Publication date: June 2016
Source:Oral Oncology, Volume 57
Author(s): Qianting He, Zujian Chen, Robert J. Cabay, Leitao Zhang, Xianghong Luan, Dan Chen, Tianwei Yu, Anxun Wang, Xiaofeng Zhou
ObjectiveWe previously performed a meta-analysis of microRNA profiling studies on head and neck/oral cancer (HNOC), and identified 11 consistently dysregulated microRNAs in HNOC. Here, we evaluate the diagnostic values of these microRNAs in oral tongue squamous cell carcinoma (OTSCC) using oral cytology samples.Materials and methodsThe levels of 11 microRNAs were assessed in 39 oral cytology samples (19 OTSCC and 20 normal subjects), and 10 paired OTSCC and adjacent normal tissues. The predictive power of these microRNAs was analyzed by receiver operating characteristic curve (ROC) and random forest (RF) model. A classification and regression trees (CART) model was generated using miR-21 and miR-375, and further validated using both independent oral cytology validation sample set (14 OTSCC and 11 normal subjects) and tissue validation sample set (12 paired OTSCC and adjacent normal tissues).ResultsDifferential expression of miR-21, miR-100, miR-125b and miR-375 was validated in oral cytology training sample set. Based on the RF model, the combination of miR-21 and miR-375 was selected which provide best prediction of OTSCC. A CART model was constructed using miR-21 and miR-375, and was tested in both oral cytology and tissue validation sample sets. A sensitivity of 100% and specificity of 64% was achieved in distinguishing OTSCC from normal in the oral cytology validation set, and a sensitivity of 83% and specificity of 83% was achieved in the tissue validation set.ConclusionThe utility of microRNA from oral cytology samples as biomarkers for OTSCC detection is successfully demonstrated in this study.
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Πέμπτη 31 Μαρτίου 2016
microRNA-21 and microRNA-375 from oral cytology as biomarkers for oral tongue cancer detection
Technically unresectable recurrent oral cancers: Is NACT the answer?
Surgical excision of loco-regionally recurrent head and neck cancers is associated with a median disease free survival of 17.9months [1]. The utility of surgical excision is limited to stage I–II patients; only very few of recurrent head and neck cancer patients can undergo resection [2]. When surgical salvage is not possible, re-irradiation is the next option. However, patients with locally advanced technically unresectable disease (T4a and T4b) are unlikely to be candidates for re-irradiation.
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Osteoradionecrosis in patients with salivary gland malignancies
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microRNA-21 and microRNA-375 from oral cytology as biomarkers for oral tongue cancer detection
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Validation of metabolic tumor volume as a prognostic factor for oral cavity squamous cell carcinoma treated with primary surgery
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Induced Loudness Reduction and Enhancement in Acoustic and Electric Hearing
Abstract
The loudness of a tone can be reduced by preceding it with a more intense tone. This effect, known as induced loudness reduction (ILR), has been reported to last for several seconds. The underlying neural mechanisms are unknown. One possible contributor to the effect involves changes in cochlear gain via the medial olivocochlear (MOC) efferents. Since cochlear implants (CIs) bypass the cochlea, investigating whether and how CI users experience ILR should help provide a better understanding of the underlying mechanisms. In the present study, ILR was examined in both normal-hearing listeners and CI users by examining the effects of an intense precursor (50 or 500 ms) on the loudness of a 50-ms target, as judged by comparing it to a spectrally remote 50-ms comparison sound. The interstimulus interval (ISI) between the precursor and the target was varied between 10 and 1000 ms to estimate the time course of ILR. In general, the patterns of results from the CI users were similar to those found in the normal-hearing listeners. However, in the short-precursor short-ISI condition, an enhancement in the loudness of target was observed in CI subjects that was not present in the normal-hearing listeners, consistent with the effects of an additional attenuation present in the normal-hearing listeners but not in the CI users. The results suggest that the MOC may play a role but that it is not the only source of these loudness context effects.
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Induced Loudness Reduction and Enhancement in Acoustic and Electric Hearing
Abstract
The loudness of a tone can be reduced by preceding it with a more intense tone. This effect, known as induced loudness reduction (ILR), has been reported to last for several seconds. The underlying neural mechanisms are unknown. One possible contributor to the effect involves changes in cochlear gain via the medial olivocochlear (MOC) efferents. Since cochlear implants (CIs) bypass the cochlea, investigating whether and how CI users experience ILR should help provide a better understanding of the underlying mechanisms. In the present study, ILR was examined in both normal-hearing listeners and CI users by examining the effects of an intense precursor (50 or 500 ms) on the loudness of a 50-ms target, as judged by comparing it to a spectrally remote 50-ms comparison sound. The interstimulus interval (ISI) between the precursor and the target was varied between 10 and 1000 ms to estimate the time course of ILR. In general, the patterns of results from the CI users were similar to those found in the normal-hearing listeners. However, in the short-precursor short-ISI condition, an enhancement in the loudness of target was observed in CI subjects that was not present in the normal-hearing listeners, consistent with the effects of an additional attenuation present in the normal-hearing listeners but not in the CI users. The results suggest that the MOC may play a role but that it is not the only source of these loudness context effects.
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Six Degrees of Auditory Spatial Separation
Abstract
The location of a sound is derived computationally from acoustical cues rather than being inherent in the topography of the input signal, as in vision. Since Lord Rayleigh, the descriptions of that representation have swung between "labeled line" and "opponent process" models. Employing a simple variant of a two-point separation judgment using concurrent speech sounds, we found that spatial discrimination thresholds changed nonmonotonically as a function of the overall separation. Rather than increasing with separation, spatial discrimination thresholds first declined as two-point separation increased before reaching a turning point and increasing thereafter with further separation. This "dipper" function, with a minimum at 6 ° of separation, was seen for regions around the midline as well as for more lateral regions (30 and 45 °). The discrimination thresholds for the binaural localization cues were linear over the same range, so these cannot explain the shape of these functions. These data and a simple computational model indicate that the perception of auditory space involves a local code or multichannel mapping emerging subsequent to the binaural cue coding.
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Six Degrees of Auditory Spatial Separation
Abstract
The location of a sound is derived computationally from acoustical cues rather than being inherent in the topography of the input signal, as in vision. Since Lord Rayleigh, the descriptions of that representation have swung between "labeled line" and "opponent process" models. Employing a simple variant of a two-point separation judgment using concurrent speech sounds, we found that spatial discrimination thresholds changed nonmonotonically as a function of the overall separation. Rather than increasing with separation, spatial discrimination thresholds first declined as two-point separation increased before reaching a turning point and increasing thereafter with further separation. This "dipper" function, with a minimum at 6 ° of separation, was seen for regions around the midline as well as for more lateral regions (30 and 45 °). The discrimination thresholds for the binaural localization cues were linear over the same range, so these cannot explain the shape of these functions. These data and a simple computational model indicate that the perception of auditory space involves a local code or multichannel mapping emerging subsequent to the binaural cue coding.
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Otofaciocervical syndrome and metachondromatosis in a girl: Presentation of a novel association and remarks on clinical variability of branchial-arch disorders
Publication date: June 2016
Source:International Journal of Pediatric Otorhinolaryngology, Volume 85
Author(s): Victor M. Salinas-Torres, Rafael A. Salinas-Torres
Otofaciocervical syndrome (OFCS) is a rare disorder characterized by facial, ear, branchial, and musculoskeletal anomalies, along with hearing loss and mild intellectual disability. Clinically, its distinction from branchiootorenal syndrome can be difficult. To date, the coexistence of OFCS and metachondromatosis has not been reported. Here, we describe a sporadic patient with both OFCS and metachondromatosis. This novel association prompts us to do some remarks on the clinical variability of branchial-arch disorders; in fact, our observations are consistent with the highly variable expressivity of OFCS and illustrate the need of a more accurate characterization of these branchial-arch disorders. In the meantime, involvement of clavicles, scapulae and shoulders remains a distinctive feature of OFCS.
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Attention deficit hyperactivity disorder symptoms in children with vocal fold nodules
Publication date: June 2016
Source:International Journal of Pediatric Otorhinolaryngology, Volume 85
Author(s): Omer Erdur, Arzu Herguner, Kayhan Ozturk, Ertugrul Kibar, Cagdas Elsurer, Mete Kaan Bozkurt, Sabri Herguner
ObjectivesThe aim of this case–control study was to investigate the symptoms of attention-deficit/hyperactivity disorder (ADHD) in children with vocal fold nodules (VNs).MethodsStudy group (SG) included children between 4 and 12 years. As a control group (CG), children between 4 and 12 years without VNs were included in the study. Parents of the participants completed the Conners' Parent Rating Scale-Revised: Short Form (CPRS-RS) which was used to analyze the symptoms of ADHD.ResultsForty-five children (30 boys and 15 girls) with VNs and 45 controls (30 boys and 15 girls) were enrolled in the study. Multivariate analysis of variance revealed that the CPRS-RS Hyperactivity and Oppositional Subscales were significantly higher in the SG than the CG (p < .05), after controlling the effects of age and gender.ConclusionsOur findings suggest associations between VNs and hyperactivity and oppositional behaviors in children. Clinicians should be aware of ADHD symptoms in children with VNs.
