Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com

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Σάββατο 19 Αυγούστου 2017

Skin suturing and cortical surface viral infusion improves imaging of neuronal ensemble activity with head-mounted miniature microscopes

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Publication date: Available online 19 August 2017
Source:Journal of Neuroscience Methods
Author(s): Xinjian Li, Vania Y. Cao, Wenyu Zhang, Surjeet S. Mastwal, Qing Liu, Stephani Otte, Kuan Hong Wang
BackgroundIn vivo optical imaging of neural activity provides important insights into brain functions at the single-cell level. Cranial windows and virally delivered calcium indicators are commonly used for imaging cortical activity through two-photon microscopes in head-fixed animals. Recently, head-mounted one-photon microscopes have been developed for freely behaving animals. However, minimizing tissue damage from the virus injection procedure and maintaining window clarity for imaging can be technically challenging.New methodWe used a wide-diameter glass pipette at the cortical surface for infusing the viral calcium reporter AAV-GCaMP6 into the cortex. After infusion, the scalp skin over the implanted optical window was sutured to facilitate postoperative recovery. The sutured scalp was removed approximately two weeks later and a miniature microscope was attached above the window to image neuronal activity in freely moving mice.ResultsWe found that cortical surface virus infusion efficiently labeled neurons in superficial layers, and scalp skin suturing helped to maintain the long-term clarity of optical windows. As a result, several hundred neurons could be recorded in freely moving animals.Comparison with existing methodsCompared to intracortical virus injection and open-scalp postoperative recovery, our methods minimized tissue damage and dura overgrowth underneath the optical window, and significantly increased the experimental success rate and the yield of identified neurons.ConclusionOur improved cranial surgery technique allows for high-yield calcium imaging of cortical neurons with head-mounted microscopes in freely behaving animals. This technique may be beneficial for other optical applications such as two-photon microscopy, multi-site imaging, and optogenetic modulation.



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Corrigendum to ‘A system to measure the pupil response to steady lights in freely behaving mice’ [J. Neurosci. Methods 273 (2016) 74–85]

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Publication date: Available online 19 August 2017
Source:Journal of Neuroscience Methods
Author(s): Mark Bushnell, Yumiko Umino, Eduardo Solessio




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A high-sensitive nano-modified biosensor for dynamic monitoring of glutamate and neural spike covariation from rat cortex to hippocampal sub-regions

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Publication date: Available online 19 August 2017
Source:Journal of Neuroscience Methods
Author(s): Guihua Xiao, Yilin Song, Song Zhang, Lili Yang, Shengwei Xu, Yu Zhang, Huiren Xu, Fei Gao, Ziyue Li, Xinxia Cai
BackgroundHippocampus is a critical part of brain tissue involved in many cognitive neural activities. They are controlled by various neurotransmitters such as glutamate (Glu), and affected by electrophysiology.New methodHerein, we fabricated a 16-site (25μm in diameter) microelectrode array (MEA) biosensor applied in dual-mode tests including Glu and neural spike measurements.MethodsAll the 16 recording sites were electrodeposited with platinum nanoparticles (PtNPs) and 8 sites were used for electrical recording. Glutamate oxidase enzyme (Gluox) and 1,3-Phenylenediamine (mPD) layer were specially modified on the other 8 sites for Glu recording. The dual-mode MEA was implanted from cortex to hippocampus of anesthetized rat to record Glu content and firing rate.ResultsThe electrical sites showed much lower impedance. The Glu sites showed much higher sensitivity(7.807 pA/μM), and ideal selectivity to the major molecules in brain. The post calibration sensitivity (3.935 pA/μM) maintained on a positive level. Different Glu content peaks including cortex (18.32μM) and hippocampal CA1 (4.39μM), CA3 (10.16μM), dentate gyrus (DG, two layers: 5.36μM and 10.34μM) have detected. The corresponded firing rate was recorded, too.Comparison with existingmethods This modification showed much lower impedance and much higher sensitivity. We obtained more neuron activities simultaneously by dual-mode recording. The covariation of Glu and neural spike signals was discovered in the specific hippocampus sub-region.ConclusionsThe covariation between Glu and firing rate changes were synchronous, and effected by regions. The dual-mode signals were useful to find the neurology disease mechanism.



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Covalent and non-covalent chemical engineering of actin for biotechnological applications

Publication date: Available online 19 August 2017
Source:Biotechnology Advances
Author(s): Saroj Kumar, Alf Mansson
The cytoskeletal filaments are self-assembled protein polymers with 8–25nm diameters and up to several tens of micrometres length. They have a range of pivotal roles in eukaryotic cells, including transportation of intracellular cargoes (primarily microtubules with dynein and kinesin motors) and cell motility (primarily actin and myosin) where muscle contraction is one example. For two decades, the cytoskeletal filaments and their associated motor systems have been explored for nanotechnological applications including miniaturized sensor systems and lab-on-a-chip devices. Several developments have also revolved around possible exploitation of the filaments alone without their motor partners. Efforts to use the cytoskeletal filaments for applications often require chemical or genetic engineering of the filaments such as specific conjugation with fluorophores, antibodies, oligonucleotides or various macromolecular complexes e.g. nanoparticles. Similar conjugation methods are also instrumental for a range of fundamental biophysical studies. Here we review methods for non-covalent and covalent chemical modifications of actin filaments with focus on critical advantages and challenges of different methods as well as critical steps in the conjugation procedures. We also review potential uses of the engineered actin filaments in nanotechnological applications and in some key fundamental studies of actin and myosin function. Finally, we consider possible future lines of investigation that may be addressed by applying chemical conjugation of actin in new ways.



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Reputation Management and Content Control: An Analysis of Radiation Oncologists’ Digital Identities

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Publication date: Available online 19 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Arpan V. Prabhu, Christopher Kim, Eison De Guzman, Eric Zhao, Evan Madill, Jonathan Cohen, David R. Hansberry, Nitin Agarwal, Dwight E. Heron, Sushil Beriwal
IntroductionGoogle is the most popular search engine in the United States, and patients are increasingly relying on online webpages to seek information about individual physicians. This study aims to characterize what patients find when they search for radiation oncologists online.Material & MethodsThe Centers for Medicare and Medicaid Services (CMS) Physician Comparable Downloadable File was used to identify all Medicare-participating radiation oncologists in the United States and Puerto Rico. Each radiation oncologist was characterized by medical school education, year of graduation, city of practice, gender, and affiliation to an academic institution. Using a custom Google-based search engine, up to the top 10 search results for each physician were extracted and categorized as relating to: (1) physician, hospital, or healthcare system, (2) third-party, (3) social media, (4) academic journal articles, or (5) other.ResultsAmongst all U.S. health care providers within CMS, 4,443 self-identified as being radiation oncologists and yielded 40,764 search results. Of these, 1,161 (26.1%) and 3,282 (73.9%) were classified as academic and nonacademic radiation oncologists, respectively. At least one search result was obtained for 4,398 physicians (99.0%). Physician, hospital and healthcare-controlled websites (16,006; 39.3%) and third-party websites (10,494; 25.7%) were the two most observed domain types. Social media platforms accounted for 2,729 (6.7%) hits, and peer-reviewed academic journal websites accounted for 1,397 (3.4%) results. About 6.8% and 6.7% of the top ten links were social media websites for academic and nonacademic radiation oncologists, respectably.ConclusionsMost radiation oncologists lack self-controlled online content when patients search within the first page of Google search results. With the strong presence of third-party websites and lack of social media, opportunities exist for radiation oncologists to increase their online presence to improve patient-provider communication and better the image of the overall field. We discuss strategies to improve online visibility.

Teaser

The authors identified all Medicare-participating radiation oncologists in the United States and Puerto Rico and developed a customized Google-based search engine. Up tothe top 10 search results for each physician were extracted and categorized. Results for academic and nonacademic radiation oncologists were compared. Most radiation, oncologists lacked self-controlled online content in the first page of Google search results. Strategies for radiation oncologists to improve their digital presence are discussed.


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Autologous platelet-rich plasma versus conventional therapy for the treatment of chronic venous leg ulcers: A comparative study

Summary

Background

Chronic venous leg ulcers drastically reduce the quality of life of affected patients. There is heightened interest in autologous platelet-rich plasma (PRP) as one of the promising therapies for leg ulcers.

Aim

Our aim was to compare the clinical efficacy of PRP in the management of chronic venous leg ulcers vs conventional treatment.

Patients/Methods

In total, 40 patients with chronic venous leg ulcers were included in the study. Twenty patients were treated with autologous PRP weekly for 6 weeks (Group A), and 20 patients were treated with conventional treatment (compression and dressing) for 6 weeks (Group B). Treatment results were calculated by percentage of improvement in area of the ulcer.

Results

Compared to conventional therapy, a highly significant improvement in the ulcer size was observed post-PRP therapy (P-value = .0001). The mean change in the area of the ulcer post-PRP and conventional therapy was 4.92 ± 11.94 cm and 0.13 ± 0.27 cm, respectively, while the mean percentage improvement in the area of the ulcer post-PRP and conventional therapy was 67.6% ± 36.6% and 13.67% ± 28.06%, respectively. Subjective improvement in pain associated with the ulcer was noted by all patients.

Conclusions

Platelet-rich plasma is a safe nonsurgical procedure for treating chronic venous leg ulcers. Additional studies with larger sample size and longer follow-up periods are required to confirm or refute our findings.



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Autologous platelet-rich plasma versus conventional therapy for the treatment of chronic venous leg ulcers: A comparative study

Summary

Background

Chronic venous leg ulcers drastically reduce the quality of life of affected patients. There is heightened interest in autologous platelet-rich plasma (PRP) as one of the promising therapies for leg ulcers.

Aim

Our aim was to compare the clinical efficacy of PRP in the management of chronic venous leg ulcers vs conventional treatment.

Patients/Methods

In total, 40 patients with chronic venous leg ulcers were included in the study. Twenty patients were treated with autologous PRP weekly for 6 weeks (Group A), and 20 patients were treated with conventional treatment (compression and dressing) for 6 weeks (Group B). Treatment results were calculated by percentage of improvement in area of the ulcer.

Results

Compared to conventional therapy, a highly significant improvement in the ulcer size was observed post-PRP therapy (P-value = .0001). The mean change in the area of the ulcer post-PRP and conventional therapy was 4.92 ± 11.94 cm and 0.13 ± 0.27 cm, respectively, while the mean percentage improvement in the area of the ulcer post-PRP and conventional therapy was 67.6% ± 36.6% and 13.67% ± 28.06%, respectively. Subjective improvement in pain associated with the ulcer was noted by all patients.

Conclusions

Platelet-rich plasma is a safe nonsurgical procedure for treating chronic venous leg ulcers. Additional studies with larger sample size and longer follow-up periods are required to confirm or refute our findings.



