-processing deficit specific to some AD patients, and greater than any form-processing deficit for this group. In parallel, we identified a more gradual decline in static form recognition, with thresholds raised in MCI patients and slightly further in the AD group compared with controls. We conclude that complex motion processing is more vulnerable to decline in dementia than complex form processing, perhaps owing to greater reliance on long-range neural connections heavily targeted by AD pathology.



http://ift.tt/2ni8Nl8

Successful use of Bruton's kinase inhibitor, ibrutinib, to control paraneoplastic pemphigus in a patient with paraneoplastic autoimmune multiorgan syndrome and chronic lymphocytic leukaemia

Abstract

We present the case of a 51-year-old man who developed paraneoplastic pemphigus (PNP) in the context of chronic lymphocytic leukemia (CLL). His CLL was successfully controlled with ibrutinib. Concurrently, there was significant improvement of his PNP, suggesting that ibrutinib may be a very useful addition to the treatment options in this potentially life-threatening autoimmune disorder.

http://ift.tt/2nidpYg

Successful use of Bruton's kinase inhibitor, ibrutinib, to control paraneoplastic pemphigus in a patient with paraneoplastic autoimmune multiorgan syndrome and chronic lymphocytic leukaemia

Abstract

We present the case of a 51-year-old man who developed paraneoplastic pemphigus (PNP) in the context of chronic lymphocytic leukemia (CLL). His CLL was successfully controlled with ibrutinib. Concurrently, there was significant improvement of his PNP, suggesting that ibrutinib may be a very useful addition to the treatment options in this potentially life-threatening autoimmune disorder.

http://ift.tt/2nidpYg

The PD-L1/PD-1 pathway promotes dysfunction, but not “exhaustion”, in tumor-responding T cells from pleural effusions in lung cancer patients

Abstract

Malignant pleural effusions are frequent in patients with advanced stages of lung cancer and are commonly infiltrated by lymphocytes and tumor cells. CD8+ T cells from these effusions have reduced effector functions. The programmed death receptor 1(PD-1)/programmed death ligand 1 (PD-L1) pathway is involved in T-cell exhaustion, and it might be responsible for T-cell dysfunction in lung cancer patients. Here, we show that PD-L1 is expressed on tumor cell samples from malignant effusions, on lung cancer cell lines, and, interestingly, on MRC-5 lung fibroblasts. PD-L1 was up-regulated in lung cancer cell lines upon treatment with IFN-gamma, but not under hypoxic conditions, as detected by RT-qPCR and flow cytometry. Blockade of PD-L1 on tumor cells restored granzyme-B expression in allogenic CD8+ T cells in vitro. Remarkably, pleural effusion CD8+ T cells that responded to the tumor antigens MAGE-3A and WT-1 (identified as CD137+ cells) were lower in frequency than CMV pp65-responding CD8+ T cells and did not have an exhausted phenotype (PD-1+ TIM-3+). Nonetheless, tumor-responding CD8+ T cells had a memory phenotype and expressed higher levels of PD-1. A PD-L1 blocking antibody increased the expression of granzyme-B and perforin on polyclonal- and tumor-stimulated CD8+ T cells. Taken together, our data show that rather than being exhausted, tumor-responding CD8+ T cells are not completely differentiated into effector cells and are prone to negative regulation by PD-L1. Hence, our study provides evidence that lung cancer patients respond to immunotherapy due to blockade of the PD-L1/PD-1 pathway.

http://ift.tt/2mE3Fod

Expression patterns of programmed death-ligand 1 in esophageal adenocarcinomas: comparison between primary tumors and metastases

Abstract

Expression analysis of programmed death-ligand 1 (PD-L1) may be helpful in guiding clinical decisions for immune checkpoint inhibition therapy, but testing by immunohistochemistry may be hampered by heterogeneous staining patterns within tumors and expression changes during metastatic course. PD-L1 expression (clone SP142) was investigated in esophageal adenocarcinomas using tissue microarrays (TMA) from 112 primary resected tumors, preoperative biopsies and full slide sections from a subset of these cases (n = 24), corresponding lymph node (n = 55) and distant metastases (n = 17). PD-L1 expression was scored as 0.1–1, >1, >5, >50% positive membranous staining of tumor cells and any positive staining of tumor-associated inflammatory infiltrates and/or stroma cells. There was a significant correlation with overall PD-L1 expression between the full slide sections and the TMA (p = 0.001), but not with the corresponding biopsies. PD-L1 expression in tumor cells >1% was detected in 8.0% of cases (9/112) and 51.8% of cases (58/112) in tumor-associated inflammatory infiltrates and/or stroma cells of primary tumors. Epithelial expression in metastases was found in 5.6% of cases (4/72) and immune cell expression in 18.1% of cases (13/72), but did not correlate with the expression pattern in the primary tumor. Overall PD-L1 expression in the primary tumor did not influence survival. However, PD-L1 expression was correlated with the number of CD3⁺ tumor-infiltrating lymphocytes in the tumor center, and a combinational score of PD-L1 status/CD3⁺ tumor-infiltrating lymphocytes was correlated with patients' overall survival.

http://ift.tt/2mGDrD1

Radial/Circumferential Surgical Margin in Laryngectomy Specimens

http://ift.tt/2mlrqAp

Long-Term Control of Hypercortisolism by Vandetanib in a Case of Medullary Thyroid Carcinoma with a Somatic RET Mutation

Thyroid , Vol. 0, No. 0.


http://ift.tt/2mlYjwN

Long-Term Control of Hypercortisolism by Vandetanib in a Case of Medullary Thyroid Carcinoma with a Somatic RET Mutation

Thyroid , Vol. 0, No. 0.


http://ift.tt/2mlYjwN

Postoperative brachial artery entrapment associated with pediatric supracondylar fracture of the humerus: a case report

Severely displaced supracondylar fractures of the humerus in children are frequently associated with complications including neurovascular injuries, non-union, or compartment syndrome. In the current literatur...

http://ift.tt/2nnKNK0

The effect of rLH supplementation to the GnRH-antagonist protocol on endocrine dynamics in the advanced reproductive age

Abstract

Purpose

To explore serum endocrine dynamics, specifically LH levels, following rLH supplementation to rFSH following GnRH-antagonist treatment in the advance reproductive age.

Methods

Women were prospectively and similarly treated employing rFSH and the flexible GnRH-antagonist protocol, while rLH was supplemented only to the study group. Serum FSH, LH, E_2, and P were evaluated throughout the follicular phase. Three strategies were a priori planned to examine endocrine dynamics among women enrolled.

Results

While serum LH drop were similar before GnRH-antagonist stimulation, it dropped more times in the control group compared to the study group. Among women receiving rFSH only, serum LH levels dropped ≤2, ≤1 and ≤0.5 mIU/mL in 71.4, 46.4, and 28.6% of cases, while this occurred only in 38.7% (P = 0.01), 6.5% (P = 0.0004) and 3.2% (P = 0.007) of women receiving combined rFSH and rLH treatment, respectively. The same trend was found when serum LH dropped in at least two occasions following the GnRH-antagonist administration. Conversely, serum LH diagrams throughout the follicular phase did not differ between the two groups. Furthermore, individual area under the curve values of LH, E_2, and P was similar between the two groups following GnRH-antagonist initiation.

Conclusions

Different strategies to explore LH dynamics following the GnRH-antagonist administration have resulted in diverse results, implying the need for a consensus definition of LH threshold for adequate folliculogenesis and steroidogenesis. Such action would pave the way for understanding which groups of patients may benefit from rLH supplementation.

http://ift.tt/2mUDCeF

Postoperative brachial artery entrapment associated with pediatric supracondylar fracture of the humerus: a case report

Severely displaced supracondylar fractures of the humerus in children are frequently associated with complications including neurovascular injuries, non-union, or compartment syndrome. In the current literatur...

http://ift.tt/2nnKNK0

Is Coronary Atherosclerosis One Disease or Many?: Setting Realistic Expectations for Precision Medicine.

Author: Khera, Amit V. MD; Kathiresan, Sekar MD

Page: 1005-1007

http://ift.tt/2n39lLa

The Gut Microbiome and Its Role in Cardiovascular Diseases.

Author: Tang, W. H. Wilson MD; Hazen, Stanley L. MD, PhD

Page: 1008-1010

http://ift.tt/2mlEQf2

Releasing the Brakes on the Fibrinolytic System in Pulmonary Emboli: Unique Effects of Plasminogen Activation and [alpha]2-Antiplasmin Inactivation.

Author: Singh, Satish PhD; Houng, Aiilyan BS; Reed, Guy L. MD

Page: 1011-1020

http://ift.tt/2n36cL6

Thrombolytic Therapy Targeting Alpha 2-Antiplasmin.

Author: Urano, Tetsumei MD, PhD; Suzuki, Yuko MD, PhD

Page: 1021-1023

http://ift.tt/2mlK0aN

Use of Intravenous Recombinant Tissue Plasminogen Activator in Patients With Acute Ischemic Stroke Who Take Non-Vitamin K Antagonist Oral Anticoagulants Before Stroke.

Author: Xian, Ying MD, PhD; Federspiel, Jerome J. MD, PhD; Hernandez, Adrian F. MD, MHS; Laskowitz, Daniel T. MD, MHS; Schwamm, Lee H. MD; Bhatt, Deepak L. MD, MPH; Smith, Eric E. MD, MPH; Fonarow, Gregg C. MD; Peterson, Eric D. MD, MPH

Page: 1024-1035

http://ift.tt/2n3nHuY

Three Arterial Grafts Improve Late Survival: A Meta-Analysis of Propensity-Matched Studies.

Author: Gaudino, Mario MD; Puskas, John D. MD; Di Franco, Antonino MD; Ohmes, Lucas B. MD; Iannaccone, Mario MD; Barbero, Umberto MD; Glineur, David MD; Grau, Juan B. MD; Benedetto, Umberto MD; D'Ascenzo, Fabrizio MD; Gaita, Fiorenzo MD; Girardi, Leonard N. MD; Taggart, David P. MD

Page: 1036-1044

http://ift.tt/2mlEPru

Does First-Trimester Screening Modify the Natural History of Congenital Heart Disease?: Analysis of Outcome of Regional Cardiac Screening at 2 Different Time Periods.