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Morphology of the distal thoracic duct and the right lymphatic duct in different head and neck pathologies: an imaging based study
Abstract
Background
The purpose of this study was to assess the influence of head and neck pathologies on the detection rate, configuration and diameter of the thoracic duct (TD) and right lymphatic duct (RLD) in computed tomography (CT) of the head and neck.
Methods
One hundred ninety-seven patients were divided into the subgroups "healthy", "benign disease" and "malignant disease". The interpretation of the images was performed at a slice thickness of 3 mm in the axial and coronal plane. In each case we looked for the distal part of the TD and RLD respectively and subsequently evaluated their configuration (tubular, sacciform, dendritic) as well as their maximum diameter and correlated the results with age, gender and diagnosis group.
Results
The detection rate in the study population was 81.2 % for the TD and 64.2 % for the RLD and did not differ significantly in any of the subgroups. The predominant configuration was tubular. The configuration distribution did not differ significantly between the diagnosis groups. The mean diameter of the TD was 4.79 ± 2.41 mm and that of the RLD was 3.98 ± 1.96 mm. No significant influence of a diagnosis on the diameter could be determined.
Conclusions
There is no significant influence of head/neck pathologies on the CT detection rate, morphology or size of the TD and RLD. However our study emphasizes that both the RLD and the TD are detectable in the majority of routine head and neck CTs and therefore reading physicians and radiologists should be familiar with their various imaging appearances.
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Reliable classification of facial phenotypic variation in craniofacial microsomia: a comparison of physical exam and photographs
Abstract
Background
Craniofacial microsomia is a common congenital condition for which children receive longitudinal, multidisciplinary team care. However, little is known about the etiology of craniofacial microsomia and few outcome studies have been published. In order to facilitate large, multicenter studies in craniofacial microsomia, we assessed the reliability of phenotypic classification based on photographs by comparison with direct physical examination.
Methods
Thirty-nine children with craniofacial microsomia underwent a physical examination and photographs according to a standardized protocol. Three clinicians completed ratings during the physical examination and, at least a month later, using respective photographs for each participant. We used descriptive statistics for participant characteristics and intraclass correlation coefficients (ICCs) to assess reliability.
Results
The agreement between ratings on photographs and physical exam was greater than 80 % for all 15 categories included in the analysis. The ICC estimates were higher than 0.6 for most features. Features with the highest ICC included: presence of epibulbar dermoids, ear abnormalities, and colobomas (ICC 0.85, 0.81, and 0.80, respectively). Orbital size, presence of pits, tongue abnormalities, and strabismus had the lowest ICC, values (0.17 or less). There was not a strong tendency for either type of rating, physical exam or photograph, to be more likely to designate a feature as abnormal. The agreement between photographs and physical exam regarding the presence of a prior surgery was greater than 90 % for most features.
Conclusions
Our results suggest that categorization of facial phenotype in children with CFM based on photographs is reliable relative to physical examination for most facial features.
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Validation of metabolic tumor volume as a prognostic factor for oral cavity squamous cell carcinoma treated with primary surgery
Publication date: June 2016
Source:Oral Oncology, Volume 57
Author(s): Han Zhang, Hadi Seikaly, Nhu-Tram Nguyen, Jonathan T. Abele, Peter T. Dziegielewski, Jeffrey R. Harris, Daniel A. O'Connell
BackgroundDespite the promise of metabolic tumor volume (MTV) as a risk-stratifying marker, the retrospective design of the initial study limits its generalizability. Therefore, this study sought to validate MTV as a prognostic factor for oral cavity squamous cell carcinoma (OCSCC) treated with primary surgery within an independent data set.MethodsThe validation data set consisted of 42 patients diagnosed with OCSCC between 2008 and 2012. The original cohort consisted of 80 patients. MTV and SUVmax were calculated for the primary tumor and nodal metastasis separately, as well as combined. Before statistical analysis, MTV and SUVmax values were divided into intertertile thirds to allow for intergroup survival analysis. Validation analysis was conducted on the validation data set alone. Data from both cohorts were then combined (n=122) to increase statistical power.ResultsAn increase in combined MTV of 17.5cm3 was associated with statistically significant increase in risk of disease recurrence (HR=19.2, p<0.001) and death (HR=9.2, p<0.05). Combined SUVmax failed to predict overall (HR=1.0, p>0.05) and disease-free survival (HR=1.0, p>0.05). Increase in the MTV of the primary tumor was associated with an increase in the risk of disease recurrence (HR=21.7, p=0.0001) and risk of death (HR=7.0, p=0.0001), while increase in the MTV of the locoregional neck metastasis was not (p>0.05). An MTV cutoff value of greater than 10.2cm3 was found to significantly affect survival.ConclusionDue to the reproducibility of MTV findings, this study validates MTV as an independent prognostic factor for OCSCC treated with primary surgery.
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microRNA-21 and microRNA-375 from oral cytology as biomarkers for oral tongue cancer detection
Publication date: June 2016
Source:Oral Oncology, Volume 57
Author(s): Qianting He, Zujian Chen, Robert J. Cabay, Leitao Zhang, Xianghong Luan, Dan Chen, Tianwei Yu, Anxun Wang, Xiaofeng Zhou
ObjectiveWe previously performed a meta-analysis of microRNA profiling studies on head and neck/oral cancer (HNOC), and identified 11 consistently dysregulated microRNAs in HNOC. Here, we evaluate the diagnostic values of these microRNAs in oral tongue squamous cell carcinoma (OTSCC) using oral cytology samples.Materials and methodsThe levels of 11 microRNAs were assessed in 39 oral cytology samples (19 OTSCC and 20 normal subjects), and 10 paired OTSCC and adjacent normal tissues. The predictive power of these microRNAs was analyzed by receiver operating characteristic curve (ROC) and random forest (RF) model. A classification and regression trees (CART) model was generated using miR-21 and miR-375, and further validated using both independent oral cytology validation sample set (14 OTSCC and 11 normal subjects) and tissue validation sample set (12 paired OTSCC and adjacent normal tissues).ResultsDifferential expression of miR-21, miR-100, miR-125b and miR-375 was validated in oral cytology training sample set. Based on the RF model, the combination of miR-21 and miR-375 was selected which provide best prediction of OTSCC. A CART model was constructed using miR-21 and miR-375, and was tested in both oral cytology and tissue validation sample sets. A sensitivity of 100% and specificity of 64% was achieved in distinguishing OTSCC from normal in the oral cytology validation set, and a sensitivity of 83% and specificity of 83% was achieved in the tissue validation set.ConclusionThe utility of microRNA from oral cytology samples as biomarkers for OTSCC detection is successfully demonstrated in this study.
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Osteoradionecrosis in patients with salivary gland malignancies
Publication date: June 2016
Source:Oral Oncology, Volume 57
Author(s): J. Rhet Tucker, Li Xu, Erich M. Sturgis, Abdallah S.R. Mohamed, Theresa M. Hofstede, Mark S. Chambers, Stephen Y. Lai, Clifton David Fuller, Beth Beadle, G. Brandon Gunn, Katherine A. Hutcheson
PurposeThe present study was undertaken to evaluate osteoradionecrosis (ORN) in patients with salivary gland malignancies (SGM) after treatment with radiation therapy.Materials and methodsThe medical records of 172 patients treated with radiation therapy for SGM during a 12-year period (August 2001 to November 2013) were reviewed. Incidence, time to event, staging and management of ORN were analyzed.ResultsOf the 172 patients, 7 patients (4%) developed ORN (median latency: 19months, range: 4–72months). Of those 7 patients, 4 required major surgery, 1 required hyperbaric oxygen therapy (HBO), one required minor debridement, and one required conservative management. Total prescribed radiation dose varied from 50Gy (1 case) to 70Gy (1 case) among those patients who developed ORN, and radiotherapy was delivered postoperatively after osseous resection in 4 of 7 cases. Three of the 7 cases of ORN occurred after traumatic injury to the bone. Of the 7 patients who developed ORN, 3 had SGM of the major glands, 3 had other sites of the oral cavity, and 1 had a sinonasal location.ConclusionWhile the rate of ORN after radiotherapy for SGM was somewhat lower (4%) than previously published data on patients with squamous cell carcinomas of the head and neck treated with radiation therapy (8–14%), ORN necessitating major surgery remains a clinically significant, possible late effect of radiotherapy in SGM survivors. Location of SGM is very important, with cases that developed ORN disproportionally having primary disease arising in the oral cavity.
