Head and Neck Diseases by Alexandros G.Sfakianakis: 05/24/17

Τετάρτη 24 Μαΐου 2017

Use of Hyperlinks in PowerPoint Presentations as an Educational Tool

Publication date: Available online 24 May 2017
Source:Academic Radiology
Author(s): Gregory Scott Stacy, Steven G. Thiel
PowerPoint software (Microsoft, Redmond, WA) has become a popular tool for creating and displaying electronic presentations. The "hyperlink" function in PowerPoint allows users to advance from one slide to another slide in the presentation when they click on a predetermined word, shape, or image, thereby allowing for a more dynamic and interactive experience than can be obtained with serial presentation of slides alone. The objective of this article is to provide a tutorial describing the necessary steps to create hyperlinks and incorporate them in a variety of ways into a PowerPoint presentation. Hyperlinks can turn a passive learning experience into an active one by allowing the participant to become more engaged with the presentation.

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Imaging Workup of Suspected Classical Paraneoplastic Neurological Syndromes

Publication date: Available online 24 May 2017
Source:Academic Radiology
Author(s): Benedikt Sundermann, Jens-Burchard Schröder, Tobias Warnecke, Walter Heindel, Michael Schäfers, Matthias Weckesser, Boris Buerke
Rationale and ObjectivesThis study aimed to assess the clinical efficacy of positron emission tomography (PET) or combined PET-computed tomography (CT) with ¹⁸F-fluorodeoxyglucose (FDG) for whole-body cancer screening in patients with suspected paraneoplastic neurological syndromes (PNS). The following main research questions were addressed: What is the percentage of positive findings to be expected in whole-body FDG-PET-CT in adult patients with PNS? How many false positives can be expected as assessed by clinical and histopathological workup? Are there patients who present with a tumor despite initially negative findings?Materials and MethodsThis is a systematic review of the literature and retrospective analysis of FDG-PET-CT and clinical follow-up data from 45 consecutive patients (age: 56.6 ± standard deviation 15.8 years, 14 female, 31 male). Suspicious lesions were identified and correlated with immediate workup and clinical follow-up.ResultsFourteen studies were included in the review. Eleven malignancies (24.4% of patients) were identified by FDG-PET-CT in this sample. This is a higher percentage of positive findings compared to most previous reports. There was one initially negative finding.ConclusionsWhole-body FDG-PET-CT is suitable to identify additional malignancies in patients with suspected classical PNS referred to a tertiary medical center. The utility by means of true-positive findings is higher in classical PNS than suggested by studies in less select patient populations.

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Correlation Between Screening Mammography Interpretive Performance on a Test Set and Performance in Clinical Practice

Publication date: Available online 24 May 2017
Source:Academic Radiology
Author(s): Diana L. Miglioretti, Laura Ichikawa, Robert A. Smith, Diana S.M. Buist, Patricia A. Carney, Berta Geller, Barbara Monsees, Tracy Onega, Robert Rosenberg, Edward A. Sickles, Bonnie C. Yankaskas, Karla Kerlikowske
Rationale and ObjectivesEvidence is inconsistent about whether radiologists' interpretive performance on a screening mammography test set reflects their performance in clinical practice. This study aimed to estimate the correlation between test set and clinical performance and determine if the correlation is influenced by cancer prevalence or lesion difficulty in the test set.Materials and MethodsThis institutional review board-approved study randomized 83 radiologists from six Breast Cancer Surveillance Consortium registries to assess one of four test sets of 109 screening mammograms each; 48 radiologists completed a fifth test set of 110 mammograms 2 years later. Test sets differed in number of cancer cases and difficulty of lesion detection. Test set sensitivity and specificity were estimated using woman-level and breast-level recall with cancer status and expert opinion as gold standards. Clinical performance was estimated using women-level recall with cancer status as the gold standard. Spearman rank correlations between test set and clinical performance with 95% confidence intervals (CI) were estimated.ResultsFor test sets with fewer cancers (N = 15) that were more difficult to detect, correlations were weak to moderate for sensitivity (woman level = 0.46, 95% CI = 0.16, 0.69; breast level = 0.35, 95% CI = 0.03, 0.61) and weak for specificity (0.24, 95% CI = 0.01, 0.45) relative to expert recall. Correlations for test sets with more cancers (N = 30) were close to 0 and not statistically significant.ConclusionsCorrelations between screening performance on a test set and performance in clinical practice are not strong. Test set performance more accurately reflects performance in clinical practice if cancer prevalence is low and lesions are challenging to detect.

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Free-breathing Functional Pulmonary MRI

Publication date: Available online 24 May 2017
Source:Academic Radiology
Author(s): Dante P.I. Capaldi, Khadija Sheikh, Rachel L. Eddy, Fumin Guo, Sarah Svenningsen, Parameswaran Nair, David G. McCormack, Grace Parraga
Rationale and ObjectivesVentilation heterogeneity is a hallmark feature of asthma. Our objective was to evaluate ventilation heterogeneity in patients with severe asthma, both pre- and post-salbutamol, as well as post-methacholine (MCh) challenge using the lung clearance index, free-breathing pulmonary ¹H magnetic resonance imaging (FDMRI), and inhaled-gas MRI ventilation defect percent (VDP).Materials and MethodsSixteen severe asthmatics (49 ± 10 years) provided written informed consent to an ethics board-approved protocol. Spirometry, plethysmography, and multiple breath nitrogen washout to measure the lung clearance index were performed during a single visit within 15 minutes of MRI. Inhaled-gas MRI and FDMRI were performed pre- and post-bronchodilator to generate VDP. For asthmatics with forced expiratory volume in 1 second (FEV1) >70%predicted, MRI was also performed before and after MCh challenge. Wilcoxon signed-rank tests, Spearman correlations, and a repeated-measures analysis of variance were performed.ResultsHyperpolarized ³He (P = .02) and FDMRI (P = .02) VDP significantly improved post-salbutamol and for four asthmatics who could perform MCh (n = 4). ³He and FDMRI VDP significantly increased at the provocative concentration of MCh, resulting in a 20% decrease in FEV1 (PC20) and decreased post-bronchodilator (P = .02), with a significant difference between methods (P = .01). FDMRI VDP was moderately correlated with ³He VDP (ρ = .61, P = .01), but underestimated VDP relative to ³He VDP (−6 ± 9%). Whereas ³He MRI VDP was significantly correlated with the lung clearance index, FDMRI was not (ρ = .49, P = .06).ConclusionsFDMRI VDP generated in free-breathing asthmatic patients was correlated with static inspiratory breath-hold ³He MRI VDP but underestimated VDP relative to ³He MRI VDP. Although less sensitive to salbutamol and MCh, FDMRI VDP may be considered for asthma patient evaluations at centers without inhaled-gas MRI.

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Automated T2-mapping of the Menisci From Magnetic Resonance Images in Patients with Acute Knee Injury

Publication date: Available online 24 May 2017
Source:Academic Radiology
Author(s): Anthony Paproki, Craig Engstrom, Mark Strudwick, Katharine J. Wilson, Rachel K. Surowiec, Charles Ho, Stuart Crozier, Jurgen Fripp
Rationale and ObjectivesThis study aimed to evaluate the accuracy of an automated method for segmentation and T2 mapping of the medial meniscus (MM) and lateral meniscus (LM) in clinical magnetic resonance images from patients with acute knee injury.Materials and MethodsEighty patients scheduled for surgery of an anterior cruciate ligament or meniscal injury underwent magnetic resonance imaging of the knee (multiplanar two-dimensional [2D] turbo spin echo [TSE] or three-dimensional [3D]-TSE examinations, T2 mapping). Each meniscus was automatically segmented from the 2D-TSE (composite volume) or 3D-TSE images, auto-partitioned into anterior, mid, and posterior regions, and co-registered onto the T2 maps. The Dice similarity index (spatial overlap) was calculated between automated and manual segmentations of 2D-TSE (15 patients), 3D-TSE (16 patients), and corresponding T2 maps (31 patients). Pearson and intraclass correlation coefficients (ICC) were calculated between automated and manual T2 values. T2 values were compared (Wilcoxon rank sum tests) between torn and non-torn menisci for the subset of patients with both manual and automated segmentations to compare statistical outcomes of both methods.ResultsThe Dice similarity index values for the 2D-TSE, 3D-TSE, and T2 map volumes, respectively, were 76.4%, 84.3%, and 75.2% for the MM and 76.4%, 85.1%, and 76.1% for the LM. There were strong correlations between automated and manual T2 values (rMM = 0.95, ICCMM = 0.94; rLM = 0.97, ICCLM = 0.97). For both the manual and the automated methods, T2 values were significantly higher in torn than in non-torn MM for the full meniscus and its subregions (P < .05). Non-torn LM had higher T2 values than non-torn MM (P < .05).ConclusionsThe present automated method offers a promising alternative to manual T2 mapping analyses of the menisci and a considerable advance for integration into clinical workflows.

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Regional Variation in Skeletal Muscle and Adipose Tissue FDG Uptake Using PET/CT and Their Relation to BMI

Publication date: Available online 24 May 2017
Source:Academic Radiology
Author(s): Marcus D. Goncalves, Judith Green-McKenzie, Abass Alavi, Drew A. Torigian
Rationale and ObjectivesSkeletal muscle metabolism is a primary contributor to whole-body energy expenditure. Currently, methods to measure changes in skeletal muscle metabolism in vivo are limited. Our objectives were to characterize the regional variation in skeletal muscle and adipose tissue (AT) FDG uptake as a surrogate for glycolytic metabolism using ¹⁸F-2-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in healthy men and to correlate these findings to body mass index (BMI).Materials and MethodsEighteen healthy men were enrolled and underwent FDG-PET/CT. The mean standardized uptake value of 14 skeletal muscles and two AT regions was measured and linear regression analysis was performed to identify metabolic predictors of BMI.ResultsFDG-PET/CT reliably detected changes in skeletal muscle and AT depot metabolic activity based on location. The most metabolically active muscles were those used for posture and breathing, which have the highest percentage of reported type I muscle myofiber content. Visceral AT tended to have a higher FDG uptake than subcutaneous AT. The mean standardized uptake value of VAT, pectoralis major, and gluteus maximus muscles accounted for 64% of the variance in BMI.ConclusionsFDG-PET/CT can be used to quantify the regional variation in glucose metabolism of multiple skeletal muscle groups and AT depots.