Author: Jicinska, Hana MD, PhD; Vlasin, Pavel MD; Jicinsky, Michal MD; Grochova, Ilga MD; Tomek, Viktor MD, PhD; Volaufova, Julia PhD; Skovranek, Jan MD, PhD; Marek, Jan MD, PhD

Page: 1045-1055

http://ift.tt/2n3ouvM

Long-Term Biased [beta]-Arrestin Signaling Improves Cardiac Structure and Function in Dilated Cardiomyopathy.

Author: Ryba, David M. BS; Li, Jieli MD, PhD; Cowan, Conrad L. PhD; Russell, Brenda PhD; Wolska, Beata M. PhD; Solaro, R. John PhD

Page: 1056-1070

http://ift.tt/2mlLrWP

Biased Agonism at the Angiotensin Receptor: Blocker and Calcium Sensitizer at the Same Time.

Author: Woo, Anthony Yiu-Ho PhD; Komuro, Issei MD, PhD; Xiao, Rui-Ping MD, PhD

Page: 1071-1074

http://ift.tt/2n3nx6R

Ischemia and No Obstructive Coronary Artery Disease (INOCA): Developing Evidence-Based Therapies and Research Agenda for the Next Decade.

Author: Bairey Merz, C. Noel MD; Pepine, Carl J. MD; Walsh, Mary Norine MD; Fleg, Jerome L. MD; Camici, Paolo G. MD; Chilian, William M. PhD; Clayton, Janine Austin MD; Cooper, Lawton S. MD; Crea, Filippo MD; Di Carli, Marcelo MD; Douglas, Pamela S. MD; Galis, Zorina S. PhD; Gurbel, Paul MD; Handberg, Eileen M. PhD; Hasan, Ahmed MD; Hill, Joseph A. MD; Hochman, Judith S. MD; Iturriaga, Erin BS, MSN; Kirby, Ruth BS, RN; Levine, Glenn N. MD; Libby, Peter MD; Lima, Joao MD; Mehta, Puja MD; Desvigne-Nickens, Patrice MD; Olive, Michelle PhD; Pearson, Gail D. MD; Quyyumi, Arshed A. MD; Reynolds, Harmony MD; Robinson, British MA; Sopko, George MD; Taqueti, Viviany MD; Wei, Janet MD; Wenger, Nanette MD

Page: 1075-1092

http://ift.tt/2mlG21R

Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association.

Author: Satou, Gary M. MD, FAHA, Chair; Rheuban, Karen MD; Alverson, Dale MD; Lewin, Mark MD; Mahnke, Christopher MD; Marcin, James MD; Martin, Gerard R. MD, FAHA; Mazur, Lisa Schmitz JD; Sahn, David J. MD, FAHA; Shah, Sanket MD; Tuckson, Reed MD; Webb, Catherine L. MD, FAHA; Sable, Craig A. MD, FAHA, Vice Chair; On behalf of the American Heart Association Congenital Cardiac Disease Committee of the Council on Cardiovascular Disease in the Young and Council on Quality Care and Outcomes Research

Page: e648-e678

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Coronary Endothelial Dysfunction and the Index of Microcirculatory Resistance as a Marker of Subsequent Development of Cardiac Allograft Vasculopathy.

Author: Lee, Jang Hoon MD; Okada, Kozo MD, PhD; Khush, Kiran MD, MAS; Kobayashi, Yuhei MD; Sinha, Seema MD; Luikart, Helen RN; Valantine, Hannah MD; Yeung, Alan C. MD; Honda, Yasuhiro MD; Fearon, William F. MD

Page: 1093-1095

http://ift.tt/2mlCigT

Letter by Lewis and Miller Regarding Article, "Experimentally Increasing the Compliance of Titin Through RNA Binding Motif-20 (RBM20) Inhibition Improves Diastolic Function in a Mouse Model of Heart Failure With Preserved Ejection Fraction".

Author: Lewis, Gavin A. MBChB; Miller, Christopher A. MB ChB, PhD

Page: e679-e680

http://ift.tt/2n36WjG

Response by Methawasin and Granzier to Letter Regarding Article, "Experimentally Increasing the Compliance of Titin Through RNA Binding Motif-20 (RBM20) Inhibition Improves Diastolic Function in a Mouse Model of Heart Failure With Preserved Ejection Fraction".

Author: Methawasin, Mei MD, PhD; Granzier, Henk PhD

Page: e681-e682

http://ift.tt/2mlX1kx

Letter by Jin-shan and Xue-bin Regarding Article, "Tachycardia-Induced Cardiomyopathy in a 43-Year-Old Man".

Author: Jin-shan, He MD; Xue-bin, Li MD

Page: e683

http://ift.tt/2n39mic

Response by Zhao et al to Letter Regarding Article, "Tachycardia-Induced Cardiomyopathy in a 43-Year-Old Man".

Author: Zhao, Yun-Tao MD, PhD; Wang, Lei MD; Yi, Zhong MD, PhD

Page: e684-e685

http://ift.tt/2mlEKUI

Overexpression of Rsf-1 correlates with poor survival and promotes invasion in non-small cell lung cancer

Abstract

Rsf-1 (HBXAP) was recently reported to play roles in tumorigenesis and tumor progression. There have been many reports referred to Rsf-1 overexpression in various cancers and associated with the malignant behavior of cancer cells. However, the molecular mechanism of Rsf-1 in non-small cell lung cancer aggressiveness remains ambiguous. In the present study, we found that there was a significant association between Rsf-1 overexpression and poor overall survival (p = 0.028) in lung cancer. Furthermore, knockdown of Rsf-1 expression in H1299 and H460 cells with high endogenous Rsf-1 expression inhibited cell migration and invasion and downregulated MMP2 expression and nuclear levels of NF-κB. NF-κB inhibitor could also block the effect of Rsf-1 in regulation of MMP2 expression. Further experiments demonstrated that Rsf-1 depletion restrained NF-κB reporter luciferase activity and downregulated bcl-2 and p-IκB protein level. In conclusion, we demonstrated that Rsf-1 was overexpressed in lung cancer and associated with poor survival. Rsf-1 regulated cell invasion through MMP2 and NF-κB pathway.

http://ift.tt/2mlJPfN

"J Spec Oper Med"[jour]; +23 new citations

23 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

"J Spec Oper Med"[jour]

These pubmed results were generated on 2017/03/13

PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

http://ift.tt/2n2OKGx

Helicobacter Pylori infection in Omani children

http://ift.tt/2mGn2hY

Issue Information

http://ift.tt/2mlrRe4

Hox-mediated endodermal identity patterns the pharyngeal muscle formation in the chordate pharynx [RESEARCH REPORT]

Keita Yoshida, Azusa Nakahata, Nicholas Treen, Tetsushi Sakuma, Takashi Yamamoto, and Yasunori Sasakura

The pharynx, possessing gill slits and the endostyle, is a characteristic of chordates that is a complex of multiple tissues well organized along the anterior-posterior (AP) axis. Although Hox genes show AP coordinated expression in the pharyngeal endoderm, tissue specific roles of these factors for establishing the regional identities within this tissue is largely unknown. Here, we show that Hox1 is essential for the establishment of AP axial identity of the endostyle, a major structure of the pharyngeal endoderm, in the ascidian Ciona intestinalis. We found that Hox1 knockout causes posterior to anterior transformation of the endostyle identity, and Hox1 represses Otx expression and anterior identity, and vice versa. Furthermore, alteration of the regional identity of the endostyle disrupts the formation of body wall muscles, suggesting that the endodermal axial identity is essential for the coordinated pharyngeal development. Our results reveal an essential role of Hox genes for establishment of the AP regional identity in the pharyngeal endoderm and crosstalk between endoderm and mesoderm for the development of chordate pharynx.

http://ift.tt/2mGlhRY

Estrogen modulates mesenchymal-epidermal interactions in the adult nipple [RESEARCH ARTICLE]

Hsing-Jung Wu, Ji Won Oh, Dan F. Spandau, Sunil Tholpady, Jesus Diaz III, Laura J. Schroeder, Carlos D. Offutt, Adam B. Glick, Maksim V. Plikus, Sachiko Koyama, and John Foley

Maintenance of specialized epidermis requires signals from the underlying mesenchyme; however, specific pathways involved remain to be identified. By recombining cells from ventral skin of the K14-PTHrP transgenic mice with those from wild-type, we show that transgenic stroma is sufficient to reprogram wild-type keratinocytes into nipple-like epidermis. To identify candidate nipple-specific signaling factors, we compared gene expression signatures of sorted Pdgfrα-positive ventral K14-PTHrP and wild-type fibroblasts, identifying differentially-expressed transcripts of the WNT, HGF, TGFβ, IGF, BMP, FGF and estrogen signaling. Considering that some of the growth factor pathways are targets for estrogen regulation, we examined the hormone's upstream role in maintaining the nipple. Ablation of estrogen signaling by ovariectomy produced nipples with abnormally thin epidermis, and we identified TGFβ as a negatively regulated target of estrogen signaling. Estrogen treatment represses Tgfβ1 at the transcript and protein levels in K14-PTHrP fibroblasts in vitro, while ovariectomy increased Tgfβ1 in K14-PTHrP ventral skin. Moreover, ectopic delivery of Tgfβ1 protein into nipple connective tissue reduced epidermal proliferation. Taken together, specialized nipple epidermis is maintained by estrogen-induced repression of TGFβ signaling in the local fibroblasts.

http://ift.tt/2mGlkNE

The chromatin modifier Satb1 regulates cell fate through Fgf signalling in the early mouse embryo [RESEARCH ARTICLE]