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Risk, Presentation, and Outcomes of Pediatric Thyroid Cancer
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Scratching the Surface of Suicide in Head and Neck Cancer
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Nerve Preservation in Extracranial Head and Neck Schwannoma Surgery
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Bilateral Cervical Lymphadenopathy
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Mass of the Anterior Nasal Septum
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Scratching the Surface of Suicide in Head and Neck Cancer
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Expansile Maxillary Sinus Mass in a Young Child
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Preferential processing of emotionally and self-relevant stimuli persists in unconscious N2 sleep
Publication date: Available online 30 March 2016
Source:Brain and Language
Author(s): Christine Blume, Renata del Giudice, Julia Lechinger, Malgorzata Wislowska, Dominik P.J. Heib, Kerstin Hoedlmoser, Manuel Schabus
Information processing has been suggested to depend on the current state of the brain as well as stimulus characteristics (e.g. salience). We compared processing of salient stimuli (subject's own names [SONs] and angry voice [AV] stimuli) to processing of unfamiliar names (UNs) and neutral voice (NV) stimuli across different vigilance stages (i.e. wakefulness as well as sleep stages N1 and N2) by means of event-related oscillatory responses during wakefulness and a subsequent afternoon nap. Our findings suggest that emotional prosody and self-relevance drew more attentional resources during wakefulness with specifically AV stimuli being processed more strongly. During N1, SONs were more arousing than UNs irrespective of prosody. Moreover, emotional and self-relevant stimuli evoked stronger responses also during N2 sleep suggesting a 'sentinel processing mode' of the brain during this state of naturally occurring unconsciousness. Finally, this initial preferential processing of salient stimuli during N2 sleep seems to be followed by an inhibitory sleep-protecting process, which is reflected by a K-complex-like response.
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Protective benefit of predominant breastfeeding against otitis media may be limited to early childhood: results from a prospective birth cohort study
Abstract
Objectives
To examine the long-term effects of predominant breastfeeding on incidence of otitis media.
Design
Prospective birth cohort study.
Setting
The West Australian Pregnancy Cohort (Raine) Study recruited 2900 mothers through antenatal clinics at the major tertiary obstetric hospital in Perth, Western Australia between 1989 and 1992.
Participants
2237 children participated in a six year cohort follow-up and a subset of 1344 were given ear and hearing assessments.
Main outcome measures
OM diagnosis at six years of age (diagnosed by low-compliance tympanograms, 0 - 0.1 mmho). This was compared to OM diagnosed at the three year cohort follow-up using parent-report measures. Main exposure measures were duration of predominant breastfeeding (defined as the age other milk was introduced) and duration of partial (any) breastfeeding (defined as the age breastfeeding was stopped).
Results
There was a significant, independent association between predominant breastfeeding (OR = 1.33 [1.04, 1.69]; p = 0.02) and OM, and breastfeeding duration (OR = 1.35 [1.08, 1.68]; p = 0.01) with OM at three years of age. However, at six years of age this relationship was no longer statistically significant (predominant breastfeeding OR = 0.78 [0.48, 1.06]; p = 0.09; duration of breastfeeding, OR = 1.34 [0.81, 2.23]; p = 0.25).
Conclusions
Our findings are in line with a number of epidemiological studies which show a positive association between breastfeeding and OM in early childhood. However, the long-term follow-up of these children revealed that by six years of age there was no significant influence of breastfeeding on presence of OM. These results suggest that the protective effect of predominant breastfeeding for at least six months does not extend to school-age children, where other social and environmental factors may be stronger predictors of OM.
This article is protected by copyright. All rights reserved.
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Selection Pressure and Evolution Induced by Immune Checkpoint Inhibitors and Other Immunologic Therapies
Intervention:
Sponsors: University Health Network, Toronto; Princess Margaret Hospital, Canada
Recruiting - verified March 2016
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Comparative Study of Superficial Cervical Plexus Block and Nerve of Arnold Block and Incidence of PONV for Inner Ear Surgery
Interventions: Procedure: regional nerve block; Drug: Antiemetic
Sponsor: Indiana University
Recruiting - verified March 2016
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Dual-Energy CT in Patients With Head and Neck Squamous Cell Carcinomas
Intervention:
Sponsors: Ottawa Hospital Research Institute; GE Healthcare
Recruiting - verified March 2016
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Phase I Study to Assess Safety of AZD6738 Alone and in Combination With Radiotherapy in Patients With Solid Tumours
Interventions: Drug: AZD6738; Radiation: Palliative radiotherapy
Sponsors: Royal Marsden NHS Foundation Trust; AstraZeneca; Cancer Research UK; RM/ICR Biomedical Research Centre
Recruiting - verified March 2016
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Estimating annoyance to calculated wind turbine shadow flicker is improved when variables associated with wind turbine noise exposure are considered
The Community Noise and Health Study conducted by Health Canada included randomly selected participants aged 18–79 yrs (606 males, 632 females, response rate 78.9%), living between 0.25 and 11.22 km from operational wind turbines. Annoyance to wind turbinenoise (WTN) and other features, including shadow flicker (SF) was assessed. The current analysis reports on the degree to which estimating high annoyance to wind turbine shadow flicker (HAWTSF) was improved when variables known to be related to WTN exposure were also considered. As SF exposure increased [calculated as maximum minutes per day (SFm)], HAWTSF increased from 3.8% at 0 ≤ SFm m ≥ 30, p m the odds ratio was 2.02 [95% confidence interval: (1.68,2.43)]. Stepwise regression models for HAWTSF had a predictive strength of up to 53% with 10% attributed to SFm. Variables associated with HAWTSF included, but were not limited to, annoyance to other wind turbine-related features, concern for physical safety, and noise sensitivity. Reported dizziness was also retained in the final model at p = 0.0581. Study findings add to the growing science base in this area and may be helpful in identifying factors associated with community reactions to SF exposure from wind turbines.
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Self-reported and measured stress related responses associated with exposure to wind turbine noise
The current study was the first to assess stress reactions associated with wind turbine noise (WTN) exposure using self-reported and objective measures. Randomly selected participants, aged 18–79 yr (606 males; 632 females), living between 0.25 and 11.22 km from wind turbines, were exposed to outdoor calculated WTN levels up to 46 dBA (response rate 78.9%). Multiple regression modeling left the great majority (77%–89%) of the variance in perceived stress scale (PSS) scores, hair cortisol concentrations, resting blood pressure, and heart rate unaccounted for, and WTN exposure had no apparent influence on any of these endpoints. PSS scores were positively, but weakly, related to cortisol concentrations and resting heart rate (Pearson r = 0.13 and r = 0.08, respectively). Across WTN categories, modeled mean PSS scores ranged from 13.15 to 13.84 (p = 0.8614). Modeled geometric means for hair cortisol concentrations, resting mean systolic, diastolic blood pressure, and heart rate were 150.54–191.12 ng/g (p = 0.5416), 113.38–116.82 mmHg (p = 0.4990), 67.98–70.34 mmHg (p = 0.5006), and 68.24–70.71 bpm (p = 0.5223), respectively. Irrespective of WTN levels, diastolic blood pressure appeared to be slightly (2.90 mmHg 95% CI: 0.75,5.05) higher among participants highly annoyed by blinking lights on turbines (p = 0.0081). Collectively, the findings do not support an association between exposure to WTN up to 46 dBA and elevated self-reported and objectively defined measures of stress.
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Personal and situational variables associated with wind turbine noise annoyance
The possibility that wind turbinenoise (WTN) affects human health remains controversial. The current analysis presents results related to WTN annoyance reported by randomly selected participants (606 males, 632 females), aged 18–79, living between 0.25 and 11.22 km from wind turbines. WTN levels reached 46 dB, and for each 5 dB increase in WTN levels, the odds of reporting to be either very or extremely (i.e., highly) annoyed increased by 2.60 [95% confidence interval: (1.92, 3.58), p models had R2's up to 58%, with approximately 9% attributed to WTN level. Variables associated with WTN annoyance included, but were not limited to, other wind turbine-related annoyances, personal benefit, noise sensitivity, physical safety concerns, property ownership, and province. Annoyance was related to several reported measures of health and well-being, although these associations were statistically weak (R2 models. The role of community tolerance level as a complement and/or an alternative to multiple regression in predicting the prevalence of WTN annoyance is also provided. The analysis suggests that communities are between 11 and 26 dB less tolerant of WTN than of other transportation noise sources.
