Oral Administration of Clinical Stage Drug Candidate SENS-401 Effectively Reduces Cisplatin-induced Hearing Loss in Rats

Hypothesis: SENS-401, an oral clinical-stage drug, may reduce cisplatin-induced hearing loss and cochlear damage in an in vivo model. Background: Cisplatin is commonly associated with hearing loss, causing significant learning and behavioral difficulties in the pediatric cancer population, and for which there are currently no clinical solutions. SENS-401 has previously been shown to improve acoustic trauma-induced hearing loss in vivo. Methods: The effect of SENS-401 (R-azasetron besylate) on cisplatin IC50 values was evaluated in a panel of cisplatin-sensitive cell lines (NIH:OVCAR-3, SK-N-AS, NCI-H460, FaDu). Auditory brainstem response and distortion product otoacoustic emission tests were performed in a rat model of cisplatin-induced hearing-loss (8 mg/kg, day 1) at baseline, and after 14 days of SENS-401 (6.6, 13.2, 26.4 mg/kg/d). Cochlear outer hair cells were counted after immunolabeling for myosin-VIIa. Results: Cisplatin cytotoxicity was not impacted by the addition of SENS-401 (up to 10 μM) in any of the cell types evaluated. In vivo, all SENS-401 doses significantly improved auditory brainstem response threshold shift (up to 30 dB) and distortion product otoacoustic emission amplitude loss (up to 19 dB) over placebo. Body weight and survival were not significantly different between rats receiving placebo and those receiving 26.4 mg/kg SENS-401. Significantly more surviving outer hair cells were present after SENS-401 treatment compared with placebo (p 

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Long-Term Patient-Reported Outcomes After Surgery for Superior Canal Dehiscence Syndrome

Objective: Evaluate the long-term patient-reported outcomes of surgery for superior canal dehiscence syndrome (SCDS). Study Design: Cross-sectional survey. Setting: Tertiary referral center. Patients: Adults who have undergone surgery for SCDS with at least 1 year since surgery. Main Outcome Measure(s): Primary outcome: change in symptoms that led to surgery. Secondary outcomes: change in 11 SCDS-associated symptoms, change in psychosocial metrics, and willingness to recommend surgery to friends with SCDS. Results: Ninety-three (43%) respondents completed the survey with mean (SD) time since surgery of 5.3 (3.6) years. Ninety-five percent of respondents reported the symptoms that led them to have surgery were "somewhat better," "much better," or "completely cured." Those with unilateral symptoms were more likely to report improvement than those with bilateral symptoms. There was no difference between those with short (1–5 yr) versus long (5–20 yr) follow-up. Each of the SCDS-associated symptoms showed significant improvement. The largest improvements were for autophony, pulsatile tinnitus, audible bodily sounds, and sensitivity to loud sound. Headaches, imbalance, dizziness, and brain fog showed the least improvements. Most patients reported improvements in quality of life, mood, and ability to function at work and socially. Ninety-five percent of patients would recommend SCDS surgery. Conclusions: Respondents demonstrated durable improvements in the symptoms that led them to have surgery. Auditory symptoms had the greatest improvements. Headaches, imbalance, dizziness, and brain fog showed the least improvements. Nearly, all patients would recommend SCDS surgery to others. These results can be used to counsel patients regarding the lasting benefits of surgery for SCDS.

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Venous Diverticula Causing Pulsatile Tinnitus Treated With Coil Embolization and Stent Placement With Resolution of Symptoms: Report of Two Cases and Review of the Literature

Objective: To report two cases of pulsatile tinnitus caused by complex venous diverticula with successful treatment via coil embolization and stent placement followed by complete resolution of symptoms. We also review the literature pertaining to venous diverticula causing pulsatile tinnitus treated using endovascular techniques. Patients: Two women patients, aged 27 and 29 years, presented to our institution with 3-month histories of pulsatile tinnitus. In each case, non-invasive imaging and conventional digital subtraction angiography (DSA) confirmed the presence of a complex right transverse-sigmoid sinus junction diverticulum. Intervention: Both patients underwent stent-assisted coil embolization of the venous diverticula. Main Outcome and Results: Clinical and DSA follow-up at 6 and 12 months confirmed resolution of symptoms with obliteration of the venous diverticulum. We also performed a PubMed database search for the period January 1995 through June 2016 using the terms pulsatile tinnitus, venous aneurysm/diverticulum, stent-assisted coil embolization, and endovascular treatment and identified reports of 14 additional patients treated using endovascular techniques. Conclusions: Venous sinus diverticula causing pulsatile tinnitus can be successfully treated with stent-assisted coil embolization with complete resolution of clinical symptoms. This is in concordance with 13 case reports in the literature involving 14 patients with venous sinus diverticula treated using endovascular techniques.

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The Effect of Citalopram Versus a Placebo on Central Auditory Processing in the Elderly

Objective: Evaluate the effects of therapy with citalopram on the central auditory processing in the elderly measured by central auditory tests. Study Design: Prospective, randomized, double-blind, placebo-controlled study. Setting: Tertiary referral center. Patients: Thirty-nine patients older than 60 years with normal hearing thresholds or symmetrical sensorineural hearing loss up to 70 dBHL, word-recognition score equal to or better than 70%, and diagnosed with central auditory processing disorders completed the study. They underwent the mini-mental state examination, as a way to screen those with the possibility of dementia; they also underwent the Beck depression inventory, for screening individuals with depression. Intervention: Citalopram 20 mg/d or placebo for 6 months. Main Outcome Measure: The central auditory tests were applied to the selection of individuals with auditory processing disorders and repeated after 6 months' treatment. The tests were sound localization, speech in noise, dichotic digits test, pitch pattern sequence, duration pattern test, and gaps-in-noise. Results: Comparisons of central auditory tests pre- and posttreatment in groups showed: sound localization (p = 0.022), pitch pattern sequence humming (p = 0.110), pitch pattern sequence nomination (p = 0.355), duration pattern test humming (p = 0.801), duration pattern test nomination (p = 0.614), and gaps-in-noise (p = 0.230). Dichotic tests in right and left ears respectively: speech in noise (p = 0.949; p = 0.722), dichotic digits test (p = 0.943; p = 0.513). Conclusion: There was no clinical effect with the use of citalopram in central auditory processing tests of the subjects.

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Passive Transcutaneous Bone Conduction Hearing Implants: A Systematic Review

Objective: To systematically review the literature on currently available passive transcutaneous bone conduction hearing implants (pTCBI) with regard to complications, audiological outcomes, and quality-of-life scores. Data Sources: MEDLINE, EMBASE, Scopus, and Cochrane Library. Study Selection: All identified English-language articles reporting on the implantation of currently available pTCBI's and their complications. Both pediatric and adult patients were included. No limitation was placed on study design or level of evidence. Data Extraction: Complications, audiological outcomes including mean pure-tone average gain and mean speech reception threshold gain, and quality-of-life outcomes. Data Synthesis: Twenty-six articles were included in the review. Four hundred eighty-two pTCBIs have been reported in the literature. Major complications including skin breakdown, wound dehiscence, hematoma, seroma, and inability to use the device occurred in 5.2% of patients. Minor complications including pain and self-resolving erythema at the implant site occurred in 13.1% of the patients. The weighted mean pure-tone average gain of the two included devices was 28.4 ± 2.1 dB and the mean speech reception threshold gain was 32.9 ± 3.9 dB. Favorable quality-of-life scores have been demonstrated with pTCBIs. Conclusion: pTCBIs are a viable alternative to percutaneous devices in a carefully selected group of patients. These devices have demonstrated good audiological outcomes, low morbidity, and high patient satisfaction.

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Hearing Outcome With the Use of Glass Ionomer Cement as an Alternative to Crimping in Stapedotomy

Objective: To evaluate early hearing outcomes using glass ionomer cement to fix the Teflon piston prosthesis onto the long process of incus to minimize residual conductive hearing loss after stapedotomy. Study Design: Original report of prospective randomized control study. Setting: Tertiary referral center. Patients: A total of 80 consecutive patients with otosclerosis were randomized into two groups. Group A is a control group in which 40 patients underwent small fenestra stapedotomy using the classic technique. Group B included 40 patients who were subjected to small fenestra stapedotomy with fixation of the incus-prosthesis junction with glass ionomer bone cement. Interventions: Stapedotomy with the classical technique in group A and the alternative technique in group B. Primary Outcome Measure: The audiometric results before and after surgery. Results: Analysis of the results was performed using the paired t test to compare between pre and postoperative results. χ2 test was used to compare the results of the two groups. A p value less than 0.05 was considered significant from the statistical standpoint. Significant postoperative improvement of both pure-tone air conduction thresholds and air-bone gaps were reported in the two studied groups. The postoperative average residual air-bone gap and hearing gain were statistically significant in group B (p 

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Comparing Outcomes Following Salvage Microsurgery in Vestibular Schwannoma Patients Failing Gamma-knife Radiosurgery or Microsurgery

Objective: The increasing use of primary gamma-knife radiosurgery (GKS) for the treatment of vestibular schwannoma (VS) has led to a concomitant increase in the number of patients requiring salvage surgery for GKS failure. When patients underwent GKS as the primary treatment, it is known that dissecting tumor from adjacent nerves during salvage surgery is more difficult. In this report, we share our clinical experience with such patients and analyze the clinical findings of patients with tumor regrowth/recurrence. Study Design: Retrospective chart review. Setting: Tertiary center. Patients: Nine patients who underwent salvage surgery for VS regrowth/recurrence after GKS or microsurgery were enrolled. Main Outcome Measures: Symptom progression, radiological changes, intraoperative findings, and surgical outcomes were evaluated and compared. Results: Six patients with previous GKS and three with previous microsurgery underwent salvage microsurgery. The most obvious symptom of tumor regrowth was aggravation of hearing loss. Salvage surgery in all patients was limited to subtotal or near-total resection via a translabyrinthine/transotic approach. Severe adhesion, thickening, and fibrosis were more prominent findings in the GKS than in the previous microsurgery group. Dissection of the tumor from the facial nerve was more difficult in the GKS than in the microsurgery patients. Despite anatomical preservation of the facial nerve in all the six patients, three in the GKS group, but none in the revision microsurgery group, had worsening of facial nerve function. Conclusion: Salvage microsurgery of VS after failed GKS is more difficult than revision microsurgery, and the facial nerve outcomes are relatively poor. Therefore, the primary method of VS treatment should be carefully chosen. Additional imaging studies are recommended in patients with a sudden change in hearing loss who underwent GKS.

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Evaluation of Maximal Speech Intelligibility With Vibrant Soundbridge in Patients With Sensorineural Hearing Loss

Objective: The study investigated improvements in maximal speech intelligibility after Vibrant Soundbridge (VSB) implantation and analyzed the effect of the hearing loss pattern on maximal speech intelligibility represented by a phonetically balanced word score (PBmax). The effect of middle ear implants on PBmax has not been evaluated yet. Study Design: Study. Setting: Tertiary academic medical center. Patients/Interventions: Sixty patients who underwent VSB from December 2011 to January 2016 were retrospectively reviewed. All the patients had hearing aids preoperatively. Main Outcome Measures: Pure-tone and speech audiometry were checked with and without hearing aids and then with the VSB. The patients were divided into two groups: flat and down-sloping type of hearing loss. PBmax score was evaluated at the most comfortable listening level before and after VSB implantation and compared with scores with/without HA. Results: PBmax for both conventional HA and VSB were significantly higher compared with the unaided condition. The improvement in speech recognition was significantly better using VSB than using HA (p = 0.003). However, there was no significant difference in the improvement provided by VSB and HA in patients with a flat hearing loss. Patients with a down-sloping audiogram showed significantly better improvement with VSB than with HA (p = 0.003). Moreover, patients with greater preoperative high-frequency hearing loss had greater improvement in PBmax after VSB implantation. Conclusion: Speech intelligibility can be significantly improved by VSB implantation, especially in patients with a down-sloping hearing loss. This finding can help select patients who will benefit most from VSB implantation.