Mubeen Goolam and Magdalena Zernicka-Goetz

The separation of embryonic from extra-embryonic tissues within the inner-cell-mass (ICM) to generate the epiblast (EPI), that will form the new organism, from the primitive endoderm (PE), that will form the yolk sac, is a crucial developmental decision. Here we identify a chromatin modifier, Satb1, with a distinct role in this decision. Satb1 is differentially expressed within 16-cell-stage embryos with higher expression levels in the ICM progenitor cells. Depleting Satb1 increases the number of EPI cells at the expense of PE. This phenotype can be rescued by simultaneous depletion of both Satb1 and Satb2, due to their antagonistic effect on the pluripotency regulator Nanog. Consequently, increasing Satb1 expression leads to differentiation into PE and a decrease in EPI, due to the modulation of expression of several pluripotency- and differentiation-related genes by Satb1. Finally, we show that Satb1 is a downstream target of the Fgf signalling pathway, linking chromatin modification and Fgf signalling. Together, these results identify a role for Satb1 in the lineage choice between pluripotency and differentiation and further our understanding of early embryonic lineage segregation.

http://ift.tt/2mlJEBV

Distinct roles of neuroepithelial-like and radial glia-like progenitor cells in cerebellar regeneration [RESEARCH ARTICLE]

Jan Kaslin, Volker Kroehne, Julia Ganz, Stefan Hans, and Michael Brand

Zebrafish can regenerate brain injury, and the regenerative process is driven by resident stem cells. Stem cells are heterogeneous in the vertebrate brain, but the significance of having heterogeneous stem cells in regeneration is not understood. Limited availability of specific stem cells might impair the regeneration of particular cell lineages. We studied regeneration ability of the adult zebrafish cerebellum. The zebrafish cerebellum contains two major stem and progenitor cell types, ventricular zone and neuroepithelial cells. Using conditional lineage tracing, we demonstrate that cerebellar regeneration depends on availability of specific stem cells. Radial glia-like cells are thought to be the predominating stem cell type in homeostasis and after injury. However, we find that radial glia-like cells play a minor part in adult cerebellar neurogenesis and in recovery after injury. Instead, we find that neuroepithelial cells are the predominant stem cell type supporting cerebellar regeneration after injury. Zebrafish are able to regenerate many, but not all cell types in the cerebellum, which emphasizes the need to understand the contribution of different adult neural stem and progenitor cell subtypes in the vertebrate CNS.

http://ift.tt/2mGsem5

IP3R mediated Ca2+ release regulates protein metabolism in Drosophila neuroendocrine cells: implications for development under nutrient stress [RESEARCH REPORT]

Megha Megha and Gaiti Hasan

Successful completion of animal development is fundamentally reliant on nutritional cues. Adaptations for surviving nutritional loss are coordinated in part by neural circuits. As neuropeptides secreted by neuroendocrine (NE) cells critically modulate neural circuits, we investigated NE cell function during development under nutrient stress. Starved Drosophila larvae exhibited reduced pupariation, if either insulin signaling or IP₃/Ca²⁺ signaling, were down-regulated in NE cells. Moreover, an IP₃R (Inositol 1,4,5-trisphosphate receptor) loss-of-function mutant displayed reduced protein synthesis, which was rescued by over-expression of either InR (insulin receptor) or IP₃R in NE cells of the mutant, suggesting that the two signaling pathways may be functionally compensatory. Furthermore, cultured IP₃R mutant NE cells, but not neurons, exhibited reduced protein translation. Thus cell-specific regulation of protein synthesis by IP₃R in NE cells influences protein metabolism. We propose that this regulation helps developing animals survive poor nutritional conditions.

http://ift.tt/2mlJBGf

BRC1 expression regulates bud activation potential, but is not necessary or sufficient for bud growth inhibition in Arabidopsis [RESEARCH ARTICLE]

Madeleine Seale, Tom Bennett, and Ottoline Leyser

The degree of shoot branching in Arabidopsis is determined by the activation of axillary buds. Bud activity is regulated by diverse environmental and developmental signals, often mediated via plant hormones including auxin, strigolactone and cytokinin. The transcription factor, BRANCHED1 (BRC1), has been proposed to integrate these regulatory signals. This idea is based on increased branching in brc1 mutants, the effects of bud-regulating hormones on BRC1 expression, and a general correlation between BRC1 expression and bud growth inhibition. These data demonstrate the important role of BRC1 in shoot branching, but here we show that in Arabidopsis this correlation can be broken. Buds lacking BRC1 expression can remain inhibited and sensitive to inhibition by strigolactone. Furthermore, buds with high BRC1 transcript levels can be active. Based on these data, we propose that BRC1 regulates bud activation potential in concert with an auxin-transport based mechanism underpinning bud activity. In the context of strigolactone-mediated bud regulation, our data suggest a coherent feed-forward loop in which strigolactone treatment reduces the probability of bud activation by parallel effects on BRC1 transcription and the shoot auxin transport network.

http://ift.tt/2mlEUfu

Inhibition of ectopic microtubule assembly by the kinesin-13 KLP-7MCAK prevents chromosome segregation and cytokinesis defects in oocytes [RESEARCH ARTICLE]

Emmanuelle Gigant, Marine Stefanutti, Kimberley Laband, Agata Gluszek-Kustusz, Frances Edwards, Benjamin Lacroix, Gilliane Maton, Julie C. Canman, Julie P.I. Welburn, and Julien Dumont

In most species, oocytes lack centrosomes. Accurate meiotic spindle assembly and chromosome segregation -essential to prevent miscarriage or developmental defects- thus occur through atypical mechanisms that are not well characterized. Using quantitative in vitro and in vivo functional assays in the C. elegans oocyte, we provide here novel evidence that the kinesin-13 KLP-7 promotes the destabilization of the whole cellular microtubule network. By counteracting ectopic microtubule assembly and disorganization of the microtubule network, this function is strictly required for spindle organization, chromosome segregation, and cytokinesis in meiotic cells. Strikingly, when centrosome activity was experimentally reduced, the absence of the kinesin-13 proteins KLP-7 or MCAK also resulted in ectopic microtubule asters during mitosis in C. elegans zygotes and HeLa cells, respectively. Our results highlight the general function of kinesin-13 microtubule depolymerases in preventing ectopic, spontaneous microtubule assembly, when centrosome activity is defective or absent, which otherwise leads to spindle microtubule disorganization and aneuploidy.

http://ift.tt/2mGdjbk

Helios expression coordinates the development of a subset of striatopallidal medium spiny neurons [RESEARCH ARTICLE]

Raquel Martin-Ibanez, Monica Pardo, Albert Giralt, Andres Miguez, Ines Guardia, Lucile Marion-Poll, Cristina Herranz, Miriam Esgleas, Gerardo Garcia-Diaz Barriga, Michael J. Edel, Carlos Vicario-Abejon, Jordi Alberch, Jean-Antoine Girault, Susan Chan, Philippe Kastner, and Josep M. Canals

Here we unravel the mechanism of action of Helios (He) during the development of striatal medium spiny neurons (MSNs). He regulates the second wave of striatal neurogenesis involved in the generation of striatopallidal neurons that express dopamine 2 receptor (D2R) and enkephalin (ENK). To exert this effect He is expressed in neural progenitor cells (NPCs) retaining them into the G₁/G₀ phase of the cell cycle. Thus, the lack of He produces an increase of S-phase entry and S-phase length of NPCs which in turn impairs striatal neurogenesis and produces an accumulation of the number of cycling NPCs in the germinal zone (GZ) that end up dying at postnatal stages. Therefore, He^–/- mice show a reduction in the number of Dorso-Medial Striatal MSNs in the adulthood that produces deficits in motor skills acquisition. In addition, overexpression of He in NPCs induce DARPP32 phenotype when transplanted in mouse striatum.

Present findings demonstrate that He is involved in the correct development of a subset of striatopallidal MSNs and reveal new cellular mechanisms for neuronal development.

http://ift.tt/2mlwXae

Helicobacter Pylori infection in Omani children

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Issue Information

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Analysis of Disease Activity Categories in Chronic Spontaneous/Idiopathic Urticaria

Abstract

Background

Measurement of disease activity guides treatment of chronic spontaneous urticaria (CSU). A weekly Urticaria Activity Score―here, the average of twice-daily patient assessment of itch and hives scores summed over 1 week (UAS7_TD)―measures severity from 0 to 42. Insufficient evidence exists whether disease activity states, defined by categorical UAS7_TD scores, correlate with other patient-reported outcomes and treatment response.

Objective

To evaluate and compare categorical UAS7_TD scores with selected measures of disease-related quality of life and impact.

Methods

Data from three randomised clinical trials of omalizumab in CSU were pooled. Continuous UAS7_TD scores were categorised into five disease activity states: urticaria-free, well-controlled, mild, moderate, and severe urticaria. Total scores from the Dermatology Life Quality Index (DLQI); the Chronic Urticaria Quality of Life questionnaire (CU-Q₂oL); and questions on sleep and daily activity interference, presence of angioedema, and diphenhydramine use were compared within categorised UAS7_TD disease-state scores, using one-way analyses of variance for analysis at different time points and mixed-effects regressions for analysis of all data pooled.

Results

Pooled analyses showed that categorical UAS7_TD disease states accurately predicted differences among treated CSU patients with different levels of disease activity. A consistent pattern existed between categories, with higher-activity disease states associated with significantly higher impact and an increase in angioedema frequency. Results at different treatment time points were consistent.

Conclusion

Categorical UAS7_TD disease states can discriminate between measures when considering the impact of urticaria activity. Using five categorical disease states could simplify clinical assessment and monitoring of treatment efficacy.

This article is protected by copyright. All rights reserved.

http://ift.tt/2n34cme

Analysis of Disease Activity Categories in Chronic Spontaneous/Idiopathic Urticaria

Abstract

Background

Measurement of disease activity guides treatment of chronic spontaneous urticaria (CSU). A weekly Urticaria Activity Score―here, the average of twice-daily patient assessment of itch and hives scores summed over 1 week (UAS7_TD)―measures severity from 0 to 42. Insufficient evidence exists whether disease activity states, defined by categorical UAS7_TD scores, correlate with other patient-reported outcomes and treatment response.

Objective

To evaluate and compare categorical UAS7_TD scores with selected measures of disease-related quality of life and impact.