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Effect of different dental burs for experimental induction of pulpitis in mice

Publication date: November 2017
Source:Archives of Oral Biology, Volume 83
Author(s): Xilin Shi, Zhengmao Li, Ying He, Qianzhou Jiang, Xuechao Yang
ObjectiveTo evaluate the effect of using different dental burs on the development of pulpal inflammation after pulpal exposure in mice.DesignEighty-eight C57BL/6 mice were randomly assigned to group A (n=40), group B (n=40) and control group (n=8). The pulps of the maxillary first molars were occlusally exposed using ¼ round burs and polishing burs in group A and B respectively. Animals were sacrificed randomly at 0h, 4h, 8h, 12h and 24h after pulpal exposure. Micro-CT scanning was used to determine the success rate of sample preparation. Pulpal tissue changes were evaluated by histopathologic and immunohistochemical analyses.ResultsThe success rates of sample preparations were 85% in group A and 90% in group B. The mean maximum diameter of pulpal exposure area was 625.6±30.6μm in group A and 402.7±18.0μm in group B (p<0.05). In addition, the mean of the minimum remaining dentine thickness at the marked region of interest was 133.2±29.9μm in group A and 261.4±16.3μm in group B (p<0.05). Histopathologic staining demonstrated more signs of inflammation in both groups, as the duration of pulpal exposure increases. However, the rate of inflammatory progress was higher in group A, even spreading to the root pulp tissue within a few hours. For group B, the progress was relatively slow.ConclusionsPulpal exposure with different sizes of dental burs affects changes in the development of pulpal inflammation in mice.



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Linkage between human population and trace elements in soils of the Pearl River Delta: Implications for source identification and risk assessment

Publication date: 1 January 2018
Source:Science of The Total Environment, Volumes 610–611
Author(s): Yan Lin, Jin Ma, Zhengdong Zhang, Yifang Zhu, Hong Hou, Long Zhao, Zaijin Sun, Wenjuan Xue, Huading Shi
The human population is both an emitter and receptor of metals. This study aims to clarify how the relationship of metals and metalloids to human populations influences their source characterization and health risk, based on metal concentrations in 298 soil samples in the Pearl River Delta (PRD) and the corresponding zip-code level population. Nickel (Ni), copper (Cu), zinc (Zn), cadmium (Cd), mercury (Hg), and lead (Pb), but not chromium (Cr) and arsenic (As), were significantly correlated with population (p<0.01), suggesting potential anthropogenic sources. A principal component analysis (PCA) revealed three factors (i.e., F1, F2, and F3) contributing to metal levels in the PRD: (1) metal transport from rivers (F1), which explained the high levels of Cr, Ni, Cu, Zn, As, and Cd in downstream areas; (2) industrial sources (F2), mainly contributing to Ni, Cu, Zn, Cd, Hg, and Pb; and (3) natural and agricultural sources (F3), mainly contributing to As and Pb. F2 was significantly correlated with population, while F3 was not, indicating that an analysis of the correlation with population could be used to identify industrial sources of metals. Compared with directly calculated risks, the population-weighted non-carcinogenic and carcinogenic risks were increased by 4.2–4.9% and 7.7–9.2%, respectively. A unit increase in the concentration of industrial metals led to higher extra risks than a corresponding increase in natural metals due to the proximity to human populations.

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Seasonality, diaspore traits and the structure of plant-frugivore networks in Neotropical savanna forest

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Publication date: October 2017
Source:Acta Oecologica, Volume 84
Author(s): Adriano Antonio Brito Darosci, Emilio M. Bruna, José Carlos Motta-Junior, Cristiane da Silva Ferreira, John Gilman Blake, Cássia Beatriz Rodrigues Munhoz
Complex frugivory networks are common in heterogeneous environments, but how the structure of those networks varies due to seasonality and other environmental factors remains unclear. For example, seasonal variation in rainfall can influence fruit production and diaspore characteristics, which could alter the quantity and quality of resources available to different animals in the network and, hence, network structure. We investigated how a frugivory network varied seasonally in Brazilian savanna (Cerrado), where there are well-defined dry and wet seasons and fructification mainly during the rainy season for most tree species. We recorded fruit consumption by animals during the dry and wet seasons in two different gallery forests and used these data to test the hypotheses that connectance, links per species and nestedness would be higher in the dry season than rainy season due to low available food in the former that would be consumed by various species of frugivores. Concomitantly, we also measured seed width and lipid content from diaspores of the fruiting trees to determine if these characteristics influenced interaction properties between fruiting trees and frugivores. Among the measured network parameters, connectance, links per species and specialization varied between seasons in one site but not in the other, indicating that seasonal variation in networks is not necessarily consistent over time or space. The number of tree species with small diaspores with high lipid content differed between seasons, and those characteristics were key factors increasing the interaction parameter of fruiting trees. We suggest that network stability between seasons may be related to local frugivore diversity, resource availability, and fruit quality.



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Neurobiology of autoimmune encephalitis

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Publication date: February 2018
Source:Current Opinion in Neurobiology, Volume 48
Author(s): Masaki Fukata, Norihiko Yokoi, Yuko Fukata
Autoimmune encephalitis presenting with amnesia, seizures, and psychosis is highly topical in basic and clinical neuroscience. Recent studies have identified numerous associated autoantibodies, targeting cell-surface synaptic proteins including neurotransmitter receptors (e.g. NMDA receptors (NMDARs)) and a secreted protein, LGI1. In vitro and in vivo analyses of the influence of the autoantibodies have begun to clarify their causal roles. Of particular interest is the generation of recombinant monoclonal antibodies from patients' B cells with anti-NMDAR encephalitis. Patient monoclonal antibodies could be useful to reveal their direct, detailed pathogenicity. Such identification and characterization of autoantibodies could create new categories of neurological diseases and promote the understanding of patho-physiologic roles of target proteins in human brain function.



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New insights into olivo-cerebellar circuits for learning from a small training sample

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Publication date: October 2017
Source:Current Opinion in Neurobiology, Volume 46
Author(s): Isao T Tokuda, Huu Hoang, Mitsuo Kawato
Artificial intelligence such as deep neural networks exhibited remarkable performance in simulated video games and 'Go'. In contrast, most humanoid robots in the DARPA Robotics Challenge fell down to ground. The dramatic contrast in performance is mainly due to differences in the amount of training data, which is huge and small, respectively. Animals are not allowed with millions of the failed trials, which lead to injury and death. Humans fall only several thousand times before they balance and walk. We hypothesize that a unique closed-loop neural circuit formed by the Purkinje cells, the cerebellar deep nucleus and the inferior olive in and around the cerebellum and the highest density of gap junctions, which regulate synchronous activities of the inferior olive nucleus, are computational machinery for learning from a small sample. We discuss recent experimental and computational advances associated with this hypothesis.



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Amino acid functionalized zinc oxide nanostructures for cytotoxicity effect and hemolytic behavior: Theoretical and experimental studies

Publication date: 15 November 2017
Source:Materials & Design, Volume 134
Author(s): Satvinder Singh, Baljinder Singh, Prateek Sharma, Anu Mittal, Sanjeev Kumar, G.S.S. Saini, S.K. Tripathi, Gurinder Singh, Aman Kaura
Blending of theoretical and experimental approach, provide an important strategy in designing the nanostructure at a microscopic level and helps in predicting the response of synthesized material towards inhibition of the growth of breast cancer cell. In this work, ab initio calculations using super cell approach are performed for three different amino acids (AAs)-Histidine (His), Arginine (Arg) and Aspartic acid (Asp) coated Zinc oxide (ZnO) nanostructures to explain the growth mechanism of nanoparticles (NPs) of different shapes. Based on the first principles calculations, we reveal that ZnO-AA (Arg and Asp) NPs results in rod like and ZnO-His NPs lead to tablet like configuration. Similar morphologies are fabricated using AAs through synthetic route. The effect of concentration ratio of reactants and pH has been studied. As synthesized samples, are characterized by using Transmission Electron Microscopy (TEM), X-ray diffraction (XRD), Fourier Transform Infrared (FTIR) and UV–Vis spectroscopy techniques. Based on the results, a plausible mechanism of formation of nanostructures has been proposed. The nanostructures with rod like morphology are found to be biocompatible with normal red blood cells and show cytotoxic effect as evaluated from hemolysis and cytotoxicity assays on breast (MCF-7, T47D, MDA-MB-231) & prostate cancer (PC-3) cell lines.

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Isolated Second Implant Adaptation Period in Sequential Cochlear Implantation in Adults

imageObjective: To determine if depriving the use of the first cochlear implant (CI1) impacts adaptation to a sequential implant (CI2). Study Design: Prospective cohort. Setting: Academic center. Patients: Sixteen unilateral cochlear implant recipients undergoing contralateral implantation (sequential bilateral) were matched according to age, etiology, duration of deafness, device age, and delay between implants. Intervention: During a 4-week adaptation period after CI2 activation, patients underwent deprivation of CI1 or were permitted continued use of it. Main Outcome Measures: Speech perception scores and subjective quality of life outcomes before CI2 and at 1, 3, 6, and 12-months following activation. Results: Maximal CI2 speech perception scores in quiet were achieved by 1-month postactivation for the "deprivation" group (71.3% for hearing in noise test [HINT], p = 0.767 for change beyond 1-mo) compared with 6-months for the "continued use" group (67.9% for HINT, p = 0.064 for change beyond 6-mo). The "deprivation" group experienced a temporary drop in CI1 scores (67.9% for HINT in quiet at 1-mo versus 78.4% pre-CI2, p = 0.009) recovering to 77.3% by 3-months; unchanged from baseline levels (p = 1.0). A binaural advantage over the better hearing ear was present for HINT sentences with noise (72.4% versus 58.8% for "deprivation", p = 0.001; 71.5% versus 52.7% for "continued use," p = 0.01). Missing data precluded a meaningful analysis of subjective quality of life outcome scales. Conclusion: Bilateral cochlear implantation improves speech perception compared with one implant. A period of deprivation from CI1 shortens time to maximum speech perception by CI2 without long-term consequences on the performance of CI1.

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Musical Rehabilitation in Adult Cochlear Implant Recipients With a Self-administered Software

imageObjective: The goal of this study was to determine if a self-administered computer-based rehabilitation program could improve music appreciation and speech understanding in adults who have a cochlear implant (CI). Study Design: Prospective study. Setting: Tertiary adult CI program. Patients: Twenty-one postlingually deafened cochlear implant users between the ages of 27 and 79 years were recruited. Interventions(s): A self-administered music rehabilitative software was designed to help improve the perception of musical patterns of increasing complexity, as well as pitch and timbre perception, premised on focused and divided attention. All participants completed a diagnostic music test before and after rehabilitative training, including tests of pitch and timbre perception and pattern identification with increasing levels of difficulty. Speech data in quiet and noise was also collected both pre- and post-training. Participants trained for a minimum of 3.5 hours a week, for 4 weeks. Main Outcome Measure(s): Mean changes in music perception and enjoyment as well as speech perception (IEEE sentence test in quiet and noise). Results: Post-training diagnostic test scores, as compared with pretraining scores, indicated significant improvements in musical pattern perception. Tests of speech perception in quiet and in noise were significantly improved in a subset of this cohort. All of the training participants thought that the training helped to improve their recognition skills, and found the program to be beneficial. Conclusion: Despite the limitations of current CI technology, the results of this study suggest that auditory training can improve music perception skills, and possibly speech intelligibility, lending further support to rehabilitation being an integral part of the postimplantation paradigm.