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Measurement Accuracy of Atherosclerotic Plaque Structure on CT Using Phantoms to Establish Ground Truth

Publication date: Available online 24 May 2017
Source:Academic Radiology
Author(s): Samantha St. Pierre, Jenifer Siegelman, Nancy A. Obuchowski, Xiaonan Ma, David Paik, Andrew J. Buckler
Rationale and ObjectivesThe purpose of this study was to characterize analytic performance of software-aided arterial vessel structure measurements across a range of scanner settings for computed tomography angiography where ground truth is known. We characterized performance for measurands that may be efficiently measured for clinical cases without use of software, as well as those that may be done manually but which is generally not done due to the effort level required unless software is employed.Materials and MethodsFour measurands (lumen area, stenosis, wall area, wall thickness) were evaluated using tissue-mimicking phantoms to estimate bias, heteroscedasticity, and limits of quantitation both pooled across scanner settings and individually for eight different settings. Reproducibility across scanner settings was also estimated.ResultsMeasurements of lumen area have a near constant bias of +1.3 mm for measurements ranging from 3 mm² to 40 mm²; stenosis bias is +7% across a 30%–70% range; wall area bias is +14% across a 50–450 mm² range; and wall thickness bias is +1.2 mm across a 3–9 mm range. All measurements possess properties that make them suitable for measuring longitudinal change. Lumen area demonstrates the most sensitivity to scanner settings (bias from as low as +.1 mm to as high as +2.7 mm); wall thickness demonstrates negligible sensitivity.ConclusionsVariability across scanner settings for lumen measurands was generally higher than bias for a given setting. The converse was true for the wall measurands, where variability due to scanner settings was very low. Both bias and variability due to scanner settings of vessel structure were within clinically useful levels.

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Ex vivo magnetic resonance imaging using hyaluronic acid fillers: Differences between monophasic and biphasic fillers

Background/Purpose

Hyaluronic acid (HA) is an anionic, non-sulfated glycosaminoglycan distributed throughout the human skin and injectable HA fillers are the most commonly used in aesthetic field. This study aimed to determine if differences in physical characteristics of HA products (monophasic or biphasic fillers) affect the patterns of magnetic resonance imaging (MRI).

Methods

Twenty biphasic fillers and nine monophasic fillers were obtained from a commercial source, and examined with a 3.0 Tesla MRI scanner. Visual assessments and measurements of signal intensity for region of interest (ROI) were performed. A non-parametric Wilcoxon rank sum test was used to compare the ROI values.

Results

Visual assessments by a radiologist did not show significant differences between the two types of fillers. While the signal intensity between the two types of filler did not differ significantly for T1-weighted images, the signal intensity of the biphasic filler was lower than that of the monophasic filler for T2-weighted images (P<.01).

Conclusion

Monophasic and biphasic HA fillers exhibited different MRI properties. Our findings may provide better insights into the use of in vivo MRI to evaluate aesthetic, procedure-related complications.

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Effect of addition of enzymatically modified guar gum on Glycemic index of selected Indian traditional foods (idli, chapatti)

Publication date: Available online 24 May 2017
Source:Bioactive Carbohydrates and Dietary Fibre
Author(s): Shital Giri, Anamika Banerji, S.S. Lele, Laxmi Ananthanarayan
India has a high prevalence of type 2 diabetes and there is a need to develop low glycemic index (GI) foods or modify existing popular foods to lower their GI. Guar gum, a hydrocolloid and soluble fibre, may be used as an additive for lowering glycemic response of foods. It increases the viscosity of food systems and may adversely affect their processing and physical properties, posing a constraint on the concentration at which it can be used in foods. In this study solid state enzymatic modification with mannanase was carried out to improve viscous properties of guar gum, facilitating the use of a higher concentration of the gum to lower GI of two popular Indian traditional foods, idli and chapatti. The modification process was optimized; 40µl mannanase/ g guar gum was used and the reaction was carried out at pH 5, temperature of 50°C for a period of 48h. Incorporation of the modified guar gum at 5% resulted in lower idli batter viscosity (Δviscosity: 33538cps), higher bulk density of idli (Δbulk density: 0.013g/cc) and lower stickiness of chapatti dough (Δstickiness: 6.76g) as compared to idli and chapatti with added unmodified guar gum. Texture and sensory attributes of both the products with 5% modified guar gum were found to be acceptable. GI of idli was reduced from 71.28 to 60.00 and 61.63 and GI of chapatti was reduced from 62.56 to 51.25 and 53.45 by addition (5%) of unmodified and modified guar gum respectively.

Graphical abstract

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Microstructure and kinetics of intermetallic phase growth of three-layered A1050/AZ31/A1050 clads prepared by explosive welding combined with subsequent annealing

Publication date: 15 September 2017
Source:Materials & Design, Volume 130
Author(s): D.M. Fronczek, R. Chulist, L. Litynska-Dobrzynska, S. Kac, N. Schell, Z. Kania, Z. Szulc, J. Wojewoda-Budka
The effect of annealing has been investigated with respect to interface microstructure and evolution of intermetallic phases in three-layered explosively welded A1050/AZ31/A1050 specimens. Both interfaces in the state after welding were characterized by wavy shape morphology with intermediate phases, which formed segmented structures. Two different morphologies consisted of equiaxed and columnar grains were observed within the Mg2Al3 phase, while the Mg17Al12 phase was built of only columnar grains. Furthermore, a small amount of Mg23Al30 was detected by X-ray synchrotron diffraction. Annealing at 350°C strongly induced the Mg23Al30 phase development in the form of discontinuous layer between Mg2Al3 and Mg17Al12 phases after 10h of annealing. Kinetics calculations indicated that, Mg2Al3 phase growth at 300°C was controlled by different mechanisms according to the location: volume diffusion and chemical reaction at the upper interface and solely by volume diffusion at lower one. The growth of Mg17Al12 was governed only by volume diffusion. Furthermore, the same mechanisms were observed during annealing at 400°C, however this heat treatment significantly changed the microstructure i.e. the grain size and shape. It was also established that the nanohardness of both Mg2Al3 and Mg17Al12 was about 350HV.

Graphical abstract

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PROPIONIBACTERIUM ACNES AND CHRONIC DISEASES : P. acnes is an opportunistic pathogen, causing a range of postoperative and device-related infections e.g., surgery,post-neurosurgical infection,joint prostheses, shunts and prosthetic heart valves. P. acnes may play a role in other conditions, including inflammation of the prostate leading to cancer,SAPHO (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis) syndrome, sarcoidosis and sciatica.

http://otorhinolaryngology-crete.blogspot.com/2017/05/propionibacterium-acnes-and-chronic.html

P. acnes bacteria live deep within follicles and pores, away from the surface of the skin. In these follicles, P. acnes bacteria use sebum, cellular debris and metabolic byproducts from the surrounding skin tissue as their primary sources of energy and nutrients. Elevated production of sebum by hyperactive sebaceous glands (sebaceous hyperplasia) or blockage of the follicle can cause P. acnes bacteria to grow and multiply.[6]

P. acnes bacteria secrete many proteins, including several digestive enzymes.[7] These enzymes are involved in the digestion of sebum and the acquisition of other nutrients. They can also destabilize the layers of cells that form the walls of the follicle. The cellular damage, metabolic byproducts and bacterial debris produced by the rapid growth of P. acnes in follicles can trigger inflammation.[8] This inflammation can lead to the symptoms associated with some common skin disorders, such as folliculitis and acne vulgaris.[9][10][11]

The damage caused by P. acnes and the associated inflammation make the affected tissue more susceptible to colonization by opportunistic bacteria, such as Staphylococcus aureus. Preliminary research shows healthy pores are only colonized by P. acnes, while unhealthy ones universally include the nonpore-resident Staphylococcus epidermidis, amongst other bacterial contaminants. Whether this is a root causality, just opportunistic and a side effect, or a more complex pathological duality between P. acnes and this particular Staphylococcus species is not known.[12]

P. acnes has also been found in corneal ulcers, and is a common cause of chronic endophthalmitis following cataract surgery. Rarely, it infects heart valves leading to endocarditis, and infections of joints (septic arthritis) have been reported.[5] Furthermore, Propionibacterium species have been found in ventriculostomy insertion sites, and areas subcutaneous to suture sites in patients who have undergone craniotomy. It is a common contaminant in blood and cerebrospinal fluid cultures.

P. acnes has been found in herniated discs.[13] The propionic acid which it secretes creates micro-fractures of the surrounding bone. These micro-fractures are sensitive and it has been found that antibiotics have been helpful in resolving this type of low back pain.[14]

P. acnes can be found in bronchoalveolar lavage of approximately 70% of patients with sarcoidosis and is associated with disease activity, but it can be also found in 23% of controls.[15][16] The subspecies of P. acnes that cause these infections of otherwise sterile tissues (prior to medical procedures), however, are the same subspecies found on the skin of individuals who do not have acne-prone skin, so are likely local contaminants. Moderate to severe acne vulgaris appears to be more often associated with virulent strains.[17]

P. acnes is an opportunistic pathogen, causing a range of postoperative and device-related infections e.g., surgery,[18] post-neurosurgical infection,[19] joint prostheses, shunts and prosthetic heart valves. P. acnes may play a role in other conditions, including inflammation of the prostate leading to cancer,[20] SAPHO (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis) syndrome, sarcoidosis and sciatica.[21]

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Dichotic Listening Deficit Associated With Solvent Exposure.Due to their lipophilic nature, solvents can adversely affect large white matter tracks such as the corpus callosum. Previous investigations reveal that long-term workplace exposure to solvents is also deleterious to various auditory processes.

http://otorhinolaryngology-crete.blogspot.com/2017/05/dichotic-listening-deficit-associated.html

Dichotic Listening Deficit Associated With Solvent Exposure.

από Landry, Simon P.; Fuente, Adrian στο Otology & Neurotology Published Ahead-of-Print

Μετάφραση άρθρου

Hypothesis: A significant left ear deficit can be observed in solvent-exposed individuals using the dichotic digit test. Background: Solvents are ubiquitous in global industrial processes. Due to their lipophilic nature, solvents can adversely affect large white matter tracks such as the corpus callosum. Previous investigations reveal that long-term workplace exposure to solvents is also deleterious to various auditory processes. Investigations in exposed populations suggest a decreased performance for dichotic listening. Methods: In this present study, we examined the lateralization of a dichotic digit test score for 49 solvent-exposed individuals along with 49 age- and sex-matched controls. We evaluated group differences between test scores and the right ear advantage using a laterality index (LI). Results: Individual ear results suggest that long-term workplace solvent exposure is associated with a significantly lower dichotic listening score for the left ear. A binaural compound score analysis using a laterality index supports this left-ear deficit. Conclusion: These results provide an insight on the effects of solvent exposure on dichotic listening abilities. Further research should investigate the importance of using dichotic listening tasks to screen for solvent-induced auditory dysfunction in exposed individuals. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

A phase one, single-dose, open-label, clinical safety and PET/MR imaging study of (68)Ga-DOTATOC in healthy volunteers.