Methods

Data from three randomised clinical trials of omalizumab in CSU were pooled. Continuous UAS7_TD scores were categorised into five disease activity states: urticaria-free, well-controlled, mild, moderate, and severe urticaria. Total scores from the Dermatology Life Quality Index (DLQI); the Chronic Urticaria Quality of Life questionnaire (CU-Q₂oL); and questions on sleep and daily activity interference, presence of angioedema, and diphenhydramine use were compared within categorised UAS7_TD disease-state scores, using one-way analyses of variance for analysis at different time points and mixed-effects regressions for analysis of all data pooled.

Results

Pooled analyses showed that categorical UAS7_TD disease states accurately predicted differences among treated CSU patients with different levels of disease activity. A consistent pattern existed between categories, with higher-activity disease states associated with significantly higher impact and an increase in angioedema frequency. Results at different treatment time points were consistent.

Conclusion

Categorical UAS7_TD disease states can discriminate between measures when considering the impact of urticaria activity. Using five categorical disease states could simplify clinical assessment and monitoring of treatment efficacy.

This article is protected by copyright. All rights reserved.

http://ift.tt/2n34cme

Search strategies for finding systematic reviews

Abstract

I have read with interest the 2017 article by F Gómez-García and colleagues called "Systematic reviews and meta-analyses on psoriasis: role of funding sources, conflict of interest, and bibliometric indices as predictors of methodological quality" published in the BJD.

This study makes a very important point about the influence of funding sources and conflicts of interests on the methodological quality of systematic reviews.

However, I have some concerns about the search strategy used to find systematic reviews for this analysis.

This article is protected by copyright. All rights reserved.

http://ift.tt/2nylHYf

Search strategies for finding systematic reviews

Abstract

I have read with interest the 2017 article by F Gómez-García and colleagues called "Systematic reviews and meta-analyses on psoriasis: role of funding sources, conflict of interest, and bibliometric indices as predictors of methodological quality" published in the BJD.

This study makes a very important point about the influence of funding sources and conflicts of interests on the methodological quality of systematic reviews.

However, I have some concerns about the search strategy used to find systematic reviews for this analysis.

This article is protected by copyright. All rights reserved.

http://ift.tt/2nylHYf

Voice re-assignment in trans people

http://ift.tt/2nyczCO

Analysis of voice-related quality of life in children

RESUMO Objetivo analisar o impacto na qualidade de vida relacionado à voz de crianças disfônicas e sem alteração vocal, com uma amostra populacional da grande Belo Horizonte – Minas Gerais. Método participaram do estudo 420 indivíduos na faixa etária de seis a 10 anos de idade, cursando o ensino fundamental nas escolas públicas e privadas da cidade. A amostragem foi aleatória, e as crianças, divididas em dois grupos: disfônicas (GD) e sem alteração vocal (G0). A avaliação das vozes das crianças foi realizada por quatro fonoaudiólogas especialistas em voz e com experiência de mais de 10 anos nesta análise, utilizando o parâmetro perceptivo-auditivo de grau geral de disfonia, graduado em quatro pontos. Foi considerada, para a análise dos resultados, a avaliação das vozes das crianças realizada pela fonoaudióloga que apresentou maior concordância intra-avaliador, analisada pela estatística Kappa. O protocolo Qualidade de Vida em Voz Pediátrico (QVV-P) foi respondido pelos responsáveis das crianças. Para análise inferencial, foi realizada a análise descritiva dos dados e utilizado o Teste-T de Student. Resultados das crianças avaliadas, 98 eram disfônicas (GD) e 322 não tinham alteração vocal (G0). A análise dos três Escores do QVV-P não apresentou diferença para os grupos testados (GD e G0). Também não foi observada diferença nos valores do QVV-P, considerando-se o grau de desvio vocal. Conclusão crianças disfônicas não apresentam impacto negativo na qualidade de vida relacionada à voz, considerando-se a resposta do informante secundário.

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ABSTRACT Purpose To analyze the voice-related quality of life of children with dysphonia and without voice disorders in a population sample of Belo Horizonte, Minas Gerais state, Brazil. Methods Study participants were 420 children, 98 with dysphonia and 322 without voice disorders, aged six to 10 years, enrolled in public and private elementary schools. The random sample was divided into two groups: dysphonic children (study group - SG) and children without vocal disorders (control group - CG). Assessment of the children's voices was performed by four voice-expert speech-language pathologists with more than 10 years of experience in this field, using the auditory-perceptual parameter of overall severity of dysphonia graded in four points. The results were analyzed based on the evaluation of children's voices conducted by the speech-language pathologist that presented the highest intra-rater agreement, using the Kappa statistical method. The Pediatric Voice-related Quality-of-Life (PVRQoL) survey was answered by the children's parents/legal guardians. Descriptive statistical analysis of the data was conducted using the Student's t-Test. Results Of the 420 children evaluated, 98 were dysphonic (SG) and 322 presented no voice alteration (CG). Analysis of the three PVRQoL scores (total, physical, and social-emotional) showed no difference between the groups tested (SG and CG). No difference was observed in PVRQoL values regarding the degree of vocal deviation. Conclusion Dysphonia does not have a negative impact on the voice-related quality of life of children considering the response of secondary informants.

http://ift.tt/2nhFy1G

Cross-cultural adaptation of the Brazilian version of the Vocal Fatigue Index – VFI

RESUMO O objetivo deste estudo foi desenvolver a equivalência cultural da versão brasileira do protocolo Vocal Fatigue Index – VFI. Dois fonoaudiólogos brasileiros bilíngues traduziram a versão original do VFI do inglês para o português. As traduções foram revisadas pelos pesquisadores e por um comitê de cinco fonoaudiólogos especialistas em voz, chegando-se a uma versão final do instrumento. Um terceiro fonoaudiólogo bilíngue retrotraduziu essa versão final e o mesmo comitê reviu as diferenças em relação à versão original. A versão final em português do protocolo VFI, assim como o original em inglês, é respondida de acordo com a frequência de ocorrência em que se experienciam os sintomas: 0 = nunca, 1 = quase nunca, 2 = às vezes, 3 = quase sempre e 4 = sempre. Para a equivalência cultural da versão em português, a opção "não aplicável" foi acrescida na chave de respostas e 20 indivíduos com queixa vocal e disfonia completaram o instrumento. Se alguma questão fosse considerada "não aplicável", seria eliminada da versão brasileira do protocolo; nenhuma questão foi eliminada do instrumento. A versão em português brasileiro foi intitulada Índice de Fadiga Vocal – IFV e apresenta 19 questões, da mesma forma que o instrumento original. Dos 19 itens, 11 referem-se à fadiga e restrição vocal, 5, ao desconforto físico associado à voz e 3 à recuperação dos sintomas com o repouso. A versão para o português brasileiro do VFI apresenta equivalência cultural e linguística em relação ao instrumento original. A validação do IFV para o português brasileiro está em andamento.

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ABSTRACT The purpose of this study was to perform the cultural adaptation of the Brazilian version of the Vocal Fatigue Index (VFI). Two Brazilian bilingual speech-language pathologists (SLP) translated the original version of the VFI in English into Portuguese. The translations were reviewed by a committee of five voice specialist SLPs resulting in the final version of the instrument. A third bilingual SLP back-translated this final version and the same committee reviewed the differences from its original version. The final Portuguese version of the VFI, as in the original English version, was answered on a categorical scale of 0-4 indicating the frequency they experience the symptoms: 0=never, 1=almost never, 2=sometimes, 3=almost always, and 4=always. For cultural equivalence of the Portuguese version, the option "not applicable" was added to the categorical scale and 20 individuals with vocal complaints and dysphonia completed the index. Questions considered "not applicable" would be disregarded from the Brazilian version of the protocol; no question had to be removed from the instrument. The Brazilian Portuguese version was entitled "Índice de Fadiga Vocal – IFV" and features 19 questions, equivalent to the original instrument. Of the 19 items, 11 were related with tiredness of voice and voice avoidance, five concerned physical discomfort associated with voicing, and three were related to improvement of symptoms with rest or lack thereof. The Brazilian version of the VFI presents cultural and linguistic equivalence to the original instrument. The IFV validation into Brazilian Portuguese is in progress.

http://ift.tt/2nyfJXp

The C- terminal region of the Major Outer Sheath Protein (Msp) of Treponema denticola inhibits neutrophil chemotaxis

Summary

Treponema denticola is an oral spirochete strongly associated with severe periodontal disease. A prominent virulence factor, the major outer sheath protein (Msp), disorients neutrophil chemotaxis by altering the cellular phosphoinositide balance, leading to impairment of downstream chemotactic events including actin rearrangement, Rac1 activation and Akt activation in response to chemoattractant stimulation. The specific regions of Msp responsible for interactions with neutrophils remain unknown. In this study, we investigated the inhibitory effect of truncated Msp regions on neutrophil chemotaxis and associated signaling pathways. Murine neutrophils were treated with recombinant protein truncations followed by assessment of chemotaxis and associated signal pathway activation. Chemotaxis assays indicate sequences within the C-terminal region; particularly the first 130 amino acids, have the strongest inhibitory effect on neutrophil chemotaxis. Neutrophils incubated with the C-terminal region protein also demonstrated the greatest inhibition of Rac1 activation, increased phosphoinositide phosphatase activity, and decreased Akt activation; orchestrating impairment of chemotaxis. Furthermore, incubation with antibodies specific to only the C-terminal region blocked the Msp induced inhibition of chemotaxis and denaturing the protein restored Rac1 activation. Msp from the strain OTK, with numerous amino acid substitutions throughout the polypeptide, including the C-terminal region compared to strain 35405, showed increased ability to impair neutrophil chemotaxis. Collectively, these results indicate the C-terminal region of Msp is the most potent region to modulate neutrophil chemotactic signaling and that specific sequences and structure is likely required. Knowledge of how spirochetes dampen neutrophil response is limited and Msp may represent a novel therapeutic target for periodontal disease.

This article is protected by copyright. All rights reserved.