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Sensitivity and Specificity of Clinical and Laboratory Otolith Function Tests

Objective: To evaluate clinic based and laboratory tests of otolith function for their sensitivity and specificity in demarcating unilateral compensated complete vestibular deficit from normal. Study Design: Prospective cross-sectional study. Setting: Tertiary care hospital vestibular physiology laboratory. Subjects: Control group—30 healthy adults, 20–45 years age; Case group-15 subjects post vestibular shwannoma excision or post-labyrinthectomy with compensated unilateral complete audio-vestibular loss. Intervention: Otolith function evaluation by precise clinical testing (head tilt test—HTT; subjective visual vertical—SVV) and laboratory testing (headroll-eye counterroll—HR-ECR; vesibular evoked myogenic potentials—cVEMP). Main Outcome Measure: Sensitivity and specificity of clinical and laboratory tests in differentiating case and control subjects. Results: Measurable test results were universally obtained with clinical otolith tests (SVV; HTT) but not with laboratory tests. The HR-ECR test did not indicate any definitive wave forms in 10% controls and 26% cases. cVEMP responses were absent in 10% controls. HTT test with normative cutoff at 2 degrees deviations from vertical noted as 93.33% sensitive and 100% specific. SVV test with normative cutoff at 1.3 degrees noted as 100% sensitive and 100% specific. Laboratory tests demonstrated poorer specificities owing primarily to significant unresponsiveness in normal controls. Conclusions: Clinical otolith function tests, if conducted with precision, demonstrate greater ability than laboratory testing in discriminating normal controls from cases with unilateral complete compensated vestibular dysfunction.

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Patient-Reported Outcomes From the United States Clinical Trial for a Hybrid Cochlear Implant

Objective: To assess patient-reported outcomes (PROs) in individuals with significant residual low-frequency hearing and severe-to-profound high-frequency sensorineural hearing loss (SNHL) who received the hybrid cochlear implant (CI). Study Design: Prospective, multicenter, nonrandomized, single-arm repeated measures, single-subject design. Setting: Tertiary centers, ambulatory care. Patients: Fifty adults with severe-to-profound high-frequency SNHL and residual low-frequency hearing with aided word recognition scores between 10 and 60% in the ear to be implanted, and in the contralateral ear greater than or equal to implant ear less than or equal to 80%. Intervention: Therapeutic; hybrid CI. Main Outcome Measures: Speech, spatial and qualities of hearing scale (SSQ), device use questionnaire (DUQ), University of Washington Clinical Assessment of Music Perception (UW-CAMP) assessed preoperatively and after 6 and 12 (SSQ and DUQ only) months of hybrid CI use. Results: Significant improvements in mean SSQ ratings were demonstrated at 6 and 12 months postactivation overall and for domains related to speech hearing, spatial hearing, and sound quality. Significant improvement was also found for overall satisfaction on the DUQ and across a number of specific listening situations in addition to aspects related to social engagement. UW-CAMP pitch discrimination and melody and timbre recognition abilities were not compromised postoperatively, allowing hybrid subjects to maintain superior music perception abilities than typically observed with standard CIs. Conclusions: Patients who received the hybrid CI demonstrated significant PRO benefits on the SSQ and the DUQ after 6 and 12 months of CI use. In addition, given the opportunity to maintain useful low-frequency acoustic hearing, patients retained music listening abilities, as assessed by the UW-CAMP.

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Comparison of an Electromagnetic Middle Ear Implant and Hearing Aid Word Recognition Performance to Word Recognition Performance Obtained Under Earphones

Objective: To report the results of patients with the Maxum middle ear implant (MEI) and compare word recognition scores (WRS) and speech perception gap (SP Gap) of Maxum versus optimally fit hearing aids (HA). Study Design: Case series with chart review. Setting: Single, private otology clinic. Patients: Eleven ears, in nine adult patients (two women; average age 62.7 yr). Interventions: Twelve consecutive ears with moderate to severe sensorineural hearing loss (SNHL) underwent implantation of the Maxum system. One patient was not included due to inadequate preoperative testing. Main Outcome Measures: Primary outcome measures included word recognition score (WRS) and SP Gap (maximum word understanding [PB max] – WRSaided) improvement compared with HAs. Results: The average Maxum WRS was 64.7% (range, 28–94%), a 41.6% improvement (range, 10–66%) over HAs (p 

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Hearing Preservation During Cochlear Implantation and Electroacoustic Stimulation in Patients With SLC26A4 Mutations

Background and Objectives: Patients with SCL26A4 mutations presenting with Mondini deformity and enlarged vestibular aqueduct (EVA) tend to have comparable residual hearing. Although cochlear implantation (CI) produces good results in this group, deterioration of residual hearing can be an adverse event after surgery due to accompanying cochlear malformation and perilymph leakage during cochleostomy. The purpose of this study was to investigate if CI in patients with SCL26A4 mutations via the round window (RW) approach could achieve preservation of residual hearing, and to evaluate their speech reception with electroacoustic stimulation (EAS). Subjects and Methods: This is a retrospective chart review of eight patients with bilateral EVA, who were bi-allelic patients with SCL26A4 mutations. CI was performed in all patients by a single surgeon using the RW approach. Audiological results were compared before and after implantation. Results: Additional hearing loss after CI was less than 10 dBHL in five out of eight patients. Average hearing deterioration after CI was 8.75 dB (range, 0–26). Six out of eight patients used EAS mode after CI. The acoustic stimulation frequency ranged from 271 to 438 Hz. Patients showed better speech recognition in quiet and in noise using EAS mode compared with electrical stimulation alone. Conclusions: Preservation of residual hearing could be achieved after CI in patients with the SLC26A4 mutation via the RW approach. For successful preservation of residual hearing, application of newly-developed soft electrode and meticulous surgical is necessary. Our study showed that patients with the SLC26A4 mutation can be good candidates for EAS surgery.

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Clinical Characteristics of Benign Recurrent Vestibulopathy: Clearly Distinctive From Vestibular Migraine and Menière's Disease?

Objective: We aimed to systematically investigate the clinical characteristics of benign recurrent vestibulopathy (BRV), vestibular migraine (VM), and Menière's disease (MD) and to assess whether clinical symptoms exist that are unique to BRV. Study Design: Prospective cohort study. Setting: Tertiary referral center. Methods: Between January 2015 and November 2016, patients were prospectively recruited at a specialized dizziness clinic. Patients were included if they met the diagnostic criteria for BRV, VM, or MD which was evaluated by simultaneous consultation of an otorhinolaryngologist and neurologist. All patients received a comprehensive clinical examination that included vestibular tests and pure-tone audiometry. A questionnaire was designed to systematically document symptoms of the three vestibular disorders. Results: A total of 122 patients were included in our study, 65 (53%) were females in whom 29 (24%) were postmenopausal. The mean age was 55.5 ± 13.7 years and the mean age of onset of vertigo attacks was 49.2 ± 14.8 years (n = 119). Forty-five (37%) patients had a clinical diagnosis of BRV, 34 (28%) of VM, and 43 (35%) of MD. No symptom could be identified which was specifically linked to BRV. In patients with BRV, similar to those with VM, we found a female preponderance (p = 0.05 in BRV, p = 0.001 in VM). Patients with VM reported significantly more often a positive history of motion sickness (p = 0.01). In addition, canal paresis was most profound in patients with MD (p = 0.001). Conclusion: We found no clinical characteristics that were distinctive for BRV. However, we did find several distinctive clinical features for VM and MD which may assist the physician in their history taking.

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The Modified Rambo Transcanal Approach for Cochlear Implantation in CHARGE Syndrome

Objective: CHARGE syndrome is associated with a variety of temporal bone anomalies and deafness. The lack of surgical landmarks and facial nerve irregularities make cochlear implantation in this population a challenging endeavor. This study aims to describe a safe and efficacious transcanal approach for cochlear implantation that obviates the need to perform a mastoidectomy and facial recess. Patients: Three children with profound hearing loss secondary to CHARGE syndrome. Intervention: Transcanal cochlear implantation with closure of the ear canal via a modified Rambo meatoplasty. Main Outcome Measure(s): Retrospective chart review of temporal bone anomalies associated with CHARGE syndrome, technical nuances of this transcanal approach, and cochlear implant outcomes. Results: The mean patient age was 2.5 years (range 1.5–3.8 yr). Two were male and two were left ears. All patients had a hypoplastic mastoid, semicircular canal aplasia, and had some degree of cochlear dysplasia. A full cochlear implant insertion was achieved in all cases, even in the presence of grossly abnormal middle ear and facial nerve anatomy. There were no intraoperative or postoperative complications. The mean follow-up was 12.4 months (range, 3.9–25.2 mo). All three patients use their device daily. Their guardians report improved vocalization and environmental awareness. Conclusions: The modified Rambo transcanal approach provides a safe corridor for cochlear implantation in patients with CHARGE syndrome. This approach minimizes the anatomical variations associated with the syndrome and may reduce the risk of electrode extrusion. Implant outcomes in this patient population remain highly variable based on the patient's global cognitive capacity.

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The First Reported Case of Primary Intestinal-type Adenocarcinoma of the Middle Ear and Review of the Literature

Objective: Adenocarcinoma of the middle ear is a rare entity that must be distinguished from other adenomatous tumors of the temporal bone. We present the first patient of an intestinal-type adenocarcinoma originating from the middle ear. Patients: A 58-year-old woman presented with an 8-year history of left otorrhea. Her middle ear effusions were quite thick and gummy. She underwent eight sets of pressure-equalization tubes within 3 years. In 2011, her physical examination identified a middle ear mass, and she underwent mastoidectomy. A middle ear adenoma was resected. She underwent an additional three mastoidectomies for recurrence, with pathology from the 4th mastoidectomy revealing a diagnosis of adenocarcinoma. Imaging, at that time, showed an extensive temporal bone and Eustachian tube tumor. Interventions: She underwent a left subtotal temporal bone resection, parotidectomy, infratemporal fossa resection, dural resection, and microvascular free flap reconstruction followed by postoperative proton beam radiotherapy. Main Outcome Measures: The final pathology report revealed intestinal-type adenocarcinoma. Results: Treatment was successful and the patient remains disease free 4 years later. Conclusion: This is the first report of an intestinal-type adenocarcinoma of the middle ear and temporal bone. This patient also illustrates the difficulty of accurate histologic diagnosis of adenomatous tumors of the middle ear.

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Duration of Eligibility Prior to Cochlear Implantation: Have We Made Any Progress?

Objective: The objective is to determine if eligibility (as defined as the duration of severe to profound hearing loss before cochlear implantation [CI]) has changed over the 30 years since Food and Drug Administration approval. Data Sources: English-language, peer-reviewed articles, theses, and trial data available through PubMed and Cochrane Library databases up until and including May 31, 2016. Study Selection: One thousand six unique articles were identified. Prospective studies that reported duration of severe/profound hearing loss before CI in adult patients were included. Retrospective studies, reviews, meta-analyses, articles reporting pediatric or mixed data, hybrid/electroacoustic CI, and articles from centers outside the United States were excluded. Seventy-one studies met inclusion criteria and were included for analysis. Data Extraction: Contributing authors independently reviewed included studies for data validity and applicability. Data Synthesis: Metaregression was used to assess the relationship between the year of publication and duration of hearing loss. To account for a possible age effect, a second model was estimated including mean age at the time of study as a covariate. Conclusion: A positive association between study year and the duration of hearing loss before implantation was found showing a 0.28-year increase in the duration of hearing loss for every increasing study year. Contrary to conventional assumption, duration of eligibility for CI appears to be increasing. Though the reasons for this are not clear, current strategies to increase both awareness and access to CI seem to be falling short.