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Exposure to wind turbine noise: Perceptual responses and reported health effects
Health Canada, in collaboration with Statistics Canada, and other external experts, conducted the Community Noise and Health Study to better understand the impacts of wind turbinenoise (WTN) on health and well-being. A cross-sectional epidemiological study was carried out between May and September 2013 in southwestern Ontario and Prince Edward Island on 1238 randomly selected participants (606 males, 632 females) aged 18–79 years, living between 0.25 and 11.22 km from operational wind turbines. Calculated outdoor WTN levels at the dwelling reached 46 dBA. Response rate was 78.9% and did not significantly differ across sample strata. Self-reported health effects (e.g., migraines, tinnitus, dizziness, etc.), sleep disturbance, sleep disorders, quality of life, and perceived stress were not related to WTN levels. Visual and auditory perception of wind turbines as reported by respondents increased significantly with increasing WTN levels as did high annoyance toward several wind turbine features, including the following: noise, blinking lights, shadow flicker, visual impacts, and vibrations. Concern for physical safety and closing bedroom windows to reduce WTN during sleep also increased with increasing WTN levels. Other sample characteristics are discussed in relation to WTN levels. Beyond annoyance, results do not support an association between exposure to WTN up to 46 dBA and the evaluated health-related endpoints.
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Wind turbine sound pressure level calculations at dwellings
This paper provides calculations of outdoor sound pressure levels (SPLs) at dwellings for 10 wind turbinemodels, to support Health Canada's Community Noise and Health Study. Manufacturer supplied and measured wind turbinesound power levels were used to calculate outdoor SPL at 1238 dwellings using ISO [(1996). ISO 9613-2−Acoustics] and a Swedish noise propagation method. Both methods yielded statistically equivalent results. The A- and C-weighted results were highly correlated over the 1238 dwellings (Pearson's linear correlation coefficient r > 0.8). Calculated wind turbineSPLs were compared to ambient SPLs from other sources, estimated using guidance documents from the United States and Alberta, Canada.
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Wind turbine sound power measurements
This paper provides experimental validation of the sound power level data obtained from manufacturers for the ten wind turbine models examined in Health Canada's Community Noise and Health Study (CNHS). Within measurementuncertainty, the wind turbinesound power levelsmeasured using IEC 61400-11 [(2002). (International Electrotechnical Commission, Geneva)] were consistent with the sound power level data provided by manufacturers. Based on measurements, the sound power level data were also extended to 16 Hz for calculation of C-weighted levels. The C-weighted levels were 11.5 dB higher than the A-weighted levels (standard deviation 1.7 dB). The simple relationship between A- and C- weighted levels suggests that there is unlikely to be any statistically significant difference between analysis based on either C- or A-weighted data.
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Hypothyroidism in Pancreatic Cancer: Role of Exogenous Thyroid Hormone in Tumor Invasion—Preliminary Observations
According to the epidemiological studies, about 4.4% of American general elderly population has a pronounced hypothyroidism and relies on thyroid hormone supplements daily. The prevalence of hypothyroidism in our patients with pancreatic cancer was much higher, 14.1%. A retrospective analysis was performed on patients who underwent pancreaticoduodenectomy (Whipple procedure) or distal pancreatectomy and splenectomy (DPS) at Thomas Jefferson University Hospital, Philadelphia, from 2005 to 2012. The diagnosis of hypothyroidism was correlated with clinicopathologic parameters including tumor stage, grade, and survival. To further understand how thyroid hormone affects pancreatic cancer behavior, functional studies including wound-induced cell migration, proliferation, and invasion were performed on pancreatic cancer cell lines, MiaPaCa-2 and AsPC-1. We found that hypothyroid patients taking exogenous thyroid hormone were more than three times likely to have perineural invasion, and about twice as likely to have higher T stage, nodal spread, and overall poorer prognostic stage (). Pancreatic cancer cell line studies demonstrated that exogenous thyroid hormone treatment increased cell proliferation, migration, and invasion (). We conclude that exogenous thyroid hormone may contribute to the progression of pancreatic cancer.
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The Relationship between Population T4/TSH Set Point Data and T4/TSH Physiology
Context. Population studies of the distribution of T4/TSH set points suggest a more complex inverse relationship between T4 and TSH than that suggested by physiological studies. The reasons for the similarities and differences between the curves describing these relationships are unresolved. Methods. We subjected the curve, derived from empiric data, describing the TSH suppression response to T4, and the more mathematically derived curve describing the T4 response to TSH, to the different possible models of population variation. The implied consequences of these in terms of generating a population distribution of T4/TSH equilibrium points (a "population curve") were generated and compared to the empiric population curve. The physiological responses to primary hypothyroidism and hyperthyroidism were incorporated into the analysis. Conclusions. Though the population curve shows a similarly inverse relationship, it is describing a different relationship than the curve describing the suppression of TSH by T4. The population curve is consistent with the physiological studies of the TSH response to T4 and implies a greater interindividual variation in the positive thyroid T4 response to TSH than in the central inhibitory TSH response to T4. The population curve in the dysthyroid states is consistent with known physiological responses to these states.
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Long-Term Outcome Data in Patients following One Year's Use of a Fully Implantable Active Middle Ear Implant
This study examined the safety and efficacy of a fully implantable active middle ear (AMEI) system. Outcome measures assessed AMEI performance compared with an optimally fitted conventional hearing aid (CHA). Fifty adults with stable, symmetric moderate-to-severe sensorineural hearing loss were implanted at 9 ambulatory settings. Consonant-Nucleus-Consonant (CNC) words, Bamford-Kowel-Bench Speech in Noise test (BKB-SIN), Abbreviated Profile of Hearing Aid Benefit (APHAB), and unaided hearing thresholds in the implanted ear were compared to baseline measures obtained using a personal CHA. Changes in thresholds were observed from pre- to 12-month postoperative assessments. CNC word scores decreased (within 10%), and the BKB-SIN showed no change from pre- to 12-month postoperative time points. The APHAB revealed improvement. Findings suggest no difference in performance between an appropriately fit CHA and the AMEI at 12 months. This study indicates AMEIs have the potential to help individuals who choose not to use CHAs.
Audiol Neurotol 2016;21:105-112
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Management of Severe and Complex Hypopharyngeal and/or Laryngotracheal Stenoses by Various Open Surgical Procedures: A Retrospective Study of Seventeen Patients
ORL 2016;78:111-118
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Increasing aphasia treatment intensity in an acute inpatient rehabilitation program: A feasibility study.
Increasing aphasia treatment intensity in an acute inpatient rehabilitation program: A feasibility study.
Aphasiology. 2016 May 1;30(5):542-565
Authors: Carpenter J, Cherney LR
Abstract
BACKGROUND: Intensity of therapy is a critical factor influencing outcomes in aphasia. However, there are many barriers to increasing treatment intensity for those with acute/subacute aphasia including the demands of the inpatient medical facilities and the endurance of the participants. Nevertheless, with some modifications to its original procedures, evidence suggests that Constraint Induced Language Therapy (CILT) may yield positive outcomes when given in the early stages of recovery.
AIMS: To investigate the feasibility of increasing the amount of therapy provided to individuals with aphasia on an inpatient rehabilitation unit by adding CILT at a modified intensity, and to assess whether those receiving two weeks of the additional CILT show more improvement than control participants who did not receive the additional treatment.
METHODS AND PROCEDURES: A case-series single-subject design study was conducted. All participants received usual care of approximately an hour of speech and language treatment, five to six days a week. Participants in the experimental condition received an additional hour-long CILT session, five days per week, for two weeks. Trained, untrained, and generalization probes comprising naming of pictured items and oral reading of sentences were taken at baseline, during treatment, and at post-treatment. All participants were probed equally. Probe performance was scored and effect sizes were calculated and compared. Performance gains from pre- to post-treatment on subtests of the Boston Diagnostic Aphasia Examination were also compared.
OUTCOMES AND RESULTS: Thirteen individuals with aphasia onset ranging from 7 to 68 days were recruited, with 6 allocated to the experimental Usual Care + CILT condition and 7 allocated to the control Usual Care condition. Increasing the amount of speech and language therapy by adding an hour of daily CILT was feasible. Individual performance varied within and across conditions with large gains noted in some, but not all participants. As a group, there was a small to medium effect size of the Usual Care + CILT condition over Usual Care alone for trained and untrained oral reading probes and untrained naming probes.
CONCLUSIONS: It is feasible to increase the amount of treatment provided to participants with aphasia on an acute inpatient rehabilitation unit. Preliminary results suggest that there may be better outcomes for those who receive more treatment. Further research using larger numbers of homogeneous participants and controlling for content of therapy as well as amount of therapy is warranted.
PMID: 27026751 [PubMed - as supplied by publisher]
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Asking 'What about' questions in chronic illness self-management meetings.
Asking 'What about' questions in chronic illness self-management meetings.
Patient Educ Couns. 2016 Mar 16;
Authors: Fasulo A, Zinken J, Zinken K
Abstract
OBJECTIVES: This study investigates 'What about' questions asked by patients in the course of diabetes self-management groups led by nurses, and explores their functions in these empowerment-informed settings.