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(A) Hematoxylin-eosin (×400). Lung parenchyma with metastasis from the primary parathyroid carcinoma. (B) Immunohistochemical analysis of PTH expression (×400). Diffuse intensive expression of PTH by the lung metastasis from the primary parathyroid carcinoma.

Figure 2: (A) Hematoxylin-eosin (×400). Lung parenchyma with metastasis from the primary parathyroid carcinoma. (B) Immunohistochemical analysis of PTH expression (×400). Diffuse intensive expression of PTH by the lung metastasis from the primary parathyroid carcinoma.

http://ift.tt/2mGbF9W

(A) Hematoxylin-eosin (×400). Lung parenchyma with metastasis from the primary parathyroid carcinoma. (B) Immunohistochemical analysis of PTH expression (×400). Diffuse intensive expression of PTH by the lung metastasis from the primary parathyroid carcinoma.

Figure 2: (A) Hematoxylin-eosin (×400). Lung parenchyma with metastasis from the primary parathyroid carcinoma. (B) Immunohistochemical analysis of PTH expression (×400). Diffuse intensive expression of PTH by the lung metastasis from the primary parathyroid carcinoma.

http://ift.tt/2mGbF9W

Changes in university orthodontic care over a period of 20 years

Abstract

Aim

The aim of the present study was to analyze whether there were changes in the severity of malocclusions of patients treated at the Department of Orthodontics, University of Giessen, Germany over a period of 20 years (1992–2012) and if the implementation of the KIG system (German index of treatment need) in 2001 had any effect on the patient cohort. Furthermore, the study aimed to analyze the influence of the severity of malocclusion on treatment quality and economic efficiency (relation payment per case/treatment effort).

Materials and methods

The files of all 5385 patients admitted to the orthodontic department between 1992 and 2012 were screened and the following information was recorded: patient characteristics, treatment duration, KIG, treatment outcome, and costs.

Results

In the KIG period, patients were older, pretreatment malocclusions were more severe, treatment took longer, required more appointments, and did not achieve the same degree of perfection as in the pre-KIG period. Patients with a higher pretreatment KIG category had longer treatments and did not achieve the same degree of perfection as patients with lower KIG categories. Although total payment was slightly higher for the more severe cases, their cost-per-appointment ratio was significantly lower.

Conclusion

In the present university department, a shift of the orthodontic care task towards more complex cases has occurred over the last 20 years. Generally the quality of orthodontic treatment was good, but it has been demonstrated that the higher KIG cases did not end up at the same level of excellence as the lower KIG cases. Furthermore, KIG 5 patients had a longer treatment duration, and required more appointments than lower KIG cases.

http://ift.tt/2mFOlJm

Thermal imaging of the pulp during residual adhesive removal

Abstract

Objective

The aim of this study was to evaluate the temperature changes of the pulpal area during different adhesive clean-up procedures.

Materials and methods

A total of 80 freshly extracted adult maxillary premolar teeth were divided into four groups. Adhesive clean-up was performed with 6- and 12-fluted tungsten carbide burs (TCB) using low- and high-speed handpieces with air or water cooling after bracket debonding. The temperature changes and cool down times were evaluated with a thermal camera. Paired t test, analysis of variance (ANOVA), and Student–Newman–Keuls multiple comparison analysis were used for statistical analysis of the data.

Results

All experimental groups, except the water cooling group, showed a significant temperature rise (p < 0.001) after residual adhesive removal. Only the 6-fluted TCB group with air cooling using a high-speed handpiece exceeded the critical 5.5 °C threshold value (5.91 ± 0.89 °C); this group also exhibited the longest cool down time to initial temperature (71.95 ± 13.68 s). The smallest temperature rise (0.48 ± 0.90 °C) and shortest cooling time value (11.90 ± 5.3 s) were measured in the 6-fluted TCB group with water cooling using a high-speed handpiece.

Conclusion

Appropriate cooling procedures and fine tungsten carbide burs should be used during the removal of remnant adhesives after bracket debonding in order to prevent adverse pulpal reactions.

http://ift.tt/2ml7HRr

Three-dimensional analysis of mandibular condyle position in patients with deviated mandibular prognathism

The purpose of this study was to evaluate the bilateral difference in condyle position in patients with deviated mandibular prognathism. Patients with asymmetrical (n=28) and symmetrical mandibular prognathism (n=23) were compared using the three-dimensional (3D) reformatted image from cone beam computed tomography. Significant positional differences in the condyle and subcondyle region (sigmoid notch) were found between the deviated and contralateral sides in the group with asymmetrical mandibular prognathism, but not in the control group.

http://ift.tt/2lUVoPE

The accuracy of computer-guided piezocision: a prospective clinical pilot study

Computer-guided piezocision can be used to overcome the disadvantages of corticotomy in accelerating orthodontic tooth movement. The aim of this clinical pilot study was to determine the accuracy of this technique. STROBE guidelines were followed. Ten patients were selected and treated. Using new dedicated planning software, the piezocision cuts were properly positioned in virtual models. A surgical guide was designed and printed with slots to guide the scalpel blade first and then the piezoelectric micro-saw.

http://ift.tt/2nnrqRb

From the midnight sun to the longest night: sleep in Antarctica

Sleep disturbances are the main health complaints from personnel deployed in Antarctica. The current paper presents a systematic review of research findings on sleep disturbances in Antarctica. The available sources were divided in three categories: results based on questionnaire surveys or sleep logs, studies using actigraphy, and data from polysomnography results. Other areas relevant to the issue were also examined. These included chronobiology, since the changes in photoperiod have been known to affect circadian rhythms; mood disturbances; exercise, sleep and hypoxia; countermeasure investigations in Antarctica; and other locations lacking a normal photoperiod.

http://ift.tt/2nnnNuE

Branchial Arch Anomalies: Recurrence, Malignant Degeneration and Operative Complications

Branchial arch anomalies (BAA) represent one of the commonest pediatric neck masses, but large case series are lacking with none specifically examining risk of recurrence, surgical complications, and malignancy.

http://ift.tt/2nnjaRc

Reliability and validity of the Turkish CHILDREN’S voice handicap INDEX-10 (TR-CVHI-10)

During voice production, there can be some problems which are not in correspondence with age and gender and/or there can be some changes in voice quality, pitch, loudness, resonance and duration limiting individuals' communication. Thus, all these result in dysphonia [1]. As dysphonia affects speech intelligibility, %6 of people having dysphonia have also communication problems no matter how old they are and what their gender is [2]. Therefore, treatment of pediatric dysphonia plays a key role in preventing the problems that can occur in puberty and adulthood [3].

http://ift.tt/2mU7szV

A Systematic Review of Complications Associated with Direct Implants Vs. Tissue Expanders Following Wise Pattern Skin Sparing Mastectomy

With proven oncological safety and improved aesthetic outcomes, the Type IV or "Wise Pattern" skin sparing mastectomy (SSM) is a procedure that is being performed with increasing frequency. Unfortunately, it is also associated with an increased risk of complication. The purpose of this investigation is to determine the complications associated with direct-to-implant and two-step tissue-expander breast reconstruction following Wise Pattern SSM.

http://ift.tt/2mDx2qH

Radial/Circumferential Surgical Margin in Laryngectomy Specimens

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Radial/Circumferential Surgical Margin in Laryngectomy Specimens

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Sleep-wake stability in narcolepsy patients with normal, low and unmeasurable hypocretin levels

To compare diurnal and nocturnal electrophysiological data from narcolepsy patients with undetectable (<20 pg/mL), low (20-110 pg/mL) and normal (>110 pg/mL) cerebrospinal fluid (CSF) hypocretin-1 levels.

http://ift.tt/2mUma9X

The New WASM rules for Respiratory-Related Leg Movements lack clinical or polysomnographic validation

The new World Association of Sleep Medicine (WASM) rules allow movements that start up to 10.25 seconds after a sleep disordered breathing event to be counted as respiratory-related leg movements (1). There are two problems with this approach: (A) First, it is not clear that these movements are leg movements rather than generalized body movements, during which the legs have become activated as part of generalized body movement. A video validation that these are truly leg movements ought to be considered; (B) Second it makes no sense that there would be respiratory-related leg movements that occur up to 10.25 seconds after a respiratory event without some intervening hyperventilation or EEG arousal.

http://ift.tt/2nnpM2g

Thomas Earl Starzl, MD, PhD Transplant Pioneer, Polymath, Mentor March 11th, 1926-March 4th, 2017.

No abstract available

http://ift.tt/2mU70S9

Locoregional Therapy with Curative Intent versus Primary Liver Transplant for Hepatocellular Carcinoma: Systematic Review and Meta-analysis.

Background: Loco-regional therapy with curative intent (CLRT) followed by salvage liver transplant (SLT) in case of HCC recurrence is an alternative to primary liver transplant (LT) in selected patients with HCC. Methods: We performed a systematic review and meta-analysis of studies comparing the survival of patients treated with CLRT versus LT, stratified by the stage of liver disease, extent of cancer, and whether SLT was offered or not. Results: We included 48 studies involving 9835 patients (5736 patients with CLRT and 4119 patients with primary LT). Five-year overall survival (OS) and disease-free survival (DFS) was worse for all categories of CLRT combined, than for primary LT (odds ratio (OR) for OS: 0.59 (0.48-0.71), p

http://ift.tt/2n312io

The Times, They are a-Changing: HOPE for HIV-to-HIV Organ Transplantation.