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Patulous Eustachian Tube Dysfunction: Patient Demographics and Comorbidities

Objective: The objective is to describe a large cohort of patients presenting with patulous Eustachian tube (pET) dysfunction. Study Design: Retrospective patient series. Setting: Tertiary referral center. Patients: All outpatient visits (2004–2016) that were assigned ICD9 code (381.7-Patulous Eustachian tube) were screened. Only patients with observed tympanic membrane movements during ipsilateral nasal breathing or acoustic reflex decay testing demonstrating transmitted nasal breathing were included (n = 190, n = 239 ears). Main Outcome Measures: Demographics and nasopharyngoscopy/otomicroscopy findings by comorbidities. Results: The majority (54%) was female and mean age of symptom onset was 38.0 (SD 20.0) years. Common symptoms included voice autophony (93%), breath autophony (92%), aural fullness (57%), pulsatile tinnitus (17%), and crackling or rumbling sounds (14%). Symptoms increased in frequency and duration with time (65%), were exacerbated with exercise (27%), and improved with placing the head in a dependent position (65%), sniffing (28%), upper respiratory infection (8%), and ipsilateral internal jugular vein compression (12%). In 52% pET was bilateral. Common comorbidities include environmental allergy (49%), weight loss (35%), laryngopharyngeal reflux (33%), anxiety (31%), autoimmunity (13%), and neuromuscular disease (8%). Allergy and anxiety patients were younger and more likely to have tonic contraction of the tensor veli palatini on exam (p 

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Using Electrically-evoked Compound Action Potentials to Estimate Perceptive Levels in Experienced Adult Cochlear Implant Users

Hypothesis: The cochlear implant (CI) fitting level prediction accuracy of electrically-evoked compound action potential (ECAP) should be enhanced by the addition of demographic data in models. Introduction: No accurate automated fitting of CI based on ECAP has yet been proposed. Methods: We recorded ECAP in 45 adults who had been using MED-EL CIs for more than 11 months and collected the most comfortable loudness level (MCL) used for CI fitting (prog-MCL), perception thresholds (meas-THR), and MCL (meas-MCL) measured with the stimulation used for ECAP recording. Linear mixed models taking into account cochlear site factors were computed to explain prog-MCL, meas-MCL, and meas-THR. Results: Cochlear region and ECAP threshold were predictors of the three levels. In addition, significant predictors were the ECAP amplitude for the prog-MCL and the duration of deafness for the prog-MCL and the meas-THR. Estimations were more accurate for the meas-THR, then the meas-MCL, and finally the prog-MCL. Conclusion: These results show that 1) ECAP thresholds are more closely related to perception threshold than to comfort level, 2) predictions are more accurate when the inter-subject and cochlear regions variations are considered, and 3) differences between the stimulations used for ECAP recording and for CI fitting make it difficult to accurately predict the prog-MCL from the ECAP recording. Predicted prog-MCL could be used as bases for fitting but should be used with care to avoid any uncomfortable or painful stimulation.

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RE: Skin Necrosis After Implantation with the Baha Attract: A Case Report and Review of the Literature: Chen SY, Mancuso D, and Lalwani AK. OTOL NEUROTOL 2017 MAR;38(3): 364–367

No abstract available

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The Relationship Between Environmental Sound Awareness and Speech Recognition Skills in Experienced Cochlear Implant Users

Hypothesis: 1) Environmental sound awareness (ESA) and speech recognition skills in experienced, adult cochlear implant (CI) users will be highly correlated, and, 2) ESA skills of CI users will be significantly lower than those of age-matched adults with normal hearing. Background: Enhancement of ESA is often discussed with patients with sensorineural hearing loss as a potential benefit of implantation and, in some cases, ESA may be a major motivating factor. Despite its ecological validity and patients' expectations, ESA remains largely a presumed skill. The relationship between ESA and speech recognition is not well-understood. Methods: ESA was assessed in 35 postlingually deaf, experienced CI users and a control group of 41 age-matched, normal hearing listeners using the validated, computerized familiar environmental sounds test—identification (FEST-I) and a diverse speech recognition battery. Demographic and audiological factors as well as nonverbal intelligence quotient (IQ)/nonverbal reasoning and spectral resolution were assessed. Results: Six of the 35 experienced CI users (17%) demonstrated FEST-I accuracy within the range of the NH controls. Among CI users all correlations between FEST-I accuracy and speech recognition scores were strong. Chronological age at the time of testing, duration of deafness, spectral resolution, and nonverbal IQ/nonverbal reasoning were strongly correlated with FEST-I accuracy. Partial correlation analysis showed that correlations between FEST-I and speech recognition measures remained significant when controlling for the demographic and audiological factors. Conclusion: Our findings reinforce the hypothesis that ESA and speech perception share common underlying processes rather than reflecting truly separate auditory domains.

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Decline patterns and risk assessment of 10 multi-class pesticides in young sprout amaranth ( Amaranthus mangostanus ) under greenhouse growing conditions

Abstract

The present study was designed to investigate the residual decline pattern and the risk assessment of 10 different class pesticides, namely azoxystrobin, boscalid, diazinon, diethofencarb, difenoconazole, etofenprox, flubendiamide, paclobutrazol, and pyraclostrobin in young vegetative amaranth (Amaranthus mangostanus) sprayed once or twice under greenhouse growing conditions. Field-incurred samples, collected at 3, 7, or 10 days after application of both treatments, were extracted and purified with the quick, easy, cheap, effective, rugged, and safe "QuEChERS" citrate-buffered method and analyzed with liquid chromatography-electrospray ionization tandem mass spectrometry (LC-MS/MS) in positive ion mode. The linearity was satisfactory with determination coefficients (R ²) falling between 0.9817 and 0.9999 and limits of detection (LOD) and quantification (LOQ) values of 0.0007 and 0.002 mg/kg, respectively. The mean recovery rate at four spiking levels (equivalent to 5, 10, 50, and 100 × LOQ) ranged from 78.1 to 131.6% with a relative standard deviation (RSD) of < 11%. Substantial differences in the initial deposit between the tested analytes were observed and clearly indicated that the structure, as well as the initial concentration of applied products, greatly affected the residue deposit. From the obtained residual data, the provisional marginal maximum residue limits (MRLs) and the pre-harvest intervals (PHI) were proposed. Risk assessment was evaluated by comparing the theoretical maximum daily intake (TMDI) with the acceptable daily intake (ADI). Herein, the TMDI was lower than the ADI (TMDI/ADI ratio ≤ 80% set by the Korean Ministry of Food and Drug Safety) except for difenoconazole (80.92%, marginally higher), indicating that the vegetative amaranth is not hazardous and can be consumed safely by Korean consumers.

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Evidence for contrasting accumulation pattern of cadmium in relation to other elements in Senilia senilis and Tagelus adansoni from the Bijagós archipelago, Guinea-Bissau

Abstract

Shellfish harvesting in intertidal areas is a widespread and economically important activity in many countries across West Africa. However, in some areas, there is virtually no information concerning the levels of contaminants (and other elements related to nutritional aspects) in the harvested species. We collected sediments and several individuals of the West African bloody cockle Senilia senilis and of the razor clam Tagelus adansoni during the dry season of 2015 nearby three islands in the Bijagós archipelago, Guinea-Bissau. Aluminium, Ca, Fe, Mg, As, Cd, Co, Cr, Cu, Mn, Ni, Pb and Zn were determined in sediments and whole soft tissues of the two bivalves. Sediments showed uniformly low trace element concentrations, pointing to an ecosystem with low levels of trace element contamination. T. adansoni presented higher concentrations of most elements than S. senilis, with the exception of Cd that showed up to 40 times higher values in S. senilis than in T. adansoni from the same sites. Furthermore, Cd concentrations (25±8.7 mg kg⁻¹, dw) in S. senilis are clearly above the maximum level established for human consumption. Future studies should clarify whether biological factors are the major responsible for this unusual situation.

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Characteristic of microplastics in the atmospheric fallout from Dongguan city, China: preliminary research and first evidence

Abstract

Microplastic pollution has exhibited a global distribution, including seas, lakes, rivers, and terrestrial environment in recent years. However, little attention was paid on the atmospheric environment, though the fact that plastic debris can escape as wind-blown debris was previously reported. Thus, characteristics of microplastics in the atmospheric fallout from Dongguan city were preliminarily studied. Microplastics of three different polymers, i.e., PE, PP, and PS, were identified. Diverse shapes of microplastics including fiber, foam, fragment, and film were found, and fiber was the dominant shape of the microplastics. SEM images illustrated that adhering particles, grooves, pits, fractures, and flakes were the common patterns of degradation. The concentrations of non-fibrous microplastics and fibers ranged from 175 to 313 particles/m²/day in the atmospheric fallout. Thus, dust emission and deposition between atmosphere, land surface, and aquatic environment were associated with the transportation of microplastics.

http://ift.tt/2w0x8N2

Coupling population dynamics with earth system models: the POPEM model

Abstract

Precise modeling of CO₂ emissions is important for environmental research. This paper presents a new model of human population dynamics that can be embedded into ESMs (Earth System Models) to improve climate modeling. Through a system dynamics approach, we develop a cohort-component model that successfully simulates historical population dynamics with fine spatial resolution (about 1°×1°). The population projections are used to improve the estimates of CO₂ emissions, thus transcending the bulk approach of existing models and allowing more realistic non-linear effects to feature in the simulations. The module, dubbed POPEM (from Population Parameterization for Earth Models), is compared with current emission inventories and validated against UN aggregated data. Finally, it is shown that the module can be used to advance toward fully coupling the social and natural components of the Earth system, an emerging research path for environmental science and pollution research.

http://ift.tt/2f0iI8s

Morphology and size of blood cells of Rhinella arenarum (Hensel, 1867) as environmental health assessment in disturbed aquatic ecosystem from central Argentina

Abstract

Four populations of Rhinella arenarum from aquatic environments with different degrees of disturbance in central Argentina were compared to assess the ability of cytomorphology and cytomorphometry of blood cells as a hematological biomarker. A total of 93 specimens of R. arenarum (adults sexually mature) were captured during the spring. From the analysis of cell, no variations were found in terms of morphology, whereas in nuclear and cell areas and Price-Jones curves, we observed a smaller size in erythrocytes of individuals inhabiting the site most altered, "Villa Dalcar," as well as for leukocytes, lymphocytes, neutrophils, and eosinophils for the same site. This could be caused by presence of different pollutants in the lake. Furthermore, this was confirmed by the high levels of environmental variables (conductivity, total dissolved solids, and salinity) show that Villa Dalcar is the site most affected by human activities.

http://ift.tt/2w0iUM2

Fecal sludge management in developing urban centers: a review on the collection, treatment, and composting

