Gut microbiome approaches to treat obesity in humans

Abstract

The rising worldwide prevalence of obesity has become a major concern having many implications for the public health and the economy. It is well known that many factors such as lifestyle, increased intake of foods high in fat and sugar and a host's genetic profile can lead to obesity. Besides these factors, recent studies have pointed to the gut microbiota composition as being responsible for the development of obesity. Since then, many efforts have been made to understand the link between the gut microbiota composition and obesity, as well as the role of food ingredients, such as pro- and prebiotics, in the modulation of the gut microbiota. Studies involving the gut microbiota composition of obese individuals are however still controversial, making it difficult to treat obesity. In this sense, this mini-review deals with obesity and the relationship with gut microbiota, summarising the principal findings on gut microbiome approaches for treating obesity in humans.

https://ift.tt/2EkOYRU

Population pharmacokinetic modeling of sustained release lithium in the serum, erythrocytes and urine of patients with bipolar disorder

Abstract

Purpose

Lithium (Li), the first-line treatment of bipolar disorder, was first developed as an immediate-release form with a routine therapeutic drug monitoring 12 h after the last dose. In Europe, the most commonly prescribed form is a sustained release (srLi). Yet no pharmacokinetics (PK) study has been published of srLi, administered once a day, in adults. The present study describes srLi PK in the serum and erythrocytes of bipolar patients.

Methods

To assess srLi PK, we studied prospectively 17 French bipolar patients on a median dose of 1000 mg (600–1600) for at least 2 years. Serum (S), erythrocyte (E) concentrations, and urinary (U) amount were collected over 8 h after 15 days of morning intake using monitoring electronic medical system (MEMs). Population PK parameters were estimated using the SAEM algorithm (MONOLIX 4.3.3 software).

Results

Using a population approach, we built a PK population model of srLi including one S compartment (V_S = 23.0 L, Cl_S = 1.21 L h⁻¹), one E compartment (V_E = 64.7 L, Cl_SE = 3.63 L h⁻¹, Cl_ES = 9.46 L h⁻¹), and one U compartment (F = 0.62) and estimate the ratio of concentrations to Li in E over S at 0.38 with 27% between-subject variability.

Conclusion

This is a PK model of srLi once a day in bipolar patients using a population approach simultaneously describing Li concentrations in serum, erythrocytes, and urine which provide an estimate of the ratio of concentration in erythrocyte over serum and its between-subject variability (BSV).

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Pharmacokinetics of meropenem in plasma and cerebrospinal fluid in patients with intraventricular hemorrhage after lateral ventricle drainage

https://ift.tt/2SNUeBt

Association between REM sleep and obstructive sleep apnea in obese and overweight adolescents

Abstract

Purpose

Overweight and obese children have demonstrated reduced rapid eye movement (REM) sleep, affecting energy balance regulation and predisposition to weight gain. Obstructive sleep apnea (OSA) is a known cause of decreased REM sleep. The purpose of this study is to examine the association between the percentage of REM sleep, BMI z-score, and OSA severity in overweight and obese adolescents.

Methods

We performed a cross-sectional study of 92 (43% female) overweight and obese adolescents (13–17 years old) who underwent overnight polysomnography (PSG) at Children's Hospital Los Angeles between 2010 and 2017.

Results

The average Body Mass Index (BMI) z-score was 2.27 ± 0.47, with 71% having BMI z-score ≥ 2. REM% during PSG was 15.6 ± 6.8, and obstructive apnea-hypopnea index was 17.1 ± 24.3. The distribution across categories of OSA severity was 27% none (≤ 1.5 events/h), 24% mild (> 1.5–5 events/h), 8% moderate (> 5–10 events/h), and 41% severe (> 10 events/h). REM% was not associated with BMI z-score, either on univariate or multivariate regression with adjustment for age, gender, and apnea-hypopnea index (AHI). When subdivided into OSA categories, a 1-unit increase in BMI z-score was associated with a 5.96 (p = 0.03) increase in REM% in mild OSA and an 8.86 (p = 0.02) decrease in REM% in severe OSA. There was no association between BMI z-score and REM% in none and moderate OSA.

Conclusion

Among overweight and obese adolescents, BMI z-score was associated with decreased REM% in severe OSA and unexpectedly increased REM% in mild OSA, but there was no association in none or moderate OSA.

https://ift.tt/2A3rHRn

Intraoperative stent placement for the treatment of acute portal vein complications in pediatric living donor liver transplantation

Abstract

Purpose

Pediatric living donor liver transplantation (LDLT) in low weight recipients remains one of the most complex surgical procedures, with portal vein (PV) complications occurring in up to 19% of cases. When decreased PV flow is diagnosed intra- or perioperatively, intraoperative stent placement is a good substitute for surgical adjustment. Still, at the present moment, little is known about the technical feasibility, safety, efficacy, and long-term outcome of intraoperative stenting in LDLT.

Methods

Between 2006 and 2017, seven pediatric recipients underwent PV stent placement during the transplant or in the immediate post-operative setting. Preoperative, operative, and post-operative parameters were documented retrospectively.

Results

In total, nine stents were placed in seven patients. Procedures were technically successful in all patients. During the mean imaging follow-up period of 1313 days, none of the patients showed PV abnormality and PV stent remained patent throughout the post-transplant course. There were no deaths or graft loses during the follow-up period.

Conclusions

Intraoperative stenting through the inferior mesenteric vein approach offers both a high feasibility and satisfactory results, with the potential for excellent long-term primary patency despite continued growth in children.

https://ift.tt/2A27z1V

Data Mining Application in Assessment of Weather-Based Influent Scenarios for a WWTP: Getting the Most Out of Plant Historical Data

Abstract

Since the introduction of environmental legislations and directives, the impact of combined sewer overflows (CSO) on receiving water bodies has become a priority concern in water and wastewater treatment industry. Time-consuming and expensive local sampling and monitoring campaigns are usually carried out to estimate the characteristic flow and pollutant concentrations of CSO water. This study focuses on estimating the frequency and duration of wet-weather events and their impacts on influent flow and wastewater characteristics of the largest Italian wastewater treatment plant (WWTP) located in Castiglione Torinese. Eight years (viz. 2009–2016) of historical data in addition to arithmetic mean daily precipitation rates (P_I) of the plant catchment area are elaborated. Relationships between P_I and volumetric influent flow rate (Q_in), chemical oxygen demand (COD), ammonium (N-NH₄), and total suspended solids (TSS) are investigated. A time series data mining (TSDM) method is implemented with MATLAB computing package for segmentation of time series by use of a sliding window algorithm (SWA) to partition the available records associated with wet and dry weather events. According to the TSDM results, a case-specific wet-weather definition is proposed for the Castiglione Torinese WWTP. Two significant weather-based influent scenarios are assessed by kernel density estimation. The results confirm that the method suggested within this study based on plant routinely collected data can be used for planning the emergency response and long-term preparedness for extreme climate conditions in a WWTP. Implementing the obtained results in dynamic process simulation models can improve the plant operational efficiency in managing the fluctuating loads.

https://ift.tt/2zZSTk5

Italian recommendations for diagnosis and management of congenital myasthenic syndromes

Abstract

Congenital myasthenic syndromes (CMS) are genetic disorders due to mutations in genes encoding proteins involved in the neuromuscular junction structure and function. CMS usually present in young children, but perinatal and adult onset has been reported. Clinical presentation is highly heterogeneous, ranging from mild symptoms to severe manifestations, sometimes with life-threatening respiratory episodes, especially in the first decade of life. Although considered rare, CMS are probably underestimated due to diagnostic difficulties. Because of the several therapeutic opportunities, CMS should be always considered in the differential diagnosis of neuromuscular disorders. The Italian Network on CMS proposes here recommendations for proper CMS diagnosis and management, aiming to guide clinicians in their practical approach to CMS patients.

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A Rocambolesque Metafiction

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Deep sequencing salivary proteins for periodontitis using proteomics

Abstract

Objectives

Saliva is a bodily fluid transuded from gingival crevice fluid and blood and contains many proteins. Proteins in saliva have been studied as markers for periodontal diseases. Mass spectrometric analysis is applied to investigate biomarker proteins that are related to periodontitis.

Material and methods

Saliva samples were collected from 207 participants including 36 pairs matched for age, sex, and smoking who joined Yangpyeong health cohort. Periodontitis was defined by 2005 5th European guideline. Shotgun proteomics was applied to detect proteins from saliva samples. Principal component analysis and Ingenuity Pathway Analysis for canonical pathway and protein pathway were applied. Protein-protein interaction was also applied. Enzyme-linked immunosorbent assay (ELISA) was used to verify the candidate protein markers among another matched participants (n = 80).