A phase one, single-dose, open-label, clinical safety and PET/MR imaging study of (68)Ga-DOTATOC in healthy volunteers.

Am J Nucl Med Mol Imaging. 2017;7(2):53-62

Authors: Esfahani SA, Salcedo S, Heidari P, Catalano OA, Pauplis R, Hesterman J, Kronauge JF, Mahmood U

Abstract
This prospective pilot study provides a dynamic whole body PET/MR image database, clinical safety, biodistribution profile and dosimetry of (68)Ga-DOTATOC in healthy subjects, to establish a baseline and standard reference for its use in diagnosis and treatment response evaluation among patients with somatostatin receptor expressing neoplastic diseases. Dynamic whole body PET/MR imaging was performed in 12 healthy subjects (male/female: 8/4) after injection of 242.39 ± 53.38 MBq (mean ± SD) (68)Ga-DOTATOC. Images were acquired 15, 60, 120, and 240 minutes post injection. Subjects were assessed at baseline and after (68)Ga-DOTATOC PET/MR by monitoring vital signs, 12-lead electrocardiograms, complete blood count, comprehensive metabolic panel, and urinalysis. Adverse events were monitored for one week after injection. Organ dosimetry was estimated using OLINDA/EXM 1.1 software. Radiotracer was exclusively eliminated via urinary tract (18.8 ± 1.0% of injected dose within 4 hours) and no redistribution was observed. Bladder wall, spleen and kidneys received the highest radiation exposure (0.64 ± 0.1 mSv/MBq, 0.29 ± 0.14 mSv/MBq, and 0.1 ± 0.02 mSv/MBq, respectively). Mean effective dose yielded 0.048 ± 0.007 mSv/MBq. No adverse events were reported during the one-week follow-up period. Follow-up laboratory tests and electrocardiograms showed no changes compared to the baseline. The use of MRI provided valuable anatomical information and eliminated the risk of radiation exposure compared to CT.

PMID: 28533937 [PubMed]

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Efficacy of peptide receptor radionuclide therapy with (177)Lu-octreotate in metastatic pulmonary neuroendocrine tumors: a dual-centre analysis.

Efficacy of peptide receptor radionuclide therapy with (177)Lu-octreotate in metastatic pulmonary neuroendocrine tumors: a dual-centre analysis.

Am J Nucl Med Mol Imaging. 2017;7(2):74-83

Authors: Sabet A, Haug AR, Eiden C, Auernhammer CJ, Simon B, Bartenstein P, Biersack HJ, Ezziddin S

Abstract
There is lack of data on the specific benefit of peptide receptor radionuclide therapy (PRRT) in neuroendocrine tumors (NET) of pulmonary origin. This dual- centre study aimed to assess outcome and toxicity of standardized PRRT with (177)Lu-octreotate in a patient population of advanced pulmonary NET of grade 1-2. We retrospectively assessed 22 consecutively patients treated with 4 intended cycles at 3 monthly intervals (mean activity per cycle 7.8±0.68 GBq). In a median follow-up period of 54 months, no significant nephrotoxicity (≥ grade 3) was observed. Reversible hematotoxicity (grade 3) occurred in 3 patients (13.6%). Treatment response consisted of partial response in 6 (27.3%), stable disease in 9 (40.9%), and progressive disease in 7 (31.8%) patients. Median progression-free survival (PFS) and overall survival (OS) was 27 (95% CI, 9-45) and 42 months (95% CI, 25-59), respectively. High hepatic tumor load (> 50%) and high plasma chromogranin A (> 600 ng/mL) were negative baseline predictors for PFS and OS on univariate analysis, CgA remained significant on multivariate analysis (PFS, P=0.011; OS, P=0.026). Disease progression despite PRRT was associated with shorter survival (median OS 15 vs 53 mo, P<0.001). Despite a higher incidence of treatment failure compared to NET of other origins, the observed substantial and sustained disease stabilization (median PFS of 27 mo, disease control rate of > 2/3 of pts) indicates considerable efficacy of (177)Lu-octreotate in pulmonary NET.

PMID: 28533939 [PubMed]

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Radionuclide bone scan SPECT-CT: lowering the dose of CT significantly reduces radiation dose without impacting CT image quality.

Radionuclide bone scan SPECT-CT: lowering the dose of CT significantly reduces radiation dose without impacting CT image quality.

Am J Nucl Med Mol Imaging. 2017;7(2):63-73

Authors: Gupta SK, Trethewey S, Brooker B, Rutherford N, Diffey J, Viswanathan S, Attia J

Abstract
The CT component of SPECT-CT is required for attenuation correction and anatomical localization of the uptake on SPECT but there is no guideline about the optimal CT acquisition parameters. In our department, a standard CT acquisition protocol was changed in 2013 to give lower radiation dose to the patient. In this study, we retrospectively compared the effects on patient dose as well as the CT image quality with current versus older CT protocols. Ninety nine consecutive patients [n=51 Standard dose 'old' protocol (SDP); n=48 lower dose 'new' protocol (LDP)] with lumbar spine SPECT-CT for bone scan were examined. The main differences between the two protocols were that SDP used 130 kVp tube voltage and reference current-time product of 70 mAs whereas the LDP used 110 kVp and 40 mAs respectively. Various quantitative parameters from the CT images were obtained and the images were also rated blindly by two experienced nuclear medicine physicians for bony definition and noise. The mean calculated dose length product of the LDP group (121.5±39.6 mGy.cm) was significantly lower compared to the SDP group patients (266.9±96.9 mGy.cm; P<0.0001). This translated into a significant reduction in the mean effective dose to 1.8 mSv from 4.0 mSv. The physicians reported better CT image quality for the bony structures in LDP group although for soft tissue structures, the SDP group had better image quality. The optimized new CT acquisition protocol significantly reduced the radiation dose to the patient and in-fact improved CT image quality for the assessment of bony structures.

PMID: 28533938 [PubMed]

http://ift.tt/2rT6lka

Synthesis and evaluation of [(64)Cu]PSMA-617 targeted for prostate-specific membrane antigen in prostate cancer.

Synthesis and evaluation of [(64)Cu]PSMA-617 targeted for prostate-specific membrane antigen in prostate cancer.

Am J Nucl Med Mol Imaging. 2017;7(2):40-52

Authors: Cui C, Hanyu M, Hatori A, Zhang Y, Xie L, Ohya T, Fukada M, Suzuki H, Nagatsu K, Jiang C, Luo R, Shao G, Zhang M, Wang F

Abstract
We radiolabeled a ligand, PSMA-617, of prostate-specific membrane antigen (PSMA) with copper-64 ((64)Cu), to evaluate the metabolism, biodistribution, and potential of [(64)Cu]PSMA-617 for PET imaging of prostate cancer. [(64)Cu]PSMA-617 was synthesized by heating PSMA-617 with [(64)Cu]CuCl2 in buffer solution at 90°C for 5 min. In vitro uptake was determined in two cell lines of prostate cancer. In vivo regional distributions were determined in normal and tumor-bearing mice. High radiolabeling efficiency of (64)Cu for PSMA-617 yielded [(64)Cu]PSMA-617 with >99% radiochemical purity. In vitro cellular uptake experiments demonstrated the specificity of [(64)Cu]PSMA-617 for PSMA-positive LNCaP cells. Biodistribution observations of normal mice revealed high uptake of radioactivity in the kidney and liver. PET with [(64)Cu]PSMA-617 visualized tumor areas implanted by PSMA-positive LNCaP cells in the mice. Two hours after the injection of [(64)Cu]PSMA-617 into mice, a radiolabeled metabolite was observed in the blood, liver, urine, and LNCaP tumor tissues. [(64)Cu]PSMA-617 was easily synthesized, and exhibited a favorable biodistribution in PSMA-positive tumors. Although this radioligand shows slow clearance for kidney and high liver uptake, change of its chelator moiety and easy radiolabeling may enable development of new (64)Cu or (67)Cu-labeled PSMA ligands for imaging and radiotherapy.

PMID: 28533936 [PubMed]

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Celecoxib affects estrogen sulfonation catalyzed by several human hepatic sulfotransferases, but does not stimulate 17-sulfonation in rat liver

Publication date: Available online 25 May 2017
Source:The Journal of Steroid Biochemistry and Molecular Biology
Author(s): Sriram Ambadapadi, Peter L. Wang, Sergiu P. Palii, Margaret O. James
Celecoxib is known to alter the preferred position of SULT2A1-catalyzed sulfonation of 17β-estradiol (17β-E2) and other estrogens from the 3- to the 17-position. Understanding the effects of celecoxib on estrogen sulfonation is of interest in the context of the investigational use of celecoxib to treat breast cancer. This study examined the effects on celecoxib on cytosolic sulfotransferases in human and rat liver and on SULT enzymes known to be expressed in liver. Celecoxib's effects on the sulfonation of several steroids catalyzed by human liver cytosol were similar but not identical to those observed previously for SULT2A1. Celecoxib was shown to inhibit recombinant SULT1A1-catalyzed sulfonation of 10nM estrone and 4μM p-nitrophenol with IC50 values of 2.6 and 2.1μM, respectively, but did not inhibit SULT1E1-catalyzed estrone sulfonation. In human liver cytosol, the combined effect of celecoxib and known SULT1A1 and 1E1 inhibitors, quercetin and triclosan, resulted in inhibition of 17β-E2-3-sulfonation such that the 17-sulfate became the major metabolite: this is of interest because the 17-sulfate is not readily hydrolyzed by steroid sulfatase to 17β-E2. Investigation of hepatic cytosolic steroid sulfonation in rat revealed that celecoxib did not stimulate 17β-E2 17-sulfonation in male or female rat liver as it does with human SULT2A1 and human liver cytosol, demonstrating that rat is not a useful model of this effect. In silico studies suggested that the presence of the bulky tryptophan residue in the substrate-binding site of the rat SULT2A homolog instead of glycine as in human SULT2A1 may explain this species difference.

http://ift.tt/2qYVTcK

Epstein-Barr virus, human endogenous retroviruses (HERVs) and human herpesvirus 6 (HHV-6) but also less common viruses such as Saffold and measles viruses are associated with multiple sclerosis

http://otorhinolaryngology-crete.blogspot.com/2017/05/epstein-barr-virus-human-endogenous.html

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

A review of the emerging potential therapy for neurological disorders: human embryonic stem cell therapy.

A review of the emerging potential therapy for neurological disorders: human embryonic stem cell therapy.