Abstract

The problems posed by fecal sludge (FS) are multidimensional because most cities rapidly urbanize, which results in the increase in population, urban settlement, and waste generation. Issues concerning health and waste treatment have continued to create alarming situations. These issues had indeed interfered with the proper steps in managing FS, which contaminates the environment. FS can be used in agriculture as fertilizer because it is an excellent source of nutrients. The recent decline in crop production due to loss of soil organic component, erosion, and nutrient runoff has generated interest in the recycling of FS into soil nutrients through stabilization and composting. However, human feces are considerably liable to spread microorganisms to other persons. Thus, sanitation, stabilization, and composting should be the main objectives of FS treatment to minimize the risk to public and environmental health. This review presents an improved FS management (FSM) and technology option for soil amendment that is grouped into three headings, namely, (1) collection, (2) treatment, and (3) composting. On the basis of the literature review, the main problems associated with the collection and treatment of FS, such as inadequate tools and improper treatment processes, are summarized, and the trends and challenges that concern the applicability of each of the technologies in developing urban centers are critically reviewed. Stabilization during pretreatment before composting is suggested as the best method to reduce pathogens in FS. Results are precisely intended to be used as a support for decisions on policies and strategies for FSM and investments for improved treatment facilities.

http://ift.tt/2f0iE8I

Effects of phoxim-induced hepatotoxicity on SD rats and the protection of vitamin E

Abstract

Currently, public pay more attention to the adverse effect of organophosphate pesticides on human and animal health and on the environment in developing nations. Vitamin E may protect the hepatocyte and increase the function of liver. The study was to investigate the effects of phoxim-induced hepatotoxicity on Sprague Dawley (SD) rats and the protection of vitamin E. SD rats received by gavage 180 mg kg⁻¹ (per body weight) of phoxim, 200 mg kg⁻¹ (per body weight) of vitamin E, and phoxim + vitamin E. The results showed that exposure to phoxim elevated liver coefficient; glutamyl transpeptidase (GGT), aspartate aminotransferase, alkaline phosphatase, total bilirubin, total bile acid, and alanine aminotransferase in the serum; ROS in the liver; and the expression of p53, Bax, CYP2E1, ROS, caspase-9, caspase-8, and caspase-3, while phoxim caused a reduction of total protein, albumin, and cholinesterase in the serum; acetylcholinesterase, total antioxidant capacity, glutathione peroxidase, and glutathione in the liver; and the expression of Bcl-2. Vitamin E modified the phoxim-induced hepatotoxicity by reducing the GGT in the serum, malondialdehyde in the liver, and the expression of CYP2E1 significantly. There were no significant changes of globulin in the serum, the activity of catalase in the liver, as well as expression levels of Fas and Bad in the liver. Overall, subacute exposure to phoxim induced hepatic injury, oxidative stress damage, and cell apoptosis. Vitamin E modified phoxim-induced hepatotoxicity slightly. And, vitamin E minimized oxidative stress damage and ultrastructural changes in rat hepatocytes notably.

http://ift.tt/2f0iD4E

Cadmium losses in overland flow from an agricultural soil

Abstract

Cadmium (Cd) transport in overland flow from agricultural soils is potentially important when trying to predict future soil Cd concentrations, but at present there is little information on the magnitude of loss from this pathway. This study measured Cd concentrations and fluxes in overland flow from a catchment where cattle winter-grazed a forage crop (kale) (Brassica oleracea) in year one and measurements continued in year two when the catchment was returned to pasture and grazed by sheep. Flow-weighted mean concentrations (FWMC) of total, particulate and dissolved Cd in overland flow events from the forage crop were 0.49, 0.41 and 0.08 μg L⁻¹, respectively. In contrast, no dissolved Cd was detected in overland flow from pasture, with a FWMC of total Cd of 0.09 μg L⁻¹. In line with the Cd concentrations, total Cd fluxes were greater from the forage crop (0.06 g Cd ha⁻¹ year⁻¹) than from pasture (0.04 g Cd ha⁻¹ year⁻¹). Cadmium losses in overland flow were relatively minor compared with those reported for other pathways such as plant uptake or subsurface flow. Further, compared to the amount of Cd that is currently added to soil in a maintenance application of phosphate fertiliser (30 kg P ha⁻¹ year⁻¹) which is on average 5.5 g Cd ha⁻¹, Cd losses in overland flow represented < 1% of inputs. Measurement of Cd losses in overland flow should be undertaken at other sites to confirm the low Cd losses found in this study, along with the distribution between dissolved and particulate fractions.

http://ift.tt/2w0K7Os

Chemotherapy for advanced HER2-negative breast cancer: can one algorithm fit all?

Publication date: Available online 15 September 2017
Source:Cancer Treatment Reviews
Author(s): F. Miglietta, M.V. Dieci, G. Griguolo, V. Guarneri, P.F. Conte
HER2negative (HER2-) metastatic breast cancer (MBC) represents a challenging scenario for clinicians due to its great biological and clinical heterogeneity. Although management of HER2-MBC currently relies on several options, CT still remains a worthwhile strategy to be exploited. However, to date, there is not an univoque algorithm capable of guiding the choice of the proper CT agent/regimen, sequence and duration. Evidence from randomized clinical trials (RCT) and meta-analyses can actually help guiding the decision making process, however the definition of a standard of care for all HER2-MBC patients may be impractical, also in the light of the identification of new promising molecular and immunotherapeutic agents. The purpose of this work is to review available evidence on the role of CT for HER2-MBC with particular emphasis on the need to outline personalized therapeutic strategies for each patient.



http://ift.tt/2xpiLoM

Rare cause of colonic intussusception in an adult

Colonic intussusception is an uncommon phenomenon in adults. Advanced imaging has facilitated the increase in awareness of this rare disease. When present, the lead point is most often secondary to a malignancy with primary adenocarcinoma being the most frequent cause. Current surgical management involves oncologic resections for this reason. This is a report of the third ever-reported case of colonic intussusception secondary to an angiolipoma and the first in the western hemisphere. We also demonstrate that these masses are amenable to minimally invasive resection for definitive management.

http://ift.tt/2jzNtqj

Successful twice interrupted therapy of HCV infection in patients with cirrhosis with hepatocellular carcinoma before and after liver transplantation

We are presenting the case study of the patient diagnosed at the age of 37 with liver cirrhosis due to genotype 1b hepatitis C virus infection. At the age of 46, he was diagnosed with hepatocellular carcinoma with subsequent resection of the tumour in May 2015. In December 2015, the treatment was started with ombitasvir, paritaprevir/ritonavir and dasabuvir (3D) with ribavirin (RBV) 1000 mg per day. After 24 days of this treatment, the patient received a deceased donor liver transplantation, followed by 18-day interruption of 3D therapy. Due to the anaemia, RBV dose was reduced to 600 mg per day for the rest of the treatment. At the 11th week of 3D+RBV treatment, there was another 8-day long discontinuation of therapy due to the postoperative wound infection. In total, the patient received 24 weeks of 3D+RBV treatment, achieving sustained virological response at week 24 post-treatment.

http://ift.tt/2xGuEI1

Combined caesarean with splenectomy in pregnancy with portal hypertension: defining plausibility

24-year-old woman at 28 weeks gestation was referred from peripheral hospital with diagnosis of pregnancy with portal hypertension. She had received multiple transfusion for pancytopaenia in the past and had undergone endoscopic sclerotherapy for oesophageal varices. Initially, she was admitted in our hospital at 28 weeks gestation for blood transfusion and was evaluated by multispecialty team of doctors. She was advised splenectomy for transfusion-dependent pancytopaenia secondary to hypersplenism in non-cirrhotic portal hypertension. She was readmitted at 36 weeks gestation. A decision for caesarean was taken owing to failed induction of labour at 38 weeks gestation. She underwent combined caesarean with splenectomy. Mother and child had an uneventful postoperative recovery and were discharged on ninth postoperative day. Preconceptional counselling, treatment of oesophageal varices and multispecialty approach was paramount in the management. Combined caesarean with splenectomy is feasible and cost-effective treatment associated with improved quality of life. Prospective clinical trials are essential to prove safety and efficacy of treatment.

http://ift.tt/2jw2E3w

Renal cell carcinoma with isolated metastasis to sigmoid mesentery: a rare resectable combination

Renal cell carcinoma accounts for 2%–3% of all malignancies in adults. It spreads via direct extension, lymphatic route as well as haematogenous route. Lymph nodes, lungs, bone, liver and brain are the usual sites for its metastatic spread. In the presence of limited metastatic disease with potentially resectable metastases, surgery offers the best chances of cure. In the present case, we describe a case of renal cell carcinoma with a solitary metastasis to the sigmoid mesentery in a patient with Von Hippel-Lindau syndrome. There was no retroperitoneal lymphadenopathy or tumour thrombus in the renal vein. The patient was managed with laparoscopic radical nephrectomy and excision of the sigmoid mesentery mass. At 6 months of follow-up, there is no evidence of recurrent disease.

http://ift.tt/2xGiwXC

Rare case of primary leiomyosarcoma of sigmoid mesocolon

We experienced a rare case of primary leiomyosarcoma of sigmoid mesentery. A 45-year-old woman was presented to us with left iliac fossa mass and discomfort for 4-month duration. CT scan of abdomen and pelvis revealed a huge mass 14 cmx14 cmx16 cm occupying left iliac fossa mimicked having a large left ovarian carcinoma. She was subsequently planned for elective total abdominal hysterectomy and bilateral salpingo-oophorectomy by gynaecology team. During laparotomy, a huge mass was revealed arising from sigmoid mesentery invaded to the left lower ureter. Curative resection was done and pathological findings show the tumour being leiomyosarcoma with immunohistochemistry tests on caldesmon, desmin, smooth muscle actin and CD34 reagent all positive. Clinicopathological and literature review of this rare primary leiomyosarcoma of mesocolon was discussed in our case presentation

http://ift.tt/2jvqSel

Novel fabrication of nano functionalized amorphous tungsten oxide coatings with colorful superamphiphobic surface study

Publication date: 5 December 2017
Source:Materials & Design, Volume 135
Author(s): Bingbing Xia, Hongtao Liu, Yinan Fan, Tianchi Chen, Chao Chen, Bo Wang
Fabrication of surfaces with capability of repelling both water and oil is badly needed. Meanwhile, the widespread use of nanomaterials has also attracted great interest in this field. In this paper, we provided novel methods to synthesize nano amorphous tungsten oxide coatings on Al-Mg metals. After modification with FAS-17, the surface could obtain excellent superamphiphobic abilities with lower sliding angles and higher contact angles to water and oil. In addition, outstanding anti-oil pollutant and low adhesion were obtained. Furthermore, the as-prepared superamphiphobic surfaces could survive 200cm abrasion distance under 19.6kPa pressure on 1000grid SiC sandpaper. It should be noted that this coatings could obtain different colors in different temperature. Meanwhile, we found that the droplets with lower surface energy and low viscosity are easier to bounce than the droplets with high surface energy and high viscosity. So the simple procedure and excellent superamphiphobicity about fabricating colorful tungsten oxide coatings have great potential in protecting Al-Mg metal and have potential applied in signals which need to prevent wetting or pollution by water and oils. On one level, this method about synthesizing nano amorphous tungsten oxide also has more promising using in other fields.

Graphical abstract

http://ift.tt/2jxBGZx

Microstructural evolution and properties of TLP diffusion bonding super-Ni/NiCr laminated composite to Ti-6Al-4V alloy with Cu interlayer

Publication date: 5 December 2017
Source:Materials & Design, Volume 135
Author(s): Kun Liu, Yajiang Li, Chunzhi Xia, Juan Wang
Transient liquid phase (TLP) diffusion bonding super-Ni/NiCr laminated composite to Ti-6Al-4V alloy was performed at 950°C with the pressure of 5MPa. Two configurations (super-Ni/Cu/Ti-6Al-4V and Ni80Cr20/Cu/Ti-6Al-4V) were designed to explore interfacial microstructure evolution and mechanical properties. Results showed that the joint of laminated composite and Ti-6Al-4V alloy was mainly divided into two diffusion layers and a reaction layer. The interface was composed of Ni(Cu), Cu(Ni), Ti2Cu, TiCu, Ti3Cu4, Ti2Cu3 and Ti-Cu eutectic microstructure. The width of each layer increased with prolonging the bonding time and the growth rate of interfacial layers was dominated by the diffusion rate of alloying elements i.e. Cu, Ni and Ti. The maximum value of shear strength for both two configurations was about 58MPa.