Results

Shotgun proteomics indicated that salivary S100A8 and S100A9 were candidate biomarkers for periodontitis. ELISA confirmed that both salivary S100A8 and S100A9 were higher in those with periodontitis compared to those without periodontitis (paired-t test, p < 0.05).

Conclusion

Our proteomics data showed that S100A8 and S100A9 in saliva could be candidate biomarkers for periodontitis. The rapid-test-kit using salivary S100A8 and S100A9 will be a practical tool for reducing the risk of periodontitis and promotion of periodontal health.

Clinical relevance

A rapid-test-kit using salivary biomarkers, S100A8 and S100A9, could be utilized by clinicians and individuals for screening periodontitis, which might reduce the morbidity of periodontitis and promote periodontal health.

https://ift.tt/2SKvdH6

Our Experience Regarding the Association Between Gastrointestinal Stromal Tumor and Bariatric Surgery: a Response to a Letter “Gastrointestinal Stromal Tumor After Laparoscopic Sleeve Gastrectomy: Be Awake Before, During, and After a Bariatric Procedure”

https://ift.tt/2Bpc7zt

Quorum sensing between Gram-negative bacteria responsible for methane production in a complex waste sewage sludge consortium

Abstract

Quorum sensing (QS) plays a key role in activating bacterial functions through small molecules called autoinducers. In this study, the QS of Gram-negative bacteria in waste sewage sludge (WSS) was downregulated by adding the quorum quenching enzyme, AiiM lactonase, which cleaved the acyl-homoserine lactone (AHL) autoinducer signals from Gram-negative bacteria, and subsequently methane production was inhibited by over 400%. The pH was lowered after 2 days in the anaerobic fermentation whereas protease activity at the hydrolysis step was almost the same with or without AiiM. The production of acetic acid significantly increased during the fermentation in the presence of AiiM. The bacterial community at day 2 indicated that the population of Gram-positive bacteria increased in the presence of AiiM, and the percentage of Gram-negative bacteria decreased in the WSS containing AiiM. The change in the bacterial community in the presence of AiiM may be due to the different antimicrobial agents produced in the WSS because some of the Gram-positive bacteria were killed by adding the solid-phase extraction (SPE) fraction from the WSS without AiiM. In contrast, the SPE fraction with AiiM had reduced bactericidal activity against Gram-negative bacteria. Thus, bacterial signaling between Gram-negative bacteria is critical for methane production by the microbial consortia.

https://ift.tt/2PFXXPl

Management of Cerebral Microbleeds in Clinical Practice

Abstract

Cerebral microbleeds (CMBs) are very frequent diagnoses with MRI imaging in the elderly or in patients with cerebral infarction, intracranial hemorrhage (ICH), and dementia. The mechanisms for CMBs are not fully understood but may be secondary to injury to the vascular wall from long-standing hypertension or amyloid deposition in the tissue. The presence of CMB increases the risk for stroke, dementia, and death. The increasing number of CMBs is also associated with a higher risk of hemorrhagic complications with the long-term use of anticoagulants in atrial fibrillation and in patients requiring thrombolysis for acute stroke. The presence of CMBs is however not a contraindication for anticoagulation or thrombolysis as was recently shown from the results of the CROMIS-2 study. This review will summarize our current understanding of the natural history of CMBs and offer suggestions on the best management in common clinical settings.

https://ift.tt/2PF6ZMP

Crossed obsessive-compulsive personality disorder and impaired theory of mind in temporal lobe epilepsy

Abstract

People with epilepsy often suffer psychiatric symptoms or exhibit maladaptive personality characteristics which can impact them more than seizures. This case illustrates a selective association of a Theory of Mind dysfunction, including an impaired comparison of reality and others' behavior, with an obsessive-compulsive personality disorder in a patient with left temporal lobe epilepsy and crossed cognitive functions. The patient revealed visual memory deficits and impaired interpretation of other people's behavior, mental rigidity, and a tendency to formulate inflexible judgements. Moreover, she shows impairment in understanding and sharing the emotional states of others in reference to herself (Empathic Quotient); her social relations are limited to her parents. Patients with right temporal lobe epilepsy frequently report persistent and rigid actions and thoughts, and this can have substantial psychological and social consequences for everyday life. We suggest that this could be a case of crossed cognitive functions, in particular ToM, and crossed psychobehavioral functions linked to right-hemisphere damage.

https://ift.tt/2CgZvw1

Heterogeneous brain FDG-PET metabolic patterns in patients with C9orf72 mutation

Abstract

Objective

The hexanucleotide repeat expansion in C9orf72 is an associated genetic cause in amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). In the "ALS/FTD" spectrum prevails clinical heterogeneity and an in vivo knowledge of the underling brain dysfunction in patients carrying C9orf72 mutation remain limited and only described at group level. The study aimed to assess the brain metabolic alterations characterizing patients with C9orf72 mutation using FDG-PET in single individuals.

Methods

We applied a validated statistical parametric mapping (SPM) voxel-based procedure for FDG-PET data to obtain maps of brain relative hypometabolism and hypermetabolism at single-subject level in six FTD/ALS patients carrying the C9orf72 mutation.

Results

Clinical diagnoses classified the patients as right semantic variant of frontotemporal dementia (one case, C9svFTD), behavioral variant of frontotemporal dementia (two cases, C9bvFTD), and bulbar amyotrophic lateral sclerosis (three cases, C9bALS). The FDG-PET SPM revealed a prevalent frontal hypometabolism in C9bvFTD cases, and right temporal polar and lateral involvement in C9svFTD, consistent with the clinical diagnosis. There was a quite comparable occipital and cerebellar hypermetabolism in these cases. The three C9bALS patients showed variable patterns of hypo- and hypermetabolism.

Conclusions

The present work is the first in vivo FDG-PET study showing the heterogeneous patterns of brain regional hypo- and hypermetabolism in single patients sharing C9orf72 mutation. Brain hypometabolism was consistent with the clinical phenotypes, supporting the diagnostic importance of neuroimaging functional biomarkers to capture at single-subject level specific brain dysfunction.

https://ift.tt/2SRoXxh

Neurocognitive, academic and functional outcomes in survivors of infant ependymoma (UKCCSG CNS 9204)

Abstract

Purpose

This is the first UK multi-centre case-controlled study with follow-up in excess of 10 years to report the neurocognitive, academic and psychological outcomes of individuals diagnosed with a brain tumour in early childhood. Children enrolled into the UKCCSG CNS 9204 trial, diagnosed with intracranial ependymoma when aged ≤ 36 months old, who received a primary chemotherapy strategy to defer or avoid radiotherapy, were recruited.

Methods

Outcomes of those who relapsed and subsequently received radiotherapy (n = 13) were compared to those enrolled who did not relapse (n = 16), age-matched controls—diagnosed with solid non-central nervous system (SN-CNS; n = 15) tumours or low-grade posterior fossa pilocytic astrocytoma (PFPA; n = 15), and normative data. Analyses compared nine neurocognitive outcomes as primary measures with quality of survival as secondary measures.

Results

Relapsed ependymoma participants performed significantly worse than their non-relapsed counterparts on measures of Full Scale IQ, Perceptual Reasoning, Word Reading and Numerical Operations. The relapsed ependymoma group performed significantly worse than SN-CNS controls on all primary measures, whereas non-relapsing participants only differed significantly from SN-CNS controls on measures of Processing Speed and General Memory. Relapsed ependymoma participants fared worse than all groups on measures of quality of survival.