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Linking Deafness and Dementia: Challenges and Opportunities

The rising incidence of dementia locally and worldwide has now reached a critical level. The associated costs associated with these individuals will ultimately be untenable to most societies. Furthermore there is a paucity of highly effective treatments. However, the recent discovery of the association of hearing loss and dementia may open many potential opportunities. Although we still are acquiring knowledge on the pathophysiology of this association, clinicians are hopeful that our current highly effective treatments of hearing loss may ultimately be shown to have a positive effect on those with dementia.

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Breast cancer subtype discrimination using standardized 4-IHC and digital image analysis

Abstract

Breast cancer is a heterogeneous disease. Surrogate classification of intrinsic subtypes of invasive carcinomas by combined immunohistochemistry for estrogen receptor (ER), progesterone receptor (PR), HER2, and Ki67 (4-IHC) has increased steadily since the 2011 St Gallen symposium, due to its rapid subtyping of tumors at a reasonable cost. An important step in improving 4-IHC reproducibility and reliability will be to provide reference values from the routine use of standardized 4-IHC followed by image analysis. The aims of the current study were (1) to analyze invasive breast carcinomas using standardized 4-IHC and quantitative image analysis and (2) to compare the results obtained in the classification of biological subtypes using current Ki67 and PR threshold values proposed by different authors to sub-classifying the luminal A-like and the luminal B-like (HER2-negative) subtypes. Five hundred twenty-one tumors were analyzed by standardized immunohistochemistry, with automatic image analysis, and HER2 FISH technique. Positivity for ER was found in 82.7% and for PR in 70.1% of cases. Using the Allred scoring system, hormone receptor results showed a bimodal distribution, particularly for ER. HER2 positivity was found in 15.7% of cases, and the mean Ki67 score was 32.3%. Using the most recently proposed surrogate definitions for the classification of luminal breast cancer subtypes, the percentages of different subtypes that we found were similar to those published with genomic platforms: 40.7% luminal A-like, 32.4% luminal B-like/HER2-negative, 9.8% luminal B-like/HER2-positive, 6.0% HER2-positive, and 11.1% triple negative. Standardized 4-IHC with automatic image analysis constitutes a low-cost method for surrogate definitions of biological subtypes of breast cancer that delivers accurate results in a day.



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Metastable Zr–Nb alloys for spinal fixation rods with tunable Young′s modulus and low magnetic resonance susceptibility

Publication date: Available online 19 August 2017
Source:Acta Biomaterialia
Author(s): X.L. Zhao, L. Li, M. Niinomi, M. Nakai, D.L. Zhang, C. Suryanarayana
Good ductility, low magnetic susceptibility, and tunable Young′s modulus are highly desirable properties for materials usage as spinal fixation rods. In this study, the effects of niobium content on the microstructure, magnetic susceptibility, and mechanical properties of Zr–xNb (13≤x≤23 wt.%) alloys were investigated. For the Zr–15Nb and Zr–17Nb alloys, a remarkable increase in Young′s modulus was achieved due to the occurrence of deformation-induced ω phase transformation. This was the result of the competition of two factors associated with the Nb content: an increase of the stability of β phase and a decrease of the amount of athermal ω phase with increasing Nb content. When the Nb content was 15% or 17%, the amount of deformation-induced ω phase was maximum. Moreover, the magnetic susceptibility decreased with the deformation-induced β→ω phase transformation, and the Zr–17Nb alloy with apparent kink bands exhibited a smaller amount of springback than the Zr–15Nb alloy with {332}<113> mechanical twins. Furthermore, the ions released from the Zr–xNb alloys in accelerated immersion tests were at a very low level. The combination of low initial Young′s modulus, and its remarkable variation induced by deformation, low magnetic susceptibility, good ductility, and smaller springback make the Zr–17Nb alloy a potential candidate for spinal fixation rods.

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The role of inattention and hyperactivity/impulsivity in the fine motor coordination in children with ADHD

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Publication date: October 2017
Source:Research in Developmental Disabilities, Volume 69
Author(s): Javier Fenollar-Cortés, Ana Gallego-Martínez, Luis J. Fuentes
ObjectiveDeficits in fine motor coordination have been suggested to be associated with Attention-Deficit/Hyperactivity Disorder (ADHD). However, despite the negative impact of poor fine motor skills on academic achievement, researchers have paid little attention to this problem. The aim of this study was to explore the relationship between ADHD dimensions and fine motor performance.MethodParticipants were 43 children with a diagnosis of ADHD aged between 7 and 14 years (M=9.61; 81% male) and 42 typically developing (TP) children in the same age range (M=10.76; 75.2% male).ResultsChildren with ADHD performed worse than TP on all tasks (δFine_motor_tasks, −0.19 to −0.44). After controlling for age and ADHD-HY (hyperactivity/impulsivity), higher scores on ADHD-IN (inattentiveness) predicted a larger number of mistakes among all psychomotricity tasks and conditions (β 0.39–0.58, ps<0.05).ConclusionThe ADHD group showed poorer fine motor performance than controls across all fine motor coordination tasks. However, lower performance (more mistakes), was related to the inattention dimension but not to the hyperactivity/impulsivity dimensions. Authors recommend including training and enhancement of the fine motor skills for more comprehensive ADHD treatment.



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CCR10 activation stimulates the invasion and migration of breast cancer cells through the ERK1/2/MMP-7 signaling pathway

Publication date: October 2017
Source:International Immunopharmacology, Volume 51
Author(s): Hao-yu Lin, Shu-ming Sun, Xiao-feng Lu, Ping-ying Chen, Chun-fa Chen, Wei-quan Liang, Chun-yan Peng
CCR10, a member of the chemokine receptor subfamily, is overexpressed in several tumors and play a crucial role in cancer development and progression. However, the functions of CCR10 in breast cancer are unknown. Here, we detected the protein levels of CCR10 in breast cancer cells by western blotting, and examined CCR10 expression in breast cancer tissues via immunohistochemical assay. The results showed that CCR10 expression was elevated in breast cancer MCF7, BT-474 and MDA-MB-231 cells. Further, 63 of 89 cases (70.8%) had positive CCR10 staining, and the CCR10 level was closely related to capsular invasion, lymph node metastasis and tumor stage. Moreover, CCL27, the ligand of CCR10, dose-dependently stimulated the invasion and migration of breast cancer cells, and promoted MMP-7 expression and ERK1/2 activation. CCR10 knockdown in breast cancer cells through siRNA transfection attenuated CCL27-induced cell invasiveness, and suppressed MMP-7 expression and ERK1/2 activation. Additionally, blocking the ERK1/2 pathway inhibited the CCL27/CCR10-promoted cell invasion of breast cancer cells. Together, these data suggest that CCL27/CCR10 interaction induces the ERK1/2 pathway, which then increases MMP-7 expresion and subsequently promotes breast cancer cell invasion and migration. Thus, CCR10 may be a key regulator in breast cancer cell invasion and migration.



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Progesterone therapy induces an M1 to M2 switch in microglia phenotype and suppresses NLRP3 inflammasome in a cuprizone-induced demyelination mouse model

Publication date: October 2017
Source:International Immunopharmacology, Volume 51
Author(s): Roya Aryanpour, Parichehr Pasbakhsh, Kazem Zibara, Zeinab Namjoo, Fatemeh Beigi Boroujeni, Saeed Shahbeigi, Iraj Ragerdi Kashani, Cordian Beyer, Adib Zendehdel
Demyelination of the central nervous system (CNS) has been associated to reactive microglia in neurodegenerative disorders, such as multiple sclerosis (MS). The M1 microglia phenotype plays a pro-inflammatory role while M2 is involved in anti-inflammatory processes in the brain. In this study, CPZ-induced demyelination mouse model was used to investigate the effect of progesterone (PRO) therapy on microglia activation and neuro-inflammation. Results showed that progesterone therapy (CPZ+PRO) decreased neurological behavioral deficits, as demonstrated by significantly decreased escape latencies, in comparison to CPZ mice. In addition, CPZ+PRO caused a significant reduction in the mRNA expression levels of M1-markers (iNOS, CD86, MHC-II and TNF-α) in the corpus callosum region, whereas the expression of M2-markers (Trem-2, CD206, Arg-1 and TGF-β) was significantly increased, in comparison to CPZ mice. Moreover, CPZ+PRO resulted in a significant decrease in the number of iNOS+ and Iba-1+/iNOS+ cells (M1), whereas TREM-2+ and Iba-1+/TREM-2+ cells (M2) significantly increased, in comparison to CPZ group. Furthermore, CPZ+PRO caused a significant decrease in mRNA and protein expression levels of NLRP3 and IL-18 (~2-fold), in comparison to the CPZ group. Finally, CPZ+PRO therapy was accompanied with reduced levels of demyelination, compared to CPZ, as confirmed by immunofluorescence to myelin basic protein (MBP) and Luxol Fast Blue (LFB) staining, as well as transmission electron microscopy (TEM) analysis. In summary, we reported for the first time that PRO therapy causes polarization of M2 microglia, attenuation of M1 phenotype, and suppression of NLRP3 inflammasome in a CPZ-induced demyelination model of MS.



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Collagenase treatment enhances proteomic coverage of low-abundance proteins in decellularized matrix bioscaffolds

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Publication date: November 2017
Source:Biomaterials, Volume 144
Author(s): Miljan Kuljanin, Cody F.C. Brown, Matthew J. Raleigh, Gilles A. Lajoie, Lauren E. Flynn
There is great interest in the application of advanced proteomic techniques to characterize decellularized tissues in order to develop a deeper understanding of the effects of the complex extracellular matrix (ECM) composition on the cellular response to these pro-regenerative bioscaffolds. However, the identification of proteins in ECM-derived bioscaffolds is hindered by the high abundance of collagen in the samples, which can interfere with the detection of lower-abundance constituents that may be important regulators of cell function. To address this limitation, we developed a novel multi-enzyme digestion approach using treatment with a highly-purified collagenase derived from Clostridium Histolyticum to selectively deplete collagen from ECM-derived protein extracts, reducing its relative abundance from up to 90% to below 10%. Moreover, we applied this new method to characterize the proteome of human decellularized adipose tissue (DAT), human decellularized cancellous bone (DCB), and commercially-available bovine tendon collagen (BTC). We successfully demonstrated with all three sources that collagenase treatment increased the depth of detection and enabled the identification of a variety of signaling proteins that were masked by collagen in standard digestion protocols with trypsin/LysC, increasing the number of proteins identified in the DAT by ∼2.2 fold, the DCB by ∼1.3 fold, and the BTC by ∼1.6 fold. In addition, quantitative proteomics using label-free quantification demonstrated that the DAT and DCB extracts were compositionally distinct, and identified a number of adipogenic and osteogenic proteins that were consistently more highly expressed in the DAT and DCB respectively. Overall, we have developed a new processing method that may be applied in advanced mass spectrometry studies to improve the high-throughput proteomic characterization of bioscaffolds derived from mammalian tissues. Further, our study provides new insight into the complex ECM composition of two human decellularized tissues of interest as cell-instructive platforms for regenerative medicine.