METHODS: Conversation Analysis of 24 video-recorded sessions of a Start Insulin Group Programme for patients with type 2 diabetes, in a diabetes centre in the South of England. The groups included 2-7 patients and were led by 5 nurses, all of whom had received training in the empowerment approach.
RESULTS: The analysis revealed a prevalence of single-unit 'Whatabout X' questions and found that they were used to embed requests for information in current or just closed activities. The nurses always provided the information, but could ask patients to specify the content of the question and collaborate to the answer.
CONCLUSION: The analysis suggests that the short form of the question may be adapting to the nurses' restraint in giving recommendations or immediate responses to information seeking-questions.
PRACTICE IMPLICATIONS: When healthcare communication practices are shaped in observance to a theoretical approach, such as empowerment, it is recommendable that practitioners monitor not only what they do, but also how patients change their habitual forms of speech in response.
PMID: 27026389 [PubMed - as supplied by publisher]
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Comparison of Newborn Hearing Screening in Well-Baby Nursery and NICU: A Study Applied to Reduce Referral Rate in NICU.
| Related Articles |
Comparison of Newborn Hearing Screening in Well-Baby Nursery and NICU: A Study Applied to Reduce Referral Rate in NICU.
PLoS One. 2016;11(3):e0152028
Authors: Li PC, Chen WI, Huang CM, Liu CJ, Chang HW, Lin HC
Abstract
OBJECTIVES: To determine whether newborn hearing screening in a well-baby nursery (WBN) and neonatal intensive care unit (NICU) nursery: 1) meet three targeted, screening, referral, and diagnostic follow-up rates; 2) compare the average age of diagnosis for infants admitted to the WIN and NICU; and 3) determine prevalence of hearing loss in neonatal population; and 4) try to find a practical newborn hearing screening time algorithm to reduce refer rate in NICU.
MATERIALS AND METHODS: It examined 15,624 newborns in the WBN (13,676) and NICU (1948) screened for congenital HL using AABR. The variables analyzed in it were the screening rate, referral rate, follow-up rate, diagnostic rate and diagnostic age, prevalence rate, degrees of congenital bilateral HL. The study was approved by the hospital's institutional review board (13MMHISO23).
RESULTS: The screening rates were 99.8% and 99.6% in the WBN and NICU groups, respectively, without significant difference. The referral rates were 0.7% and 2.8% in the WBN and NICU groups, with significant difference. Furthermore, the diagnostic follow-up rates were 76.7% and 89.1% in the WBN and NICU groups, without significant difference. The average initial diagnostic ages were 1.9 months and 3.8 months in the WBN and NICU groups, with significant difference. The prevalence of congenital bilateral hearing loss were 0.27% and 1.6% in the WBN and NICU groups, with significant difference.
CONCLUSION: The screening, referral and follow-up rate in the WBN and NICU groups were equivalent to the quality indicators. For NICU group, screening and diagnostic follow up were performed later than those in WBN group; however the lower referral rate in our NICU group was successfully achieved in this study and can be applied clinically. The prevalence of congenital bilateral hearing loss was higher in the NICU group than in the WBN group.
PMID: 27023324 [PubMed - in process]
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Treatment for dysphagia (swallowing difficulties) in hereditary ataxia.
 | Related Articles |
Treatment for dysphagia (swallowing difficulties) in hereditary ataxia.
Cochrane Database Syst Rev. 2015;11:CD010169
Authors: Vogel AP, Keage MJ, Johansson K, Schalling E
Abstract
BACKGROUND: Hereditary ataxias are a heterogeneous group of disorders resulting in progressive inco-ordination. Swallowing impairment, also known as dysphagia, is a common and potentially life threatening sequel of disease progression. The incidence and nature of dysphagia in these conditions is largely unknown. The loss of an effective and safe swallow can dramatically affect the health and well-being of an individual. Remediation of difficulties of eating and drinking is an important goal in the clinical care of people with hereditary ataxia.
OBJECTIVES: To assess the effects of interventions for swallowing impairment (dysphagia) in people with hereditary ataxias.
SEARCH METHODS: We searched the Cochrane Neuromuscular Disease Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL Plus, PsycINFO, and the Education Resources Information Center (ERIC) on 14 September 2015. We also searched Linguistics and Language Behavior Abstracts (LLBA), Dissertation Abstracts, and Trials Registries on 24 September 2015.
SELECTION CRITERIA: We considered all randomised controlled trials (RCTs) and quasi-RCTs that compared treatments for hereditary ataxia with placebo or no treatment. We only included studies measuring dysphagia.
DATA COLLECTION AND ANALYSIS: Three review authors (ES, KJ, MK) independently screened all titles and abstracts. In the event of any disagreement or uncertainty over the inclusion of a particular paper, the review authors planned to meet and reach consensus.
MAIN RESULTS: We identified no RCTs from the 519 titles and abstracts screened. We excluded papers primarily for not including participants with a hereditary ataxia (that is, being focused on other neurological conditions), being theoretical reviews rather than intervention studies, or being neither randomised nor quasi-randomised trials.We identified five papers of various design that described treatment for dysphagia, or improvement to swallow as a by-product of treatment, in people with hereditary ataxia. None of these studies were RCTs or quasi-RCTs.
AUTHORS' CONCLUSIONS: There is an absence of any significant evidence supporting the use of any dysphagia intervention in hereditary ataxia. The lack of evidence highlights the critical need for well-controlled treatment trials in the field.
PMID: 26564018 [PubMed - indexed for MEDLINE]
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Development and validation of Australian aphasia rehabilitation best practice statements using the RAND/UCLA appropriateness method.
  | Related Articles |
Development and validation of Australian aphasia rehabilitation best practice statements using the RAND/UCLA appropriateness method.
BMJ Open. 2015;5(7):e007641
Authors: Power E, Thomas E, Worrall L, Rose M, Togher L, Nickels L, Hersh D, Godecke E, O'Halloran R, Lamont S, O'Connor C, Clarke K
Abstract
OBJECTIVES: To develop and validate a national set of best practice statements for use in post-stroke aphasia rehabilitation.
DESIGN: Literature review and statement validation using the RAND/UCLA Appropriateness Method (RAM).
PARTICIPANTS: A national Community of Practice of over 250 speech pathologists, researchers, consumers and policymakers developed a framework consisting of eight areas of care in aphasia rehabilitation. This framework provided the structure for the development of a care pathway containing aphasia rehabilitation best practice statements. Nine speech pathologists with expertise in aphasia rehabilitation participated in two rounds of RAND/UCLA appropriateness ratings of the statements. Panellists consisted of researchers, service managers, clinicians and policymakers.
MAIN OUTCOME MEASURES: Statements that achieved a high level of agreement and an overall median score of 7-9 on a nine-point scale were rated as 'appropriate'.
RESULTS: 74 best practice statements were extracted from the literature and rated across eight areas of care (eg, receiving the right referrals, providing intervention). At the end of Round 1, 71 of the 74 statements were rated as appropriate, no statements were rated as inappropriate, and three statements were rated as uncertain. All 74 statements were then rated again in the face-to-face second round. 16 statements were added through splitting existing items or adding new statements. Seven statements were deleted leaving 83 statements. Agreement was reached for 82 of the final 83 statements.
CONCLUSIONS: This national set of 82 best practice statements across eight care areas for the rehabilitation of people with aphasia is the first to be validated by an expert panel. These statements form a crucial component of the Australian Aphasia Rehabilitation Pathway (AARP) (http://ift.tt/1RM2BIx) and provide the basis for more consistent implementation of evidence-based practice in stroke rehabilitation.
PMID: 26137883 [PubMed - indexed for MEDLINE]
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Inner Speech: Development, Cognitive Functions, Phenomenology, and Neurobiology.
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Inner Speech: Development, Cognitive Functions, Phenomenology, and Neurobiology.
Psychol Bull. 2015 Sep;141(5):931-65
Authors: Alderson-Day B, Fernyhough C
Abstract
Inner speech-also known as covert speech or verbal thinking-has been implicated in theories of cognitive development, speech monitoring, executive function, and psychopathology. Despite a growing body of knowledge on its phenomenology, development, and function, approaches to the scientific study of inner speech have remained diffuse and largely unintegrated. This review examines prominent theoretical approaches to inner speech and methodological challenges in its study, before reviewing current evidence on inner speech in children and adults from both typical and atypical populations. We conclude by considering prospects for an integrated cognitive science of inner speech, and present a multicomponent model of the phenomenon informed by developmental, cognitive, and psycholinguistic considerations. Despite its variability among individuals and across the life span, inner speech appears to perform significant functions in human cognition, which in some cases reflect its developmental origins and its sharing of resources with other cognitive processes.
PMID: 26011789 [PubMed - indexed for MEDLINE]
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The language skeleton after dissecting meaning: A functional segregation within Broca's Area.