HIV-infected persons who achieve undetectable viral loads on antiretroviral therapy currently have near-normal lifespans. Liver disease is a major cause of non-AIDS-related deaths, and as a result of longer survival, the prevalence of end-stage renal disease in HIV is increasing. HIV-infected persons undergoing organ transplantation generally achieve comparable patient and graft survival rates compared to their HIV-uninfected counterparts, despite a nearly threefold increased risk of acute rejection. However, the ongoing shortage of suitable organs can limit transplantation as an option, and patients with HIV have higher waitlist mortality than others. One way to solve this problem would be to expand the donor pool to include HIV-infected individuals. The results of a South Africa study involving 27 HIV-to-HIV kidney transplants showed promise, with 3 and 5-year patient and graft survival rates similar to those of those of their HIV-uninfected counterparts. Similarly, individual cases of HIV-to-HIV liver transplantation from the United Kingdom and Switzerland have also shown good results. In the United States, HIV-to-HIV kidney and liver transplants are currently permitted only under a research protocol. Nevertheless, areas of ambiguity exist, including streamlining organ allocation practices, optimizing HIV-infected donor and recipient selection, managing donor-derived transmission of a resistant HIV strain, determining optimal immunosuppressive and antiretroviral regimens, and elucidating the incidence of rejection in HIV-to-HIV solid organ transplant recipients. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2nxVid6

Motor Speech Phenotypes of Frontotemporal Dementia, Primary Progressive Aphasia, and Progressive Apraxia of Speech

Purpose

Our purpose was to create a comprehensive review of speech impairment in frontotemporal dementia (FTD), primary progressive aphasia (PPA), and progressive apraxia of speech in order to identify the most effective measures for diagnosis and monitoring, and to elucidate associations between speech and neuroimaging.

Method

Speech and neuroimaging data described in studies of FTD and PPA were systematically reviewed. A meta-analysis was conducted for speech measures that were used consistently in multiple studies.

Results

The methods and nomenclature used to describe speech in these disorders varied between studies. Our meta-analysis identified 3 speech measures which differentiate variants or healthy control-group participants (e.g., nonfluent and logopenic variants of PPA from all other groups, behavioral-variant FTD from a control group). Deficits within the frontal-lobe speech networks are linked to motor speech profiles of the nonfluent variant of PPA and progressive apraxia of speech. Motor speech impairment is rarely reported in semantic and logopenic variants of PPA. Limited data are available on motor speech impairment in the behavioral variant of FTD.

Conclusions

Our review identified several measures of speech which may assist with diagnosis and classification, and consolidated the brain–behavior associations relating to speech in FTD, PPA, and progressive apraxia of speech.

http://ift.tt/2ny2EgE

The Effects of Parent-Focused Slow Relaxed Speech Intervention on Articulation Rate, Response Time Latency, and Fluency in Preschool Children Who Stutter

Purpose

This study investigated the effects of an intervention to reduce caregivers' articulation rates with children who stutter on (a) disfluency, (b) caregiver and child's articulation rates, and (c) caregiver and child's response time latency (RTL).

Method

Seventeen caregivers and their preschool children who stuttered participated in a group study of treatment outcomes. One speech sample was collected as a baseline, and 2 samples were collected after treatment. Posttreatment samples were of caregivers speaking as they typically would and using reduced articulation rates.

Results

Caregivers reduced articulation rates significantly in the 2 posttreatment samples, and a significant decrease of stuttering-like disfluencies (SLD) was found in the children in those 2 samples. No direct relationship was found between the caregiver's articulation rate and RTL, and there was a small correlation of RTL with the lower levels of SLD found postintervention. No significant relationships were found between the reduced levels of SLD and articulation rates for either caregivers or children.

Conclusions

Results suggest caregivers can be trained to slow their speech, and children increased their fluency at the end of a program designed to slow caregiver articulation. The intentionally slower rate of the caregivers, however, was not significantly related to fluency.

http://ift.tt/2n2Qsbc

Delayed Early Vocabulary Development in Children at Family Risk of Dyslexia

Purpose

This study aimed to gain more insight into the relation between vocabulary and reading acquisition by examining early growth trajectories in the vocabulary of children at family risk (FR) of dyslexia longitudinally.

Method

The sample included 212 children from the Dutch Dyslexia Program with and without an FR. Parents reported on their children's receptive and expressive vocabulary size at ages 17, 23, 29, and 35 months using the Dutch MacArthur Communicative Development Inventories. Dyslexia status at the end of Grade 2 (8 years) rendered 3 groups: FR-dyslexic (n = 51), FR-nondyslexic (n = 92), and typically developing–nondyslexic (TD) children (n = 69).

Results

Repeated measures analyses showed that FR-dyslexic children had lower receptive vocabulary scores from 23 months onward and lower expressive scores from 17 months onward than FR-nondyslexic children. Latent growth curve modeling showed lower initial growth rates in FR-dyslexic children, followed by partial recovery, indicating a delayed increase in receptive and expressive vocabulary. FR-nondyslexic and TD children did not differ.

Conclusions

Early deficits in receptive and expressive vocabulary are associated with later reading. Early vocabulary growth of FR-dyslexic children is characterized by a delay but not deviance of growth. Vocabulary can be considered an additional risk factor for dyslexia.

http://ift.tt/2nxP8tA

Spurious Hypoxemia During Craniotomy.

No abstract available

http://ift.tt/2nxIjIf

Changes in university orthodontic care over a period of 20 years

Abstract

Aim

The aim of the present study was to analyze whether there were changes in the severity of malocclusions of patients treated at the Department of Orthodontics, University of Giessen, Germany over a period of 20 years (1992–2012) and if the implementation of the KIG system (German index of treatment need) in 2001 had any effect on the patient cohort. Furthermore, the study aimed to analyze the influence of the severity of malocclusion on treatment quality and economic efficiency (relation payment per case/treatment effort).

Materials and methods

The files of all 5385 patients admitted to the orthodontic department between 1992 and 2012 were screened and the following information was recorded: patient characteristics, treatment duration, KIG, treatment outcome, and costs.

Results

In the KIG period, patients were older, pretreatment malocclusions were more severe, treatment took longer, required more appointments, and did not achieve the same degree of perfection as in the pre-KIG period. Patients with a higher pretreatment KIG category had longer treatments and did not achieve the same degree of perfection as patients with lower KIG categories. Although total payment was slightly higher for the more severe cases, their cost-per-appointment ratio was significantly lower.

Conclusion

In the present university department, a shift of the orthodontic care task towards more complex cases has occurred over the last 20 years. Generally the quality of orthodontic treatment was good, but it has been demonstrated that the higher KIG cases did not end up at the same level of excellence as the lower KIG cases. Furthermore, KIG 5 patients had a longer treatment duration, and required more appointments than lower KIG cases.

http://ift.tt/2mFOlJm

Thermal imaging of the pulp during residual adhesive removal

Abstract

Objective

The aim of this study was to evaluate the temperature changes of the pulpal area during different adhesive clean-up procedures.

Materials and methods

A total of 80 freshly extracted adult maxillary premolar teeth were divided into four groups. Adhesive clean-up was performed with 6- and 12-fluted tungsten carbide burs (TCB) using low- and high-speed handpieces with air or water cooling after bracket debonding. The temperature changes and cool down times were evaluated with a thermal camera. Paired t test, analysis of variance (ANOVA), and Student–Newman–Keuls multiple comparison analysis were used for statistical analysis of the data.

Results

All experimental groups, except the water cooling group, showed a significant temperature rise (p < 0.001) after residual adhesive removal. Only the 6-fluted TCB group with air cooling using a high-speed handpiece exceeded the critical 5.5 °C threshold value (5.91 ± 0.89 °C); this group also exhibited the longest cool down time to initial temperature (71.95 ± 13.68 s). The smallest temperature rise (0.48 ± 0.90 °C) and shortest cooling time value (11.90 ± 5.3 s) were measured in the 6-fluted TCB group with water cooling using a high-speed handpiece.

Conclusion

Appropriate cooling procedures and fine tungsten carbide burs should be used during the removal of remnant adhesives after bracket debonding in order to prevent adverse pulpal reactions.

http://ift.tt/2ml7HRr

A Review of Electronic Devices to Assess Inhaler Technique

Abstract

Purpose of Review

Multiple electronic devices exist that provide feedback on the accuracy of patient inhaler technique. Our purpose is to describe the inhaler technique feedback provided by these devices, including specific technique steps measured, how feedback is displayed, target of feedback (patient, provider, researcher), and compatibility with inhaler type (metered-dose inhaler [MDI], diskus, etc.).

Recent Findings

We identified eight devices that provide feedback on inhaler technique. Only one device assessed all evidence-based MDI technique steps. Most devices provide limited real-time feedback to patients, if any feedback at all.

Summary

Technologies to assess inhaler technique are advancing and hold great potential for improving patient inhaler technique. Many devices are limited in their ability to detect all evidence-based technique steps and provide real-time user-friendly feedback to patients and providers. Usability tests with patients and providers could identify ways to improve these devices to improve their utility in clinical settings.

http://ift.tt/2nxrptx

SLHS well-represented at SDSU Student Research Symposium!

Our SLHS students did a wonderful job at their poster and oral presentations at the SDSU Student Research Symposium this year!

See the photos!

[See image gallery at slhs.sdsu.edu]

 

 

 

 

http://ift.tt/2ngY0HU

SLHS students present their work at the American Auditory Society Conference!

Congratulations to our students who presented their work with the Recreational Noise Exposure and Hearing Lab at the annual conference of the American Auditory Society last weekend!

See the photos!

[See image gallery at slhs.sdsu.edu]

 

 

http://ift.tt/2mkVqeP

Lipreading Ability and Its Cognitive Correlates in Typically Developing Children and Children With Specific Language Impairment

Purpose

Lipreading and its cognitive correlates were studied in school-age children with typical language development and delayed language development due to specific language impairment (SLI).

Method

Forty-two children with typical language development and 20 children with SLI were tested by using a word-level lipreading test and an extensive battery of standardized cognitive and linguistic tests.

Results

Children with SLI were poorer lipreaders than their typically developing peers. Good phonological skills were associated with skilled lipreading in both typically developing children and in children with SLI. Lipreading was also found to correlate with several cognitive skills, for example, short-term memory capacity and verbal motor skills.

Conclusions

Speech processing deficits in SLI extend also to the perception of visual speech. Lipreading performance was associated with phonological skills. Poor lipreading in children with SLI may be, thus, related to problems in phonological processing.

http://ift.tt/2mgeIqq

Nonword Repetition and Vocabulary Knowledge as Predictors of Children's Phonological and Semantic Word Learning

Purpose

This study examined the unique and shared variance that nonword repetition and vocabulary knowledge contribute to children's ability to learn new words. Multiple measures of word learning were used to assess recall and recognition of phonological and semantic information.