Am J Stem Cells. 2017;6(1):1-12

Authors: Shroff G, Dhanda Titus J, Shroff R

Abstract
The first human embryonic stem cell (hESC) line was developed in the late nineties. hESCs are capable of proliferating indefinitely and differentiate into all the three embryonic germ layers. Further, the differentiation of hESC lines into neural precursor cells and neurons, astrocytes and oligodendrocytes showed their potential in treating several incurable neurological disorders such as spinal cord injury (SCI), cerebral palsy (CP), Parkinson's disease (PD). In this review, we will discuss the global scenario of research and therapeutic use of hESCs in the treatment of neurological disorders. Following this, we will discuss the development of a unique hESC line, how it differs from the other available hESC lines and its use in the treatment of neurological disorders. hESCs were isolated from mixture of neuronal and non-neuronal progenitor cells in their pre progenitor state in a Good Laboratory Practices, Good Tissue Practices and Good Manufacturing Practices compliant laboratory. Blastomere cells have served as a source to derive the hESCs and the xeno-free culture was demonstrated to be more safe and effective in clinical therapeutic application of hESCs. All the patients showed a remarkable improvement in their conditions and no serious adverse events were reported. This study concluded that hESC lines could be scalable and used in the treatment of various neurological disorders such as SCI, CP, and PD.

PMID: 28533935 [PubMed]

http://ift.tt/2qYux4s

Concomitant lymphoplasmacytic lymphoma and plasma cell myeloma, a diagnostic challenge.

Concomitant lymphoplasmacytic lymphoma and plasma cell myeloma, a diagnostic challenge.

Am J Blood Res. 2017;7(2):10-17

Authors: Mansour AT, Shandiz AE, Zimmerman MK, Roth TD, Zhou J

Abstract
BACKGROUND: Lymphoplasmacytic lymphoma and plasma cell myeloma are two B cell lymphoproliferative neoplasms derived from mature B-lymphocytes in different differentiation stages. The coexistence of these two tumors in the same patient is exceedingly rare and can be difficult to diagnose.
CASE PRESENTATION: A 76-year-old male presented with a pathologic fracture after a fall. Radiography showed a lytic lesion in the pelvis. Serum immunofixation showed distinct IgM kappa and IgA kappa monoclonal protein bands. Bone marrow examination revealed aggregates of small, mature lymphoid cells with admixed plasma cells. Immunohistochemical studies and flow cytometric analysis showed the lymphoid cells were CD10-/CD5- kappa restricted monoclonal B cells. The plasma cells were monoclonal with kappa light chain restriction. The majority of plasma cells were positive for IgA and cyclin D1 with a few plasma cells positive for IgM. Additional studies showed the presence of both a positive MYD88 L265P mutation and a CCND1/IGH fusion. A diagnosis of concomitant lymphoplasmacytic lymphoma and plasma cell myeloma was rendered.
CONCLUSION: Concomitant lymphoplasmacytic lymphoma and plasma cell myeloma can be rarely encountered and is diagnostic challenging. It is commonly associated with biclonal monoclonal proteins. This case demonstrates the importance of a comprehensive work-up in the diagnosis of this disease combination and highlights the diagnostic role of MYD88 mutation study.

PMID: 28533926 [PubMed]

http://ift.tt/2qjnscy

Mortality outcomes in trauma patients undergoing prehospital red blood cell transfusion: a systematic literature review.

Mortality outcomes in trauma patients undergoing prehospital red blood cell transfusion: a systematic literature review.

Int J Burns Trauma. 2017;7(2):17-26

Authors: Huang GS, Dunham CM

Abstract
The value of prehospital red blood cell (RBC) transfusion for trauma patients is controversial. The purposes of this literature review were to determine the mortality rate of trauma patients with hemodynamic instability and the benefit of prehospital RBC transfusion. A 30-year systematic literature review was performed in 2016. Eligible studies were combined for meta-analysis when tests for heterogeneity were insignificant. The synthesized mortality was 35.6% for systolic blood pressure ≤ 90 mmHg; 51.1% for ≤ 80 mmHg; and 63.9% for ≤ 70 mmHg. For patients with either hypotension or emergency trauma center transfused RBCs, the synthesized Injury Severity Score (ISS) was 27.0 and mortality was 36.2%; the ISS and mortality correlation was r = 0.766 (P = 0.0096). For civilian patients receiving prehospital RBC transfusions, the synthesized ISS was 27.5 and mortality was 39.5%. One civilian study suggested a decrement in mortality with prehospital RBC transfusion; however, patient recruitment was only one per center per year and mortality was < 10% despite an ISS of 37. The same study created a matched control subset and indicated that mortality decreased using multivariate analysis; however, neither the assessed factors nor raw mortality was presented. Civilian studies with patients undergoing prehospital RBC transfusion and a matched control subset showed that the synthesized mortality was similar for those transfused (37.5%) and not transfused (38.7%; P = 0.8933). A study of civilian helicopter patients demonstrated a similar 30-day mortality for those with and without prehospital blood product availability (22% versus 21%; P = 0.626). Mortality in a study of matched military patients was better for those receiving prehospital blood or plasma (8%) than the controls (20%; P = 0.013). However, transfused patients had a shorter prehospital time, more advanced airway procedures, and higher hospital RBC transfusion (P < 0.05). A subset with an ISS > 16 showed similar mortality with and without prehospital RBC availability (27.6% versus 32.0%; P = 0.343). Trauma patient mortality increases with the magnitude of hemodynamic instability and anatomic injury. Some literature evidence indicates no survival advantage with prehospital RBC availability. However, other data suggesting a potential benefit is confounded or likely to be biased.

PMID: 28533934 [PubMed - in process]

http://ift.tt/2qejgjc

Negative wound pressure therapy is safe and useful in pediatric burn patients.

Negative wound pressure therapy is safe and useful in pediatric burn patients.

Int J Burns Trauma. 2017;7(2):12-16

Authors: Ren Y, Chang P, Sheridan RL

Abstract
INTRODUCTION: Negative Pressure Wound Therapy (NPWT) has proven to be a powerful tool in facilitating healing of difficult wounds of a variety of etiologies. The pediatric experience with NPWT has been limited due to concerns about vascular compression and pain associated with treatment.
METHOD: A retrospective review was performed to evaluate the therapeutic effect of NPWT on children with difficult wounds due to burns or soft-tissue trauma. NPWT was instituted in the operating room under general anesthesia using a commercially available system. NPWT was not initiated until all necrotic material was removed from the wounds. Negative pressure applied ranged from 50-125 mmHg continuous suction, with younger children being prescribed less negative pressures. NPWT dressings were changed every 5-7 days, in the operating room. When wounds were clean and had granulated they were closed with split-thickness skin grafts.
RESULTS: 29 children with an average age of 9.34 ± 1.95 years (range 2 months to 18 years) were treated with NPWT. Average total wound size was 24.8 ± 8.9 (range 0 to 95) percent of the body surface in those patients who had suffered burns and non-burn injuries. Injury mechanisms included hot liquid (2 children), contact with hot object (4 children), electricity (7 children), flame (9 children), and other non-burn injuries such as abrasion and Stevens-Johnson syndrome (7 children). Over 90% of the patients required central venous or bladder catheters. Perceived benefits of the treatment included reduced numbers of dressing changes and more rapid wound granulation. There were no episodes of bleeding associated with NPWT. All patients healed their wounds, were successfully grafted, and survived.
CONCLUSION: NPWT has a useful role in the pediatric burn unit in facilitating wounds healing and improving life qualities. We also found that a significant correlation between third degree burned wound size and the number of negative pressure therapies received, which indicated that NPWT could be more effective in treating complicated burned wounds. NPWT seems safe and effective when applied to well-debrided wounds. It does not seem to be associated with excessive bleeding or discomfort in children.

PMID: 28533933 [PubMed - in process]

http://ift.tt/2qYwgqp

Efficacy of peptide receptor radionuclide therapy with (177)Lu-octreotate in metastatic pulmonary neuroendocrine tumors: a dual-centre analysis.

Efficacy of peptide receptor radionuclide therapy with (177)Lu-octreotate in metastatic pulmonary neuroendocrine tumors: a dual-centre analysis.

Am J Nucl Med Mol Imaging. 2017;7(2):74-83

Authors: Sabet A, Haug AR, Eiden C, Auernhammer CJ, Simon B, Bartenstein P, Biersack HJ, Ezziddin S

PMID: 28533939 [PubMed]

http://ift.tt/2rSPH3N

Radionuclide bone scan SPECT-CT: lowering the dose of CT significantly reduces radiation dose without impacting CT image quality.

Radionuclide bone scan SPECT-CT: lowering the dose of CT significantly reduces radiation dose without impacting CT image quality.

Am J Nucl Med Mol Imaging. 2017;7(2):63-73

Authors: Gupta SK, Trethewey S, Brooker B, Rutherford N, Diffey J, Viswanathan S, Attia J

PMID: 28533938 [PubMed]

http://ift.tt/2rT6lka

A phase one, single-dose, open-label, clinical safety and PET/MR imaging study of (68)Ga-DOTATOC in healthy volunteers.

A phase one, single-dose, open-label, clinical safety and PET/MR imaging study of (68)Ga-DOTATOC in healthy volunteers.

Am J Nucl Med Mol Imaging. 2017;7(2):53-62

Authors: Esfahani SA, Salcedo S, Heidari P, Catalano OA, Pauplis R, Hesterman J, Kronauge JF, Mahmood U

PMID: 28533937 [PubMed]

http://ift.tt/2rSH2i2

Synthesis and evaluation of [(64)Cu]PSMA-617 targeted for prostate-specific membrane antigen in prostate cancer.

Synthesis and evaluation of [(64)Cu]PSMA-617 targeted for prostate-specific membrane antigen in prostate cancer.

Am J Nucl Med Mol Imaging. 2017;7(2):40-52

Authors: Cui C, Hanyu M, Hatori A, Zhang Y, Xie L, Ohya T, Fukada M, Suzuki H, Nagatsu K, Jiang C, Luo R, Shao G, Zhang M, Wang F

PMID: 28533936 [PubMed]

http://ift.tt/2rSTI8I

Etiology and treatment of amyotrophic lateral sclerosis.

Etiology and treatment of amyotrophic lateral sclerosis.