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The language skeleton after dissecting meaning: A functional segregation within Broca's Area.
Neuroimage. 2015 Jul 1;114:294-302
Authors: Goucha T, Friederici AD
Abstract
Broca's area is proposed as a crucial brain area for linguistic computations. Language processing goes beyond word-level processing, also implying the integration of meaningful information (semantics) with the underlying structural skeleton (syntax). There is an on-going debate about the specialisation of the subregions of Broca's area-Brodmann areas (BA) 44 and 45-regarding the latter aspects. Here, we tested if syntactic information is specifically processed in BA 44, whereas BA 45 is mainly recruited for semantic processing. We contrasted conditions with sentence structure against conditions with random order in two fMRI experiments. Besides, in order to disentangle these processes, we systematically removed the amount of semantic information available in the stimuli. This was achieved in Experiment 1 by replacing meaningful words (content words) by pseudowords. Within real word conditions we found broad activation in the left hemisphere, including the inferior frontal gyrus (BA 44/45/47), the anterior temporal lobe and posterior superior temporal gyrus (pSTG) and sulcus (pSTS). For pseudowords we found a similar activation pattern, still involving BA 45. Among the pseudowords in Experiment 1, we kept those word elements that convey meaning like un- in unhappy or -hood in brotherhood (i.e. derivational morphology). In Experiment 2 we tested whether the activation in BA 45 was due to their presence. We therefore further removed derivational morphology, only leaving word elements that determine syntactic structure (i.e. inflectional morphology, e.g. the verb ending -s in he paints). Now, in the absence of all semantic cues, including derivational morphology, only BA 44 was active. Additional analyses showed a selective responsiveness of this area to syntax-relevant cues. These findings confirm BA 44 as a core area for the processing of pure syntactic information. This furthermore suggests that the brain represents structural and meaningful aspects of language separately.
PMID: 25871627 [PubMed - indexed for MEDLINE]
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Effectiveness of honey on radiation-induced oral mucositis, time to mucositis, weight loss, and treatment interruptions among patients with head and neck malignancies: A meta-analysis and systematic review of literature.
Effectiveness of honey on radiation-induced oral mucositis, time to mucositis, weight loss, and treatment interruptions among patients with head and neck malignancies: A meta-analysis and systematic review of literature.
Head Neck. 2016 Mar 29;
Authors: Co JL, Mejia MB, Que JC, Dizon JM
Abstract
BACKGROUND: Mucositis is a disabling effect of radiotherapy in head and neck cancers. There is no current standard on management of radiation-induced mucositis. Honey has been shown to reduce radiation-induced mucositis.
METHODS: A systematic review and meta-analysis were undertaken to assess the ability of honey in reducing the severity of oral mucositis, time to mucositis, weight loss, and treatment interruptions.
RESULTS: Eight studies were included and showed that honey was significantly better in lowering the risk for treatment interruptions, weight loss, and delaying time to mucositis, but not severity of mucositis.
CONCLUSION: There is current evidence that honey is beneficial for patients with head and neck cancers by decreasing treatment interruptions, weight loss, and delaying the onset of oral mucositis, but not in decreasing peak mucositis score. In light of the results, honey is a reasonable treatment for radiation-induced mucositis, but more randomized clinical trials (RCTs) should be done. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.
PMID: 27028991 [PubMed - as supplied by publisher]
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Ovarian cancer treatment with a tumor-targeting and gene expression-controllable lipoplex.
Ovarian cancer treatment with a tumor-targeting and gene expression-controllable lipoplex.
Sci Rep. 2016;6:23764
Authors: He ZY, Deng F, Wei XW, Ma CC, Luo M, Zhang P, Sang YX, Liang X, Liu L, Qin HX, Shen YL, Liu T, Liu YT, Wang W, Wen YJ, Zhao X, Zhang XN, Qian ZY, Wei YQ
Abstract
Overexpression of folate receptor alpha (FRα) and high telomerase activity are considered to be the characteristics of ovarian cancers. In this study, we developed FRα-targeted lipoplexes loaded with an hTERT promoter-regulated plasmid that encodes a matrix protein (MP) of the vesicular stomatitis virus, F-LP/pMP(2.5), for application in ovarian cancer treatment. We first characterized the pharmaceutical properties of F-LP/pMP(2.5). The efficient expression of the MP-driven hTERT promoter in SKOV-3 cells was determined after an in-vitro transfection assay, which was significantly increased compared with a non-modified LP/pMP(2.5) group. F-LP/pMP(2.5) treatment significantly inhibited the growth of tumors and extended the survival of mice in a SKOV-3 tumor model compared with other groups. Such an anti-tumor effect was due to the increased expression of MP in tumor tissue, which led to the induction of tumor cell apoptosis, inhibition of tumor cell proliferation and suppression of tumor angiogenesis. Furthermore, a preliminary safety evaluation demonstrated a good safety profile of F-LP/pMP(2.5) as a gene therapy agent. Therefore, FRα-targeted lipoplexes with therapeutic gene expression regulated by an hTERT promoter might be a promising gene therapy agent and a potential translational candidate for the clinical treatment of ovarian cancer.
PMID: 27026065 [PubMed - in process]
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Tonsillar microbiota in children with PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and adenitis) syndrome.
Tonsillar microbiota in children with PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and adenitis) syndrome.
Eur J Clin Microbiol Infect Dis. 2016 Mar 30;
Authors: Tejesvi MV, Uhari M, Tapiainen T, Pirttilä AM, Suokas M, Lantto U, Koivunen P, Renko M
Abstract
Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) is a childhood febrile syndrome of unknown origin that is often cured with tonsillectomy. We aimed to compare the bacterial microbiota of the tonsils removed from PFAPA patients with those of controls. We used next-generation sequencing technology to investigate the bacterial microbiota of the tonsils of 30 PFAPA patients and 24 controls. We found significant differences in the presence and relative abundance of many bacteria between PFAPA cases and controls. For example, cyanobacteria, potential producers of microcystins and other toxins, were more common in the case samples (14/30, 47 %) than in the controls (4/24, 17 %, p = 0.02), and the mean relative abundance of cyanobacteria was higher in the case samples (0.2 %) than in the controls (0.01 %, p = 0.01). Streptococci were present in all samples in both groups, but their mean relative abundance was lower in the case samples (3.7 %) than in the controls (9.6 %, p = 0.01). Typical nasopharyngeal microbes such as fusobacteria, Prevotella, Tannerella, Porphyromonas, and Parvimonas dominated the microbiota of the tonsils in both groups. The microbiota of the tonsils removed from PFAPA patients differed significantly from those of the controls. Tonsillar microbiota may play a role in triggering the inflammatory processes that lead to symptoms of PFAPA.
PMID: 27025724 [PubMed - as supplied by publisher]
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Benefits of Multi-Session Balance and Gait Training with Multi-Modal Biofeedback in Healthy Older Adults
Publication date: Available online 30 March 2016
Source:Gait & Posture
Author(s): Shannon B. Lim, Brian C. Horslen, Justin R. Davis, John H.J. Allum, Mark G. Carpenter
Real-time balance-relevant biofeedback from a wearable sensor can improve balance in many patient populations, however, it is unknown if balance training with biofeedback has lasting benefits for healthy older adults once training is completed and biofeedback removed. This study was designed to determine if multi-session balance training with and without biofeedback leads to changes in balance performance in healthy older adults; and if changes persist after training. 36 participants (age 60-88) were randomly divided into two groups. Both groups trained on seven stance and gait tasks for two consecutive weeks (3x/week) while trunk angular sway and task duration were monitored. One group received real-time multi-modal biofeedback of trunk sway and a control group trained without biofeedback. Training effects were assessed at the last training session, with biofeedback available to the feedback group. Post-training effects (without biofeedback) were assessed immediately after, 1-week, and 1-month post-training. Both groups demonstrated training effects; participants swayed less when standing on foam with eyes closed (EC), maintained tandem-stance EC longer, and completed 8 tandem-steps EC faster and swayed less at the last training session. Changes in sway and duration, indicative of faster walking, were also observed after training for other gait tasks. While changes in walking speed persisted post-training, few other post-training effects were observed. These data suggest there is little added benefit to balance training with biofeedback, beyond training without, in healthy older adults. However, transient use of wearable balance biofeedback systems as balance aides remains beneficial for challenging balance situations and some clinical populations.