Graphical abstract

http://ift.tt/2jy5J3a

18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography May Exclude Malignancy in Sonographically Suspicious and Scintigraphically Hypofunctional Thyroid Nodules and Reduce Unnecessary Thyroid Surgeries

Thyroid , Vol. 0, No. 0.


http://ift.tt/2x9m2YU

Long-Term Antithyroid Drug Treatment: A Systematic Review and Meta-Analysis

Thyroid , Vol. 0, No. 0.


http://ift.tt/2x9lBxH

Comparison of Core-Needle Biopsy and Fine-Needle Aspiration for Evaluating Thyroid Incidentalomas Detected by 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: A Propensity Score Analysis

Thyroid , Vol. 0, No. 0.


http://ift.tt/2ydZGUP

Th9 cells promote antitumor immunity via IL-9 and IL-21 and demonstrate atypical cytokine expression in breast cancer

Publication date: November 2017
Source:International Immunopharmacology, Volume 52
Author(s): Fa-Ping You, Jian Zhang, Tao Cui, Rui Zhu, Chong-Qing Lv, Hai-Tao Tang, Di-Wen Sun
Breast cancer is a major cause of cancer-related death in women. Antitumor T cell responses play critical therapeutic roles, including direct cytotoxicity mediated by CD8⁺ T cells and immunomodulatory roles mediated by CD4⁺ T cells. The IL-9-expressing Th9 cells are recently found to present antitumor immunity in melanoma and lung adenocarcinoma. In this study, we found that IL-9 expression in the serum and in circulating CD4⁺ T cells were significantly upregulated in breast cancer patients compared to healthy controls. The IL-9-expressing Th9 cells were enriched in the CCR4⁻CCR6⁻CXCR3⁻ subset. Upon TCR stimulation, this subset also presented potent IL-10 and IL-21 expression in addition to IL-9 expression. CCR4⁻CCR6⁻CXCR3⁻ CD4⁺ T cells also assisted in the killing of autologous tumor cells by CD8⁺ T cells, but did not initiate cytotoxicity by themselves. This enhancement in CD8⁺ T cell-mediated cytotoxicity was dependent on IL-9 as well as on IL-21. Interestingly, the tumor-infiltrating Th9 cells presented comparable IL-9, reduced IL-10, and elevated IL-21 expression compared with their counterparts in the peripheral blood. Together, these results demonstrated that IL-9-expressing Th9 cells were upregulated in breast cancer patients and potentially possessed antitumor roles by enhancing CD8⁺ T cell-mediated cytotoxicity.



http://ift.tt/2x9Mi5x

18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography May Exclude Malignancy in Sonographically Suspicious and Scintigraphically Hypofunctional Thyroid Nodules and Reduce Unnecessary Thyroid Surgeries

Thyroid , Vol. 0, No. 0.


http://ift.tt/2x9m2YU

Long-Term Antithyroid Drug Treatment: A Systematic Review and Meta-Analysis

Thyroid , Vol. 0, No. 0.


http://ift.tt/2x9lBxH

Comparison of Core-Needle Biopsy and Fine-Needle Aspiration for Evaluating Thyroid Incidentalomas Detected by 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: A Propensity Score Analysis

Thyroid , Vol. 0, No. 0.


http://ift.tt/2ydZGUP

Radioactive seed migration following parotid gland interstitial brachytherapy

Publication date: Available online 15 September 2017
Source:Brachytherapy
Author(s): Yi Fan, Ming-wei Huang, Yi-jiao Zhao, Hong Gao, Jian-Guo Zhang
PurposeTo evaluate the incidence and associated factors of pulmonary seed migration after parotid brachytherapy using a novel migrated seed detection technique.Methods and MaterialsPatients diagnosed with parotid cancer who underwent permanent parotid brachytherapy from January 2006 to December 2011 were reviewed retrospectively. Head and neck CT scans and chest X-rays were evaluated during routine follow-up. Mimics software and Geomagic Studio software were used for seed reconstruction and migrated seed detection from the original implanted region, respectively. Postimplant dosimetry analysis was performed after seeds migration if the seeds were still in their emitting count. Adverse clinical sequelae from seed embolization to the lung were documented.ResultsThe radioactive seed implants were identified on chest X-rays in 6 patients. The incidence rate of seed migration in 321 parotid brachytherapy patients was 1.87% (6/321) and that of individual seed migration was 0.04% (6/15218 seeds). All migrated seeds were originally from the retromandibular region. No adverse dosimetric consequences were found in the target region. Pulmonary symptoms were not reported by any patient in this study.ConclusionsIn our patient set, migration of radioactive seeds with an initial radioactivity of 0.6–0.7 mCi to the chest following parotid brachytherapy was rare. Late migration of a single seed from the central target region did not affect the dosimetry significantly, and patients did not have severe short-term complications. This study proposed a novel technique to localize the anatomical origin of the migrated seeds during brachytherapy. Our evidence suggested that placement of seeds adjacent to blood vessels was associated with an increased likelihood of seed migration to the lungs.



http://ift.tt/2fqvOwF

Dangling regimes after free flap reconstruction of the lower limb; further evidence is required

We read with interest the recent systematic review by McGhee et al.1 on flap survival and morbidity following early post-operative rehabilitation after lower limb free flap reconstruction, where it was concluded that post-operative dangling confers physiological benefit in flap healing.

http://ift.tt/2fcqPTg

Information content of dendritic spines after motor learning

Publication date: 15 January 2018
Source:Behavioural Brain Research, Volume 336
Author(s): Davide Viggiano, Luisa Speranza, Marianna Crispino, Gian Carlo Bellenchi, Umberto di Porzio, Attilio Iemolo, Elvira De Leonibus, Floriana Volpicelli, Carla Perrone-Capano
Dendritic spines, small protrusions emerging from the dendrites of most excitatory synapses in the mammalian brain, are highly dynamic structures and their shape and number is continuously modulated by memory formation and other adaptive changes of the brain.In this study, using a behavioral paradigm of motor learning, we applied the non-linear analysis of dendritic spines to study spine complexity along dendrites of cortical and subcortical neural systems, such as the basal ganglia, that sustain important motor learning processes.We show that, after learning, the spine organization has greater complexity, as indexed by the maximum Lyapunov exponent (LyE). The positive value of the exponent demonstrates that the system is chaotic, while recurrence plots show that the system is not simply composed by random noise, but displays quasi-periodic behavior. The increase in the maximum LyE and in the system entropy after learning was confirmed by the modification of the reconstructed trajectories in phase-space. Our results suggest that the remodeling of spines, as a result of a chaotic and non-random dynamical process along dendrites, may be a general feature associated with the structural plasticity underlying processes such as long-term memory maintenance.Furthermore, this work indicates that the non-linear method is a very useful tool to allow the detection of subtle stimulus-induced changes in dendritic spine dynamics, giving a key contribution to the study of the relationship between structure and function of spines.



http://ift.tt/2ydI3EF

An undergraduate Otolaryngology curriculum comparison in the United Kingdom using a curriculum evaluation framework

http://ift.tt/2xGiRcJ

Bile acids: a potential role in the pathogenesis of pharyngeal malignancy

http://ift.tt/2jwHsdL

Assessment of carotid artery intima‐media thickness in patients with obstructive sleep apnoea

http://ift.tt/2xGDnde

Single‐sided deafness affects language and auditory development – a case–control study

http://ift.tt/2jvYqJh

Local extension staging of sinonasal tumours: retrospective comparison between CT/MRI assessment and pathological findings

http://ift.tt/2xFnLXl

Adaptation and validation of the Singing Voice Handicap Index into Polish

http://ift.tt/2jxUXK3

An evaluation of the quality of evidence available to inform current bone conducting hearing device national policy

http://ift.tt/2xEPckl

Effect on mortality of elective parathyroid surgery in one hundred and three patients with chronic kidney disease: our experience

http://ift.tt/2jxqA6P

The value of direct audiology access for magnetic resonance imaging: an audit of 40 cases

http://ift.tt/2xGea2r

Dura and sinus compression with a transcutaneous bone conduction device – hearing outcomes and safety in 38 patients

http://ift.tt/2jxJr1z

Congenital anosmia: our experience of eleven patients with aplasia or hypoplasia of the olfactory tract

http://ift.tt/2xG546b

UK tertiary centre experience of outcomes from osseointegrated transcutaneous magnetic bone conduction hearing system implanted in twenty‐five patients using a linear incision technique

http://ift.tt/2jvYqcf

Short‐term results from seventy‐six patients receiving a bone‐anchored hearing implant installed with a novel minimally invasive surgery technique

http://ift.tt/2xETOql

Squamous cell carcinoma associated with inverted papilloma of the maxillary sinus: our experience with 21 patients

http://ift.tt/2jwDnq8

Functional magnetic resonance imaging in seven borderline cochlear implant candidates: a preliminary research study

http://ift.tt/2xETLe9

Balloon tuboplasty in patients with Eustachian tube dysfunction: a prospective study in 39 patients (55 ears)

http://ift.tt/2xFIRox

A retrospective analysis of seven patients with acquired immunodeficiency syndrome and pharyngeal and/or laryngeal Talaromyces marneffei infection

http://ift.tt/2jxIKFv

Workload and costs of audiological assessment on tertiary settings: Data analysis and audit

http://ift.tt/2xGf7bl

The role of sentinel lymph node biopsy in the management of laryngeal carcinoma

http://ift.tt/2jy6A41

Insulin effect on hearing recovery in idiopathic sudden sensorineural hearing loss: Retrospective study of 145 patients

http://ift.tt/2xFnK5J

An undergraduate Otolaryngology curriculum comparison in the United Kingdom using a curriculum evaluation framework

http://ift.tt/2xGiRcJ

Bile acids: a potential role in the pathogenesis of pharyngeal malignancy

http://ift.tt/2jwHsdL

Assessment of carotid artery intima‐media thickness in patients with obstructive sleep apnoea

http://ift.tt/2xGDnde

Single‐sided deafness affects language and auditory development – a case–control study

http://ift.tt/2jvYqJh

Local extension staging of sinonasal tumours: retrospective comparison between CT/MRI assessment and pathological findings

http://ift.tt/2xFnLXl

Adaptation and validation of the Singing Voice Handicap Index into Polish

http://ift.tt/2jxUXK3

An evaluation of the quality of evidence available to inform current bone conducting hearing device national policy

http://ift.tt/2xEPckl

Effect on mortality of elective parathyroid surgery in one hundred and three patients with chronic kidney disease: our experience

http://ift.tt/2jxqA6P

The value of direct audiology access for magnetic resonance imaging: an audit of 40 cases

http://ift.tt/2xGea2r

Dura and sinus compression with a transcutaneous bone conduction device – hearing outcomes and safety in 38 patients

http://ift.tt/2jxJr1z

Congenital anosmia: our experience of eleven patients with aplasia or hypoplasia of the olfactory tract

http://ift.tt/2xG546b

UK tertiary centre experience of outcomes from osseointegrated transcutaneous magnetic bone conduction hearing system implanted in twenty‐five patients using a linear incision technique

http://ift.tt/2jvYqcf

Short‐term results from seventy‐six patients receiving a bone‐anchored hearing implant installed with a novel minimally invasive surgery technique

http://ift.tt/2xETOql

Squamous cell carcinoma associated with inverted papilloma of the maxillary sinus: our experience with 21 patients

http://ift.tt/2jwDnq8

Functional magnetic resonance imaging in seven borderline cochlear implant candidates: a preliminary research study

http://ift.tt/2xETLe9

Balloon tuboplasty in patients with Eustachian tube dysfunction: a prospective study in 39 patients (55 ears)

http://ift.tt/2xFIRox

A retrospective analysis of seven patients with acquired immunodeficiency syndrome and pharyngeal and/or laryngeal Talaromyces marneffei infection

http://ift.tt/2jxIKFv

Workload and costs of audiological assessment on tertiary settings: Data analysis and audit

http://ift.tt/2xGf7bl

The role of sentinel lymph node biopsy in the management of laryngeal carcinoma

http://ift.tt/2jy6A41

Insulin effect on hearing recovery in idiopathic sudden sensorineural hearing loss: Retrospective study of 145 patients

http://ift.tt/2xFnK5J

For Irritating Itch, a Promising Option Under Scrutiny

Investigational serlopitant afforded clinical trial patients quick relief for a variety of pruritis-characterized diseases.
Medscape Medical News

http://ift.tt/2yd6YIr

Testing Potential Uses for Light Therapy

Green and red light therapies explored to treat migraines and skin conditions.
WebMD Health News

http://ift.tt/2f9bNh7

How Is the Serial Order of a Visual Sequence Represented? Insights From Transposition Latencies.