Conclusions

The relapsed irradiated ependymoma group demonstrated the most significantly impaired neurocognitive outcomes at long-term follow-up. Non-relapsing participants demonstrated better outcomes than those who relapsed. Results tentatively suggest avoiding radiotherapy helped preserve neurocognitive and learning outcomes of individuals diagnosed with ependymoma when aged ≤ 36 months old. Prospective neurocognitive surveillance is required. Recommendations for clinical and research practice are provided.

https://ift.tt/2QzlVkP

A new high-order particle method for solving high Reynolds number incompressible flows

Abstract

In this study, a new high-order particle method is proposed to solve the incompressible Navier–Stokes equations. The proposed method combines the advantages of particle and mesh methods to approximate the total and the spatial derivative terms under the Lagrangian and the Eulerian frameworks. Our aim is to avoid convective instability and increase solution accuracy at the same time. Data transfer from Lagrangian particles to Eulerian grids is realized by moving least squares interpolation. In contrast to the previously proposed method, there is no need to interpolate diffusion terms from Eulerian grids to Lagrangian particles. Therefore, the accuracy of the present solution will not be deteriorated by interpolation error. Additionally, no extra work is required to manage particles for searching procedure. Because no convection term needs to be discretized by upwinding schemes, false diffusion and dispersion errors will not be introduced, thereby increasing the solution accuracy. To verify the proposed particle method, several benchmark problems are solved to show that the present simulation is more stable, accurate, and efficient. The proposed particle method renders fourth- and second-order accurate solutions in space for velocity and pressure, respectively.

https://ift.tt/2SKeMKU

Idiopathic Pulmonary Fibrosis for Cardiologists: Differential Diagnosis, Cardiovascular Comorbidities, and Patient Management

Abstract

The presence of rare comorbidities in patients with cardiovascular disease (CVD) presents a diagnostic challenge to cardiologists. In evaluating these patients, cardiologists are faced with a unique opportunity to shorten diagnosis times and direct patients towards correct treatment pathways. Idiopathic pulmonary fibrosis (IPF), a type of interstitial lung disease (ILD), is an example of a rare disease where patients frequently demonstrate comorbid CVD. Both CVD and IPF most commonly affect a similar patient demographic: men over the age of 60 years with a history of smoking. Moreover, IPF and heart failure (HF) share a number of symptoms. As a result, patients with IPF can be misdiagnosed with HF and vice versa. This article aims to increase awareness of IPF among cardiologists, providing an overview for cardiologists on the differential diagnosis of IPF from HF, and describing the signs and symptoms that would warrant referral to a pulmonologist with expertise in ILD. Once patients with IPF have received a diagnosis, cardiologists can have an important role in managing patients who are candidates for a lung transplant or those who develop pulmonary hypertension (PH). Group 3 PH is one of the most common cardiovascular complications diagnosed in patients with IPF, its prevalence varying between reports but most often cited as between 30% and 50%. This review summarizes the current knowledge on Group 3 PH in IPF, discusses data from clinical trials assessing treatments for Group 1 PH in patients with IPF, and highlights that treatment guidelines recommend against these therapies in IPF. Finally, this article provides the cardiologist with an overview on the use of the two approved treatments for IPF, the antifibrotics pirfenidone and nintedanib, in patients with IPF and CVD comorbidities. Conversely, the impact of treatments for CVD comorbidities on patients with IPF is also discussed.

Funding: F. Hoffmann-La Roche, Ltd.

Plain Language Summary: Plain language summary available for this article.

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Efficacy and Safety of CFTR Corrector and Potentiator Combination Therapy in Patients with Cystic Fibrosis for the F508del-CFTR Homozygous Mutation: A Systematic Review and Meta-analysis

Abstract

Introduction

Cystic fibrosis (CF) is a progressive, genetic disease that causes persistent lung infections and limits the ability to breathe over time. The combination of a cystic fibrosis transmembrane conductance regulator (CFTR) corrector and potentiator has provided a benefit by decreasing sweat chloride concentration in CF for the F508del-CFTR homozygous mutation, but it remains controversial in lung function, nutritional status, clinical score and safety.

Methods

The authors performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of combination therapy on lung function, nutritional status, clinical score and safety in CF for the F508del-CFTR homozygous mutation. Web of Science, Cochrane Central Register of Controlled Trials, Medline, and Embase were searched. The registered PROSPERO number was CRD42018085875.

Results

Five RCTs, including a total of 1637 participants with the F508del-CFTR homozygous mutation who accepted CFTR corrector and potentiator combination therapy along with basic treatment were enrolled in this analysis. Primary analysis revealed that combination therapy improved the percent of predicted FEV₁ (ppFEV₁) (MD 2.38, 1.62–3.15, P < 0.00001), Cystic Fibrosis Questionnaire-Revised (CFQ-R) respiratory domain score (MD 2.59, 0.96–4.22, P = 0.002) and body-mass index (BMI) (MD 0.21, 0.03–0.39, P = 0.02). In the secondary analysis, combination therapy had no impact on the number of participants reporting adverse events (OR 0.88, 0.58–1.33, P = 0.53), but increased the proportion of discontinued treatments due to adverse events (OR 2.71, 1.3–5.63, P = 0.008).

Conclusions

CFTR corrector and potentiator combination therapy effectively improves lung function, nutritional status and clinical score in CF patients with the F508del-CFTR homozygous mutation, and has an acceptable safety profile.

https://ift.tt/2RXqt0W

Evaluation of Physicochemical and Biological Stability of 36-Months-Aged SB5 (Adalimumab Biosimilar) for 4 Weeks at Room Temperature

Abstract

Introduction

Tumor necrosis factor (TNF-alpha) inhibitors, such as adalimumab, have shown success in treating autoimmune inflammatory diseases but are associated with substantial financial burdens to the healthcare system. Biosimilars, which are highly similar to biologic agents, offer the potential to reduce the financial burden of treatment. In the case of TNF-alpha inhibitors, they may also offer improved stability and enable prolonged use. SB5, an adalimumab biosimilar, has shown equivalent efficacy and comparable safety to its reference product in clinical trials. Currently, SB5 is approved for storage for 36 months at 2–8 °C and may be stored at room temperature (25 °C) for a maximum period of 14 days. The objective of this study was to evaluate the stability of SB5, aged to its shelf-life of 36 months, at room temperature (25 ± 2 °C) and 60 ± 5% relative humidity (RH) for a period of 4 weeks, which is longer by 14 days than that of SB5 currently approved in the European Union.

Methods

This study evaluated the stability of SB5, aged to its shelf-life of 36 months, at room temperature (25 ± 2 °C) for a period of 4 weeks. Three independent batches of 36 months-aged SB5 were stored at 25 ± 2 °C and 60 ± 5% RH for 4 weeks. Samples were tested at 0, 2, and 4 weeks.

Results

Color, clarity, visible particles, pH, protein concentration, and particulate matter were consistent among the batches, and all the test results met the acceptance criteria at each time point. Percent charge variance was maintained over time. Percent of high molecular weight species detected, total purity, relative binding activity by TNF-alpha, and relative potency by TNF-alpha neutralization did not change over time within each batch, and all values were within the acceptance criteria limits.

Conclusion

SB5 aged for 36 months is physicochemically and biologically stable for 4 weeks at 25 ± 2 °C and 60 ± 5% RH, which is 2 weeks longer than the alternative storage condition as approved by the European Medicines Agency, which is at 25 °C for a period of up to 14 days.

Funding

Samsung Bioepis Co., Ltd.

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Treatment failure of syringomyelia associated with Chiari I malformation following foramen magnum decompression: how should we proceed?

Abstract

The preferred treatment of patients with persistent, recurrent, or progressive syringomyelia after foramen magnum decompression (FMD) for Chiari I (CMI)-associated syringomyelia is controversial, and may include redo FMD, stabilization, or shunting procedures (such as syringopleural or syringo-subarachnoid shunts). We describe our experience in treating these patients and discuss the treatment modalities for these patients. We retrospectively collected data of CMI patients with persistent, recurrent, or progressive syringomyelia after FMD. In addition to baseline characteristics, surgical treatments and neurological and radiological outcomes were assessed. Further, we assessed through uni- and multivariate analyses possible technical, surgical, and radiological factors which might lead to failed FMD. Between 1998 and 2017, 48 consecutive patients (35 females (73%), average age 16.8 ± 11.5 years) underwent FMD for a syringomyelia-Chiari complex. Twenty-four patients (50%) underwent surgical treatment for a persistent (n = 10), progressive (n = 12), or recurrent (n = 2) syringomyelia 21.4 ± 27.9 months (median 14.6 months, range 12 days–134.9 months) after FMD. Of all analyzed factors, only extradural FMD was significantly associated with lower failure rates. Two patients (8%) underwent redo FMD, 18 (75%) underwent 19 syringo-subarachnoid-shunts, and 4 (17%) had 6 cranial CSF diversion procedures. The overall follow-up time was 40.1 ± 47.4 months (median 25 months, range 3–230 months). Based on our results, 50% of the patients undergoing FMD for syringomyelia-Chiari complex may require further surgical treatment due to persistent, progressive, or recurrent syringomyelia. Treatment should be tailored to the suspected underlying pathology. A subgroup of patients may be managed conservatively; however, these patients need close clinical and radiological follow-ups. The technical aspects of FMD in CMI-syrinx complex should be the focus of larger studies, as an effort to improve failure rates.

https://ift.tt/2zZyqMh

Induction of apoptosis-like death by periplanetasin-2 in Escherichia coli and contribution of SOS genes