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Degradable bioadhesive nanoparticles for prolonged intravaginal delivery and retention of elvitegravir

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Publication date: November 2017
Source:Biomaterials, Volume 144
Author(s): Muneeb Mohideen, Elias Quijano, Eric Song, Yang Deng, Gauri Panse, Wei Zhang, Meredith R. Clark, W. Mark Saltzman
New methods for long-lasting protection against sexually transmitted disease, such as the human immunodeficiency virus (HIV), are needed to help reduce the severity of STD epidemics, especially in developing countries. Intravaginal delivery of therapeutics has emerged as a promising strategy to provide women with local protection, but residence times of such agents are greatly reduced by the protective mucus layer, fluctuating hormone cycle, and complex anatomical structure of the reproductive tract. Polymeric nanoparticles (NPs) capable of encapsulating the desired cargo, penetrating through the mucosal surfaces, and delivering agents to the site of action have been explored. However, prolonged retention of polymer carriers and their enclosed materials may also be needed to ease adherence and confer longer-lasting protection against STDs. Here, we examined the fate of two poly (lactic acid)-hyperbranched polyglycerols (PLA-HPG) NP formulations – 1) nonadhesive PLA-HPG NPs (NNPs) and 2) surface-modified bioadhesive NPs (BNPs) – loaded with the antiretroviral elvitegravir (EVG) after intravaginal administration. BNP distribution was widespread throughout the reproductive tract, and retention was nearly 5 times higher than NNPs after 24 h. Moreover, BNPs were found to be highly associated with submucosal leukocytes and epithelial cell populations for up to 48 h after topical application, and EVG was retained significantly better in the vaginal lumen when delivered with BNPs as opposed to NNPs over a 24 h period. Our results suggest that bioadhesive PLA-HPG NPs can greatly improve and prolong intravaginal delivery of agents, which may hold potential in providing sustained protection over longer durations.



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Failure modes and effects analysis for ocular brachytherapy

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Publication date: Available online 18 August 2017
Source:Brachytherapy
Author(s): Yongsook C. Lee, Yongbok Kim, Jason Wei-Yeong Huynh, Russell J. Hamilton
PurposeThe aim of the study was to identify potential failure modes (FMs) having a high risk and to improve our current quality management (QM) program in Collaborative Ocular Melanoma Study (COMS) ocular brachytherapy by undertaking a failure modes and effects analysis (FMEA) and a fault tree analysis (FTA).Methods and MaterialsProcess mapping and FMEA were performed for COMS ocular brachytherapy. For all FMs identified in FMEA, risk priority numbers (RPNs) were determined by assigning and multiplying occurrence, severity, and lack of detectability values, each ranging from 1 to 10. FTA was performed for the major process that had the highest ranked FM.ResultsTwelve major processes, 121 sub-process steps, 188 potential FMs, and 209 possible causes were identified. For 188 FMs, RPN scores ranged from 1.0 to 236.1. The plaque assembly process had the highest ranked FM. The majority of FMs were attributable to human failure (85.6%), and medical physicist–related failures were the most numerous (58.9% of all causes). After FMEA, additional QM methods were included for the top 10 FMs and 6 FMs with severity values > 9.0. As a result, for these 16 FMs and the 5 major processes involved, quality control steps were increased from 8 (50%) to 15 (93.8%), and major processes having quality assurance steps were increased from 2 to 4.ConclusionsTo reduce high risk in current clinical practice, we proposed QM methods. They mainly include a check or verification of procedures/steps and the use of checklists for both ophthalmology and radiation oncology staff, and intraoperative ultrasound-guided plaque positioning for ophthalmology staff.



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Conchal contractility after inferior turbinate hypertrophy treatment: A prospective, randomized clinical trial

The aim of this study is to evaluate the effects of these two methods (Nasal corticosteroids (NCS) and radiofrequency (RF) application) on conchal contractility utilizing objective rhinologic measurement parameters.

http://ift.tt/2igjXVB

Conchal contractility after inferior turbinate hypertrophy treatment: A prospective, randomized clinical trial

The aim of this study is to evaluate the effects of these two methods (Nasal corticosteroids (NCS) and radiofrequency (RF) application) on conchal contractility utilizing objective rhinologic measurement parameters.

http://ift.tt/2igjXVB

Trends in antibiotic prescribing by dental practitioners in Germany

To analyze the structure of antibiotic prescriptions by dentists in Germany during a time-period of four years in relation to medical antibiotic prescriptions.

http://ift.tt/2uThfeE

Long-term therapy with intravenous zoledronate increases the number of nonattached osteoclasts

Bisphosphonates (BPs) are antiresorptive drugs that are being used clinically to treat bone-related diseases, such as osteoporosis or cancer with bone metastasis (Williams et al., 2014). Users of these drugs are known to be at higher risk of developing osteonecrosis of the jaw (ONJ), which was first described by Marx (2003).

http://ift.tt/2vc0o28

Determining the fate of cranial sutures after surgical correction of non-syndromic craniosynostosis

"Secondary craniosynostosis" (SCS) refers to a loss of sutures after corrective vault reconstruction. There are no prior studies that comprehensively review SCS in various types of non-syndromic craniosynostosis. We assessed idiopathic and iatrogenic SCS using 3-dimensional computed tomography (3D CT). We also performed a systematic review to estimate the overall incidence of SCS in each craniosynostosis type, and to characterize its clinical features.

http://ift.tt/2uTCxZF

Perinatal complications in patients with unisutural craniosynostosis: An international multicentre retrospective cohort study

Craniosynostosis may lead to hampered fetal head moulding and birth complications. To study the interaction between single suture craniosynostosis and delivery complications, an international, multicentre, retrospective cohort study was performed.

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Effects of low-level laser therapy and platelet concentrate on bone repair: Histological, histomorphometric, immunohistochemical, and radiographic study

Low-level laser therapy (LLLT) can increase bone metabolism, cell proliferation, and maturation, and reduce inflammation, while platelet concentrate (PC) assists bone healing process by releasing proteins and growth factors. Here, we evaluated the efficacy of combined LLLT and PC therapy in the healing of critical-size bone defects.

http://ift.tt/2uTGTjp

Development and Validation of a Modular Endoscopic Ear Surgery Skills Trainer

imageObjective: Endoscopic ear surgery (EES) is an emerging technique requiring single-handed dissection with limited depth perception. Current options for EES simulation and training are limited. Herein, we introduce a versatile, low-cost surgical skills trainer that aims to improve the fine motor control necessary for EES. Study Design: Prospective validation study. Setting: Surgical simulation laboratory. Participants: Seven subjects ranging in experience from medical students ("Novices") to experienced ear surgeons ("Experts") participated in the validation study. Experts (n = 3) were defined as performing >10 EES cases per year. Methods: The skills trainer was constructed from a 3" diameter polyvinyl chloride pipe cap modified with two ports for instrument passage. A wooden platform was placed inside at an appropriate working distance for ear surgery. Eight interchangeable skills modules were fabricated on wooden squares (3 cm × 3 cm) using materials such as #19 wire brads, 1.6 mm glass beads, and 26-gauge jewelry wire. The material cost of this reusable model was $15. Subjects completed each skills module in triplicate, followed by a Likert-based survey. Results: Expert performance was superior to novices in 100% (8/8) of skills modules, i.e., threading beads on a wire (43 versus 127 s, p 

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Diagnosis of Superior Semicircular Canal Dehiscence in the Presence of Concomitant Otosclerosis

imageObjective: To review three patients with concurrent otosclerosis and superior canal dehiscence identified before operative intervention and provide a practical diagnostic approach to this clinical scenario. Study Design: Retrospective patient series. Setting: Tertiary/quaternary referral center. Patients: Individuals with confirmed diagnoses of concurrent otosclerosis and superior semicircular canal dehiscence syndrome. Interventions: Detailed history and physical examinations were performed on these patients, as well as detailed audiovestibular testing and computed tomography imaging. Main Outcome Measures: Establishing a clear diagnosis of concurrent otosclerosis and superior semicircular canal dehiscence syndrome using a thorough diagnostic approach. Results: Three patients presented with conductive hearing loss and normal tympanic membranes. When history and physical examination yielded suspicious third window symptoms/signs, more detailed audiovestibular testing and computed tomography scan imaging were performed. All three patients were ultimately identified to have concurrent otosclerosis and superior canal dehiscence. Conservative management was the option of choice for two of these patients (trial of a hearing aid) and surgical intervention was performed to treat the otosclerosis in the remaining patient.

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Significance of Endolymphatic Hydrops in Ears With Unilateral Sensorineural Hearing Loss

imageObjective: The purpose of this study was to investigate the existence of endolymphatic hydrops (EH) in affected and unaffected ears in patients with unilateral sensorineural hearing loss (SNHL) using contrast-enhanced magnetic resonance imaging (MRI), and to evaluate the significance of EH in various otological diseases. Study Design: Retrospective study. Setting: University hospital. Methods: One hundred eighty-two ears from 91 patients with unilateral SNHL were studied. The endolymphatic space was evaluated using 3-Tesla MRI with gadodiamide hydrate. Imaging data about the degree of EH in the cochlea and vestibule were analyzed and compared between ears with various otological diseases. Results: All affected ears with delayed endolymphatic hydrops had EH. In affected ears with definite Menière's disease, cochlear EH was observed in all ears and vestibular EH in 93% of ears, and these rates were significantly higher in the affected than in the unaffected ears. EH was also observed in the cochlea and vestibule in 66% and 41%, respectively, of the affected ears with idiopathic sudden SNHL; however, these percentages did not differ significantly from those in the unaffected ears (52% and 38%, respectively). Conclusion: MRI showed that a high percentage of ears affected by Menière's disease or delayed endolymphatic hydrops had EH. Further studies should evaluate the implications of EH in ears, especially in those with sudden SNHL, in terms of secondary or pre-existing EH.