Am J Neurodegener Dis. 2017;6(1):1-8

Authors: Rafael H, David JO, Vilca AS

Abstract
BACKGROUND: To date all researchers conclude that the etiology of Amyotrophic lateral sclerosis (ALS) is not known. On the contrary, since August 2009, we believe that disease is of ischemic origin in the anterior surface of the medulla oblongata.
MATERIAL AND METHOD: We present our surgical experience into 45 patients with ALS (bulbar form in 36 cases and spinal form in 9). Preoperative MRI scans revealed microinfarcts in the medulla oblongata and/or cervical cord. During surgery we found: 1) poor quality of omentum in most cases; 2) degenerative changes in the cervical spine; 3) anatomical anomalies at the V4 segments of the vertebral arteries; 4) moderate to severe atherosclerosis at both V4 segments; 5) unilateral absence or stenosis in the anterior-ventral spinal arteries (AVSAs). All patients received omentum on the anterior, lateral and posterior surface of the medulla oblongata, and in 9 cases, an additional segment at the C5-C6 level.
RESULTS: Neurological improvement was better during the first days or weeks after surgery than in the following months or years, in all patients. However, 13 patients suffered neurological impairment in about 4 months later, due to greater deterioration of the cervical spine, by contrast, 7 patients with mild ALS have experienced neurological improvement by 80 to 100% during a follow-up of 4 and 6 years.
CONCLUSIONS: These results confirm that ALS is of ischemic origin in the intraparenchymal territory of the AVSAs and/or in anterior spinal artery caused by atherosclerosis and associated to anatomical variants in the V4 segments of the vertebral arteries. Because in contrast to this, its revascularization by means of omentum can cure (mild degree) or improve this disease.

PMID: 28533943 [PubMed]

http://ift.tt/2qb3sO7

Combined therapy for epistaxis by Hereditary Hemorrhagic Teleangiectasia: A 3-year follow up study on 45 patients

Hereditary hemorrhagic telangiectasia (HHT) is a mutilating disease associated with the majority of patients with recurrent epistaxis episodes. The aim of this study was to present a single institution experience with patients treated for nasal epistaxis using a combination of Nd:YAG laser and argon plasma coagulation (APC) vs Nd:YAG laser alone, with a minimum follow-up of 3 years.45 patients (21 men, 24 women) aged from 15 to 84 years with the diagnosis of HHT were treated in the Department of Otolaryngology, Head and Neck Surgery in Homburg/Saar between 10/2002 and 10/2012 because of epistaxis, using a combination of Nd:YAG laser and APC or Nd:YAG laser alone.

http://ift.tt/2qmdmYA

A clinical decision rule to predict zygomatico-maxillary fractures

Patients presenting with periorbital trauma require clinical assessment to exclude zygomatico-maxillary fractures. A single-centre pilot investigation was undertaken at a general hospital in the United Kingdom. The sample was composed of 229 adult patients attending our emergency department with periorbital injuries. Findings from 17 signs or symptoms of facial injury were recorded on a validated tool. The relationship between clinical presentation and displaced zygomatico-maxillary fracture was assessed using diagnostic test parameters and tests for correlation.

http://ift.tt/2qRAgux

“Local effects of epidermal growth factor on the wound healing in esophageal anastomosis: An experimental study”

In this study with the experimental model of primary repair of esophageal atresia(EA), we investigated the effects of the epidermal growth factor(EGF) on wound healing in the anastomosis of EA.

http://ift.tt/2rWzQk3

An evaluation of oxidative and nitrosative stress in children-who-stutter and its relationship to severity

Although there has been much research into the cause of stuttering, it has not yet been fully clarified. There is known to be a close relationship between stress severity and stuttering. The aim of this study was to evaluate the levels of oxidative and nitrosative stress by comparing a stuttering group and a control group. It was also aimed to evaluate the relationship between the oxidative and nitrosative stress levels and the severity of the stutter.

http://ift.tt/2qYOTwD

Decisional regret following ventilation tube insertion

The purpose of this study was to see if parental regret following ventilation tube (VT) insertion was related to non-resolution of ear infections and thus ongoing need for otolaryngological care and VT reinsertion.

http://ift.tt/2qYGkBV

Speech-evoked auditory brainstem responses in children with hearing loss

The main objective of the present study was to investigate subcortical auditory processing in children with sensorineural hearing loss.

http://ift.tt/2rWFfaL

Safety and outcomes of aspirin desensitization for aspirin-exacerbated respiratory disease: a single center study

Aspirin desensitization is an effective treatment option for aspirin-exacerbated respiratory disease (AERD). Aspirin desensitization protocol modifications have improved the safety and efficiency of this procedure, yet some providers remain reluctant to perform it.

http://ift.tt/2qe8Fox

Molecular diagnostics and lack of clinical allergy in helminth-endemic areas in Indonesia

Allergen microarray characterization of sensitization to common allergen sources in a helminth-endemic area of Indonesia shows that helminth induced cross-reactivity to cross-reactive carbohydrate determinants (CCD), and not primary sensitization to their major allergens, is the dominant feature.

http://ift.tt/2qYlWPb

Abstracts from the 3rd International Severe Asthma Forum (ISAF)

http://ift.tt/2qixPhA

Abstracts from the 3rd International Severe Asthma Forum (ISAF)

http://ift.tt/2qixPhA

Sensory recovery of the breast after innervated and non-innervated autologous breast reconstructions: A systematic review

The sensory recovery of the reconstructed breast is an undervalued topic in the field of autologous breast reconstruction. The aim of this systematic review was to evaluate the available literature on the sensory recovery of the breast after innervated and non-innervated autologous breast reconstructions and to assess the possible benefits of sensory nerve coaptation compared to spontaneous reinnervation of the flap.

http://ift.tt/2qiCSP8

Improvement of Hydration and Epidermal Barrier Function in Human Skin by a Novel Compound Isosorbide Dicaprylate

Abstract

Objective

The study involved the synthesis of a novel derivative of caprylic acid - isosorbide dicaprylate (IDC) - and the evaluation of its potential in improving water homeostasis and epidermal barrier function in human skin.

Methods

The effect of IDC on gene expression was assayed in skin organotypic cultures by DNA microarrays. The results were then confirmed for a few key genes by quantitative PCR, immuno- and cytochemistry. Final validation of skin hydration properties was obtained by four separate clinical studies. Level of hydration was measured by corneometer either by using 2% IDC lotion alone vs placebo or in combination with 2% glycerol lotion vs 2% glycerol only. A direct comparison in skin hydration between 2% IDC and 2% Glycerol lotions was also carried out. The epidermal barrier function improvement was assessed by determining changes in trans-epidermal water loss (TEWL) on the arms before and after treatment with 2% IDC lotion versus placebo.

Results

IDC was found to up-regulate the expression of AQP3, CD44 and proteins involved in keratinocyte differentiation as well as the formation and function of stratum corneum. A direct comparison between 2% IDC versus 2% glycerol lotions revealed a 3-fold advantage of IDC in providing skin hydration. Severely dry skin treated with 2% IDC in combination with 2% glycerol showed 133% improvement whereas 35% improvement was observed with moderately dry human skin.

Conclusion

Topical isosorbide dicaprylate favorably modulates genes involved in the maintenance of skin structure and function, resulting in superior clinical outcomes. By improving skin hydration and epidermal permeability barrier it offers therapeutic applications in skin aging.

http://ift.tt/2rWRTqg

Subcellular localization prediction of apoptosis proteins based on evolutionary information and support vector machine

Publication date: Available online 24 May 2017
Source:Artificial Intelligence in Medicine
Author(s): Qilin Xiang, Bo Liao, Xianhong Li, Huimin Xu, Jing Chen, Zhuoxing Shi, Qi Dai, Yuhua Yao
ObjectivesIn this paper, a high-quality sequence encoding scheme is proposed for predicting subcellular location of apoptosis proteins.MethodsIn the proposed methodology, the novel evolutionary-conservative information is introduced to represent protein sequences. Meanwhile, based on the proportion of golden section in mathematics, position-specific scoring matrix (PSSM) is divided into several blocks. Then, these features are predicted by support vector machine (SVM) and the predictive capability of proposed method is implemented by jackknife testResultsThe results show that the golden section method is better than no segmentation method. The overall accuracy for ZD98 and CL317 is 98.98% and 91.11%, respectively, which indicates that our method can play a complimentary role to the existing methods in the relevant areas.ConclusionsThe proposed feature representation is powerful and the prediction accuracy will be improved greatly, which denotes our method provides the state-of-the-art performance for predicting subcellular location of apoptosis proteins.

http://ift.tt/2rWLaN3

Evolution in Mind: Evolutionary Dynamics, Cognitive Processes, and Bayesian Inference

Publication date: Available online 24 May 2017
Source:Trends in Cognitive Sciences
Author(s): Jordan W. Suchow, David D. Bourgin, Thomas L. Griffiths
Evolutionary theory describes the dynamics of population change in settings affected by reproduction, selection, mutation, and drift. In the context of human cognition, evolutionary theory is most often invoked to explain the origins of capacities such as language, metacognition, and spatial reasoning, framing them as functional adaptations to an ancestral environment. However, evolutionary theory is useful for understanding the mind in a second way: as a mathematical framework for describing evolving populations of thoughts, ideas, and memories within a single mind. In fact, deep correspondences exist between the mathematics of evolution and of learning, with perhaps the deepest being an equivalence between certain evolutionary dynamics and Bayesian inference. This equivalence permits reinterpretation of evolutionary processes as algorithms for Bayesian inference and has relevance for understanding diverse cognitive capacities, including memory and creativity.

http://ift.tt/2qYtAuZ

Neurobiology of Schemas and Schema-Mediated Memory

Publication date: Available online 24 May 2017
Source:Trends in Cognitive Sciences
Author(s): Asaf Gilboa, Hannah Marlatte
Schemas are superordinate knowledge structures that reflect abstracted commonalities across multiple experiences, exerting powerful influences over how events are perceived, interpreted, and remembered. Activated schema templates modulate early perceptual processing, as they get populated with specific informational instances (schema instantiation). Instantiated schemas, in turn, can enhance or distort mnemonic processing from the outset (at encoding), impact offline memory transformation and accelerate neocortical integration. Recent studies demonstrate distinctive neurobiological processes underlying schema-related learning. Interactions between the ventromedial prefrontal cortex (vmPFC), hippocampus, angular gyrus (AG), and unimodal associative cortices support context-relevant schema instantiation and schema mnemonic effects. The vmPFC and hippocampus may compete (as suggested by some models) or synchronize (as suggested by others) to optimize schema-related learning depending on the specific operationalization of schema memory. This highlights the need for more precise definitions of memory schemas.

http://ift.tt/2rWOuIe

Therapeutic targets in the management of striae distensae: A systematic review

Striae distensae are permanent dermal lesions that can cause significant psychosocial distress. A detailed understanding of the numerous treatment modalities available is essential to ensuring optimal patient outcomes.

http://ift.tt/2qRdgeU

Gene expression of sphingolipid metabolism pathways is altered in hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a debilitating skin disease characterized by painful recurrent nodules and abscesses caused by chronic inflammation. Early events in the development of HS are believed to occur in the folliculopilosebaceous unit; however, the signaling pathways behind this mechanism are unknown. Sphingolipids, such as ceramide, are essential components of the skin and appendages and have important structural and signaling roles.

http://ift.tt/2qm3cqN

Effects of low-dose acetazolamide on exercise performance in simulated altitude.