Abstract

Periplanetasin-2 is a 15-mer antimicrobial peptide (AMP), derived from the American cockroach Periplaneta americana. This novel AMP exhibits potent antibacterial effect against several pathogenic bacteria including Escherichia coli. Distinct from the targeting cell membrane, which is the general antibacterial mechanism of AMP, periplanetasin-2 exerts its antibacterial activity via apoptosis-like death, which is physiologically and mechanistically similar to eukaryotic apoptosis. E. coli cells treated with periplanetasin-2 showed features of apoptosis in a concentration-dependent manner, such as membrane depolarization, DNA fragmentation, caspase-like protein activation, and phosphatidylserine externalization. These physiological changes were attenuated by pretreatment with the reactive oxygen species (ROS) scavenger, which demonstrates that periplanetasin-2 induced apoptosis-like death in E. coli by generating ROS. In addition, periplantasin-2-induced apoptotic death was affected by SOS response components. In the absence of RecA, an essential protein for SOS response, apoptosis did not occur and the antibacterial activity of periplanetasin-2 was decreased. In contrast, deletion of the SOS gene dinF caused higher ROS accumulation and apoptotic features were detected. Collectively, these results indicate that the antibacterial mechanism of periplanetasin-2 is ROS-induced apoptosis-like death, which requires RecA for proceeding it, and the role of DinF is assumed to contribute to the ROS defense SOS response.

https://ift.tt/2Elr1d2

Effects of Tympanic Membrane Perforation on Middle Ear Transmission in Gerbil

Publication date: Available online 15 December 2018

Source: Hearing Research

Author(s): Glenna Stomackin, Stephanie Cipta, Timothy T. Jung, Glen K. Martin, Wei Dong

Abstract

Perforations of the tympanic membrane (TM) alter its structural and mechanical properties, thus resulting in a deterioration of sound transmission through the middle ear (ME), which presents itself clinically as a conductive hearing loss (CHL). The resulting CHL is proposed to be due to the loss of the pressure difference across the TM between the outer ear-canal space and the ME cavity, a hypothesis which has been tested with both theoretical and experimental approaches. In the past, direct experimental observations had been either from the ME input (umbo) or the output of the stapes, and were focused mainly on the low frequency region. However, there was little documentation providing a thorough picture of the influence of systematically increasing sizes of TM perforations on ME sound transmission from the input (i.e., pressure at the TM or motion of the umbo) to the output (pressure produced by the motion of the stapes). Our study explored ME transmission in gerbil under conditions of a normal, intact TM followed by the placement of mechanically-induced TM perforations ranging from miniscule to complete removal of the pars tensa, leaving the other parts of ME intact. Testing up to 50 kHz, variations of ME transmission were characterized in simultaneously measured tone induced pressure responses at the TM (P_TM), pressure responses in the scala vestibuli next to the stapes (P_SV), and velocity measurements of the umbo (V_umbo), as well as by detailed descriptions of sound transmission from the TM to the stapes, i.e., the umbo transfer function (TF), the transfer of the sound stimulus along the ossicular chain as found from the ratio of cochlear pressure to umbo motion, and ME pressure gain (MEPG). Our results suggested that increasing the size of TM perforations led to a reduction in MEPG, which appeared to be primarily due to the reduction in the effective/initial mechanical drive to the umbo, with a relatively smaller decrease of sound transfer along the ossicular chain. Expansion of the perforation more than 25% appeared to drastically reduce sound transmission through the ME, especially for the higher frequencies.

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Dual-Laser Measurement and Finite Element Modeling of Human Tympanic Membrane Motion under Blast Exposure

Publication date: Available online 14 December 2018

Source: Hearing Research

Author(s): Shangyuan Jiang, Kyle Smith, Rong Z. Gan

Abstract

Hearing damage is one of most prevalent injuries in military personnel and civilians exposed to a blast. However, the mechanism of how the blast overpressure interacts with the tympanic membrane (TM) and impairs the peripheral auditory system still remains unclear. A 3D finite element (FE) model of the human ear has been developed to predict the blast overpressure transmission through the ear (Leckness et al, 2018), but the model needs to be further validated in TM response to blast pressure. This paper reports the first-ever approach using two laser Doppler vibrometers (LDVs) to measure the motion of the TM when the ear was exposed to a blast.

Five fresh human temporal bones were used in this study with a pressure sensor inserted near the TM to measure the pressure reaching the TM (P1). The temporal bone was mounted in a “head block” and exposed to blast at the overpressure around 35 kPa measured at the entrance of the ear canal (P0). The movements of the TM at the umbo and the “head block” were measured simultaneously by two LDVs and the exact motion of the TM was determined by subtracting the head block motion from the TM data. Results include that the maximum TM velocity was 12.62 ± 3.63 m/s (mean ± SD) and the displacement was 0.78 ± 0.26 mm. The peak-to-peak displacement normalized by the P0 pressure was 22.9 ± 6.6 μm/kPa. The frequency domain analysis indicated that the spectrum peaks were located at frequencies below 3 kHz. The TM motion was then compared with that calculated from the FE model of the human ear with the measured P0 pressure wave applied at the ear canal entrance. The FE model-derived TM displacement under blast overpressure was consistent with the experimental results. This study provides a new methodology to determine the behavior of the middle ear in response to blast overpressure. The experimental data are critical for validating the FE model of the human ear for blast wave transduction and understanding the TM damage induced by blast exposure.

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Neural envelope tracking as a measure of speech understanding in cochlear implant users

Publication date: Available online 14 December 2018

Source: Hearing Research

Author(s): Eline Verschueren, Ben Somers, Tom Francart

Abstract

The speech envelope is essential for speech understanding and can be reconstructed from the electroencephalogram (EEG) recorded while listening to running speech. This so-called “neural envelope tracking” has been shown to relate to speech understanding in normal hearing listeners, but has barely been investigated in persons wearing cochlear implants (CI). We investigated the relation between speech understanding and neural envelope tracking in CI users.

EEG was recorded in 8 CI users while they listened to a story. Speech understanding was varied by changing the intensity of the presented speech. The speech envelope was reconstructed from the EEG using a linear decoder. Next, the reconstructed envelope was correlated with the envelope of the speech stimulus as a measure of neural envelope tracking which was compared to actual speech understanding.

This study showed that neural envelope tracking increased with increasing speech understanding in every participant. Furthermore behaviorally measured speech understanding was correlated with participant-specific neural envelope tracking results indicating the potential of neural envelope tracking as an objective measure of speech understanding in CI users. This could enable objective and automatic fitting of CIs and pave the way towards closed-loop CIs that adjust continuously and automatically to individual CI users.

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Neural envelope tracking as a measure of speech understanding in cochlear implant users

Publication date: Available online 14 December 2018

Source: Hearing Research

Author(s): Eline Verschueren, Ben Somers, Tom Francart

Abstract

The speech envelope is essential for speech understanding and can be reconstructed from the electroencephalogram (EEG) recorded while listening to running speech. This so-called "neural envelope tracking" has been shown to relate to speech understanding in normal hearing listeners, but has barely been investigated in persons wearing cochlear implants (CI). We investigated the relation between speech understanding and neural envelope tracking in CI users.

EEG was recorded in 8 CI users while they listened to a story. Speech understanding was varied by changing the intensity of the presented speech. The speech envelope was reconstructed from the EEG using a linear decoder. Next, the reconstructed envelope was correlated with the envelope of the speech stimulus as a measure of neural envelope tracking which was compared to actual speech understanding.

This study showed that neural envelope tracking increased with increasing speech understanding in every participant. Furthermore behaviorally measured speech understanding was correlated with participant-specific neural envelope tracking results indicating the potential of neural envelope tracking as an objective measure of speech understanding in CI users. This could enable objective and automatic fitting of CIs and pave the way towards closed-loop CIs that adjust continuously and automatically to individual CI users.

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Effects of Tympanic Membrane Perforation on Middle Ear Transmission in Gerbil

Publication date: Available online 15 December 2018

Source: Hearing Research

Author(s): Glenna Stomackin, Stephanie Cipta, Timothy T. Jung, Glen K. Martin, Wei Dong

Abstract

Perforations of the tympanic membrane (TM) alter its structural and mechanical properties, thus resulting in a deterioration of sound transmission through the middle ear (ME), which presents itself clinically as a conductive hearing loss (CHL). The resulting CHL is proposed to be due to the loss of the pressure difference across the TM between the outer ear-canal space and the ME cavity, a hypothesis which has been tested with both theoretical and experimental approaches. In the past, direct experimental observations had been either from the ME input (umbo) or the output of the stapes, and were focused mainly on the low frequency region. However, there was little documentation providing a thorough picture of the influence of systematically increasing sizes of TM perforations on ME sound transmission from the input (i.e., pressure at the TM or motion of the umbo) to the output (pressure produced by the motion of the stapes). Our study explored ME transmission in gerbil under conditions of a normal, intact TM followed by the placement of mechanically-induced TM perforations ranging from miniscule to complete removal of the pars tensa, leaving the other parts of ME intact. Testing up to 50 kHz, variations of ME transmission were characterized in simultaneously measured tone induced pressure responses at the TM (P_TM), pressure responses in the scala vestibuli next to the stapes (P_SV), and velocity measurements of the umbo (V_umbo), as well as by detailed descriptions of sound transmission from the TM to the stapes, i.e., the umbo transfer function (TF), the transfer of the sound stimulus along the ossicular chain as found from the ratio of cochlear pressure to umbo motion, and ME pressure gain (MEPG). Our results suggested that increasing the size of TM perforations led to a reduction in MEPG, which appeared to be primarily due to the reduction in the effective/initial mechanical drive to the umbo, with a relatively smaller decrease of sound transfer along the ossicular chain. Expansion of the perforation more than 25% appeared to drastically reduce sound transmission through the ME, especially for the higher frequencies.