Method

Fifty children, with a mean age of 8 years (range 5–12 years), completed experimental assessments of word learning and norm-referenced assessments of receptive and expressive vocabulary knowledge and nonword repetition skills. Hierarchical multiple regression analyses examined the variance in word learning that was explained by vocabulary knowledge and nonword repetition after controlling for chronological age.

Results

Together with chronological age, nonword repetition and vocabulary knowledge explained up to 44% of the variance in children's word learning. Nonword repetition was the stronger predictor of phonological recall, phonological recognition, and semantic recognition, whereas vocabulary knowledge was the stronger predictor of verbal semantic recall.

Conclusions

These findings extend the results of past studies indicating that both nonword repetition skill and existing vocabulary knowledge are important for new word learning, but the relative influence of each predictor depends on the way word learning is measured. Suggestions for further research involving typically developing children and children with language or reading impairments are discussed.

http://ift.tt/2mgi3FG

Speaking Tongues Are Actively Braced

Purpose

Bracing of the tongue against opposing vocal-tract surfaces such as the teeth or palate has long been discussed in the context of biomechanical, somatosensory, and aeroacoustic aspects of tongue movement. However, previous studies have tended to describe bracing only in terms of contact (rather than mechanical support), and only in limited phonetic contexts, supporting a widespread view of bracing as an occasional state, peculiar to specific sounds or sound combinations.

Method

The present study tests the pervasiveness and effortfulness of tongue bracing in continuous English speech passages using electropalatography and 3-D biomechanical simulations.

Results

The tongue remains in continuous contact with the upper molars during speech, with only rare exceptions. Use of the term bracing (rather than merely contact) is supported here by biomechanical simulations showing that lateral bracing is an active posture requiring dedicated muscle activation; further, loss of lateral contact for onset /l/ allophones is found to be consistently accompanied by contact of the tongue blade against the anterior palate. In the rare instances where direct evidence for contact is lacking (only in a minority of low vowel and postvocalic /l/ tokens), additional biomechanical simulations show that lateral contact is maintained against pharyngeal structures dorsal to the teeth.

Conclusion

Taken together, these results indicate that tongue bracing is both pervasive and active in running speech and essential in understanding tongue movement control.

http://ift.tt/2leNY8K

A Cross-Language Study of Laryngeal-Oral Coordination Across Varying Prosodic and Syllable-Structure Conditions

Purpose

The purpose of this study is to use prosodic and syllable-structure variation to probe the underlying representation of laryngeal kinematics in languages traditionally considered to differ in voicing typology (German vs. Dutch and French).

Method

Transillumination and videofiberendoscopic filming were used to investigate the devoicing gesture in German, Dutch, and French for material that compared, first, a strong versus weak prosodic condition and, second, singletons versus clusters (stop + /r/ and /l/).

Results

The results showed strengthening of the devoicing gesture in the strong prosodic condition and in the segmental context stop + /r/ for German and French but not for Dutch. In terms of timing (duration of oral occlusion, voice onset time, timing of peak glottal opening relative to stop release), French was intermediate between German and Dutch.

Conclusions

(a) The representation of French voiceless plosives requires an active specification for glottal spreading just as in German. (b) Static features are not well suited to capturing cross-language differences in voicing typology and changes in voicing specification over time.

http://ift.tt/2lVXCdg

The Impact of Clinical History on the Threshold Estimation of Auditory Brainstem Response Results for Infants

Purpose

This study assesses the impact of patient clinical history on audiologists' performance when interpreting auditory brainstem response (ABR) results.

Method

Fourteen audiologists' accuracy in estimating hearing threshold for 16 infants through interpretation of ABR traces was compared on 2 occasions at least 5 months apart. On the 1st occasion, ABR traces were presented to the audiologists with no clinical information except for the age of the child. On the 2nd occasion, audiologists were given a full clinical history for the ABR cases.

Results

The addition of clinical history information had no statistically significant impact on sensitivity, specificity, or accuracy of diagnosis. Although the mean numbers of true-negative and true-positive diagnoses were higher when audiologists were given clinical information, the difference was again not statistically significant.

Conclusion

This study suggests that if there are circumstances in which case material is incomplete or unavailable, audiologists have no cause for concern regarding the accuracy of their interpretation of ABR traces. In a clinical manner, this may help audiologists with large caseloads or audiologists who need to provide a diagnosis of hearing loss in a short time by allowing them to focus on conducting ABR without the need for case history information.

http://ift.tt/2l8JGQR

Laryngeal Aerodynamics in Healthy Older Adults and Adults With Parkinson's Disease

Purpose

The present study compared laryngeal aerodynamic function of healthy older adults (HOA) to adults with Parkinson's disease (PD) while speaking at a comfortable and increased vocal intensity.

Method

Laryngeal aerodynamic measures (subglottal pressure, peak-to-peak flow, minimum flow, and open quotient [OQ]) were compared between HOAs and individuals with PD who had a diagnosis of hypophonia. Increased vocal intensity was elicited via monaurally presented multitalker background noise.

Results

At a comfortable speaking intensity, HOAs and individuals with PD produced comparable vocal intensity, rates of vocal fold closure, and minimum flow. HOAs used smaller OQs, higher subglottal pressure, and lower peak-to-peak flow than individuals with PD. Both groups increased speaking intensity when speaking in noise to the same degree. However, HOAs produced increased intensity with greater driving pressure, faster vocal fold closure rates, and smaller OQs than individuals with PD.

Conclusions

Monaural background noise elicited equivalent vocal intensity increases in HOAs and individuals with PD. Although both groups used laryngeal mechanisms as expected to increase sound pressure level, they used these mechanisms to different degrees. The HOAs appeared to have better control of the laryngeal mechanism to make changes to their vocal intensity.

http://ift.tt/2mu6iHH

Sensitivity to Morphosyntactic Information in 3-Year-Old Children With Typical Language Development: A Feasibility Study

Purpose

This study tested the feasibility of a method designed to assess children's sensitivity to tense/agreement information in fronted auxiliaries during online comprehension of questions (e.g., Are the nice little dogs running?). We expected that a group of children who were proficient in auxiliary use would show this sensitivity, indicating an awareness of the relation between the subject–verb sequence (e.g., dogs running) and preceding information (e.g., are). Failure to grasp this relation is proposed to play a role in the protracted inconsistency in auxiliary use in children with specific language impairment (SLI).

Method

Fifteen 3-year-old typically developing children who demonstrated proficiency in auxiliary use viewed pairs of pictures showing a single agent and multiple agents while hearing questions with or without an agreeing fronted auxiliary. Proportion looking to the target was measured.

Results

Children showed anticipatory looking on the basis of the number information contained in the auxiliary (is or are).

Conclusions

The children tested in this study represent a group that frequently serves as a comparison for older children with SLI. Because the method successfully demonstrated their sensitivity to tense/agreement information in questions, future research that involves direct comparisons of these 2 groups is warranted.

http://ift.tt/2mkBEAh

Literacy Outcomes for Primary School Children Who Are Deaf and Hard of Hearing: A Cohort Comparison Study

Purpose

In this study, we compared the language and literacy of two cohorts of children with severe–profound hearing loss, recruited 10 years apart, to determine if outcomes had improved in line with the introduction of newborn hearing screening and access to improved hearing aid technology.

Method

Forty-two children with deafness, aged 5–7 years with a mean unaided loss of 102 DB, were assessed on language, reading, and phonological skills. Their performance was compared with that of a similar group of 32 children with deafness assessed 10 years earlier and also a group of 40 children with normal hearing of similar single word reading ability.

Results

English vocabulary was significantly higher in the new cohort although it was still below chronological age. Phonological awareness and reading ability had not significantly changed over time. In both cohorts, English vocabulary predicted reading, but phonological awareness was only a significant predictor for the new cohort.

Conclusions

The current results show that vocabulary knowledge of children with severe–profound hearing loss has improved over time, but there has not been a commensurate improvement in phonological skills or reading. They suggest that children with severe–profound hearing loss will require continued support to develop robust phonological coding skills to underpin reading.

http://ift.tt/2mgcR4G

The Quantal Larynx: The Stable Regions of Laryngeal Biomechanics and Implications for Speech Production

Purpose

Recent proposals suggest that (a) the high dimensionality of speech motor control may be reduced via modular neuromuscular organization that takes advantage of intrinsic biomechanical regions of stability and (b) computational modeling provides a means to study whether and how such modularization works. In this study, the focus is on the larynx, a structure that is fundamental to speech production because of its role in phonation and numerous articulatory functions.

Method

A 3-dimensional model of the larynx was created using the ArtiSynth platform (http://ift.tt/2lPoHkZ). This model was used to simulate laryngeal articulatory states, including inspiration, glottal fricative, modal prephonation, plain glottal stop, vocal–ventricular stop, and aryepiglotto–epiglottal stop and fricative.

Results

Speech-relevant laryngeal biomechanics is rich with "quantal" or highly stable regions within muscle activation space.

Conclusions

Quantal laryngeal biomechanics complement a modular view of speech control and have implications for the articulatory–biomechanical grounding of numerous phonetic and phonological phenomena.

http://ift.tt/2lTsbRI

Exploring Use of the Coordinate Response Measure in a Multitalker Babble Paradigm

Purpose

Three experiments examined the use of competing coordinate response measure (CRM) sentences as a multitalker babble.

Method

In Experiment I, young adults with normal hearing listened to a CRM target sentence in the presence of 2, 4, or 6 competing CRM sentences with synchronous or asynchronous onsets. In Experiment II, the condition with 6 competing sentences was explored further. Three stimulus conditions (6 talkers saying same sentence, 1 talker producing 6 different sentences, and 6 talkers each saying a different sentence) were evaluated with different methods of presentation. Experiment III examined the performance of older adults with hearing impairment in a subset of conditions from Experiment II.