Effects of low-dose acetazolamide on exercise performance in simulated altitude.

Int J Physiol Pathophysiol Pharmacol. 2017;9(2):28-34

Authors: Elisabeth E, Hannes G, Johannes B, Martin F, Elena P, Martin B

Abstract
Preventive effects of acetazolamide (ACZ) on acute mountain sickness (AMS) are well established but effects on exercise performance at high altitude or in hypoxia have been less considered and are still inconsistent. We hypothesized that low-dose ACZ would not impair exercise performance at simulated high altitude. Thus, the aim of this study was to evaluate the interaction between low-dose ACZ and exercise performance in normobaric hypoxia. Sixteen subjects (8 males and 8 females) were randomly assigned either to receive low-dose ACZ (3×125 mg in 36 hours) or placebo. Incremental cycle spiro-ergometry was performed before and after drug treatment in normobaric hypoxia (inspired fraction of oxygen, FiO2 = 13.5%; equivalent to about 4000 m). Whereas maximal power output and submaximal exercise responses did not change differently from pre- to post-treatment between ACZ and placebo, absolute and relative VO2max values and maximal oxygen pulse were slightly decreased in hypoxia after ACZ pre-treatment. ANOVA results suggest that aerobic capacity in males might be more affected by ACZ pre-treatment than in females. In conclusion, the presented findings may be of practical importance, possibly more meaningful for female mountaineers, because low-dose ACZ (125 mg bd) was shown to prevent AMS development with similar effectiveness as higher doses. This means that low-dose ACZ would prevent both, AMS development and a pronounced reduction in exercise performance.

PMID: 28533889 [PubMed - in process]

http://ift.tt/2qVm1TJ

Malate-aspartate shuttle inhibitor aminooxyacetic acid blocks lipopolysaccharides-induced activation of BV2 microglia.

Malate-aspartate shuttle inhibitor aminooxyacetic acid blocks lipopolysaccharides-induced activation of BV2 microglia.

Int J Physiol Pathophysiol Pharmacol. 2017;9(2):58-63

Authors: Shang W, Wei X, Ying W

Abstract
NADH shuttles, including malate-aspartate shuttle (MAS) and glycerol-3-phosphate shuttle, mediate the transfer of the reducing equivalents of cytosolic NADH into mitochondria. In our current study, we used BV2 microglia as a cellular model to determine the roles of NADH shuttles in lipopolysaccharides (LPS)-induced microglial activation. We found that aminooxyacetic acid (AOAA), a widely used MAS inhibitor, significantly attenuated LPS-induced increases in the levels of nitric oxide-a hallmarker of microglial activation. Our Western Blot assays also showed that AOAA blocked the LPS-induced increases in the protein levels of iNOS, TNF-α and COX-2. Furthermore, we found that AOAA decreased LPS-induced nuclear translocation of NF-κB. Collectively, our study has suggested that AOAA may be a new agent for inhibiting microglial activation. Our study has also suggested that MAS may be a novel target for modulating microglial activation under pathological conditions.

PMID: 28533892 [PubMed - in process]

http://ift.tt/2qdL6fD

Nuclear uptake of an amino-terminal fragment of apolipoprotein E4 promotes cell death and localizes within microglia of the Alzheimer's disease brain.

Nuclear uptake of an amino-terminal fragment of apolipoprotein E4 promotes cell death and localizes within microglia of the Alzheimer's disease brain.

Int J Physiol Pathophysiol Pharmacol. 2017;9(2):40-57

Authors: Love JE, Day RJ, Gause JW, Brown RJ, Pu X, Theis DI, Caraway CA, Poon WW, Rahman AA, Morrison BE, Rohn TT

Abstract
Although harboring the apolipoprotein E4 (APOE4) allele is a well known risk factor in Alzheimer's disease (AD), the mechanism by which it contributes to disease risk remains elusive. To investigate the role of proteolysis of apoE4 as a potential mechanism, we designed and characterized a site-directed cleavage antibody directed at position D151 of the mature form of apoE4 and E3. Characterization of this antibody indicated a high specificity for detecting synthesized recombinant proteins corresponding to the amino acid sequences 1-151 of apoE3 and E4 that would generate the 17 kDa (p17) fragment. In addition, this antibody also detected a ~17 kDa amino-terminal fragment of apoE4 following incubation with collagenase and matrix metalloproteinase-9 (MMP-9), but did not react with full-length apoE4. Application of this amino-terminal apoE cleavage-fragment (nApoECFp17) antibody, revealed nuclear labeling within glial cells and labeling of a subset of neurofibrillary tangles in the human AD brain. A quantitative analysis indicated that roughly 80% of labeled nuclei were microglia. To confirm these findings, cultured BV2 microglia cells were incubated with the amino-terminal fragment of apoE4 corresponding to the cleavage site at D151. The results indicated efficient uptake of this fragment and trafficking to the nucleus that also resulted in significant cell death. In contrast, a similarly designed apoE3 fragment showed no toxicity and primarily localized within the cytoplasm. These data suggest a novel cleavage event by which apoE4 is cleaved by the extracellular proteases, collagenase and MMP-9, generating an amino-terminal fragment that is then taken up by microglia, traffics to the nucleus and promotes cell death. Collectively, these findings provide important mechanistic insights into the mechanism by which harboring the APOE4 allele may elevate dementia risk observed in AD.

PMID: 28533891 [PubMed - in process]

http://ift.tt/2qee9jf

Effect of music tempo on exercise performance and heart rate among young adults.

Effect of music tempo on exercise performance and heart rate among young adults.

Int J Physiol Pathophysiol Pharmacol. 2017;9(2):35-39

Authors: Thakare AE, Mehrotra R, Singh A

Abstract
BACKGROUND & OBJECTIVES: Music captures attention, triggers a range of emotions, alters or regulates mood, increases work output, heightens arousal, induces states of higher functioning, reduces inhibitions and encourages rhythmic movement. Music has ergo-genic effect as well, it increases exercise performance, delays fatigue and increases performance and endurance, power and strength. Our study tried to evaluate the effect of music on exercise performance in young untrained subjects.
METHODS: In this study, we tested the effect of music on sub maximal exercise performance time duration in young adults. 25 Male and 25 females were subjected to standard submaximal exercise with and without music. Resting HR and Max. HR during exercise and the exercise time duration was recorded.
RESULTS: Total exercise duration in whole group with music (37.12 ± 16.26** min) was significantly greater than exercise duration without music (22.48 ± 10.26 min). Males (42.4 ± 15.6** min) outperformed significantly better than females (31.84 ± 15.48 min). Also, we observed statistically significant higher values of Maximal heart rate with music than without music. But there was no significant correlation between duration of exercise, music and change in Heart rate.
INTERPRETATION & CONCLUSION: We can conclude that Music increases duration of exercise in both sexes and hence endurance.

PMID: 28533890 [PubMed - in process]

http://ift.tt/2qdRjrG

Neuroprotective effects of melatonin administration against chronic immobilization stress in rats.

Neuroprotective effects of melatonin administration against chronic immobilization stress in rats.

Int J Physiol Pathophysiol Pharmacol. 2017;9(2):16-27

Authors: Gomaa AM, Galal HM, Abou-Elgait AT

Abstract
Chronic stress can impair brain functions and play a well-known role in the development of stress-related disorders such as anxiety. Melatonin (Mel) is a neurohormone which regulate several physiological processes including mood and behavior. This experimental study was designed to evaluate the effect of Mel on chronic immobilization stress (CIS) for 6 weeks in rats and to elucidate its possible underlying mechanisms. Twenty-eight adult male Wistar albino rats were divided into four equal groups: the control group, the Mel-treated group which was injected daily with Mel (10 mg/kg/day; IP) for 6 weeks, the stressed group which was subjected to CIS protocol daily for 6 weeks, and the Mel-treated stressed group which was injected with Mel and concurrently exposed to CIS protocol for 6 weeks. The Mel-treated stressed group showed reduction of both relative adrenal weight and the serum corticosterone levels, suppression of the anxiety-like behavior, increased levels of serotonin, noradrenaline and oxytocin in the frontal cortex, and improved histopathological structure and decreased chromogranin A (CgA) protein expression in the frontal cortex when compared with the chronically stressed group. We concluded that Mel is anxiolytic and this effect was mediated in part by its ability to increase the central release of oxytocin and monoamines and to downregulate CgA protein expression in the frontal cortex.

PMID: 28533888 [PubMed - in process]

http://ift.tt/2qdRhA4

Lidocaine suppresses glioma cell proliferation by inhibiting TRPM7 channels.

Lidocaine suppresses glioma cell proliferation by inhibiting TRPM7 channels.

Int J Physiol Pathophysiol Pharmacol. 2017;9(2):8-15

Authors: Leng T, Lin S, Xiong Z, Lin J

Abstract
BACKGROUND: Malignant glioma is the most common brain cancer with devastating prognosis. Recurrence of malignant glioma following surgery is very common with few preventive and therapeutic options. Novel targets and therapeutic agents are constantly sought for better outcome. Our previous study established that inhibition of transient receptor potential melastatin 7 (TRPM7) channels resulted in significant decrease of human glioma cell growth and proliferation. As local anesthetic lidocaine has been shown to inhibit TRPM7 currents, we hypothesize that lidocaine may suppress glioma cell proliferation through TRPM7 channel inhibition.
METHODS: TRPM7 currents were recorded in rat C6 glioma cells using the whole cell patch clamp technique. Cell growth and proliferation were assessed under microscopic examination and biochemical assays.
RESULTS: Lidocaine inhibits TRPM7-like currents in a dose-dependent and reversible manner. At 1 and 3 mM, it inhibits ~30% and ~50% of TRPM7 currents. At these concentrations, it is effective in inhibiting the proliferation of C6 cells. As expected, the TRPM7 inhibitors gadolinium and 2-Aminoethoxydiphenyl borate have similar effects on TRPM7 currents and proliferation of C6 cells. Similar to its effect on C6 cells, lidocaine inhibits the proliferation of A172 cells, a human glioblastoma cell line.
CONCLUSIONS: Lidocaine significantly inhibits the proliferation of glioma cells. The effect of lidocaine is mediated, at least in part, by inhibiting TRPM7 channels.