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Dual-Laser Measurement and Finite Element Modeling of Human Tympanic Membrane Motion under Blast Exposure

Publication date: Available online 14 December 2018

Source: Hearing Research

Author(s): Shangyuan Jiang, Kyle Smith, Rong Z. Gan

Abstract

Hearing damage is one of most prevalent injuries in military personnel and civilians exposed to a blast. However, the mechanism of how the blast overpressure interacts with the tympanic membrane (TM) and impairs the peripheral auditory system still remains unclear. A 3D finite element (FE) model of the human ear has been developed to predict the blast overpressure transmission through the ear (Leckness et al, 2018), but the model needs to be further validated in TM response to blast pressure. This paper reports the first-ever approach using two laser Doppler vibrometers (LDVs) to measure the motion of the TM when the ear was exposed to a blast.

Five fresh human temporal bones were used in this study with a pressure sensor inserted near the TM to measure the pressure reaching the TM (P1). The temporal bone was mounted in a "head block" and exposed to blast at the overpressure around 35 kPa measured at the entrance of the ear canal (P0). The movements of the TM at the umbo and the "head block" were measured simultaneously by two LDVs and the exact motion of the TM was determined by subtracting the head block motion from the TM data. Results include that the maximum TM velocity was 12.62 ± 3.63 m/s (mean ± SD) and the displacement was 0.78 ± 0.26 mm. The peak-to-peak displacement normalized by the P0 pressure was 22.9 ± 6.6 μm/kPa. The frequency domain analysis indicated that the spectrum peaks were located at frequencies below 3 kHz. The TM motion was then compared with that calculated from the FE model of the human ear with the measured P0 pressure wave applied at the ear canal entrance. The FE model-derived TM displacement under blast overpressure was consistent with the experimental results. This study provides a new methodology to determine the behavior of the middle ear in response to blast overpressure. The experimental data are critical for validating the FE model of the human ear for blast wave transduction and understanding the TM damage induced by blast exposure.

from #Audiology via ola Kala on Inoreader https://ift.tt/2EtqRRG

Effects of Tympanic Membrane Perforation on Middle Ear Transmission in Gerbil

Publication date: Available online 15 December 2018

Source: Hearing Research

Author(s): Glenna Stomackin, Stephanie Cipta, Timothy T. Jung, Glen K. Martin, Wei Dong

Abstract

Perforations of the tympanic membrane (TM) alter its structural and mechanical properties, thus resulting in a deterioration of sound transmission through the middle ear (ME), which presents itself clinically as a conductive hearing loss (CHL). The resulting CHL is proposed to be due to the loss of the pressure difference across the TM between the outer ear-canal space and the ME cavity, a hypothesis which has been tested with both theoretical and experimental approaches. In the past, direct experimental observations had been either from the ME input (umbo) or the output of the stapes, and were focused mainly on the low frequency region. However, there was little documentation providing a thorough picture of the influence of systematically increasing sizes of TM perforations on ME sound transmission from the input (i.e., pressure at the TM or motion of the umbo) to the output (pressure produced by the motion of the stapes). Our study explored ME transmission in gerbil under conditions of a normal, intact TM followed by the placement of mechanically-induced TM perforations ranging from miniscule to complete removal of the pars tensa, leaving the other parts of ME intact. Testing up to 50 kHz, variations of ME transmission were characterized in simultaneously measured tone induced pressure responses at the TM (P_TM), pressure responses in the scala vestibuli next to the stapes (P_SV), and velocity measurements of the umbo (V_umbo), as well as by detailed descriptions of sound transmission from the TM to the stapes, i.e., the umbo transfer function (TF), the transfer of the sound stimulus along the ossicular chain as found from the ratio of cochlear pressure to umbo motion, and ME pressure gain (MEPG). Our results suggested that increasing the size of TM perforations led to a reduction in MEPG, which appeared to be primarily due to the reduction in the effective/initial mechanical drive to the umbo, with a relatively smaller decrease of sound transfer along the ossicular chain. Expansion of the perforation more than 25% appeared to drastically reduce sound transmission through the ME, especially for the higher frequencies.

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Dual-Laser Measurement and Finite Element Modeling of Human Tympanic Membrane Motion under Blast Exposure

Publication date: Available online 14 December 2018

Source: Hearing Research

Author(s): Shangyuan Jiang, Kyle Smith, Rong Z. Gan

Abstract

Hearing damage is one of most prevalent injuries in military personnel and civilians exposed to a blast. However, the mechanism of how the blast overpressure interacts with the tympanic membrane (TM) and impairs the peripheral auditory system still remains unclear. A 3D finite element (FE) model of the human ear has been developed to predict the blast overpressure transmission through the ear (Leckness et al, 2018), but the model needs to be further validated in TM response to blast pressure. This paper reports the first-ever approach using two laser Doppler vibrometers (LDVs) to measure the motion of the TM when the ear was exposed to a blast.

Five fresh human temporal bones were used in this study with a pressure sensor inserted near the TM to measure the pressure reaching the TM (P1). The temporal bone was mounted in a “head block” and exposed to blast at the overpressure around 35 kPa measured at the entrance of the ear canal (P0). The movements of the TM at the umbo and the “head block” were measured simultaneously by two LDVs and the exact motion of the TM was determined by subtracting the head block motion from the TM data. Results include that the maximum TM velocity was 12.62 ± 3.63 m/s (mean ± SD) and the displacement was 0.78 ± 0.26 mm. The peak-to-peak displacement normalized by the P0 pressure was 22.9 ± 6.6 μm/kPa. The frequency domain analysis indicated that the spectrum peaks were located at frequencies below 3 kHz. The TM motion was then compared with that calculated from the FE model of the human ear with the measured P0 pressure wave applied at the ear canal entrance. The FE model-derived TM displacement under blast overpressure was consistent with the experimental results. This study provides a new methodology to determine the behavior of the middle ear in response to blast overpressure. The experimental data are critical for validating the FE model of the human ear for blast wave transduction and understanding the TM damage induced by blast exposure.

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Neural envelope tracking as a measure of speech understanding in cochlear implant users

Publication date: Available online 14 December 2018

Source: Hearing Research

Author(s): Eline Verschueren, Ben Somers, Tom Francart

Abstract

The speech envelope is essential for speech understanding and can be reconstructed from the electroencephalogram (EEG) recorded while listening to running speech. This so-called “neural envelope tracking” has been shown to relate to speech understanding in normal hearing listeners, but has barely been investigated in persons wearing cochlear implants (CI). We investigated the relation between speech understanding and neural envelope tracking in CI users.

EEG was recorded in 8 CI users while they listened to a story. Speech understanding was varied by changing the intensity of the presented speech. The speech envelope was reconstructed from the EEG using a linear decoder. Next, the reconstructed envelope was correlated with the envelope of the speech stimulus as a measure of neural envelope tracking which was compared to actual speech understanding.

This study showed that neural envelope tracking increased with increasing speech understanding in every participant. Furthermore behaviorally measured speech understanding was correlated with participant-specific neural envelope tracking results indicating the potential of neural envelope tracking as an objective measure of speech understanding in CI users. This could enable objective and automatic fitting of CIs and pave the way towards closed-loop CIs that adjust continuously and automatically to individual CI users.