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Plantar Pressure Measurements and Running-related Injury: A Systematic Review of Methods and Possible Associations
Publication date: Available online 30 March 2016
Source:Gait & Posture
Author(s): Robert Mann, Laurent Malisoux, Axel Urhausen, Kenneth Meijer, Daniel Theisen
Pressure-sensitive measuring devices have been identified as appropriate tools for measuring an array of parameters during running. It is unclear which biomechanical characteristics relate to running-related injury (RRI) and which data-processing techniques are most promising to detect this relationship. This systematic review aims to identify pertinent methodologies and characteristics measured using plantar pressure devices, and to summarise their associations with RRI. PubMed, Embase, CINAHL, ScienceDirect and Scopus were searched up until March 2015. Retrospective and prospective, biomechanical studies on running using any kind of pressure-sensitive device with RRI as an outcome were included. All studies involving regular or recreational runners were considered. The study quality was assessed and the measured parameters were summarised. One low quality, two moderate quality and five high quality studies were included. Five different subdivisions of plantar area were identified, as well as five instants and four phases of measurement during foot-ground contact. Overall many parameters were collated and subdivided as plantar pressure and force, plantar pressure and force location, contact area, timing and stride parameters. Differences between the injured and control group were found for mediolateral and anteroposterior displacement of force, contact area, velocity of force displacement, relative force-time integral, mediolateral force ratio, time to peak force and inter-stride correlative patterns. However, no consistent results were found between studies and no biomechanical risk patterns were apparent. Additionally, conflicting findings were reported for peak force in three studies. Based on these observations, we provide suggestions for improved methodology measurement of pertinent parameters for future studies.
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Difference between apnea-hypopnea index (AHI) and oxygen desaturation index (ODI): proportional increase associated with degree of obesity
Abstract
Purpose
Obesity is one of the main predisposing factors for obstructive sleep apnea (OSA) hypopnea syndrome. It has been described that body mass index (BMI) influences the accuracy of oxygen desaturation index (ODI) for the diagnosis of OSA by polysomnography (PSG). We analyzed the relationship between traditional indicators: apnea-hypopnea index (AHI) and ODI in a population at high risk for OSA, by respiratory polygraphy (RP) and PSG.
Methods
This is a retrospective study of 1898 patients with suspicion of OSA, from which 1053 underwent RP and 582 underwent PSG with OSA. We compared results considering gender, age, and degree of obesity.
Results
This study included 1333 records of patients with OSA—more than 80 % of whom were overweight or obese. We observed that AHI and ODI increased progressively with obesity grade and said increase was associated with BMI only in men. The evaluation of the agreement between AHI and ODI found a difference between normal weight and obese patients, regardless of gender.
Conclusions
Study findings contribute to understand the role of oximetry in the diagnosis of OSA in obese patients. Our results were observed using full PSG and a simplified home method. The correlation between these indicators could improve our clinical interpretation of OSA severity among obese patients when abbreviated tests are used.
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Τετάρτη 30 Μαρτίου 2016
Scanning Electron Microscopic Examination of the Extracellular Matrix in the Decellularized Mouse and Human Cochlea
Abstract
Decellularized tissues have been used to investigate the extracellular matrix (ECM) in a number of different tissues and species. Santi and Johnson JARO 14:3-15 (2013) first described the decellularized inner ear in the mouse, rat, and human using scanning thin-sheet laser imaging microscopy (sTSLIM). The purpose of the present investigation is to examine decellularized cochleas in the mouse and human at higher resolution using scanning electron microscopy (SEM). Fresh cochleas were harvested and decellularized using detergent extraction methods. Following decellularization, the ECM of the bone, basilar membrane, spiral limbus, and ligament remained, and all of the cells were removed from the cochlea. A number of similarities and differences in the ECM of the mouse and human were observed. A novel, spirally directed structure was present on the basilar membrane and is located at the border between Hensen and Boettcher cells. These septa-like structures formed a single row in the mouse and multiple rows in the human. The basal lamina of the stria vascularis capillaries was present and appeared thicker in the human compared with the mouse. In the mouse, numerous openings beneath the spiral prominence that previously housed the root processes of the external sulcus cells were observed but in the human there was only a single row of openings. These and other anatomical differences in the ECM between the mouse and human may reflect functional differences and/or be due to aging; however, decellularized cochleas provide a new way to examine the cochlear ECM and reveal new observations.
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Production of Korean Idiomatic Utterances Following Left- and Right-Hemisphere Damage: Acoustic Studies
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The beneficial role of memory reactivation for language learning during sleep: A review
Source:Brain and Language
Author(s): Thomas Schreiner, Björn Rasch
Sleep is essential for diverse aspects of language learning. According to a prominent concept these beneficial effects of sleep rely on spontaneous reactivation processes. A series of recent studies demonstrated that inducing such reactivation processes by re-exposure to memory cues during sleep enhances foreign vocabulary learning. Building upon these findings, the present article reviews recent models and empirical findings concerning the beneficial effects of sleep on language learning. Consequently, the memory function of sleep, its neural underpinnings and the role of the sleeping brain in language learning will be summarized. Finally, we will propose a working model concerning the oscillatory requirements for successful reactivation processes and future research questions to advance our understanding of the role of sleep on language learning and memory processes in general.
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Does flat epithelial atypia have rounder nuclei than columnar cell change/hyperplasia? A morphometric approach to columnar cell lesions of the breast
Abstract
Columnar cell lesions of the breast encompass columnar cell change/hyperplasia (CCC/CCH) and flat epithelial atypia (FEA). These have attracted researchers because emerging data suggest that FEA may represent the earliest histologically detectable non-obligate precursor of breast cancer. However, it is occasionally difficult to distinguish FEA from CCC/CCH because of similar histology. Although the nuclei of FEA are frequently described as relatively round compared with those of CCC/CCH, there are few morphometric studies to support this statement. The aim of this study was to provide objective data as to the nuclear shape in columnar cell lesions. As a shape descriptor, we adopted ellipticity that is defined by the formula 2b/2a, where a is the length of the long axis of the ellipse and b is the length of the short axis. Contrary to circularity, ellipticity reflects the overall configuration of an ellipse irrespective of surface irregularity. Our image analysis included generating whole slide images, extracting glandular cell nuclei, measuring nuclear ellipticity, and superimposing graded colors based on execution of results on the captured images. A total of 7917 nuclei extracted from 22 FEA images and 5010 nuclei extracted from 13 CCC/CCH images were analyzed. There was a significant difference in nuclear roundness between FEA and CCC/CCH with mean ellipticity values of 0.723 and 0.679, respectively (p < 0.001, Welch's t test). Furthermore, FEA with malignancy had significantly rounder nuclei than FEA without malignancy (p < 0.001). Our preliminary results suggest that nuclear ellipticity is a key parameter in reproducibly classifying columnar cell lesions of the breast.
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Expression of cell cycle markers is predictive of the response to primary systemic therapy of locally advanced breast cancer
Abstract
We aimed to analyze to what extent expression of four cell cycle regulation markers—minichromosome maintenance protein (MCM2), Ki-67, cyclin A, and phosphohistone-H3 (PHH3)—predict response to primary systemic therapy in terms of pathological complete remission (pCR). In search of an accurate and reproducible scoring method, we compared computer-assisted (CA) and routine visual assessment (VA) of immunoreactivity. We included 57 patients with breast cancer in the study. The cell cycle markers were detected using immunohistochemistry on pre-therapy core biopsy samples. Parallel CA (validated by manual labeling) and standard VA were performed and compared for diagnostic agreement and predictive value for pCR. CA and VA results were dichotomized based on receiver operating characteristic analysis defined optimal cut-off values. "High" was defined by staining scores above the optimal cut-off, while "low" had staining scores below the optimal cut-off. The CA method resulted in significantly lower values for Ki-67 and MCM2 compared to VA (mean difference, −3.939 and −4.323). Diagnostic agreement was highest for cyclin A and PHH3 (−0.586 and −0.666, respectively). Regardless of the method (CA/VA) used, all tested markers were predictive of pCR. Optimal cut-off-based dichotomization improved diagnostic agreement between the CA and VA methods for every marker, in particular for MCM2 (κ = 1, p < 0.000). Cyclin A displayed excellent agreement (κ = 0.925; p < 0.000), while Ki-67 and PHH3 showed good agreement (κ = 0.789, p < 0.000 and κ = 0.794, p < 0.000, respectively). We found all cell cycle markers (Ki-67, MCM2, cyclin A, and PHH3) predictive of pCR. Diagnostic agreement between CA and VA was better at lower staining scores but improved after optimal cut-off-based dichotomization.