Author: Hurlstone, Mark J.; Hitch, Graham J.

DOI: 10.1037/xlm0000440

Publication Date: POST AUTHOR CORRECTIONS, 14 September 2017

http://ift.tt/2w0vI4W

Olfactory deficits decrease the time resolution for trigeminal lateralization

Publication date: Available online 15 September 2017
Source:International Journal of Psychophysiology
Author(s): A. Oleszkiewicz, T. Meusel, M. Güpfert, B. Westermann, T. Hummel, A. Welge-Lüssen
ObjectivesTo date the temporal resolution of the detection of almost simultaneously applied intranasal trigeminal stimuli is unknown. The aim of our study was to examine this temporal resolution in an/hyposmic subjects, who are known to have reduced trigeminal sensitivity and compare it with healthy controls.MethodsParticipants were 20 posttraumatic an/hyposmic patients, and 23 healthy controls (matched with regard to sex and age). Olfactory function was tested psychophysically using the Sniffin´ Sticks test battery. Bilateral trigeminal stimulation was carried out using a birhinal high-precision olfactometer. The trigeminal stimulus used was CO₂ 60% v/v, the interstimulus interval ranged from 28 to 32s, stimulus duration was 200ms. Time-lags tested between right and left side of stimulation were at 40, 80, 120, 160 and 200ms. Subjects raised their left or right hand to indicate the side on which the stimulus had been perceived first.ResultsIn both groups the accuracy in the trigeminal lateralization task increased with the time-lag but normosmic subjects significantly outperformed an/hyposmics in the 200ms time-lag condition. Normosmics significantly exceeded 50% chance level at the time-lag of 80ms, whereas an/hyposmics were only able to score above chance starting from 120ms time-lag. Lateralization scores significantly decreased with age.ConclusionsAt a time lag of 200ms intranasal trigeminal stimuli can be lateralized. The reduced trigeminal sensitivity in patients with anosmia or hyposmia leads to an increased time lag required for correct perception of intranasal, almost simultaneously, applied stimuli.



http://ift.tt/2x9cc9C

Parity and Risk of Thyroid Cancer: a Population-Based Study in Lithuania

Abstract

An association between parity and thyroid cancer risk has been investigated in a number of independent studies but yielded contradictory findings. The aim of this study was to explore the association between parity and thyroid cancer risk. The population-based cohort study in Lithuanian was conducted. The study dataset based on the linkages between all records from the 2001 population census, all cancer incidence records from the Lithuanian Cancer Registry, and all death and emigration records from Statistics Lithuania for the period between 6 April 2001 and 31 December 2009. Cox's proportional hazards regression models were used to estimate the hazard ratios (HRs) for parity, age at first birth, number of children, place of residence, education, and age at census. The cohort of 868,105 women was followed for 8.6 years, and 1775 thyroid cancer cases were diagnosed during the study period. The significantly higher thyroid cancer risk was observed among parous women (HR = 1.45, 95% CI: 1.20, 1.75) and in women with 1, 2, and 3 children, after adjusting for the possible confounding effects of relevant demographic variables. The findings of this study are consistent with the hypothesis that parity might be associated with the risk of thyroid cancer in women.

http://ift.tt/2ydzUjj

The impact of intraoperative opioid use on survival after oral cancer surgery

Publication date: November 2017
Source:Oral Oncology, Volume 74
Author(s): Miguel A. Patino, Rafael E. Ramirez, Carlos A. Perez, Lei Feng, Pranav Kataria, Jeffrey Myers, Juan P. Cata
ObjectivesTo investigate the impact of opioid use on cancer recurrence after oral cancer surgery. We hypothesized that the amount of opioids administered during oral cancer surgery is an independent predictor of recurrence free survival (RFS) and overall survival (OS).MethodsAfter Institutional Review Board approval, we collected demographic, tumor related, intraoperative and survival data of patients who had oral cancer surgery. Multivariable Cox proportional hazards models were used to determine the impact of important covariates on RFS and OS.Results268 patients were included. After adjusting for significant covariates, the amount of opioids administered during surgery was not an independent predictor of RFS (HR: 1.27 [CI 95%, 0.838–1.924], p=0.26). However, we observed an association between opioid consumption and shorter OS (HR=1.77, [CI 95%=0.995–3.149]. p=0.05).ConclusionsHigh requirements of opioids during surgery increase the risk of recurrence and mortality by 27% and 77%, although the association is not statically significant.



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Learning with three factors: modulating Hebbian plasticity with errors

Publication date: October 2017
Source:Current Opinion in Neurobiology, Volume 46
Author(s): Łukasz Kuśmierz, Takuya Isomura, Taro Toyoizumi
Synaptic plasticity is a central theme in neuroscience. A framework of three-factor learning rules provides a powerful abstraction, helping to navigate through the abundance of models of synaptic plasticity. It is well-known that the dopamine modulation of learning is related to reward, but theoretical models predict other functional roles of the modulatory third factor; it may encode errors for supervised learning, summary statistics of the population activity for unsupervised learning or attentional feedback. Specialized structures may be needed in order to generate and propagate third factors in the neural network.



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(Reinforcement?) Learning to forage optimally

Publication date: October 2017
Source:Current Opinion in Neurobiology, Volume 46
Author(s): Nils Kolling, Thomas Akam
Foraging effectively is critical to the survival of all animals and this imperative is thought to have profoundly shaped brain evolution. Decisions made by foraging animals often approximate optimal strategies, but the learning and decision mechanisms generating these choices remain poorly understood. Recent work with laboratory foraging tasks in humans suggest their behaviour is poorly explained by model-free reinforcement learning, with simple heuristic strategies better describing behaviour in some tasks, and in others evidence of prospective prediction of the future state of the environment. We suggest that model-based average reward reinforcement learning may provide a common framework for understanding these apparently divergent foraging strategies.



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BRAEBON sets new sleep apnea record in official Malaysian Book of Records: 110 Military Veterans Take Part In Sleep Apnea Test In State of Perak

New sleep apnea testing record using MediByte equipment in official Malaysian Book of Records: 110 Military Veterans Take Part In Sleep Apnea Test In State of Perak

LUMUT, MALAYSIA: A total of 110 military veterans in Perak participated in the largest sleep apnoea test to raise public awareness on the danger of the disorder as well as to educate them on the symptoms, diagnosis and treatment.

Braebon Malaysia Sdn Bhd President, Jojo Chegne said the test was carried out because one in three Malaysians aged 45 years and above had snoring problems with the possibility of obstructive sleep apnoea (OSA) syndrome.

He said the participants, who were the members of the Perak Malaysian Armed Forces Veterans Association (PVATM), aged between 45 and 76, underwent the test at the Swiss Garden hotel in Segari last night.

"Before they went to sleep, all of them were hooked up to the apnoea testing equipment called Medibyte Jr, to record their breathing patterns, snoring, oxygen levels, heart rate, chest movements and sleep position," he said here today.

Mr. Chegne said the test revealed that 34% of the participants had severe sleep apnoea with as many as 45 pauses in breathing per hour while sleeping.

"This causes a lack of oxygen in the blood and brain which can lead to many other health problems.

"In fact, the lack of oxygen especially in the brain can be fatal if left untreated," Jojo said.

He said those suffering from OSA would experience between 10 and 60 seconds of breathing pauses each time, and up to 400 times each night.

People with OSA often wake up suddenly due to shortness of breath, he added.

Take a closer look at the Technology behind BRAEBON Click Here

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Review of breast augmentation and reconstruction for the radiologist with emphasis on MRI

Publication date: January–February 2018
Source:Clinical Imaging, Volume 47
Author(s): Lauren A. Green, Jillian A. Karow, Jordan E. Toman, Antonella Lostumbo, Karen Xie
It is imperative to continue screening for breast cancer and/or detect tumor recurrence in patients after they have undergone breast augmentation or reconstruction. As there is an increasing role for both screening and diagnostic imaging of the post-operative breast, it is important for the radiologist to be familiar with the commonly performed surgical techniques in breast augmentation and reconstruction. Imaging of the augmented and reconstructed breast, as well as complications, will be reviewed with a focus on Magnetic Resonance Imaging (MRI).



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Chlorin e6-mediated photodynamic therapy promotes collagen production and suppresses MMPs expression via modulating AP-1 signaling in P. acnes-stimulated HaCaT cells

Publication date: December 2017
Source:Photodiagnosis and Photodynamic Therapy, Volume 20
Author(s): A-Reum Ryu, Mi-Young Lee
BackgroundPhotodynamic therapy (PDT) is a clinically approved therapeutic for cancers and non-neoplastic diseases, based on the use of a photosensitizer activated by light. The feasibility of PDT depends on several factors, such as PDT dose, photosensitizer efficacy, type of light source, and target tissue irradiated.MethodsIn this study, the second generation photosensitizer chlorin e6 (Ce6) and halogen light were used to investigate their PDT effect on the collagen production and MMPs expression of heat killed P. acnes-stimulated HaCaT cells. The mRNA levels of COL1A1, c-Jun, and c-Fos were detected by RT-PCR. The protein levels of MMPs, ERK and JNK were detected by western blot. The transactivation of AP-1 was detected by luciferase assay.ResultsCe6-based PDT markedly upregulated the mRNA level of COL1A1 and type I procollagen level; and at the same time downregulated the expression of MMPs in P. acnes-infected HaCaT cells. Moreover, Ce6-mediated PDT, in a dose dependent manner, inhibited P. acnes-induced phosphorylation of JNK and ERK, as wells as the phosphorylation of their downstream targets c-Jun and c-Fos. P. acnes-induced mRNA expression of c-Jun and c-Fos were also suppressed by Ce6-mediated PDT. The transactivation of AP-1 induced by P. acnes infection was also downregulated.ConclusionThese results indicated that Ce6-mediated PDT with halogen light enhanced collagen production, but inhibited the expression of MMPs in P. acnes-infected HaCaT cells, by regulating AP-1 signals. This investigation provided the first molecular basis for the increase in collagen production by Ce6-mediated PDT, suggesting its potential use for scar amelioration and skin rejuvenation in acne treatment.