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via IFTTT

Effects of Tympanic Membrane Perforation on Middle Ear Transmission in Gerbil

Publication date: Available online 15 December 2018

Source: Hearing Research

Author(s): Glenna Stomackin, Stephanie Cipta, Timothy T. Jung, Glen K. Martin, Wei Dong

Abstract

Perforations of the tympanic membrane (TM) alter its structural and mechanical properties, thus resulting in a deterioration of sound transmission through the middle ear (ME), which presents itself clinically as a conductive hearing loss (CHL). The resulting CHL is proposed to be due to the loss of the pressure difference across the TM between the outer ear-canal space and the ME cavity, a hypothesis which has been tested with both theoretical and experimental approaches. In the past, direct experimental observations had been either from the ME input (umbo) or the output of the stapes, and were focused mainly on the low frequency region. However, there was little documentation providing a thorough picture of the influence of systematically increasing sizes of TM perforations on ME sound transmission from the input (i.e., pressure at the TM or motion of the umbo) to the output (pressure produced by the motion of the stapes). Our study explored ME transmission in gerbil under conditions of a normal, intact TM followed by the placement of mechanically-induced TM perforations ranging from miniscule to complete removal of the pars tensa, leaving the other parts of ME intact. Testing up to 50 kHz, variations of ME transmission were characterized in simultaneously measured tone induced pressure responses at the TM (P_TM), pressure responses in the scala vestibuli next to the stapes (P_SV), and velocity measurements of the umbo (V_umbo), as well as by detailed descriptions of sound transmission from the TM to the stapes, i.e., the umbo transfer function (TF), the transfer of the sound stimulus along the ossicular chain as found from the ratio of cochlear pressure to umbo motion, and ME pressure gain (MEPG). Our results suggested that increasing the size of TM perforations led to a reduction in MEPG, which appeared to be primarily due to the reduction in the effective/initial mechanical drive to the umbo, with a relatively smaller decrease of sound transfer along the ossicular chain. Expansion of the perforation more than 25% appeared to drastically reduce sound transmission through the ME, especially for the higher frequencies.

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Dual-Laser Measurement and Finite Element Modeling of Human Tympanic Membrane Motion under Blast Exposure

Publication date: Available online 14 December 2018

Source: Hearing Research

Author(s): Shangyuan Jiang, Kyle Smith, Rong Z. Gan

Abstract

Hearing damage is one of most prevalent injuries in military personnel and civilians exposed to a blast. However, the mechanism of how the blast overpressure interacts with the tympanic membrane (TM) and impairs the peripheral auditory system still remains unclear. A 3D finite element (FE) model of the human ear has been developed to predict the blast overpressure transmission through the ear (Leckness et al, 2018), but the model needs to be further validated in TM response to blast pressure. This paper reports the first-ever approach using two laser Doppler vibrometers (LDVs) to measure the motion of the TM when the ear was exposed to a blast.

Five fresh human temporal bones were used in this study with a pressure sensor inserted near the TM to measure the pressure reaching the TM (P1). The temporal bone was mounted in a “head block” and exposed to blast at the overpressure around 35 kPa measured at the entrance of the ear canal (P0). The movements of the TM at the umbo and the “head block” were measured simultaneously by two LDVs and the exact motion of the TM was determined by subtracting the head block motion from the TM data. Results include that the maximum TM velocity was 12.62 ± 3.63 m/s (mean ± SD) and the displacement was 0.78 ± 0.26 mm. The peak-to-peak displacement normalized by the P0 pressure was 22.9 ± 6.6 μm/kPa. The frequency domain analysis indicated that the spectrum peaks were located at frequencies below 3 kHz. The TM motion was then compared with that calculated from the FE model of the human ear with the measured P0 pressure wave applied at the ear canal entrance. The FE model-derived TM displacement under blast overpressure was consistent with the experimental results. This study provides a new methodology to determine the behavior of the middle ear in response to blast overpressure. The experimental data are critical for validating the FE model of the human ear for blast wave transduction and understanding the TM damage induced by blast exposure.

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Neural envelope tracking as a measure of speech understanding in cochlear implant users

Publication date: Available online 14 December 2018

Source: Hearing Research

Author(s): Eline Verschueren, Ben Somers, Tom Francart

Abstract

The speech envelope is essential for speech understanding and can be reconstructed from the electroencephalogram (EEG) recorded while listening to running speech. This so-called “neural envelope tracking” has been shown to relate to speech understanding in normal hearing listeners, but has barely been investigated in persons wearing cochlear implants (CI). We investigated the relation between speech understanding and neural envelope tracking in CI users.

EEG was recorded in 8 CI users while they listened to a story. Speech understanding was varied by changing the intensity of the presented speech. The speech envelope was reconstructed from the EEG using a linear decoder. Next, the reconstructed envelope was correlated with the envelope of the speech stimulus as a measure of neural envelope tracking which was compared to actual speech understanding.

This study showed that neural envelope tracking increased with increasing speech understanding in every participant. Furthermore behaviorally measured speech understanding was correlated with participant-specific neural envelope tracking results indicating the potential of neural envelope tracking as an objective measure of speech understanding in CI users. This could enable objective and automatic fitting of CIs and pave the way towards closed-loop CIs that adjust continuously and automatically to individual CI users.

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via IFTTT

Effects of Tympanic Membrane Perforation on Middle Ear Transmission in Gerbil

Publication date: Available online 15 December 2018

Source: Hearing Research

Author(s): Glenna Stomackin, Stephanie Cipta, Timothy T. Jung, Glen K. Martin, Wei Dong

Abstract

Perforations of the tympanic membrane (TM) alter its structural and mechanical properties, thus resulting in a deterioration of sound transmission through the middle ear (ME), which presents itself clinically as a conductive hearing loss (CHL). The resulting CHL is proposed to be due to the loss of the pressure difference across the TM between the outer ear-canal space and the ME cavity, a hypothesis which has been tested with both theoretical and experimental approaches. In the past, direct experimental observations had been either from the ME input (umbo) or the output of the stapes, and were focused mainly on the low frequency region. However, there was little documentation providing a thorough picture of the influence of systematically increasing sizes of TM perforations on ME sound transmission from the input (i.e., pressure at the TM or motion of the umbo) to the output (pressure produced by the motion of the stapes). Our study explored ME transmission in gerbil under conditions of a normal, intact TM followed by the placement of mechanically-induced TM perforations ranging from miniscule to complete removal of the pars tensa, leaving the other parts of ME intact. Testing up to 50 kHz, variations of ME transmission were characterized in simultaneously measured tone induced pressure responses at the TM (P_TM), pressure responses in the scala vestibuli next to the stapes (P_SV), and velocity measurements of the umbo (V_umbo), as well as by detailed descriptions of sound transmission from the TM to the stapes, i.e., the umbo transfer function (TF), the transfer of the sound stimulus along the ossicular chain as found from the ratio of cochlear pressure to umbo motion, and ME pressure gain (MEPG). Our results suggested that increasing the size of TM perforations led to a reduction in MEPG, which appeared to be primarily due to the reduction in the effective/initial mechanical drive to the umbo, with a relatively smaller decrease of sound transfer along the ossicular chain. Expansion of the perforation more than 25% appeared to drastically reduce sound transmission through the ME, especially for the higher frequencies.

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Dual-Laser Measurement and Finite Element Modeling of Human Tympanic Membrane Motion under Blast Exposure

Publication date: Available online 14 December 2018

Source: Hearing Research

Author(s): Shangyuan Jiang, Kyle Smith, Rong Z. Gan

Abstract

Hearing damage is one of most prevalent injuries in military personnel and civilians exposed to a blast. However, the mechanism of how the blast overpressure interacts with the tympanic membrane (TM) and impairs the peripheral auditory system still remains unclear. A 3D finite element (FE) model of the human ear has been developed to predict the blast overpressure transmission through the ear (Leckness et al, 2018), but the model needs to be further validated in TM response to blast pressure. This paper reports the first-ever approach using two laser Doppler vibrometers (LDVs) to measure the motion of the TM when the ear was exposed to a blast.

Five fresh human temporal bones were used in this study with a pressure sensor inserted near the TM to measure the pressure reaching the TM (P1). The temporal bone was mounted in a "head block" and exposed to blast at the overpressure around 35 kPa measured at the entrance of the ear canal (P0). The movements of the TM at the umbo and the "head block" were measured simultaneously by two LDVs and the exact motion of the TM was determined by subtracting the head block motion from the TM data. Results include that the maximum TM velocity was 12.62 ± 3.63 m/s (mean ± SD) and the displacement was 0.78 ± 0.26 mm. The peak-to-peak displacement normalized by the P0 pressure was 22.9 ± 6.6 μm/kPa. The frequency domain analysis indicated that the spectrum peaks were located at frequencies below 3 kHz. The TM motion was then compared with that calculated from the FE model of the human ear with the measured P0 pressure wave applied at the ear canal entrance. The FE model-derived TM displacement under blast overpressure was consistent with the experimental results. This study provides a new methodology to determine the behavior of the middle ear in response to blast overpressure. The experimental data are critical for validating the FE model of the human ear for blast wave transduction and understanding the TM damage induced by blast exposure.

from #Audiology via ola Kala on Inoreader https://ift.tt/2EtqRRG

Neural envelope tracking as a measure of speech understanding in cochlear implant users

Publication date: Available online 14 December 2018

Source: Hearing Research

Author(s): Eline Verschueren, Ben Somers, Tom Francart

Abstract

The speech envelope is essential for speech understanding and can be reconstructed from the electroencephalogram (EEG) recorded while listening to running speech. This so-called "neural envelope tracking" has been shown to relate to speech understanding in normal hearing listeners, but has barely been investigated in persons wearing cochlear implants (CI). We investigated the relation between speech understanding and neural envelope tracking in CI users.