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Androgen receptor and metastasis-associated protein-1 are frequently expressed in estrogen receptor negative/HER2 positive breast cancer
Abstract
The prognostic value of androgen receptor (AR) and its related molecules in breast cancer is not well characterized. We retrospectively investigated 120 ER+ and 120 ER− invasive breast cancers of 240 women, who were treated at our institution between January 2008 and December 2009. We excluded in situ, recurrent, metastatic, and bilateral carcinomas as well as non-epithelial lesions. Median follow-up was 74 months. Immunohistochemical assessment of expression of AR and metastasis-associated protein-1 (MTA1) resulted in 59.2 % (n = 142) AR+ and 36.7 % (n = 88) high MTA1 expressing (MTA1High) carcinomas. MTA1High tumors were significantly more often ER−, while AR+ tumors were significantly more often HER2+ (p < 0.01). MTA1High/ER− tumors were more often AR−/HER2− (p < 0.01). Patients with an AR+/ER+ tumor had better disease-free survival (DFS; p = 0.011). Patients with an ER−/MTA1High tumor had significantly shorter DFS (p = 0.006) as well as patients with an AR+/HER2+ tumor (p < 0.01). In Cox models, AR expression (HR, 0.248; 95 % CI, 0.086–0.716) and lymph node status (HR, 6.401; 95 % CI, 1.428–28.686) were independent predictors for DFS in ER+ cancers, whereas AR+/HER2+ expression status (HR, 2.927; 95 % CI, 1.256–6.821) and lymph node status (HR, 2.690; 95 % CI, 1.041–7.840) were independent predictors for DFS in ER− cancers. We show that AR might be an additional marker for endocrine responsiveness in ER+ cancers and suggests that blocking MTA1 might be an effective way to inhibit AR/HER2 signaling in ER− breast cancer.
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Comparison of Newborn Hearing Screening in Well-Baby Nursery and NICU: A Study Applied to Reduce Referral Rate in NICU
by Pei-Chun Li, Wei-I Chen, Chih-Ming Huang, Ching-Ju Liu, Hsiu-wen Chang, Hung-Ching Lin
ObjectivesTo determine whether newborn hearing screening in a well-baby nursery (WBN) and neonatal intensive care unit (NICU) nursery: 1) meet three targeted, screening, referral, and diagnostic follow-up rates; 2) compare the average age of diagnosis for infants admitted to the WIN and NICU; and 3) determine prevalence of hearing loss in neonatal population; and 4) try to find a practical newborn hearing screening time algorithm to reduce refer rate in NICU
Materials and MethodsIt examined 15,624 newborns in the WBN (13,676) and NICU (1948) screened for congenital HL using AABR. The variables analyzed in it were the screening rate, referral rate, follow-up rate, diagnostic rate and diagnostic age, prevalence rate, degrees of congenital bilateral HL. The study was approved by the hospital's institutional review board (13MMHISO23).
ResultsThe screening rates were 99.8% and 99.6% in the WBN and NICU groups, respectively, without significant difference. The referral rates were 0.7% and 2.8% in the WBN and NICU groups, with significant difference. Furthermore, the diagnostic follow-up rates were 76.7% and 89.1% in the WBN and NICU groups, without significant difference. The average initial diagnostic ages were 1.9 months and 3.8 months in the WBN and NICU groups, with significant difference. The prevalence of congenital bilateral hearing loss were 0.27% and 1.6% in the WBN and NICU groups, with significant difference.
ConclusionThe screening, referral and follow-up rate in the WBN and NICU groups were equivalent to the quality indicators. For NICU group, screening and diagnostic follow up were performed later than those in WBN group; however the lower referral rate in our NICU group was successfully achieved in this study and can be applied clinically. The prevalence of congenital bilateral hearing loss was higher in the NICU group than in the WBN group.
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Top 5 EMS videos of March 2016
A video explaining how to diagnose the cause of chest pain and consensus definitions for sepsis and septic shock were among this month's top videos.
A simplified method for 12-lead ECG electrode placement
This example provides an alternative to the sternal notch placement of electrodes for acquiring a 12-lead ECG.
5 bougie tips for better airway management
Kevin High talks about five airway tips for performing an intubation with a bougie. How to position yourself, prepare your equipment, pass the bougie and the tube and follow-through.
How to diagnose the cause of chest pain
Learn about the different types of chest pain and how to interpret them.
Sexy CPR video goes viral, sparks controversy
The German video features scantily clad women changing the words of pop songs to teach CPR.
Consensus definitions for sepsis and septic shock
Learn the Sepsis III definitions for sepsis and septic shock.
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Comparison of Newborn Hearing Screening in Well-Baby Nursery and NICU: A Study Applied to Reduce Referral Rate in NICU
by Pei-Chun Li, Wei-I Chen, Chih-Ming Huang, Ching-Ju Liu, Hsiu-wen Chang, Hung-Ching Lin
ObjectivesTo determine whether newborn hearing screening in a well-baby nursery (WBN) and neonatal intensive care unit (NICU) nursery: 1) meet three targeted, screening, referral, and diagnostic follow-up rates; 2) compare the average age of diagnosis for infants admitted to the WIN and NICU; and 3) determine prevalence of hearing loss in neonatal population; and 4) try to find a practical newborn hearing screening time algorithm to reduce refer rate in NICU
Materials and MethodsIt examined 15,624 newborns in the WBN (13,676) and NICU (1948) screened for congenital HL using AABR. The variables analyzed in it were the screening rate, referral rate, follow-up rate, diagnostic rate and diagnostic age, prevalence rate, degrees of congenital bilateral HL. The study was approved by the hospital's institutional review board (13MMHISO23).
ResultsThe screening rates were 99.8% and 99.6% in the WBN and NICU groups, respectively, without significant difference. The referral rates were 0.7% and 2.8% in the WBN and NICU groups, with significant difference. Furthermore, the diagnostic follow-up rates were 76.7% and 89.1% in the WBN and NICU groups, without significant difference. The average initial diagnostic ages were 1.9 months and 3.8 months in the WBN and NICU groups, with significant difference. The prevalence of congenital bilateral hearing loss were 0.27% and 1.6% in the WBN and NICU groups, with significant difference.
ConclusionThe screening, referral and follow-up rate in the WBN and NICU groups were equivalent to the quality indicators. For NICU group, screening and diagnostic follow up were performed later than those in WBN group; however the lower referral rate in our NICU group was successfully achieved in this study and can be applied clinically. The prevalence of congenital bilateral hearing loss was higher in the NICU group than in the WBN group.
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Zika Virus Disease Outbreak and Infant Hearing Loss
On February 1, the World Health Organization declared a Public Health Emergency of International Concern about the recent outbreak of the Zika Virus Disease. Within one week of the WHO's declaration, the Center for Disease Control issued its highest response (Level 1) activation, due to the growing number of Zika cases recently reported.
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Poor prognosis in human papillomavirus–positive oropharyngeal squamous cell carcinomas that overexpress hypoxia inducible factor-1α
Abstract
Background
Hypoxia induces stabilization of the transcription factor HIF-1alpha (HIF-1α), associated with (chemo-)radiotherapy resistance in oropharyngeal squamous cell carcinoma (SCC). We investigated the effect of HIF-1α expression on survival in relation to human papillomavirus (HPV) status in oropharyngeal SCC.
Methods
We conducted an immunohistochemical analysis of HIF-1α protein expression and downstream targets carbonic anhydrase-IX (CA-IX) and glucose transporter-1 (GLUT-1) in 274 patients with oropharyngeal SCC. Overall survival (OS) was analyzed in total and stratified for HPV status and treatment.
Results
In HPV-positive tumors (n = 44), HIF-1α overexpression predicted worse OS (hazard ratio [HR] = 6.23; p = .012), whereas TNM classification or treatment modality did not. In HPV-negative tumors (n = 218), advanced T and N classification and HIF-1α overexpression all independently predicted worse OS. However, the effect of HIF-1α overexpression on OS was lower in HPV-negative (HR = 1.50; p = .024) than in HPV-positive tumors.
Conclusion
HIF-1α overexpression is associated with worse OS and characterized a subgroup of patients with HPV-positive oropharyngeal SCC with poor prognosis. Possibly, patients with HIF-1α overexpressing HPV-positive tumors should not be eligible for treatment dose deescalation. © 2016 Wiley Periodicals, Inc. Head Neck, 2016
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Nonlinear acoustic pulse propagation in dispersive sediments using fractional loss operators
The nonlinear progressive wave equation (NPE) is a time-domain formulation of the Euler fluid equations designed to model low-angle wave propagation using a wave-following computational domain. The wave-following frame of reference permits the simulation of long-range propagation and is useful in modeling blast wave effects in the ocean waveguide. Existing models do not take into account frequency-dependent sediment attenuation, a feature necessary for accurately describing sound propagation over, into, and out of the ocean sediment. Sediment attenuation is addressed in this work by applying lossy operators to the governing equation that are based on a fractional Laplacian. These operators accurately describe frequency-dependent attenuation and dispersion in typical ocean sediments. However, dispersion within the sediment is found to be a secondary process to absorption and effectively negligible for ranges of interest. The resulting fractional NPE is benchmarked against a Fourier-transformed parabolic equationsolution for a linear case, and against the analytical Mendousse solution to Burgers' equation for the nonlinear case. The fractional NPE is then used to investigate the effects of attenuation on shock wave propagation.
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