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Vestibular Function in Adults With Epilepsy of Unknown Etiology

imageObjective: This study aimed to evaluate vestibular function in adults with chronic epilepsy of unknown etiology in the inter-ictal period. Background: Epilepsy is a chronic medical disorder. Life-long therapy may be required in one-third of patients. Epilepsy is associated with comorbid somatic conditions which impairs patients' quality of life. Methods: This cross-sectional study included 28 with generalized tonic clonic (GTC) convulsions and 14 and 3 with temporal (TLE) and frontal lobe (FLE) epilepsies with secondary generalization (all were on regular carbamazepine therapy) and 40 healthy control subjects. The patients' mean age was 34.97 ± 7.35 years and the duration of illness was 18.75 ± 7.99 years. All underwent videonystagmography (VNG). Results: Compared with controls, patients had frequent vestibular symptoms including dizziness (62.22%) (p = 0.0001) and sense of imbalance (44.44%) (p = 0.0001). Eleven patients (24.44%) had central vestibular dysfunction (p = 0.0001); 9 (20%) had mixed vestibular dysfunction and one (2.22%) had peripheral vestibular dysfunction (p = 0.0001). Abnormalities were observed in saccadic (44.4%) and pursuit (42.2%) eye movements, optokinetic nystagmus (42.2%) and positioning/positional (11.11%) and caloric (13.33%) testing. TLE and FLE were associated with more VNG abnormalities than GTC. No significant differences were observed in the demographic and clinical characteristics between patients with and without VNG abnormalities. Conclusion: Vestibular manifestations are frequent in patients with epilepsy. This may be a result of the permanent damaging effect of chronic epilepsy on the vestibular cortical areas and/or a toxic effect from prolonged carbamazepine therapy on the peripheral and central vestibular systems.

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Noonan Syndrome: An Underestimated Cause of Severe to Profound Sensorineural Hearing Impairment. Which Clues to Suspect the Diagnosis?

imageObjective: To highlight Noonan syndrome as a clinically recognizable cause of severe to profound sensorineural hearing impairment. Study Design: New clinical cases and review. Setting: Patients evaluated for etiological diagnosis by a medical geneticist in a reference center for hearing impairment. Patients: Five patients presenting with confirmed Noonan syndrome and profound sensorineural hearing impairment. Interventions: Diagnostic and review of the literature. Results: Five patients presented with profound sensorineural hearing impairment and molecularly confirmed Noonan syndrome. Sensorineural hearing impairment has been progressive for three patients. Cardiac echography identified pulmonary stenosis in two patients and was normal for the three other patients. Short stature was found in two patients. Mild intellectual disability was found in one patient. Inconspicuous clinical features as facial dysmorphism, cryptorchidism, or easy bruising were of peculiar interest to reach the diagnosis of Noonan syndrome. Conclusion: Profound sensorineural hearing impairment can be the main feature of Noonan syndrome. Associated features are highly variable; thus, detailed medical history and careful physical examination are mandatory to consider the diagnosis in case of a sensorineural hearing impairment.

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Outcomes and Time to Emergence of Auditory Skills After Cochlear Implantation of Children With Charge Syndrome

imageObjective: Review perioperative complications, benefits, and the timeframe over which auditory skills develop in children with CHARGE syndrome who receive a cochlear implant (CI). Study Design: IRB-approved retrospective chart review of children with CHARGE syndrome who had at least 12 months of cochlear implant use. Setting: Tertiary care children's hospital. Patients: Twelve children, seven males and five females. Mean age implant = 3.5 years (1.7–8.2 yr); mean duration follow-up = 4.7 years (1.5–10.1 yr). Intervention: Cochlear implantation. Main Outcome Measures: Auditory skills categorized into four levels, temporal bone imaging findings, perioperative complications, time to emergence of speech perception, expressive communication mode. Results: All children imaged with magnetic resonance imaging had cochlear nerve deficiency in at least one ear. Speech awareness threshold improved with the CI compared with aided preoperative in 83% of children, with means of 51.7 dB SAT preoperative and 27.1 dB with the CI (p ≤ 0.002). Overall, four children improved to auditory Level 2 (improved detection), three obtained Level 3 (closed-set speech perception), and three had open-set speech perception with their CIs (Level 4) that was first evident at 3.5, 3.3, and 0.8 years postimplant testing. Two children had minimal or limited improvement. One child with hypoplasia of the cochlear nerve obtained open-set levels. Conclusion: Auditory skills may develop slowly in children with CHARGE syndrome who receive a CI but most can achieve at least improved detection. In our series, half acquired some speech perception ability. Cochlear nerve deficiency is frequent, but should not be a contraindication to implantation.

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Audiologic Gain of Incus Short Process Vibroplasty With Conventional Incus Long Process Vibroplasty: A Retrospective Analysis of 36 Patients

imageObjective: To compare the audiological and non-audiological benefits of incus short process (SP) vibroplasty with those of conventional incus long process (LP) vibroplasty. Study Design: Retrospective analysis. Setting: Tertiary referral center. Patients: Thirty-six patients with sensorineural hearing loss were treated with the semi-implantable middle ear hearing device. Of these, 22 were treated with conventional LP vibroplasty, and 14 were treated with SP vibroplasty using SP couplers. Interventions: Implantation with the semi-implantable middle ear hearing device by different methods. Main Outcome Measures: Pre- and postoperative hearing level, word recognition score, operation time, and duration of hospital stay were compared. We also surveyed a questionnaire to assess postoperative complications. Results: The improvement in hearing gain was comparable between SP vibroplasty and conventional LP vibroplasty, except at 8 kHz, at which LP vibroplasty showed better hearing gain (p 

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The Influence of Intraoperative Testing on Surgical Decision-making During Cochlear Implantation

Objective: To review our use of intraoperative testing during cochlear implantation (CI) and determine its impact on surgical decision-making. Study Design: Retrospective chart review. Setting: Tertiary referral center. Patients: A total of 197 children and adults who underwent a total of 266 primary and/or revision CI by a single surgeon from 2010 to 2015. Intervention: Intraoperative electrophysiologic monitoring including evoked compound action potentials and electrical impedances. Main Outcome Measures: Whether surgical management was changed based on intraoperative testing. Results: In only 2 of 266 patients (0.8%), the back-up device was used due to findings on intraoperative testing. In three patients (1.1%), X-ray was performed intraoperatively to confirm intracochlear electrode placement, which was found to be normal in all patients. Conclusion: Our data suggest that with respect to CI in children and adults in straightforward cases (e.g., normal anatomy, nondifficult insertion, etc.), routine intraoperative evoked compound action potentials, impedances, and imaging rarely influence surgical decision-making in our clinic and may have limited usefulness in these patients. The implications of this are discussed and a review of the literature is presented.

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Reduction in Temporary and Permanent Audiological Injury Through Internal Jugular Vein Compression in a Rodent Blast Injury Model

imageHypothesis: Internal jugular vein (IJV) compression influences not only intracranial but also intracochlear physiology and has demonstrated preclinical effectiveness in reducing acute audiological injury in a rodent blast model. However, the long-term effects in this model are unknown. Background: Blast wave-induced audiological injury from an improvised explosive device is a leading cause of morbidity among service members in theater but there are limitations to the current protective measures. Methods: For this study, we exposed 20 Sprague Dawley rats to a 16.8 ± 0.3 PSI (195.3 dB SPL) right-sided shock wave in which 10 had application of a custom IJV compression collar in place at the time of injury. Results: IJV compression at the time of injury was shown acutely to significantly reduce the incidence of tympanic membrane rupture and the initial temporary threshold shift on otoacoustic emissions in both the right and left ears of animals who had collar application immediately after and 7 days post injury. At 28 days from injury, collared animals demonstrated a return to baseline of otoacoustic emission values while the noncollared animals had persistent threshold shifts, signifying the presence of a permanent threshold shift only in those animals without collar application. IJV compression was also found to significantly reduce hair cell loss at the base of the cochlea secondary to mechanical trauma from the blast wind. Conclusion: Previously observed acute protective effects of IJV compression are sustained at chronic time points. IJV compression can potentially be used to reduce long-term permanent morbidity from blast-induced audiological trauma.

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Role of Multislice CT Imaging in Predicting the Visibility of the Round Window in Pediatric Cochlear Implantation

imageBackground: High-resolution computed tomography (HRCT) magnifies the role of preoperative imaging for detailed inner and middle ear anatomical information and enhances more efforts for better dependent correlation and measurements of round window (RW). Objective: To find an applicable way by HRCT imaging for the prediction of the visibility of the RW during cochlear implantation (CI) surgery. Methods: Five radiologic measurements were performed on the axial HRCT and these measurements were correlated with the degree of RW visibility after performing posterior tympanotomy during CI surgery. Results: Sixty ears of 60 children were included in the current study. A significant correlation was found between the degree of RW visibility and the following: 1) the angle between RW, facial nerve (FN), and the coronal axis (p 

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Visual Processing Recruits the Auditory Cortices in Prelingually Deaf Children and Influences Cochlear Implant Outcomes

imageObjective: Although visual processing recruitment of the auditory cortices has been reported previously in prelingually deaf children who have a rapidly developing brain and no auditory processing, the visual processing recruitment of auditory cortices might be different in processing different visual stimuli and may affect cochlear implant (CI) outcomes. Methods: Ten prelingually deaf children, 4 to 6 years old, were recruited for the study. Twenty prelingually deaf subjects, 4 to 6 years old with CIs for 1 year, were also recruited; 10 with well-performing CIs, 10 with poorly performing CIs. Ten age and sex-matched normal-hearing children were recruited as controls. Visual ("sound" photo [photograph with imaginative sound] and "nonsound" photo [photograph without imaginative sound]) evoked potentials were measured in all subjects. P1 at Oz and N1 at the bilateral temporal-frontal areas (FC3 and FC4) were compared. Results: N1 amplitudes were strongest in the deaf children, followed by those with poorly performing CIs, controls and those with well-performing CIs. There was no significant difference between controls and those with well-performing CIs. "Sound" photo stimuli evoked a stronger N1 than "nonsound" photo stimuli. Further analysis showed that only at FC4 in deaf subjects and those with poorly performing CIs were the N1 responses to "sound" photo stimuli stronger than those to "nonsound" photo stimuli. No significant difference was found for the FC3 and FC4 areas. No significant difference was found in N1 latencies and P1 amplitudes or latencies. Conclusion: The results indicate enhanced visual recruitment of the auditory cortices in prelingually deaf children. Additionally, the decrement in visual recruitment of auditory cortices was related to good CI outcomes.

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Can Preoperative CT Scans Be Used to Predict Facial Nerve Stimulation Following CI?

imageObjectives: 1) To determine the ability of preoperative computed tomography (CT) to predict facial nerve stimulation (FNS) after cochlear implantation (CI). 2) To recognize the limitations of CT in predicting FNS. Study Design: Patient control study. Setting: Tertiary care academic medical center. Subjects: Adult patients with CI from 2003 to 2015. Methods: Patients with severe FNS (n = 4) were compared with randomly selected CI patients (n = 28). Three blinded reviewers evaluated preoperative temporal bone CT scans to measure the distance from the labyrinthine segment of the facial nerve to the basal turn of the cochlea and attempted to predict whether or not the subject had FNS after CI. Results: In total, 32 CT scans were evaluated representing 49 ears that underwent CI. The distances (mm) measured from the labyrinthine segment of the facial nerve to the basal turn of the cochlea in both the axial (0.3 ± 0.3 versus 0.6 ± 0.3) and coronal (0.4 ± 0.2 versus 0.6 ± 0.2) orientation were significantly different between the two groups (p = 0.0001 and p = 0.0034) respectively. The intraclass correlation coefficient demonstrated good (K > 0.7) reviewer correlation in both the reviewers' measurements and predictions. The sensitivity, specificity, positive predictive value, and negative predictive value for preoperative CT scans to predict FNS were 38.5, 85.1, 19.2, and 93.8% respectively. The reviewers were 23% accurate in predicting FNS. Conclusion: Based on a blinded retrospective patient-control study, CT scan measurements show a significantly reduced distance between the labyrinthine facial nerve and the basal turn of the cochlea in patients with FNS. However, it is difficult to predict who will have FNS based on these measurements.