PMID: 28533887 [PubMed - in process]

http://ift.tt/2rz854s

Postoperative nausea and vomiting in facial fracture patients: A Randomized and controlled trial on the effect of dexamethasone

This study aimed to establish the incidence of postoperative nausea and vomiting (PONV) in facial fracture patients. The specific aim was to investigate the effect of perioperative dexamethasone on PONV. A total of 119 adult patients with facial fractures were analysed in this prospective study. Patients were randomized to receive perioperatively either a total dose of 30mg of dexamethasone i.v. and i.m., or no glucocorticoid (control). PONV was evaluated every 6hours during the first postoperative 24hours and when pain medications were given.

http://ift.tt/2qYBwfC

Systemic Preoperative Antibiotics with Mandible Fractures: Are They Indicated at the Time of Injury?

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1603458

Mandible fractures are the most common result of facial trauma. The proximity of oral flora to the site of both the injury and resulting surgical instrumentation makes managing infection a unique challenge. The benefit of antibiotic prophylaxis at the time of surgical treatment of mandible fractures is well established. However, the routine use of antibiotics between the time of injury and surgery is of unclear benefit. We aim to define the role of antibiotics in the preoperative period: from the time of injury to surgical intervention. Demographic and clinical data were collected retrospectively on all patients who were treated for mandible fracture by the Division of Plastic and Reconstructive Surgery at our institution between 2003 and 2013. The use of both preoperative (between injury and surgery) and perioperative (at the time of surgery) systemic antibiotics was recorded along with the incidence of postoperative infections and other complications. Complete data were available for 269 patients. Of the 216 patients who received preoperative antibiotics, 22 (10%) developed an infection postoperatively. Of the 53 patients who did not receive preoperative antibiotics, 2 (4%) developed infection (p = 0.184). Likewise, preoperative antibiotics were not significantly associated with hardware complication rates. In our retrospective review, the use of antibiotics between injury and surgical repair had no impact on postoperative infection rates. These data suggest that preoperative antibiotic use may actually be associated with an increased incidence of postoperative infection. Our results do not support the routine use of antibiotics between injury and surgical repair in patients with mandible fractures.
[...]

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Article in Thieme eJournals:
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Excessive gestational weight gain in first trimester is a risk factor for exacerbation of asthma during pregnancy: A prospective study of 1283 pregnancies

Acute exacerbation during pregnancy is the most important risk factor for an unfavorable outcome of pregnancy in women with asthma.

http://ift.tt/2qdEhe3

Re: Re: Le Fort I advancement osteotomies of 1cm or more. How safe or stable?

We were grateful for the comments on our recent publication from Mr Smyth.1,2 The aim of the study was to find out whether large Le Fort I advancements were associated with a higher degree of relapse and avascular necrosis. We found that advancements of 1cm or more, done in the way we described, are safe for both.

http://ift.tt/2rBCr6m

"J BUON"[jour]; +45 new citations

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

"J BUON"[jour]

These pubmed results were generated on 2017/05/24

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/2rj9wV6

Vocal Behavior in Environmental Noise: Comparisons Between Work and Leisure Conditions in Women With Work-related Voice Disorders and Matched Controls

This study aimed to assess vocal behavior in women with voice-intensive occupations to investigate differences between patients and controls and between work and leisure conditions with environmental noise level as an experimental factor.

http://ift.tt/2qlUKrT

The Use of the Gaps-In-Noise Test as an Index of the Enhanced Left Temporal Cortical Thinning Associated with the Transition between Mild Cognitive Impairment and Alzheimer's Disease.

The Use of the Gaps-In-Noise Test as an Index of the Enhanced Left Temporal Cortical Thinning Associated with the Transition between Mild Cognitive Impairment and Alzheimer's Disease.

J Am Acad Audiol. 2017 May;28(5):463-471

Authors: Iliadou VV, Bamiou DE, Sidiras C, Moschopoulos NP, Tsolaki M, Nimatoudis I, Chermak GD

Abstract
BACKGROUND: The known link between auditory perception and cognition is often overlooked when testing for cognition.
PURPOSE: To evaluate auditory perception in a group of older adults diagnosed with mild cognitive impairment (MCI).
RESEARCH DESIGN: A cross-sectional study of auditory perception.
STUDY SAMPLE: Adults with MCI and adults with no documented cognitive issues and matched hearing sensitivity and age.
DATA COLLECTION: Auditory perception was evaluated in both groups, assessing for hearing sensitivity, speech in babble (SinB), and temporal resolution.
RESULTS: Mann-Whitney test revealed significantly poorer scores for SinB and temporal resolution abilities of MCIs versus normal controls for both ears. The right-ear gap detection thresholds on the Gaps-In-Noise (GIN) Test clearly differentiated between the two groups (p < 0.001), with no overlap of values. The left ear results also differentiated the two groups (p < 0.01); however, there was a small degree of overlap ∼8-msec threshold values. With the exception of the left-ear inattentiveness index, which showed a similar distribution between groups, both impulsivity and inattentiveness indexes were higher for the MCIs compared to the control group.
CONCLUSIONS: The results support central auditory processing evaluation in the elderly population as a promising tool to achieve earlier diagnosis of dementia, while identifying central auditory processing deficits that can contribute to communication deficits in the MCI patient population. A measure of temporal resolution (GIN) may offer an early, albeit indirect, measure reflecting left temporal cortical thinning associated with the transition between MCI and Alzheimer's disease.

PMID: 28534735 [PubMed - in process]

http://ift.tt/2rW6zpF

The Impact of Single-Sided Deafness upon Music Appreciation.

The Impact of Single-Sided Deafness upon Music Appreciation.

J Am Acad Audiol. 2017 May;28(5):444-462

Authors: Meehan S, Hough EA, Crundwell G, Knappett R, Smith M, Baguley DM

Abstract
BACKGROUND: Many of the world's population have hearing loss in one ear; current statistics indicate that up to 10% of the population may be affected. Although the detrimental impact of bilateral hearing loss, hearing aids, and cochlear implants upon music appreciation is well recognized, studies on the influence of single-sided deafness (SSD) are sparse.
PURPOSE: We sought to investigate whether a single-sided hearing loss can cause problems with music appreciation, despite normal hearing in the other ear.
RESEARCH DESIGN: A tailored questionnaire was used to investigate music appreciation for those with SSD.
STUDY SAMPLE: We performed a retrospective survey of a population of 51 adults from a University Hospital Audiology Department SSD clinic. SSD was predominantly adult-onset sensorineural hearing loss, caused by a variety of etiologies.
DATA ANALYSIS: Analyses were performed to assess for statistical differences between groups, for example, comparing music appreciation before and after the onset of SSD, or before and after receiving hearing aid(s).
RESULTS: Results demonstrated that a proportion of the population experienced significant changes to the way music sounded; music was found to sound more unnatural (75%), unpleasant (71%), and indistinct (81%) than before hearing loss. Music was reported to lack the perceptual qualities of stereo sound, and to be confounded by distortion effects and tinnitus. Such changes manifested in an altered music appreciation, with 44% of participants listening to music less often, 71% of participants enjoying music less, and 46% of participants reporting that music played a lesser role in their lives than pre-SSD. Negative effects surrounding social occasions with music were revealed, along with a strong preference for limiting background music. Hearing aids were not found to significantly ameliorate these effects.
CONCLUSIONS: Results could be explained in part through considerations of psychoacoustic changes intrinsic to an asymmetric hearing loss and impaired auditory scene analysis. Given the prevalence of music and its capacity to influence an individual's well-being, results here present strong indications that the potential effects of SSD on music appreciation should be considered in a clinical context; an investigation into relevant rehabilitation techniques may prove valuable.

PMID: 28534734 [PubMed - in process]

http://ift.tt/2qOSyML

Acute Acoustic Trauma among Soldiers during an Intense Combat.

Acute Acoustic Trauma among Soldiers during an Intense Combat.

J Am Acad Audiol. 2017 May;28(5):436-443

Authors: Yehudai N, Fink N, Shpriz M, Marom T

Abstract
BACKGROUND: During military actions, soldiers are constantly exposed to various forms of potentially harmful noises. Acute acoustic trauma (AAT) results from an impact, unexpected intense noise ≥140 dB, which generates a high-energy sound wave that can damage the auditory system.
PURPOSE: We sought to characterize AAT injuries among military personnel during operation "Protective Edge," to analyze the effectiveness of hearing protection devices (HPDs), and to evaluate the benefit of steroid treatment in early-diagnosed AAT injury.
RESEARCH DESIGN: We retrospectively identified affected individuals who presented to military medical facilities with solitary or combined AAT injuries within 4 mo following an intense military operation, which was characterized with an abrupt, intensive noise exposure (July-December 2014).
STUDY SAMPLE: A total of 186 participants who were referred during and shortly after a military operation with suspected AAT injury.
INTERVENTIONS: HPDs, oral steroids.
DATA COLLECTION AND ANALYSIS: Data extracted from charts and audiograms included demographics, AAT severity, worn HPDs, first and last audiograms and treatment (if given). The Student's independent samples t test was used to compare continuous variables. All tests were considered significant if p values were ≤0.05.
RESULTS: A total of 186 participants presented with hearing complaints attributed to AAT: 122, 39, and 25 were in duty service, career personnel, and reservists, with a mean age of 21.1, 29.2, and 30.4 yr, respectively. Of them, 92 (49%) participants had confirmed hearing loss in at least one ear. Hearing impairment was significantly more common in unprotected participants, when compared with protected participants: 62% (74/119) versus 45% (30/67), p < 0.05. Tinnitus was more common in unprotected participants when compared with protected participants (75% versus 49%, p = 0.04), whereas vertigo was an uncommon symptom (5% versus 2.5%, respectively, p > 0.05). In the 21 participants who received steroid treatment for early-diagnosed AAT, bone-conduction hearing thresholds significantly improved in the posttreatment audiograms, when compared with untreated participants (p < 0.01, for 1-4 kHz).
CONCLUSIONS: AAT is a common military injury, and should be diagnosed early to minimize associated morbidity. HPDs were proven to be effective in preventing and minimizing AAT hearing sequelae. Steroid treatment was effective in AAT injury, if initiated within 7 days after noise exposure.

PMID: 28534733 [PubMed - in process]

http://ift.tt/2rPtEeB

Evaluation of Adaptive Noise Management Technologies for School-Age Children with Hearing Loss.

Evaluation of Adaptive Noise Management Technologies for School-Age Children with Hearing Loss.