EEG was recorded in 8 CI users while they listened to a story. Speech understanding was varied by changing the intensity of the presented speech. The speech envelope was reconstructed from the EEG using a linear decoder. Next, the reconstructed envelope was correlated with the envelope of the speech stimulus as a measure of neural envelope tracking which was compared to actual speech understanding.

This study showed that neural envelope tracking increased with increasing speech understanding in every participant. Furthermore behaviorally measured speech understanding was correlated with participant-specific neural envelope tracking results indicating the potential of neural envelope tracking as an objective measure of speech understanding in CI users. This could enable objective and automatic fitting of CIs and pave the way towards closed-loop CIs that adjust continuously and automatically to individual CI users.

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Validity and reliability of an iPad with a three-dimensional camera for posture imaging

Publication date: Available online 15 December 2018

Source: Gait & Posture

Author(s): A. Agustsson, MK. Gislason, P. Ingvarsson, E. Rodby-Bousquet, Th Sveinsson

Abstract

Background

It is important to quantify a static posture to evaluate the need for and effectiveness of interventions such as physical management, physiotherapy, spinal orthosis or surgical treatment on the alignment of body segments. Motion analysis systems can be used for this purpose, but they are expensive, require a high degree of technical experience and are not easily accessible. A simpler method is needed to quantify static posture. Research objective: Assess validity and inter and intra rater reliability using an iPad with a 3-D camera to evaluate posture and postural deformity.

Method

A 3-D model of a lying posture, created using an iPad with a 3-D camera, was compared to a Qualisys motion analysis system of the same lying posture, the latter used as the gold standard. Markers on the trunk and the leg were captured by both systems, and results from distance and angle measurements were compared.

Results

All intra-class correlation coefficient values were above 0.98, the highest systematic error was 4.3 mm for length measurements and 0.2° for angle measurements. Significance: A 3-D model of a person, with markers on anatomical landmarks, created with an iPad with a 3-D camera, is a valid and reliable method of quantifying static posture.

Conclusion

An iPad with a 3-D camera is a relatively inexpensive, valid and reliable method to quantify static posture in a clinical environment.

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Response to Darting Primates: Steps toward Procedural and Reporting Standards

Abstract

The safety of primates which are captured and released in the wild is a topic of concern for many field primatologists. Our article and the recent commentary by Fernandez-Duque et al. contribute to the discussion. Although Fernandez-Duque et al. found a slightly higher rate of fatalities (2.5 %) than Cunningham et al. (2.0 %), their combined rate of fatal and serious injuries was lower (4.0 % vs 5.0 %). The differences in rate are not substantial, given limitations of the data. However, as Fernandez-Duque et al. highlight the need for standardizing methods of analysis, we believe the methods they suggest merit careful consideration. We agree that variation in size, habitat, and the experience of the darting team are important factors. Cunningham et al. reported the influence of these factors on injury and fatality rates. There are, however, some important differences in the methods of Cunningham et al. and Fernandez-Duque et al. We believe it is important to 1) acknowledge possible bias in the data, 2) report results of serious complications that arise during capture, 3) report results of capturing medically compromised primates, and 4) report rates of primates falling to the ground.

https://ift.tt/2Cg8QEp

Effects of Tympanic Membrane Perforation on Middle Ear Transmission in Gerbil

Publication date: Available online 15 December 2018

Source: Hearing Research

Author(s): Glenna Stomackin, Stephanie Cipta, Timothy T. Jung, Glen K. Martin, Wei Dong

Abstract

Perforations of the tympanic membrane (TM) alter its structural and mechanical properties, thus resulting in a deterioration of sound transmission through the middle ear (ME), which presents itself clinically as a conductive hearing loss (CHL). The resulting CHL is proposed to be due to the loss of the pressure difference across the TM between the outer ear-canal space and the ME cavity, a hypothesis which has been tested with both theoretical and experimental approaches. In the past, direct experimental observations had been either from the ME input (umbo) or the output of the stapes, and were focused mainly on the low frequency region. However, there was little documentation providing a thorough picture of the influence of systematically increasing sizes of TM perforations on ME sound transmission from the input (i.e., pressure at the TM or motion of the umbo) to the output (pressure produced by the motion of the stapes). Our study explored ME transmission in gerbil under conditions of a normal, intact TM followed by the placement of mechanically-induced TM perforations ranging from miniscule to complete removal of the pars tensa, leaving the other parts of ME intact. Testing up to 50 kHz, variations of ME transmission were characterized in simultaneously measured tone induced pressure responses at the TM (P_TM), pressure responses in the scala vestibuli next to the stapes (P_SV), and velocity measurements of the umbo (V_umbo), as well as by detailed descriptions of sound transmission from the TM to the stapes, i.e., the umbo transfer function (TF), the transfer of the sound stimulus along the ossicular chain as found from the ratio of cochlear pressure to umbo motion, and ME pressure gain (MEPG). Our results suggested that increasing the size of TM perforations led to a reduction in MEPG, which appeared to be primarily due to the reduction in the effective/initial mechanical drive to the umbo, with a relatively smaller decrease of sound transfer along the ossicular chain. Expansion of the perforation more than 25% appeared to drastically reduce sound transmission through the ME, especially for the higher frequencies.

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Validity and reliability of an iPad with a three-dimensional camera for posture imaging

Publication date: Available online 15 December 2018

Source: Gait & Posture

Author(s): A. Agustsson, MK. Gislason, P. Ingvarsson, E. Rodby-Bousquet, Th Sveinsson

Abstract

Background

It is important to quantify a static posture to evaluate the need for and effectiveness of interventions such as physical management, physiotherapy, spinal orthosis or surgical treatment on the alignment of body segments. Motion analysis systems can be used for this purpose, but they are expensive, require a high degree of technical experience and are not easily accessible. A simpler method is needed to quantify static posture. Research objective: Assess validity and inter and intra rater reliability using an iPad with a 3-D camera to evaluate posture and postural deformity.

Method

A 3-D model of a lying posture, created using an iPad with a 3-D camera, was compared to a Qualisys motion analysis system of the same lying posture, the latter used as the gold standard. Markers on the trunk and the leg were captured by both systems, and results from distance and angle measurements were compared.

Results

All intra-class correlation coefficient values were above 0.98, the highest systematic error was 4.3 mm for length measurements and 0.2° for angle measurements. Significance: A 3-D model of a person, with markers on anatomical landmarks, created with an iPad with a 3-D camera, is a valid and reliable method of quantifying static posture.

Conclusion

An iPad with a 3-D camera is a relatively inexpensive, valid and reliable method to quantify static posture in a clinical environment.

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Dual-Laser Measurement and Finite Element Modeling of Human Tympanic Membrane Motion under Blast Exposure

Publication date: Available online 14 December 2018

Source: Hearing Research

Author(s): Shangyuan Jiang, Kyle Smith, Rong Z. Gan

Abstract

Hearing damage is one of most prevalent injuries in military personnel and civilians exposed to a blast. However, the mechanism of how the blast overpressure interacts with the tympanic membrane (TM) and impairs the peripheral auditory system still remains unclear. A 3D finite element (FE) model of the human ear has been developed to predict the blast overpressure transmission through the ear (Leckness et al, 2018), but the model needs to be further validated in TM response to blast pressure. This paper reports the first-ever approach using two laser Doppler vibrometers (LDVs) to measure the motion of the TM when the ear was exposed to a blast.

Five fresh human temporal bones were used in this study with a pressure sensor inserted near the TM to measure the pressure reaching the TM (P1). The temporal bone was mounted in a “head block” and exposed to blast at the overpressure around 35 kPa measured at the entrance of the ear canal (P0). The movements of the TM at the umbo and the “head block” were measured simultaneously by two LDVs and the exact motion of the TM was determined by subtracting the head block motion from the TM data. Results include that the maximum TM velocity was 12.62 ± 3.63 m/s (mean ± SD) and the displacement was 0.78 ± 0.26 mm. The peak-to-peak displacement normalized by the P0 pressure was 22.9 ± 6.6 μm/kPa. The frequency domain analysis indicated that the spectrum peaks were located at frequencies below 3 kHz. The TM motion was then compared with that calculated from the FE model of the human ear with the measured P0 pressure wave applied at the ear canal entrance. The FE model-derived TM displacement under blast overpressure was consistent with the experimental results. This study provides a new methodology to determine the behavior of the middle ear in response to blast overpressure. The experimental data are critical for validating the FE model of the human ear for blast wave transduction and understanding the TM damage induced by blast exposure.