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The Role of Preoperative Steroids in Atraumatic Cochlear Implantation Surgery

imageHypothesis: Depth of insertion is related to the extent of tissue response and low frequency hearing loss. Intravenous steroids have greatest effect in reducing postimplantation fibrosis and hearing loss in the presence of significant electrode insertion trauma, when compared with saline treatment. Background: Experiments exploring the enhancement of cochlear implantation (CI) outcomes with glucocorticosteroids have produced mixed results, possibly due to lack of standardization of the CI model. Methods: Forty-eight normal-hearing guinea pigs were randomly implanted with a highly flexible electrode to a depth of 1.5, 3.0, or 5.0 mm. For each insertion depth, sub-cohorts received either intravenous saline ("saline") or dexamethasone ("steroid") 60 minutes before implantation. Shifts in electrocochleography thresholds at 2 to 32 kHz were determined before and 4 weeks after implantation. Cochleae were harvested and imaged. Results: Low-frequency hearing loss was greatest with 5.0 mm insertions. Fracture of the osseous spiral lamina and/or fibrotic involvement of the round window membrane exacerbated hearing loss. The extent of intracochlear fibrosis was directly related to the depth of insertion. Steroids reduced the intracochlear tissue response for deepest insertions and in apical regions of the cochlea where basilar membrane contact was prevalent. Steroids preserved no more hearing than saline at all insertion depths. Conclusion: Cochlear trauma influenced postimplantation hearing loss and steroid effect on fibrosis. Fibrosis, and to a lesser extent, postimplantation hearing loss increased proportionally to the depth of insertion. Steroids did not influence fibrosis relating to the cochleostomy, but could reduce scarring as the electrode negotiated the hook region or near the electrode tip.

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Paediatric endonasal dacryocystorhinostomy using an otology set: How I do it

Endonasal DCR is safely performed in children presenting with persistent epiphora, not responding to conservative management. The surgical technique of endoscopic DCR in the paediatric age group essentially remains the same as that performed in adults, but children have narrower nasal passages and relatively larger inferior turbinates which limit the surgeon's working space. The standard 2.7 mm paediatric nasal endoscope gives a smaller surgical work field as compared to the 4 mm adult endoscope.

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Effectiveness of Dietetic Consultations in Primary Health Care: A Systematic Review of Randomized Controlled Trials

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Publication date: Available online 19 August 2017
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Lana J. Mitchell, Lauren E. Ball, Lynda J. Ross, Katelyn A. Barnes, Lauren T. Williams
BackgroundA dietetic consultation is a structured process aimed at supporting individual patients to modify their dietary behaviors to improve health outcomes. The body of evidence on the effectiveness of nutrition care provided by dietitians in primary health care settings has not previously been synthesized. This information is important to inform the role of dietitians in primary health care service delivery.ObjectiveThe aim of this systematic review was to evaluate the evidence of the effectiveness of individual consultations provided exclusively by dietitians in primary care to support adult patients to modify dietary intake and improve health outcomes.Study designProQuest Family Health, Scopus, PubMed Central, Medline, the Cumulative Index to Nursing and Allied Health Literature, and Cochrane databases were searched for English language systematic reviews or randomized controlled trials published before October 2016. The key terms used identified the provision of nutrition care exclusively by a dietitian in a primary health care setting aimed at supporting adult patients to modify dietary behaviors and/or improve biomarkers of health. Interventions delivered to patients aged younger than 18 years, in hospital, via telephone only, in a group or lecture setting, or by a multidisciplinary team were excluded. The methodologic quality of each study was appraised using the Cochrane Risk of Bias tool and the body of evidence was assessed using the Academy of Nutrition and Dietetics Evidence Analysis Manual.Main outcome measuresOutcomes included the effectiveness of dietetic interventions in terms of anthropometry, clinical indicators, and dietary intake. A statistically significant between-group difference was used to indicate intervention effectiveness (P<0.05).ResultsTwenty-six randomized controlled studies met eligibility criteria, representing 5,500 adults receiving dietetic consultations in a primary care setting. Eighteen of 26 included studies showed statistically significant differences in dietary, anthropometric, or clinical indicators between intervention and comparator groups. When focusing specifically on each study's stated aim, significant improvements favoring the intervention compared with control were found for the following management areas: glycemic control (four out of four studies), dietary change (four out of four studies), anthropometry (four out of seven studies), cholesterol (two out of eight studies), triglycerides (one out of five), and blood pressure (zero out of three) studies.ConclusionsDietetic consultations for adults in primary care settings appear to be effective for improvement in diet quality, diabetes outcomes (including blood glucose and glycated haemoglobin values), and weight loss outcomes (eg, changes in weight and waist circumference) and to limit gestational weight gain (Grade II: Fair evidence). Research evaluated in this review does not provide consistent support for the effectiveness of direct dietetic counseling alone in achieving outcomes relating to plasma lipid levels and blood pressure (Grade III: Limited evidence). Therefore, to more effectively control these cardiovascular disease risk factors, future research might explore novel nutrition counseling approaches as well as dietitians functioning as part of multidisciplinary teams.



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Which patient with thyroid cancer deserves systemic therapy and when?

Publication date: Available online 18 August 2017
Source:Best Practice & Research Clinical Endocrinology & Metabolism
Author(s): Furio Pacini
Distant metastases from differentiated thyroid cancer (DTC) are a rare event, occurring in less than 10% of patients with persistent or recurrent clinical disease. About 50% of these patients do respond to radioiodine (RAI) therapy, either with complete remission or stabilization of the disease on a long term period. Unfortunately, another 50% of these patients are refractory to the treatment with RAI, either from the first appearance of distant metastases or during follow-up. Overall, these patients represent 4-5 new cases/year/million. After the discovery of RAI-refractory disease, the 10-year survival rate is usually less than 10% and the mean life expectancy is 3-5 years (1). Tyrosine hinase inhibitors (TKI) have been introduced in the clinical practice based on the results of several phase III clinical trial, which brought to the approval from competent authorities in USA and Europe of two specific drugs: sorafenib and lenvatinib. Both of them, have shown objective response rates improving the progression-free survival rates, although no overall survival benefit has been demonstrated yet (2,3). The most challenging issue in RAI-refractory thyroid cancer is when a patient should be considered RAI-refractory and when to initiate treatment with TKI.



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Expansion of blood IgG4+ Bcells, Th2 and Tregulatory cells in IgG4-related disease

We here provide new insights into IgG4+ B-cells, and how their detection contributes to diagnosis and monitoring of treatment success in patients with IgG4-related disease.

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Cardiac complexity and emotional dysregulation in children

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Publication date: Available online 19 August 2017
Source:International Journal of Psychophysiology
Author(s): Charlotte Fiskum, Tonje Grønning Andersen, Per M. Aslaksen, Birgit Svendsen, Magne A. Flaten, Karl Jacobsen
ObjectiveSample entropy (SampEn) gives an estimate of signal complexity in cardiac time series and can give information beyond linear heart rate variability. Lower cardiac SampEn is associated with psychopathology in adults. Emotional dysregulation is widely present in adult psychopathology and a forerunner to later mental problems in children. Therefore, this study investigated whether SampEn relates to emotional dysregulation in children.MethodsParticipants were 32 children between 9-13 years with internalizing difficulties and 25 controls. Parents filled out the "Emotional Problems" subscale in the Strengths and Difficulties questionnaire and the "Lability/Negativity" scale in the Emotion Regulation Checklist. SampEn, root mean square of successive differences (RMSSD), normalized power of high frequency (HFnu) components of the cardiac signal and pre-ejection period (PEP) were computed at rest. The study investigated the predictive power of SampEn, RMSSD and HFnu on the measures of emotional dysregulation. It also tested whether RMSSD or PEP were related to SampEn.ResultsSampEn was a significant predictor of both measures of emotional dysregulation, while RMSSD and HFnu were not. RMSSD and PEP were both significant predictors of SampEn.ConclusionsSampEn is a potential marker of dysregulation in the underlying neurovisceral processes vital for emotion regulation, and an important complementary measure to linear cardiac indices, explaining more of the variance in emotional dysregulation than RMSSD and HFnu in this study. Lower SampEn can also be linked to both higher vagal and sympathetic activation via RMSSD and PEP.



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Diagnostic implications of TERT promoter mutation status in diffuse gliomas in a routine clinical setting

Abstract

IDH (isocitrate dehydrogenase) gene mutations are present in most diffuse low-grade gliomas and define the clinico-pathological core of the respective morphologically defined entities. Conversely, according to the 2016 WHO classification, the majority of glioblastomas belong to the IDH-wildtype category, which is defined by exclusion. TERT (telomerase reverse transcriptase gene) promoter mutations have been suggested as a molecular marker for primary glioblastomas. We analyzed molecular, histopathological, and clinical profiles of a series of 110 consecutive diffuse gliomas (WHO grades II-IV) diagnosed at our institution, in which TERT promoter mutation analysis had been performed as part of diagnostic work-up. A diagnostic algorithm based on IDH, TERT, ATRX, H3F3A, and 1p19q co-deletion status resulted in a consistent molecular classification with only 14 (13%) marker-negative tumors. TERT promoter mutations were present in 77% of IDH-wildtype tumors. The TERT/IDH-wildtype category was highly enriched for tumors with unconventional clinical or histological features. Molecular classes were associated with distinct rates of MGMT promoter methylation. We conclude that, in a routine diagnostic setting, TERT promoter mutations define a relatively homogeneous core group among IDH-wildtype diffuse gliomas that includes the majority of primary glioblastomas as well as their putative precursor lesions.