Graphical abstract

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Highly sensitive surface plasmon resonance biosensor for the detection of HIV-related DNA based on dynamic and structural DNA nanodevices

Publication date: 15 February 2018
Source:Biosensors and Bioelectronics, Volume 100
Author(s): Wei Diao, Min Tang, Shijia Ding, Xinmin Li, Wenbin Cheng, Fei Mo, Xiaoyu Yan, Hongmin Ma, Yurong Yan
Early detection, diagnosis and treatment of human immune deficiency virus (HIV) infection is the key to reduce acquired immunodeficiency syndrome (AIDS) mortality. In our research, an innovative surface plasmon resonance (SPR) biosensing strategy has been developed for highly sensitive detection of HIV-related DNA based on entropy-driven strand displacement reactions (ESDRs) and double-layer DNA tetrahedrons (DDTs). ESDRs as enzyme-free and label-free signal amplification circuit can be specifically triggered by target DNA, leading to the cyclic utilization of target DNA and the formation of plentiful double-stranded DNA (dsDNA) products. Subsequently, the dsDNA products bind to the immobilized hairpin capture probes and further combine with DDTs nanostructures. Due to the high efficiency of ESDRs and large molecular weight of DDTs, the SPR response signal was enhanced dramatically. The proposed SPR biosensor could detect target DNA sensitively and specifically in a linear range from 1pM to 150nM with a detection limit of 48fM. In addition, the whole detecting process can be accomplished in 60min with high accuracy and duplicability. In particular, the developed SPR biosensor was successfully used to analyze target DNA in complex biological sample, indicating that the developed strategy is promising for rapid and early clinical diagnosis of HIV infection.



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Developmental Stuttering in Children Who Are Hard of Hearing

Purpose

A number of studies with large sample sizes have reported lower prevalence of stuttering in children with significant hearing loss compared to children without hearing loss. This study used a parent questionnaire to investigate the characteristics of stuttering (e.g., incidence, prevalence, and age of onset) in children who are hard of hearing (CHH).

Method

Three hundred three parents of CHH who participated in the Outcomes of Children With Hearing Loss study (Moeller & Tomblin, 2015) were sent questionnaires asking about their child's history of stuttering.

Results

One hundred ninety-four parents of CHH responded to the survey. Thirty-three CHH were reported to have stuttered at one point in time (an incidence of 17.01%), and 10 children were still stuttering at the time of survey submission (a prevalence of 5.15%). Compared to estimates in the general population, this sample displayed a significantly higher incidence and prevalence. The age of onset, recovery rate, and other characteristics were similar to hearing children.

Conclusions

Based on this sample, mild to moderately severe hearing loss does not appear to be a protective factor for stuttering in the preschool years. In fact, the incidence and prevalence of stuttering may be higher in this population compared to the general population. Despite the significant speech and language needs that children with mild to moderately severe hearing loss may have, speech-language pathologists should appropriately prioritize stuttering treatment as they would in the hearing population.

Supplemental Material

http://ift.tt/2x5UlyF

http://article/doi/10.1044/2017_LSHSS-17-0028/2654658/Developmental-Stuttering-in-Children-Who-Are-Hard

Guidance Statement on BRCA1/2 Tumor Testing in Ovarian Cancer Patients

Publication date: Available online 15 September 2017
Source:Seminars in Oncology
Author(s): Ettore Capoluongo, Gillian Ellison, José Antonio López-Guerrero, Frederique Penault-Llorca, Marjolijn J.L. Ligtenberg, Susana Banerjee, Christian Singer, Eitan Friedman, Birgid Markiefka, Peter Schirmacher, Reinhard Büttner, Christi J. van Asperen, Isabelle Ray-Coquard, Volker Endris, Suzanne Kamel-Reid, Natalie Percival, Jane Bryce, Benno Röthlisberger, Richie Soong, David Gonzalez de Castro
The approval in 2015 of the first poly(adenosine diphosphate-ribose) polymerase inhibitor (PARPi; olaparib [Lynparza™]) for platinum-sensitive relapsed high-grade ovarian cancer with either germline or somatic BRCA1/2 deleterious mutations is changing the way that BRCA1/2 testing services are offered to patients with ovarian cancer. Ovarian cancer patients are now being referred for BRCA1/2 genetic testing for treatment decisions, in addition to familial risk estimation, and irrespective of a family history of breast/ovarian cancer. Furthermore, testing of tumor samples to identify the estimated 3–9% of patients with somatic BRCA1/2 mutations who, in addition to germline carriers, could benefit from PARPi therapy is also now being considered. This new testing paradigm poses some challenges, in particular the technical and analytical difficulties of analyzing chemically challenged DNA derived from formalin-fixed, paraffin-embedded specimens. In this manuscript, we review some of these challenges and technical recommendations to consider when undertaking BRCA1/2 testing in tumor tissue samples to detect both germline and somatic BRCA1/2 mutations. Also provided are considerations for incorporating genetic analysis of ovarian tumor samples into the patient pathway and ethical requirements.



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Erratum to: Allergen immunotherapy for allergic asthma: protocol for a systematic review

Unfortunately this article [1] was published with an error in the Funding section. The BM4SIT project is not acknowledged. This section should be corrected to the below:

http://ift.tt/2jwWP5P

Erratum to: Allergen immunotherapy for allergic rhinoconjunctivitis: protocol for a systematic review

Unfortunately this article [1] was published with an error in the Funding section. The BM4SIT project is not acknowledged. This section should be corrected to the below:

http://ift.tt/2xF69uK

Erratum to: Allergen immunotherapy for IgE-mediated food allergy: protocol for a systematic review

Unfortunately this article [1] was published with an error in the Funding section. The BM4SIT project is not acknowledged. This section should be corrected to the below:

http://ift.tt/2jzeev1

Erratum to: Allergen immunotherapy for insect venom allergy: protocol for a systematic review

Unfortunately this article [1] was published with an error in the Funding section. The BM4SIT project is not acknowledged. This section should be corrected to the below:

http://ift.tt/2xFFvC7

Erratum to: Allergen immunotherapy for allergic asthma: protocol for a systematic review

Unfortunately this article [1] was published with an error in the Funding section. The BM4SIT project is not acknowledged. This section should be corrected to the below:

http://ift.tt/2jwWP5P

Erratum to: Allergen immunotherapy for allergic rhinoconjunctivitis: protocol for a systematic review

Unfortunately this article [1] was published with an error in the Funding section. The BM4SIT project is not acknowledged. This section should be corrected to the below:

http://ift.tt/2xF69uK

Erratum to: Allergen immunotherapy for IgE-mediated food allergy: protocol for a systematic review

Unfortunately this article [1] was published with an error in the Funding section. The BM4SIT project is not acknowledged. This section should be corrected to the below:

http://ift.tt/2jzeev1

Erratum to: Allergen immunotherapy for insect venom allergy: protocol for a systematic review

Unfortunately this article [1] was published with an error in the Funding section. The BM4SIT project is not acknowledged. This section should be corrected to the below:

http://ift.tt/2xFFvC7

Emotional eating is related with temperament but not with stress biomarkers in preschool children

Publication date: 1 January 2018
Source:Appetite, Volume 120
Author(s): Nadine Messerli-Bürgy, Kerstin Stülb, Tanja H. Kakebeeke, Amar Arhab, Annina E. Zysset, Claudia S. Leeger-Aschmann, Einat A. Schmutz, Andrea H. Meyer, Ulrike Ehlert, David Garcia-Burgos, Susi Kriemler, Oskar G. Jenni, Jardena J. Puder, Simone Munsch
Emotional eating (EE) corresponds to a change in eating behavior in response to distress and results in an increase of food intake (overeating (EOE)) or in food avoidance (undereating (EUE)). EE has been related to temperament (i.e. negative emotionality) and dysregulated stress biomarkers in school-aged children; parenting has been understood to influence this relationship in older children. The aim of the study was to investigate to which extent stress biomarkers and negative emotionality are related to EE and to understand the role of parenting in this relationship. The sample consisted of 271 children aged 2–6 years of the Swiss cohort study SPLASHY. We assessed the child's EE, negative emotionality and parenting by parent based reports. Salivary samples were collected over two days to analyze cortisol and salivary alpha-amylase levels. From the whole sample of children, 1.1% showed EOE and 32.9% EUE. Negative emotionality was related to EOE and EUE (0.13 (CI 0.06, 021), p < 0.001; 0.25 (CI 0.14, 0.35), p < 0.001). There was no relationship between stress biomarkers and EE and parenting had any moderating role (all p > 0.05). Similar to a Danish study, parents reported more often EUE than EOE of their child. Both are related to the temperament. Even though the course of EE has not yet been well documented, we conclude that a certain subgroup of children with difficult temperament could be at-risk for eat and weight regulation problems in later childhood.



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Easy-going, rational, susceptible and struggling eaters: A segmentation study based on eating behaviour tendencies

Publication date: 1 January 2018
Source:Appetite, Volume 120
Author(s): Saara Pentikäinen, Anne Arvola, Leila Karhunen, Kyösti Pennanen
Eating behaviour tendencies, emotional eating (EE), uncontrolled eating (UE) and cognitive restraint (CR), are associated with various indicators of physical and mental health. Therefore, it is important to understand these tendencies in order to design interventions to improve health. Previous research has mostly examined eating behaviour tendencies individually, without considering typical combinations of these tendencies or their manifestation in well-being and food choices. This study aimed to understand the interactive occurrence of EE, UE and CR in two independent populations. Finnish (n = 1060) and German (n = 1070) samples were segmented on the basis of their responses to a modified Three-Factor Eating Questionnaire (TFEQ-R15). Well-being, coping strategies and food consumption habits of the segments were studied.Segmentation revealed four segments: "Susceptible", "Easy-going", "Rational" and "Struggling". These segments were similar in both countries with regard to well-being, coping strategies and food choices.EE and UE co-occurred, and these tendencies were mainly responsible for differentiating the segments. Members of the "Rational" and "Easy-going" segments, who had low scores for EE and UE, tended to experience vitality and positive emotions in life, and contentment with their eating. By contrast, the "Susceptible" and "Struggling" segments, with more pronounced tendencies towards EE and UE, experienced lower levels of vitality and less frequently positive emotions, applied less adaptive coping strategies and experienced more discontent with eating.The results of the current study suggest that it is possible to identify segments, with differing eating habits, coping strategies and well-being on the basis of the eating behaviour tendencies EE, UE and CR. We discuss possible viewpoints for the design of interventions and food products to help people towards psychologically and physiologically healthier eating styles.



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Learned pleasure from eating: An opportunity to promote healthy eating in children?

Publication date: 1 January 2018
Source:Appetite, Volume 120
Author(s): Lucile Marty, Stéphanie Chambaron, Sophie Nicklaus, Sandrine Monnery-Patris
Across the lifespan, eating is a common everyday act driven by the search for pleasure and reinforced by experienced pleasure. Pleasure is an innate indicator of the satisfaction of physiological needs, in addition to other attributes. Pleasure from eating is also learned and contributes to the development of children's eating habits, which remain mostly stable until adulthood. Based on classical models of determinants of food consumption behaviour, we identified three dimensions of pleasure from eating learned during childhood: 1/the sensory dimension, i.e., pleasure from sensory sensations during food consumption; 2/the interpersonal dimension, i.e., pleasure from the social context of food consumption; and 3/the psychosocial dimension, i.e., pleasure from cognitive representations of food. The objective of this narrative review is to explore whether these three dimensions may play a role in promotion of healthy eating behaviour among children. Up to now, it was assumed that providing nutritional information, pointing out which types of foods are "good" or "bad" for health, would drive healthier food choices in children. Today, we know that such strategies based on a cognitive approach toward eating have a limited impact on healthy choices and can even be counter-productive, leading children to avoid healthy foods. In the context of increasing rates of childhood obesity, new perspectives are needed to build efficient interventions that might help children adopt a healthy diet. This review suggests new directions for further research to test the efficacy of novel interventions that emphasize pleasure from eating.