J Am Acad Audiol. 2017 May;28(5):415-435

Authors: Wolfe J, Duke M, Schafer E, Jones C, Rakita L

Abstract
BACKGROUND: Children with hearing loss experience significant difficulty understanding speech in noisy and reverberant situations. Adaptive noise management technologies, such as fully adaptive directional microphones and digital noise reduction, have the potential to improve communication in noise for children with hearing aids. However, there are no published studies evaluating the potential benefits children receive from the use of adaptive noise management technologies in simulated real-world environments as well as in daily situations.
PURPOSE: The objective of this study was to compare speech recognition, speech intelligibility ratings (SIRs), and sound preferences of children using hearing aids equipped with and without adaptive noise management technologies.
RESEARCH DESIGN: A single-group, repeated measures design was used to evaluate performance differences obtained in four simulated environments. In each simulated environment, participants were tested in a basic listening program with minimal noise management features, a manual program designed for that scene, and the hearing instruments' adaptive operating system that steered hearing instrument parameterization based on the characteristics of the environment.
STUDY SAMPLE: Twelve children with mild to moderately severe sensorineural hearing loss.
DATA COLLECTION AND ANALYSIS: Speech recognition and SIRs were evaluated in three hearing aid programs with and without noise management technologies across two different test sessions and various listening environments. Also, the participants' perceptual hearing performance in daily real-world listening situations with two of the hearing aid programs was evaluated during a four- to six-week field trial that took place between the two laboratory sessions.
RESULTS: On average, the use of adaptive noise management technology improved sentence recognition in noise for speech presented in front of the participant but resulted in a decrement in performance for signals arriving from behind when the participant was facing forward. However, the improvement with adaptive noise management exceeded the decrement obtained when the signal arrived from behind. Most participants reported better subjective SIRs when using adaptive noise management technologies, particularly when the signal of interest arrived from in front of the listener. In addition, most participants reported a preference for the technology with an automatically switching, adaptive directional microphone and adaptive noise reduction in real-world listening situations when compared to conventional, omnidirectional microphone use with minimal noise reduction processing.
CONCLUSIONS: Use of the adaptive noise management technologies evaluated in this study improves school-age children's speech recognition in noise for signals arriving from the front. Although a small decrement in speech recognition in noise was observed for signals arriving from behind the listener, most participants reported a preference for use of noise management technology both when the signal arrived from in front and from behind the child. The results of this study suggest that adaptive noise management technologies should be considered for use with school-age children when listening in academic and social situations.

PMID: 28534732 [PubMed - in process]

http://ift.tt/2rQaFRd

Speech Recognition in Nonnative versus Native English-Speaking College Students in a Virtual Classroom.

Speech Recognition in Nonnative versus Native English-Speaking College Students in a Virtual Classroom.

J Am Acad Audiol. 2017 May;28(5):404-414

Authors: Neave-DiToro D, Rubinstein A, Neuman AC

Abstract
BACKGROUND: Limited attention has been given to the effects of classroom acoustics at the college level. Many studies have reported that nonnative speakers of English are more likely to be affected by poor room acoustics than native speakers. An important question is how classroom acoustics affect speech perception of nonnative college students.
PURPOSE: The combined effect of noise and reverberation on the speech recognition performance of college students who differ in age of English acquisition was evaluated under conditions simulating classrooms with reverberation times (RTs) close to ANSI recommended RTs.
RESEARCH DESIGN: A mixed design was used in this study.
STUDY SAMPLE: Thirty-six native and nonnative English-speaking college students with normal hearing, ages 18-28 yr, participated.
INTERVENTION: Two groups of nine native participants (native monolingual [NM] and native bilingual) and two groups of nine nonnative participants (nonnative early and nonnative late) were evaluated in noise under three reverberant conditions (0.03, 0.06, and 0.08 sec).
DATA COLLECTION AND ANALYSIS: A virtual test paradigm was used, which represented a signal reaching a student at the back of a classroom. Speech recognition in noise was measured using the Bamford-Kowal-Bench Speech-in-Noise (BKB-SIN) test and signal-to-noise ratio required for correct repetition of 50% of the key words in the stimulus sentences (SNR-50) was obtained for each group in each reverberant condition. A mixed-design analysis of variance was used to determine statistical significance as a function of listener group and RT.
RESULTS: SNR-50 was significantly higher for nonnative listeners as compared to native listeners, and a more favorable SNR-50 was needed as RT increased. The most dramatic effect on SNR-50 was found in the group with later acquisition of English, whereas the impact of early introduction of a second language was subtler. At the ANSI standard's maximum recommended RT (0.6 sec), all groups except the NM group exhibited a mild signal-to-noise ratio (SNR) loss. At the 0.8 sec RT, all groups exhibited a mild SNR loss.
CONCLUSION: Acoustics in the classroom are an important consideration for nonnative speakers who are proficient in English and enrolled in college. To address the need for a clearer speech signal by nonnative students (and for all students), universities should follow ANSI recommendations, as well as minimize background noise in occupied classrooms. Behavioral/instructional strategies should be considered to address factors that cannot be compensated for through acoustic design.

PMID: 28534731 [PubMed - in process]

http://ift.tt/2rgsf3q

Big Stimulus, Little Ears: Safety in Administering Vestibular-Evoked Myogenic Potentials in Children.

Big Stimulus, Little Ears: Safety in Administering Vestibular-Evoked Myogenic Potentials in Children.

J Am Acad Audiol. 2017 May;28(5):395-403

Authors: Thomas MLA, Fitzpatrick D, McCreery R, Janky KL

Abstract
BACKGROUND: Cervical and ocular vestibular-evoked myogenic potentials (VEMPs) have become common clinical vestibular assessments. However, VEMP testing requires high intensity stimuli, raising concerns regarding safety with children, where sound pressure levels may be higher due to their smaller ear canal volumes.
PURPOSE: The purpose of this study was to estimate the range of peak-to-peak equivalent sound pressure levels (peSPLs) in child and adult ears in response to high intensity stimuli (i.e., 100 dB normal hearing level [nHL]) commonly used for VEMP testing and make a determination of whether acoustic stimuli levels with VEMP testing are safe for use in children.
RESEARCH DESIGN: Prospective experimental.
STUDY SAMPLE: Ten children (4-6 years) and ten young adults (24-35 years) with normal hearing sensitivity and middle ear function participated in the study.
DATA COLLECTION AND ANALYSIS: Probe microphone peSPL measurements of clicks and 500 Hz tonebursts (TBs) were recorded in tubes of small, medium, and large diameter, and in a Brüel & Kjær Ear Simulator Type 4157 to assess for linearity of the stimulus at high levels. The different diameter tubes were used to approximate the range of cross-sectional areas in infant, child, and adult ears, respectively. Equivalent ear canal volume and peSPL measurements were then recorded in child and adult ears. Lower intensity levels were used in the participant's ears to limit exposure to high intensity sound. The peSPL measurements in participant ears were extrapolated using predictions from linear mixed models to determine if equivalent ear canal volume significantly contributed to overall peSPL and to estimate the mean and 95% confidence intervals of peSPLs in child and adult ears when high intensity stimulus levels (100 dB nHL) are used for VEMP testing without exposing subjects to high-intensity stimuli.
RESULTS: Measurements from the coupler and tubes suggested: 1) each stimuli was linear, 2) there were no distortions or nonlinearities at high levels, and 3) peSPL increased with decreased tube diameter. Measurements in participant ears suggested: 1) peSPL was approximately 3 dB larger in child compared to adult ears, and 2) peSPL was larger in response to clicks compared to 500 Hz TBs. The model predicted the following 95% confidence interval for a 100 dB nHL click: 127-136.5 dB peSPL in adult ears and 128.7-138.2 dB peSPL in child ears. The model predicted the following 95% confidence interval for a 100 dB nHL 500 Hz TB stimulus: 122.2-128.2 dB peSPL in adult ears and 124.8-130.8 dB peSPL in child ears.
CONCLUSIONS: Our findings suggest that 1) when completing VEMP testing, the stimulus is approximately 3 dB higher in a child's ear, 2) a 500 Hz TB is recommended over a click as it has lower peSPL compared to the click, and 3) both duration and intensity should be considered when choosing VEMP stimuli. Calculating the total sound energy exposure for your chosen stimuli is recommended as it accounts for both duration and intensity. When using this calculation for children, consider adding 3 dB to the stimulus level.

PMID: 28534730 [PubMed - in process]

http://ift.tt/2rghMVM

Self-Selection of Frequency Tables with Bilateral Mismatches in an Acoustic Simulation of a Cochlear Implant.

Self-Selection of Frequency Tables with Bilateral Mismatches in an Acoustic Simulation of a Cochlear Implant.

J Am Acad Audiol. 2017 May;28(5):385-394

Authors: Fitzgerald MB, Prosolovich K, Tan CT, Glassman EK, Svirsky MA

Abstract
BACKGROUND: Many recipients of bilateral cochlear implants (CIs) may have differences in electrode insertion depth. Previous reports indicate that when a bilateral mismatch is imposed, performance on tests of speech understanding or sound localization becomes worse. If recipients of bilateral CIs cannot adjust to a difference in insertion depth, adjustments to the frequency table may be necessary to maximize bilateral performance.
PURPOSE: The purpose of this study was to examine the feasibility of using real-time manipulations of the frequency table to offset any decrements in performance resulting from a bilateral mismatch.
RESEARCH DESIGN: A simulation of a CI was used because it allows for explicit control of the size of a bilateral mismatch. Such control is not available with users of CIs.
STUDY SAMPLE: A total of 31 normal-hearing young adults participated in this study.
DATA COLLECTION AND ANALYSIS: Using a CI simulation, four bilateral mismatch conditions (0, 0.75, 1.5, and 3 mm) were created. In the left ear, the analysis filters and noise bands of the CI simulation were the same. In the right ear, the noise bands were shifted higher in frequency to simulate a bilateral mismatch. Then, listeners selected a frequency table in the right ear that was perceived as maximizing bilateral speech intelligibility. Word-recognition scores were then assessed for each bilateral mismatch condition. Listeners were tested with both a standard frequency table, which preserved a bilateral mismatch, or with their self-selected frequency table.
RESULTS: Consistent with previous reports, bilateral mismatches of 1.5 and 3 mm yielded decrements in word recognition when the standard table was used in both ears. However, when listeners used the self-selected frequency table, performance was the same regardless of the size of the bilateral mismatch.
CONCLUSIONS: Self-selection of a frequency table appears to be a feasible method for ameliorating the negative effects of a bilateral mismatch. These data may have implications for recipients of bilateral CIs who cannot adapt to a bilateral mismatch, because they suggest that (1) such individuals may benefit from modification of the frequency table in one ear and (2) self-selection of a "most intelligible" frequency table may be a useful tool for determining how the frequency table should be altered to optimize speech recognition.

PMID: 28534729 [PubMed - in process]

http://ift.tt/2rgopav

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! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Τετάρτη 24 Μαΐου 2017

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