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Sarcomatoid carcinoma associated with small cell carcinoma of the urinary bladder: a series of 28 cases

Publication date: Available online 19 August 2017
Source:Human Pathology
Author(s): Yuly Ramirez Urrea, Jonathan I. Epstein
The association of sarcomatoid carcinoma (SC) with small cell carcinoma (SCC) has not been systematically studied. We identified 39 consult cases between 2001–2016 with available slides for review in 28 cases. There were 19 men and 9 women [mean age: 78years (51–89)]. In 26 (92.8%) cases, the sarcomatoid component had nonspecific malignant spindle cells, 4 (14%) chondrosarcoma, 2 (7%) myxoid sarcomatous, 1 (3.5%) osteosarcoma, and 1 (3.5%) rhabdomyosarcoma. The predominant component was in 11 (39%) cases SCC, 6 (21%) urothelial carcinoma, 3 (10%) sarcomatoid, and 8 (29%) equal sarcomatoid and SCC. There were 3 morphological groups: group 1 [18/28 (64%)] showed a gradual transition from SCC to other components; group 2 [5/28 (18%) had an abrupt transition from SCC to other components; and in group 3 [5/28 (18%)], the SCC was separate from other components. In Group 1, 12 (66%) cases of SCC showed a gradual transition to sarcomatoid areas, 3 (17%) to urothelial carcinoma, and in 3 (17%) cases to multiple components including squamous cell carcinoma, urothelial carcinoma, and sarcomatoid. Mortality did not differ based on pathological Groups. The 36-month actuarial risk of death was 64.3%. The multitude of different components in these tumors is further evidence of the remarkable ability of carcinoma of the bladder to show divergent differentiation with in some cases gradual transition between SCC and other elements including sarcomatoid. Greater recognition of this entity with chemotherapy targeted to the various histological elements may have important therapeutic implications.



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Spatial variation and toxicity assessment for heavy metals in sediments of intertidal zone in a typical subtropical estuary (Min River) of China

Abstract

Sediment samples were collected in five marshes (C1, Phragmites australis marsh; C2, P. australis and Cyperus malaccensis marsh; C3, C. malaccensis marsh; C4, Spartina alterniflora marsh; and C5, Cyperus compressus marsh) respectively along two typical transects (T1 and T2) extending from the vegetated marsh to the mudflat in a typical subtropical estuary (Min River) of China in July 2015 to investigate the spatial variation and toxicity of heavy metals (Pb, Cr, Cu, Zn, and Ni) in intertidal zone. Results showed that the concentrations of heavy metal in surface sediments of the two transects were in the order of Zn > Cr > Pb > Cu > Ni and slightly decreased from the land to the sea except for Pb and Zn. The levels of the five metals at C5 marsh were generally the lowest, while those of Pb, Cr, and Zn at C2 marsh were the highest. The vertical variations of Pb, Cr, and Zn concentrations in profiles differed among marshes or transects, and in most cases, there was no evidence of sediment organic matter (SOM) contributing to the sorption of significant amount of metals in sediments along the two transects, while grain composition was a primary factor controlling the spatial variations of metals. Both the vertical distributions of Cu and Ni levels among marshes or transects showed little fluctuation, which could be better explained by the effects of sulfur on the solubility and mobility of the two metals in profiles. Heavy metal levels in sediments of the Min River estuary were much higher compared with most estuaries in Asia, Europe, Africa, and South America. The sediments in intertidal zone of the Min River estuary were moderately polluted by the five metals, and particularly, Ni was identified as heavy metal of primary concern. Both Ni and Pb in sediments of the intertidal zone showed high potential toxicity and high contributions to the sum of the toxic units (ΣTUs). In future, the metal pollutions in intertidal zone of the Min River estuary might be more serious, and in the next step, there will be long-term potential consequences for endangered animals or migrant birds if measures are not taken to rehabilitate the sediments resulting from metal pollutions.



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Guía de Práctica Clínica Para el Diagnóstico y Tratamiento del Vértigo Posicional Paroxístico Benigno. Documento de Consenso de la Comisión de Otoneurología Sociedad Española de Otorrinolaringlogía y Cirugía de Cabeza y Cuello

Publication date: Available online 19 August 2017
Source:Acta Otorrinolaringológica Española
Author(s): Paz Pérez-Vázquez, Virginia Franco-Gutiérrez, Andrés Soto-Varela, Juan Carlos Amor-Dorado, Eduardo Martín-Sanz, Manuel Oliva-Domínguez, Jose A. Lopez-Escamez
El vértigo posicional paroxístico benigno (VPPB) es la causa más frecuente de vértigo vestibular episódico. EL propósito de esta guía, encomendada por la Comisión de Otoneurología de la SEORL CCC, es disponer de un documento de consenso que sirva de guía práctica para el manejo del VPPB en la clínica diaria. El punto de partida es la clasificación elaborada por la Barany Society, con sus variantes clínicas. Incluye una descripción de las pruebas diagnósticas y de las maniobras terapéuticas para cada una de las variantes establecidas, habiéndose seleccionado aquellas con estudios con nivel adecuado de evidencia o con suficientes series de soporte. Se ha incluido también un capítulo de diagnóstico diferencial, así como un apartado de aspectos generales básicos en el manejo de los pacientes con VPPB.Benign Paroxysmal Positional Vertigo is the most frequent episodic vestibular disorder. The purpose of this guide, requested by the committee on otoneurology of the Spanish Society of Otolaryngology and Head and Neck Surgery, is to supply a consensus document providing practical guidance for the management of BPPV. It is based on the Barany Society criteria for the diagnosis of BPPV. This guideline provides recommendations on each variant of BPPV, with a description of the different diagnostic tests and the therapeutic manoeuvres. For this purpose, we have selected the tests and manoeuvres supported by evidence-based studies or extensive series. Finally, we have also included a chapter on differential diagnosis and a section relating to general aspects in the management of BPPV.



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Recombinant human IgG1 based Fc multimers, with limited FcR binding capacity, can effectively inhibit complement-mediated disease

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Publication date: Available online 19 August 2017
Source:Journal of Autoimmunity
Author(s): Haoping Sun, Henrik S. Olsen, Emmanuel Y. Mérigeon, Edward So, Erin Burch, Susan Kinsey, John C. Papadimitriou, Cinthia B. Drachenberg, Søren M. Bentzen, David S. Block, Scott E. Strome, Xiaoyu Zhang
There is a lack of effective targeted therapies for the treatment of complement dependent diseases. We developed two recombinant Fc multimers, G207 and G211, with limited ability to interact with low/moderate affinity FcγRs, but with high avidity for C1q. These drugs effectively inhibited complement dependent cytotoxicity (CDC) in vitro, and prevented the deposition of C1q, C3b and MAC, on the surface of Ab-opsonized cells. Importantly, these inhibitory effects were both C1q dependent and independent. In order to determine the biologic relevance of our findings, we evaluated the clinical efficacy of these drugs in three different animal models, acute RBC hemolysis, anti-Thy-1 nephritis and passive Heymann's nephropathy (PHN), in which disease pathophysiology relies preferentially on complement activation. While G207 was protective in the anti-Thy-1 nephritis and PHN models, G211 was protective in all of the models tested and could effectively treat PHN. In the anti-Thy-1 nephritis model, G211 prevented the characteristic histologic changes associated with the disease and limited glomerular deposition of C3. Collectively, these data suggest that "complement preferential" Fc multimers offer a novel approach to the treatment of complement mediated diseases.



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IFC(EDITORIAL BOARD)

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Publication date: September 2017
Source:DNA Repair, Volume 57





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DNA polymerase ι: the long and the short of it!

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Publication date: Available online 19 August 2017
Source:DNA Repair
Author(s): Ekaterina G. Frank, Mary P. McLenigan, John P. McDonald, Donald Huston, Samantha Mead, Roger Woodgate
The cDNA encoding human DNA polymerase ι (POLI) was cloned in 1999. At that time, it was believed that the POLI gene encoded a protein of 715 amino acids. Advances in DNA sequencing technologies lead to the realization that there is an upstream, in-frame initiation codon that would encode a DNA polymerase ι (polι) protein of 740 amino acids. The extra 25 amino acid region is rich in acidic residues (11/25) and is reasonably conserved in eukaryotes ranging from fish to humans. As a consequence, the curated Reference Sequence (RefSeq) database identified polι a 740 amino acid protein. However, the existence of the 740 amino acid polι has never been shown experimentally. Using highly specific antibodies to the 25 N-terminal amino acids of polι, we were unable to detect the longer 740 amino acid (ι-long) isoform in western blots. However, trace amounts of the ι-long isoform were detected after enrichment by immunoprecipitation. One might argue that the longer isoform may have a distinct biological function, if it exhibits significant differences in its enzymatic properties from the shorter, well-characterized 715 amino acid polι. We therefore purified and characterized recombinant full-length (740 amino acid) polι-long and compared it to full-length (715 amino acid) polι-short in vitro. The metal ion requirements for optimal catalytic activity differ slightly between ι-long and ι-short, but under optimal conditions, both isoforms exhibit indistinguishable enzymatic properties in vitro. We also report that like ι-short, the ι-long isoform can be monoubiquitinated and polyubiuquitinated in vivo, as well as form damage induced foci in vivo. We conclude that the predominant isoform of DNA polι in human cells is the shorter 715 amino acid protein and that if, or when, expressed, the longer 740 amino acid isoform has identical properties to the considerably more abundant shorter isoform.



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A novel somatic JAK2 kinase-domain mutation in pediatric acute lymphoblastic leukemia with rapid on-treatment development of LOH

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Publication date: October 2017
Source:Cancer Genetics, Volumes 216–217
Author(s): Teresa Sadras, Susan L. Heatley, Chung H. Kok, Barbara J. McClure, David Yeung, Timothy P. Hughes, Rosemary Sutton, David S. Ziegler, Deborah L. White
We report a novel somatic mutation in the kinase domain of JAK2 (R938Q) in a high-risk pediatric case of B-cell acute lymphoblastic leukemia (ALL). The patient developed on-therapy relapse at 12 months, and interestingly, the JAK2 locus acquired loss of heterozygosity during treatment resulting in 100% mutation load. Furthermore, we show that primary ALL mononuclear cells harboring the JAK2 R938Q mutation display reduced sensitivity to the JAK1/2 ATP-competitive inhibitor ruxolitinib in vitro, compared to ALL cells that carry a more common JAK2 pseudokinase domain mutation. Our findings are in line with previous reports that demonstrate that mutations within the kinase domain of JAK2 are associated with resistance to type I JAK inhibitors. Importantly, given the recent inclusion of ruxolitinib in trial protocols for children with JAK pathway alterations, we predict that inter-patient genetic variability may result in suboptimal responses to JAK inhibitor therapy in a subset of cases. The need for alternate targeted and/or combination therapies for patients who display inherent or developed resistance to JAK inhibitor therapy will be warranted, and we propose that kinase-mutants less sensitive to type I JAK inhibitors may present a currently unexplored platform for investigation of improved therapies.