Results

In Experiment I, performance declined with increasing numbers of talkers and improved with asynchronous sentence onsets. Experiment II identified conditions under which an increase in the number of talkers led to better performance. In Experiment III, the relative effects of the number of talkers, messages, and onset asynchrony were the same for young and older listeners.

Conclusions

Multitalker babble composed of CRM sentences has masking properties similar to other types of multitalker babble. However, when the number of different talkers and messages are varied independently, performance is best with more talkers and fewer messages.

http://ift.tt/2lrNrw3

Rhythm Perception and Its Role in Perception and Learning of Dysrhythmic Speech

Purpose

The perception of rhythm cues plays an important role in recognizing spoken language, especially in adverse listening conditions. Indeed, this has been shown to hold true even when the rhythm cues themselves are dysrhythmic. This study investigates whether expertise in rhythm perception provides a processing advantage for perception (initial intelligibility) and learning (intelligibility improvement) of naturally dysrhythmic speech, dysarthria.

Method

Fifty young adults with typical hearing participated in 3 key tests, including a rhythm perception test, a receptive vocabulary test, and a speech perception and learning test, with standard pretest, familiarization, and posttest phases. Initial intelligibility scores were calculated as the proportion of correct pretest words, while intelligibility improvement scores were calculated by subtracting this proportion from the proportion of correct posttest words.

Results

Rhythm perception scores predicted intelligibility improvement scores but not initial intelligibility. On the other hand, receptive vocabulary scores predicted initial intelligibility scores but not intelligibility improvement.

Conclusions

Expertise in rhythm perception appears to provide an advantage for processing dysrhythmic speech, but a familiarization experience is required for the advantage to be realized. Findings are discussed in relation to the role of rhythm in speech processing and shed light on processing models that consider the consequence of rhythm abnormalities in dysarthria.

http://ift.tt/2mtQxR9

Increased Response to Altered Auditory Feedback in Dyslexia: A Weaker Sensorimotor Magnet Implied in the Phonological Deficit

Purpose

The purpose of this study was to examine whether developmental dyslexia (DD) is characterized by deficiencies in speech sensory and motor feedforward and feedback mechanisms, which are involved in the modulation of phonological representations.

Method

A total of 42 adult native speakers of Dutch (22 adults with DD; 20 participants who were typically reading controls) were asked to produce /bep/ while the first formant (F1) of the /e/ was not altered (baseline), increased (ramp), held at maximal perturbation (hold), and not altered again (after-effect). The F1 of the produced utterance was measured for each trial and used for statistical analyses. The measured F1s produced during each phase were entered in a linear mixed-effects model.

Results

Participants with DD adapted more strongly during the ramp phase and returned to baseline to a lesser extent when feedback was back to normal (after-effect phase) when compared with the typically reading group. In this study, a faster deviation from baseline during the ramp phase, a stronger adaptation response during the hold phase, and a slower return to baseline during the after-effect phase were associated with poorer reading and phonological abilities.

Conclusion

The data of the current study are consistent with the notion that the phonological deficit in DD is associated with a weaker sensorimotor magnet for phonological representations.

http://ift.tt/2mv54iG

Compensatory Strategies in the Developmental Patterns of English /s/: Gender and Vowel Context Effects

Purpose

The developmental trajectory of English /s/ was investigated to determine the extent to which children's speech productions are acoustically fine-grained. Given the hypothesis that young children have adultlike phonetic knowledge of /s/, the following were examined: (a) whether this knowledge manifests itself in acoustic spectra that match the gender-specific patterns of adults, (b) whether vowel context affects the spectra of /s/ in adults and children similarly, and (c) whether children adopt compensatory production strategies to match adult acoustic targets.

Method

Several acoustic variables were measured from word-initial /s/ (and /t/) and the following vowel in the productions of children aged 2 to 5 years and adult controls using 2 sets of corpora from the Paidologos database.

Results

Gender-specific patterns in the spectral distribution of /s/ were found. Acoustically, more canonical /s/ was produced before vowels with higher F₁ (i.e., lower vowels) in children, a context where lingual articulation is challenging. Measures of breathiness and vowel intrinsic F₀ provide evidence that children use a compensatory aerodynamic mechanism to achieve their acoustic targets in articulatorily challenging contexts.

Conclusion

Together, these results provide evidence that children's phonetic knowledge is acoustically detailed and gender specified and that speech production goals are acoustically oriented at early stages of speech development.

http://ift.tt/2mu0bU1

The German Focus on the Outcomes of Communication Under Six (FOCUS-G): Reliability and Validity of a Novel Assessment of Communicative Participation

Purpose

Our purpose was to explore the validity and reliability of the German Focus on the Outcomes of Communication Under Six (FOCUS-G; Thomas-Stonell, Oddson, Robertson, & Rosenbaum, 2010, 2012), which is an authorized adaptation of the Focus on the Outcomes of Communication Under Six (Thomas-Stonell et al., 2010) tool, which measures communicative participation in preschool children.

Method

Parents of typically developing children (TDC) and of children with speech impairment (CSI) completed the FOCUS-G and the Questionnaire for Measuring Health-Related Quality of Life in Children (KiddyKINDL; Ravens-Sieberer & Bullinger, 2000). To determine test–retest reliability, the FOCUS-G was readministered to a subsample of parents 1 week later.

Results

The FOCUS-G had high values for internal consistency (α = .959, Ω = .941), test–retest reliability (intraclass correlation coefficient = .974), and split–half reliability (r = .832). Total scores on the FOCUS-G and KiddyKINDL demonstrated significant associations. FOCUS-G total scores and subdomain scores for both samples showed significant correlations, indicating good construct validity. The discriminatory ability of the FOCUS-G was indicated by significantly higher mean scores for TDC (M = 6.03, SD = 0.65) than CSI (M = 5.47, SD = 1.02).

Conclusion

The overall good psychometric properties of this novel assessment of communicative participation support its use by speech-language pathologists for clinical and research purposes with German-speaking children.

http://ift.tt/2mD7gD6

Research to Establish the Validity, Reliability, and Clinical Utility of a Comprehensive Language Assessment of Mandarin

Purpose

With no existing gold standard for comparison, challenges arise for establishing the validity of a new standardized Mandarin language assessment normed in mainland China.

Method

A new assessment, Diagnostic Receptive and Expressive Assessment of Mandarin (DREAM), was normed with a stratified sample of 969 children ages 2;6 (years;months) to 7;11 in multiple urban and nonurban regions in northern and southern China. In this study of 230 children, the sensitivity and specificity of DREAM were examined against an a priori judgment of disorders. External validity was assessed using 2 indices of language production for different age groups.

Results

External validity was assessed against spontaneous language indices (correlation range: r = .6–.7; all ps r = .45, p Conclusion

http://ift.tt/2mL1zCA

Nonadjacent Dependency Learning in Cantonese-Speaking Children With and Without a History of Specific Language Impairment

Purpose

This study investigated nonadjacent dependency learning in Cantonese-speaking children with and without a history of specific language impairment (SLI) in an artificial linguistic context.

Method

Sixteen Cantonese-speaking children with a history of SLI and 16 Cantonese-speaking children with typical language development (TLD) were tested with a nonadjacent dependency learning task using artificial languages that mimic Cantonese.

Results

Children with TLD performed above chance and were able to discriminate between trained and untrained nonadjacent dependencies. However, children with a history of SLI performed at chance and were not able to differentiate trained versus untrained nonadjacent dependencies.

Conclusions

These findings, together with previous findings from English-speaking adults and adolescents with language impairments, suggest that individuals with atypical language development, regardless of age, diagnostic status, language, and culture, show difficulties in learning nonadjacent dependencies. This study provides evidence for early impairments to statistical learning in individuals with atypical language development.

http://ift.tt/2lVQWfb

Late Talkers: A Population-Based Study of Risk Factors and School Readiness Consequences

Purpose

This study was designed to (a) identify sociodemographic, pregnancy and birth, family health, and parenting and child care risk factors for being a late talker at 24 months of age; (b) determine whether late talkers continue to have low vocabulary at 48 months; and (c) investigate whether being a late talker plays a unique role in children's school readiness at 60 months.

Method

We analyzed data from the Early Childhood Longitudinal Study, a population-based sample of 9,600 children. Data were gathered when the children were 9, 24, 48, and 60 months old.

Results

The risk of being a late talker at 24 months was significantly associated with being a boy, lower socioeconomic status, being a nonsingleton, older maternal age at birth, moderately low birth weight, lower quality parenting, receipt of day care for less than 10 hr/week, and attention problems. Being a late talker increased children's risk of having low vocabulary at 48 months and low school readiness at 60 months. Family socioeconomic status had the largest and most profound effect on children's school readiness.

Conclusions

Limited vocabulary knowledge at 24 and 48 months is uniquely predictive of later school readiness. Young children with low vocabularies require additional supports prior to school entry.

http://ift.tt/2mv6IRz

Prosody and Spoken Word Recognition in Early and Late Spanish–English Bilingual Individuals

Purpose

This study was conducted to compare the influence of word properties on gated single-word recognition in monolingual and bilingual individuals under conditions of native and nonnative accent and to determine whether word-form prosody facilitates recognition in bilingual individuals.

Method

Word recognition was assessed in monolingual and bilingual participants when English words were presented with English and Spanish accents in 3 gating conditions: onset only, onset plus prosody/word length only, and onset plus prosody. Word properties were quantified to assess their influence on word recognition in the onset-only condition.

Results

Word recognition speed was proportional to language experience. In the onset-only condition, only word frequency facilitated word recognition across groups. Addition of duration information or prosodic word form did not facilitate word recognition in bilingual individuals the way it did in monolingual individuals. For the bilingual groups, Spanish accent significantly facilitated recognition in the presence of prosodic information. Word attributes were far more consequential in the English accent than in the Spanish accent condition.

Conclusions

Word rhyme information, word properties, and accent affect gated word recognition differently in monolingual and bilingual individuals. Top-down strategies emanating from word properties that may facilitate single-word recognition are experience and context dependent and become less available in the presence of a nonnative accent.

http://ift.tt/2mtWAFo