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DNA methylation patterns at sweet taste transducing genes are associated with BMI and carbohydrate intake in an adult population

Publication date: 1 January 2018
Source:Appetite, Volume 120
Author(s): O. Ramos-Lopez, A. Arpón, J.I. Riezu-Boj, F.I. Milagro, M.L. Mansego, J.A. Martinez
Individual differences in taste perception may influence appetite, dietary intakes, and subsequently, disease risk. Correlations of DNA methylation patterns at taste transducing genes with BMI and dietary intakes were studied. A nutriepigenomic analysis within the Methyl Epigenome Network Association (MENA) project was conducted in 474 adults. DNA methylation in peripheral white blood cells was analyzed by a microarray approach. KEGG pathway analyses were performed concerning the characterization and discrimination of genes involved in the taste transduction pathway. Adjusted FDR values (p < 0.0001) were used to select those CpGs that showed best correlation with BMI. A total of 29 CpGs at taste transducing genes met the FDR criteria. However, only 12 CpGs remained statistically significant after linear regression analyses adjusted for age and sex. These included cg15743657 (TAS1R2), cg02743674 (TRPM5), cg01790523 (SCN9A), cg15947487 (CALHM1), cg11658986 (ADCY6), cg04149773 (ADCY6), cg02841941 (P2RY1), cg02315111 (P2RX2), cg08273233 (HTR1E), cg14523238 (GABBR2), cg12315353 (GABBR1) and cg05579652 (CACNA1C). Interestingly, most of them were implicated in the sweet taste signaling pathway, except CACNA1C (sour taste). In addition, TAS1R2 methylation at cg15743657 was strongly correlated with total energy (p < 0.0001) and carbohydrate intakes (p < 0.0001). This study suggests that methylation in genes related to sweet taste could be an epigenetic mechanism associated with obesity.



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Parental feeding behavior in relation to children's tasting behavior: An observational study

Publication date: 1 January 2018
Source:Appetite, Volume 120
Author(s): Ellen Moens, Lien Goossens, Sandra Verbeken, Laura Vandeweghe, Caroline Braet
Children's eating habits are shaped in part by parental feeding practices. While maladaptive practices have already received a lot of research attention, the effects of adaptive strategies, especially in elementary school aged children of different weight status, are less examined. This study examines how parents (1) model and (2) encourage their child to taste an unknown food. Thereby, attention is paid to the distinction between encouraging what (i.e. adaptive type of encouragement) and the amount (i.e. maladaptive type of encouragement) children eat/drink. Twenty-five families with a child with overweight and 30 families with a child of healthy weight (7–13 years) participated in a taste task. Both the child's tasting behavior and the parents' modelling and encouragement behavior were observed and related to the child's age and weight status. As 94.3% of the children tasted the unknown food, weight status differences between tasters and non-tasters could not be investigated. Only 26.9% of the parents used modelling to enhance tasting behavior; this was unrelated to age and weight status. 77.4% of the parents encouraged their children to taste (encouragement of what children eat/drink), and this was significantly more prevalent in parents of younger children and of healthy-weight children. 21.1% of the parents also encouraged their children to finish the juice (encouragement of amount children eat/drink) and this was also more prevalent in parents of the healthy-weight group. These results evidenced that parental modelling is not often used to enhance tasting behavior in children. In contrast, parental encouragement was frequently observed, especially in parents of younger children and of healthy-weight children. Encouragement, however, seems difficult to measure and more research on adaptive parental encouragement is needed.



http://ift.tt/2wg2dk3

Can attentional bias modification inoculate people to withstand exposure to real-world food cues?

Publication date: 1 January 2018
Source:Appetite, Volume 120
Author(s): Eva Kemps, Marika Tiggemann, Ebony Stewart-Davis
Two experiments investigated whether attentional bias modification can inoculate people to withstand exposure to real-world appetitive food cues, namely television advertisements for chocolate products. Using a modified dot probe task, undergraduate women were trained to direct their attention toward (attend) or away from (avoid) chocolate pictures. Experiment 1 (N = 178) consisted of one training session; Experiment 2 (N = 161) included 5 weekly sessions. Following training, participants viewed television advertisements of chocolate or control products. They then took part in a so-called taste test as a measure of chocolate consumption. Attentional bias for chocolate was measured before training and after viewing the advertisements, and in Experiment 2 also at 24-h and 1-week follow-up. In Experiment 2, but not Experiment 1, participants in the avoid condition showed a significant reduction in attentional bias for chocolate, regardless of whether they had been exposed to advertisements for chocolate or control products. However, this inoculation effect on attentional bias did not generalise to chocolate intake. Future research involving more extensive attentional re-training may be needed to ascertain whether the inoculation effect on attentional bias can extend to consumption, and thus help people withstand exposure to real-world palatable food cues.



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Is higher formula intake and limited dietary diversity in Australian children at 14 months of age associated with dietary quality at 24 months?

Publication date: 1 January 2018
Source:Appetite, Volume 120
Author(s): Rebecca Byrne, Mei En Joy Yeo, Kimberley Mallan, Anthea Magarey, Lynne Daniels
A varied and diverse diet in childhood supports optimum long-term preferences and growth. Previous analysis from 14-month-old Australian children in the NOURISH and South Australian Infants Dietary Intake (SAIDI) studies found higher formula intake was associated with lower dietary diversity. This analysis investigated whether formula intake and dietary diversity at 14 months of age is associated with dietary quality at 24 months.This is a secondary analysis of intake data from NOURISH and SAIDI cohorts. Scores for dietary diversity, fruit variety, vegetable variety and meat/alternative variety were combined using structural equation modelling to form the latent variable 'Dietary quality' (DQ) at age 24 months. A longitudinal model examined influence of formula (grams), cow's milk (grams) and dietary diversity at 14 months and covariates, on DQ.At age 24 months (n = 337) 27% of children obtained a maximum dietary diversity score (5/5). Variety scores were relatively low – with mean variety scores (and possible range) being four for fruit (0–30); five for vegetables (0–36); and three for meat/alternatives (0–8). Dietary diversity at 14 months (β = 0.19, p = 0.001), maternal age (β = 0.24, p < 0.001) and education (β = 0.22, p < 0.001) predicted DQ at 24 months while Child Food Neophobia Score was negatively associated with DQ (β = −0.30, p < 0.001). Formula intake was negatively associated with diversity at 14 months, but not DQ at 24.Diversity and variety were limited despite sociodemographic advantage of the sample. Diversity at 14 months, degree of neophobia and sociodemographic factors predicted DQ at 24 months. There is an ongoing need to emphasise the importance of repeated early exposure to healthy foods, such that children have the opportunity to learn to like a range of tastes and texture, thereby maximising dietary diversity and quality in infancy and early toddlerhood.



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Perceived impact of smaller compared with larger-sized bottles of sugar-sweetened beverages on consumption: A qualitative analysis

Publication date: 1 January 2018
Source:Appetite, Volume 120
Author(s): Eleni Mantzari, Gareth J. Hollands, Rachel Pechey, Susan Jebb, Theresa M. Marteau
Sugar-sweetened beverage (SSB) consumption increases obesity risk and is linked to adverse health consequences. Large packages increase food consumption, but most evidence comes from studies comparing larger with standard packages, resulting in uncertainty regarding the impact of smaller packages. There is also little research on beverages. This qualitative study explores the experiences of consuming cola from smaller compared with larger bottles, to inform intervention strategies.Sixteen households in Cambridge, England, participating in a feasibility study assessing the impact of bottle size on in-home SSB consumption, received a set amount of cola each week for four weeks in one of four bottle sizes: 1500 ml, 1000 ml, 500 ml, or 250 ml, in random order. At the study end, household representatives were interviewed about their experiences of using each bottle, including perceptions of i) consumption level; ii) consumption-related behaviours; and iii) factors affecting consumption. Interviews were semi-structured and data analysed using the Framework approach. The present analysis focuses specifically on experiences relating to use of the smaller bottles.The smallest bottles were described as increasing drinking occasion frequency and encouraging consumption of numerous bottles in succession. Factors described as facilitating their consumption were: i) convenience and portability; ii) greater numbers of bottles available, which hindered consumption monitoring and control; iii) perceived insufficient quantity per bottle; and iv) positive attitudes. In a minority of cases the smallest bottles were perceived to have reduced consumption, but this was related to practical issues with the bottles that resulted in dislike.The perception of greater consumption and qualitative reports of drinking habits associated with the smallest bottles raise the possibility that the 'portion size effect' has a lower threshold, beyond which smaller portions and packages may increase consumption. This reinforces the need for empirical evidence to assess the in-home impact of smaller bottles on SSB consumption.



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A study on the independence of egocentric and allocentric neglect

Publication date: Available online 15 September 2017
Source:Cortex
Author(s): Nergiz Turgut, Claudia Mödden, Tanja Brumund, Paul Eling, Helmut Hildebrandt




http://ift.tt/2xpc467

Longitudinal study of accelerated long-term forgetting in children with genetic generalized epilepsy: Evidence of ongoing deficits

Publication date: Available online 15 September 2017
Source:Cortex
Author(s): Jasmin Grayson-Collins, Michael B. Gascoigne, Belinda Barton, Richard Webster, Deepak Gill, Suncica Lah
Accelerated long-term forgetting (ALF) is a recently described memory disorder characterised by adequate recall after short, but not long delays. Currently, the prevailing conceptualisation of ALF is of a seizure related phenomenon. The main aim of this study was to assess whether ALF subsides as epilepsy severity and seizures abate in children with genetic generalized epilepsy (GGE). Eighteen children with GGE were compared over time to 29 healthy controls on a range of cognitive measures. The primary outcome was a modified version of the California Verbal Learning Test for Children with a long delay (seven day) recall component. At approximately two years follow up, ALF was apparent, although epilepsy severity subsided and seizures resolved in many children. This result contrasts with the dominant conceptualisation of ALF being a seizure related phenomenon. Moreover, at follow-up, worse recall at the long delay was related to greater epilepsy severity at baseline and earlier age of seizure onset, but not to being seizure free at follow-up. While at follow-up worse recall at the long delay related to the worse baseline recall at the long delay, this recall did not relate to scores obtained on standardised memory tests at baseline. Our study suggests that ALF may not be seizure related and identifies factors associated with risk of ALF in children with GGE.



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Hypothesis: Watershed Zones in the Human Eye are a Key for Understanding Glaucomatous Retinal Damage

Publication date: Available online 15 September 2017
Source:Medical Hypotheses
Author(s): Christian Albrecht May, Paul Rutkowski
The pathogenesis of glaucoma is complex which has led to numerous hypothesizes concerning the important factors creating this specific type of inner retinal degeneration namely apoptosis of retinal ganglion cells. We favor a primary vascular etiology and provide evidence that the pathogenesis of glaucoma should not be confined to changes exclusively at the optic nerve head but must include changes occurring in the peripheral retina with particular emphasis on the watershed zones of both the retina and choroid. This focus may help to sharpen ones awareness for early glaucoma treatment particularly in patients with minimal findings suggestive of glaucoma.



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