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Mentalizing regions represent distributed, continuous, and abstract dimensions of others' beliefs

Publication date: 1 November 2017
Source:NeuroImage, Volume 161
Author(s): Jorie Koster-Hale, Hilary Richardson, Natalia Velez, Mika Asaba, Liane Young, Rebecca Saxe
The human capacity to reason about others' minds includes making causal inferences about intentions, beliefs, values, and goals. Previous fMRI research has suggested that a network of brain regions, including bilateral temporo-parietal junction (TPJ), superior temporal sulcus (STS), and medial prefrontal-cortex (MPFC), are reliably recruited for mental state reasoning. Here, in two fMRI experiments, we investigate the representational content of these regions. Building on existing computational and neural evidence, we hypothesized that social brain regions contain at least two functionally and spatially distinct components: one that represents information related to others' motivations and values, and another that represents information about others' beliefs and knowledge. Using multi-voxel pattern analysis, we find evidence that motivational versus epistemic features are independently represented by theory of mind (ToM) regions: RTPJ contains information about the justification of the belief, bilateral TPJ represents the modality of the source of knowledge, and VMPFC represents the valence of the resulting emotion. These representations are found only in regions implicated in social cognition and predict behavioral responses at the level of single items. We argue that cortical regions implicated in mental state inference contain complementary, but distinct, representations of epistemic and motivational features of others' beliefs, and that, mirroring the processes observed in sensory systems, social stimuli are represented in distinct and distributed formats across the human brain.



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Decoding cognitive concepts from neuroimaging data using multivariate pattern analysis

Publication date: 1 October 2017
Source:NeuroImage, Volume 159
Author(s): Sarah Alizadeh, Hamidreza Jamalabadi, Monika Schönauer, Christian Leibold, Steffen Gais
Multivariate pattern analysis (MVPA) methods are now widely used in life-science research. They have great potential but their complexity also bears unexpected pitfalls. In this paper, we explore the possibilities that arise from the high sensitivity of MVPA for stimulus-related differences, which may confound estimations of class differences during decoding of cognitive concepts. We propose a method that takes advantage of concept-unrelated grouping factors, uses blocked permutation tests, and gradually manipulates the proportion of concept-related information in data while the stimulus-related, concept-irrelevant factors are held constant. This results in a concept-response curve, which shows the relative contribution of these two components, i.e. how much of the decoding performance is specific to higher-order category processing and to lower order stimulus processing. It also allows separating stimulus-related from concept-related neuronal processing, which cannot be achieved experimentally. We applied our method to three different EEG data sets with different levels of stimulus-related confound to decode concepts of digits vs. letters, faces vs. houses, and animals vs. fruits based on event-related potentials at the single trial level. We show that exemplar-specific differences between stimuli can drive classification accuracy to above chance levels even in the absence of conceptual information. By looking into time-resolved windows of brain activity, concept-response curves can help characterize the time-course of lower-level and higher-level neural information processing and detect the corresponding temporal and spatial signatures of the corresponding cognitive processes. In particular, our results show that perceptual information is decoded earlier in time than conceptual information specific to processing digits and letters. In addition, compared to the stimulus-level predictive sites, concept-related topographies are spread more widely and, at later time points, reach the frontal cortex. Thus, our proposed method yields insights into cognitive processing as well as corresponding brain responses.



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Suppression of irrelevant sounds during auditory working memory

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Publication date: 1 November 2017
Source:NeuroImage, Volume 161
Author(s): Jyrki Ahveninen, Larry J. Seidman, Wei-Tang Chang, Matti Hämäläinen, Samantha Huang
Auditory working memory (WM) processing in everyday acoustic environments depends on our ability to maintain relevant information online in our minds, and to suppress interference caused by competing incoming stimuli. A challenge in communication settings is that the relevant content and irrelevant inputs may emanate from a common source, such as a talkative conversationalist. An open question is how the WM system deals with such interference. Will the distracters become inadvertently filtered before processing for meaning because the primary WM operations deplete all available processing resources? Or are they suppressed post perceptually, through an active control process? We tested these alternative hypotheses by measuring magnetoencephalography (MEG), EEG, and functional MRI (fMRI) during a phonetic auditory continuous performance task. Contextual WM maintenance load was manipulated by adjusting the number of "filler" letter sounds in-between cue and target letter sounds. Trial-to-trial variability of pre- and post-stimulus activations in fMRI-informed cortical MEG/EEG estimates was analyzed within and across 14 subjects using generalized linear mixed effect (GLME) models. High contextual WM maintenance load suppressed left auditory cortex (AC) activations around 250–300 ms after the onset of irrelevant phonetic sounds. This effect coincided with increased 10–14 Hz alpha-range oscillatory functional connectivity between the left dorsolateral prefrontal cortex (DLPFC) and left AC. Suppression of AC responses to irrelevant sounds during active maintenance of the task context also correlated with increased pre-stimulus 7–15 Hz alpha power. Our results suggest that under high auditory WM load, irrelevant sounds are suppressed through a "late" active suppression mechanism, which prevents short-term consolidation of irrelevant information without affecting the initial screening of potentially meaningful stimuli. The results also suggest that AC alpha oscillations play an inhibitory role during auditory WM processing.



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Unidirectional brain to muscle connectivity reveals motor cortex control of leg muscles during stereotyped walking

Publication date: 1 October 2017
Source:NeuroImage, Volume 159
Author(s): Fiorenzo Artoni, Chiara Fanciullacci, Federica Bertolucci, Alessandro Panarese, Scott Makeig, Silvestro Micera, Carmelo Chisari
In lower mammals, locomotion seems to be mainly regulated by subcortical and spinal networks. On the contrary, recent evidence suggests that in humans the motor cortex is also significantly engaged during complex locomotion tasks. However, a detailed understanding of cortical contribution to locomotion is still lacking especially during stereotyped activities. Here, we show that cortical motor areas finely control leg muscle activation during treadmill stereotyped walking. Using a novel technique based on a combination of Reliable Independent Component Analysis, source localization and effective connectivity, and by combining electroencephalographic (EEG) and electromyographic (EMG) recordings in able-bodied adults we were able to examine for the first time cortical activation patterns and cortico-muscular connectivity including information flow direction. Results not only provided evidence of cortical activity associated with locomotion, but demonstrated significant causal unidirectional drive from contralateral motor cortex to muscles in the swing leg. These insights overturn the traditional view that human cortex has a limited role in the control of stereotyped locomotion, and suggest useful hypotheses concerning mechanisms underlying gait under other conditions.One sentence summaryMotor cortex proactively drives contralateral swing leg muscles during treadmill walking, counter to the traditional view of stereotyped human locomotion.



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MB-SWIFT functional MRI during deep brain stimulation in rats

Publication date: 1 October 2017
Source:NeuroImage, Volume 159
Author(s): Lauri J. Lehto, Djaudat Idiyatullin, Jinjin Zhang, Lynn Utecht, Gregor Adriany, Michael Garwood, Olli Gröhn, Shalom Michaeli, Silvia Mangia
Recently introduced 3D radial MRI pulse sequence entitled Multi-Band SWeep Imaging with Fourier Transformation (MB-SWIFT) having virtually zero acquisition delay was used to obtain functional MRI (fMRI) contrast in rat's brain at 9.4 T during deep brain stimulation (DBS). The results demonstrate that MB-SWIFT allows functional images free of susceptibility artifacts, and provides an excellent fMRI activation contrast in the brain. Flip angle dependence of the MB-SWIFT fMRI signal and elimination of the fMRI contrast while using saturation bands, indicate a blood flow origin of the observed fMRI contrast. MB-SWIFT fMRI modality permits activation studies in the close proximity to an implanted lead, which is not possible to achieve with conventionally used gradient echo and spin echo - echo planar imaging fMRI techniques. We conclude that MB-SWIFT fMRI is a powerful imaging modality for investigations of functional responses during DBS.

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Simultaneous intrinsic signal imaging of auditory and visual cortex reveals profound effects of acute hearing loss on visual processing

Publication date: 1 October 2017
Source:NeuroImage, Volume 159
Author(s): Manuel Teichert, Jürgen Bolz
It has been suggested that primary sensory cortices do not work in isolation but receive subthreshold inputs originating from other senses. However, repercussions of an acute loss of one sense on multimodal sensory processing remain elusive. Here we investigated the early effects of acute hearing loss on visual processing in adult mice. For this, we developed a method to simultaneously map the primary auditory (A1) and visual cortex (V1) using periodic intrinsic optical imaging. We found that reducing sound evoked A1 responsiveness due to the induction of conductive hearing loss (CHL) led to a concomitant increase of visually driven V1 activity. Accordingly, using the neuronal activity marker c-fos we found the number of stained pyramidal cells to be increased in V1 layer 2/3 after CHL. In contrast, numbers of c-fos positive parvalbumin (PV) and somatostatin (SOM) expressing inhibitory neurons were reduced after CHL. Finally, we adapted the periodic intrinsic imaging method to determine V1 contrast and spatial frequency tuning. Using this method we could show that visual acuity and contrast sensitivity were improved after CHL. In addition, retrograde tracing experiments revealed direct anatomical projections from A1 to V1 which could potentially serve as a substrate for the observed effects. In summary, our results suggest that CHL rapidly disrupts the functional interplay between A1 and V1 leading to altered visually evoked V1 responses.

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Differential expression of transforming growth factor-beta1, connective tissue growth factor, phosphorylated-SMAD2/3 and phosphorylated-ERK1/2 during mouse tooth development

Abstract

Connective tissue growth factor (CTGF) is a downstream mediator of transforming growth factor-beta 1 (TGF-β1) and TGF-β1-induced CTGF expression is regulated through SMAD and mitogen-activated protein kinase (MAPK) signaling pathways. The fine modulation of TGF-β1 signaling is very important to the process of tooth development. However, little is known about the localization of CTGF, MAPK and SMAD in the context of TGF-β1 signaling during odontogenesis. Hence, we aimed to investigate the expression of TGF-β1, CTGF, phosphorylated-SMAD2/3 (p-SMAD2/3) and phosphorylated-ERK1/2 (p-ERK1/2). ICR mice heads of embryonic (E) day 13.5, E14.5, E16.5, postnatal (PN) day 0.5 and PN3.5 were processed for immunohistochemistry. Results revealed that at E13.5, TGF-β1 and CTGF were strongly expressed in dental epithelium (DE) and dental mesenchyme (DM), while p-SMAD2/3 was intensely expressed in the internal side of DE. p-ERK1/2 was not present in DE or DM. At E14.5 and E16.5, strong staining for TGF-β1 and CTGF was detected in enamel knot (EK) and dental papilla (DPL). DPL was intensely stained for p-ERK1/2 but negatively stained for p-SMAD2/3. There was no staining for p-SMAD2/3 and p-ERK1/2 in EK. At PN0.5 and PN3.5, moderate to intense staining for TGF-β1 and CTGF was evident in preameloblasts (PA), secretary ameloblasts (SA) and dental pulp (DP). p-SMAD2/3 was strongly expressed in SA and DP but sparsely localized in PA. p-ERK1/2 was intensely expressed in DP, although negative staining was observed in PA and SA. These data demonstrate that TGF-β1 and CTGF show an identical expression pattern, while p-SMAD2/3 and p-ERK1/2 exhibit differential expression, and indicate that p-SMAD2/3 and p-ERK1/2 might play a regulatory role in TGF-β1 induced CTGF expression during tooth development.



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