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via IFTTT

Neural envelope tracking as a measure of speech understanding in cochlear implant users

Publication date: Available online 14 December 2018

Source: Hearing Research

Author(s): Eline Verschueren, Ben Somers, Tom Francart

Abstract

The speech envelope is essential for speech understanding and can be reconstructed from the electroencephalogram (EEG) recorded while listening to running speech. This so-called “neural envelope tracking” has been shown to relate to speech understanding in normal hearing listeners, but has barely been investigated in persons wearing cochlear implants (CI). We investigated the relation between speech understanding and neural envelope tracking in CI users.

EEG was recorded in 8 CI users while they listened to a story. Speech understanding was varied by changing the intensity of the presented speech. The speech envelope was reconstructed from the EEG using a linear decoder. Next, the reconstructed envelope was correlated with the envelope of the speech stimulus as a measure of neural envelope tracking which was compared to actual speech understanding.

This study showed that neural envelope tracking increased with increasing speech understanding in every participant. Furthermore behaviorally measured speech understanding was correlated with participant-specific neural envelope tracking results indicating the potential of neural envelope tracking as an objective measure of speech understanding in CI users. This could enable objective and automatic fitting of CIs and pave the way towards closed-loop CIs that adjust continuously and automatically to individual CI users.

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Validity and reliability of an iPad with a three-dimensional camera for posture imaging

Publication date: Available online 15 December 2018

Source: Gait & Posture

Author(s): A. Agustsson, MK. Gislason, P. Ingvarsson, E. Rodby-Bousquet, Th Sveinsson

Abstract

Background

It is important to quantify a static posture to evaluate the need for and effectiveness of interventions such as physical management, physiotherapy, spinal orthosis or surgical treatment on the alignment of body segments. Motion analysis systems can be used for this purpose, but they are expensive, require a high degree of technical experience and are not easily accessible. A simpler method is needed to quantify static posture. Research objective: Assess validity and inter and intra rater reliability using an iPad with a 3-D camera to evaluate posture and postural deformity.

Method

A 3-D model of a lying posture, created using an iPad with a 3-D camera, was compared to a Qualisys motion analysis system of the same lying posture, the latter used as the gold standard. Markers on the trunk and the leg were captured by both systems, and results from distance and angle measurements were compared.

Results

All intra-class correlation coefficient values were above 0.98, the highest systematic error was 4.3 mm for length measurements and 0.2° for angle measurements. Significance: A 3-D model of a person, with markers on anatomical landmarks, created with an iPad with a 3-D camera, is a valid and reliable method of quantifying static posture.

Conclusion

An iPad with a 3-D camera is a relatively inexpensive, valid and reliable method to quantify static posture in a clinical environment.

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Improved representation of ocean heat content in energy balance models

Abstract

Anomaly-diffusing energy balance models (AD-EBMs) are routinely employed to analyze and emulate the warming response of both observed and simulated Earth systems. We demonstrate a deficiency in common multi-layer as well as continuous-diffusion AD-EBM variants: They are unable to, simultaneously, properly represent surface warming and the vertical distribution of heat uptake. We show that this inability is due to the diffusion approximation. On the other hand, it is well understood that transport of water from the surface mixed layer into the ocean interior is achieved, in large part, by the process of ventilation—a process associated with outcropping isopycnals. We, therefore, start from a configuration of outcropping isopycnals and demonstrate how an AD-EBM can be modified to include the effect of ventilation on ocean uptake of anomalous radiative forcing. The resulting EBM is able to successfully represent both surface warming and the vertical distribution of heat uptake, and indeed, a simple four-layer model suffices. The simplicity of the models notwithstanding, the analysis presented and the necessity of the modification highlight the role played by processes related to the down-welling branch of global ocean circulation in shaping the vertical distribution of ocean heat uptake.

https://ift.tt/2GfSNu9

[Cochlear implant for elder patients over 75 years old].

Related Articles

[Cochlear implant for elder patients over 75 years old].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Oct 05;32(19):1477-1479

Authors: Song YS, Wang ZX, X J, Han SG, Wang W, Liu Y, Wang LE, Gong SS

Abstract
Objective: To evaluate the operation safety, hearing as well as speech results of cochlear implantation that were applied in patients over 75 years old. Method: A series of patients who were diagnosed as severe to profound sensorineural hearing loss and received cochlear implantation were admitted. The clinical data and rehabilitation effects of the patients who were over 75 years old were summarized. Result: During this period, in which 7(1.31%) patients aged over 75 at implantation. The age ranged from 75 to 88, with an average of 80 years old. All of the 7 patients received a safe operation under general anesthesia. No major or minor complications happened related to surgery and anesthesia. Only one 84 years old male patient suffered from a transient mild balance problem. Follow up were carried out regularly, ranging from 4-40 months. The average of categories of auditory performance and speech intelligibility rating is 4 and 5 respectively. Conclusion: The cochlear implant surgery and general anesthesia are safe for patients over 75 years old, and these patients can benefit from cochlear implantation.

PMID: 30550191 [PubMed]

from #Audiology via ola Kala on Inoreader https://ift.tt/2Ghny1H
via IFTTT

[Cochlear implant for elder patients over 75 years old].

Related Articles

[Cochlear implant for elder patients over 75 years old].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Oct 05;32(19):1477-1479

Authors: Song YS, Wang ZX, X J, Han SG, Wang W, Liu Y, Wang LE, Gong SS

Abstract
Objective: To evaluate the operation safety, hearing as well as speech results of cochlear implantation that were applied in patients over 75 years old. Method: A series of patients who were diagnosed as severe to profound sensorineural hearing loss and received cochlear implantation were admitted. The clinical data and rehabilitation effects of the patients who were over 75 years old were summarized. Result: During this period, in which 7(1.31%) patients aged over 75 at implantation. The age ranged from 75 to 88, with an average of 80 years old. All of the 7 patients received a safe operation under general anesthesia. No major or minor complications happened related to surgery and anesthesia. Only one 84 years old male patient suffered from a transient mild balance problem. Follow up were carried out regularly, ranging from 4-40 months. The average of categories of auditory performance and speech intelligibility rating is 4 and 5 respectively. Conclusion: The cochlear implant surgery and general anesthesia are safe for patients over 75 years old, and these patients can benefit from cochlear implantation.

PMID: 30550191 [PubMed]

from #Audiology via ola Kala on Inoreader https://ift.tt/2Ghny1H
via IFTTT

[Cochlear implant for elder patients over 75 years old].

Related Articles

[Cochlear implant for elder patients over 75 years old].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Oct 05;32(19):1477-1479

Authors: Song YS, Wang ZX, X J, Han SG, Wang W, Liu Y, Wang LE, Gong SS

Abstract
Objective: To evaluate the operation safety, hearing as well as speech results of cochlear implantation that were applied in patients over 75 years old. Method: A series of patients who were diagnosed as severe to profound sensorineural hearing loss and received cochlear implantation were admitted. The clinical data and rehabilitation effects of the patients who were over 75 years old were summarized. Result: During this period, in which 7(1.31%) patients aged over 75 at implantation. The age ranged from 75 to 88, with an average of 80 years old. All of the 7 patients received a safe operation under general anesthesia. No major or minor complications happened related to surgery and anesthesia. Only one 84 years old male patient suffered from a transient mild balance problem. Follow up were carried out regularly, ranging from 4-40 months. The average of categories of auditory performance and speech intelligibility rating is 4 and 5 respectively. Conclusion: The cochlear implant surgery and general anesthesia are safe for patients over 75 years old, and these patients can benefit from cochlear implantation.

PMID: 30550191 [PubMed]

from #Audiology via ola Kala on Inoreader https://ift.tt/2Ghny1H

Lack of Standard Definitions of Primary and Secondary (Non)responders After Primary Gastric Bypass and Gastric Sleeve: a Systematic Review

Abstract

Lack of standard definitions of primary and secondary (non)responders after RYGB and SG makes it impossible to compare the literature. The aim was to analyze the different definitions used. MEDLINE® was searched for literature published between 01-07-2014 and 01-07-2017 concerning (1) patients who received a primary RYGB or SG and (2) the outcomes of primary and secondary (non)responders. One hundred twelve out of 650 papers were eligible. Forty out of 47 papers described a definition of weight loss success. Sixty-seven out of 112 papers mentioned weight loss failure of which 42 described a definition, in total 23 different definitions. Weight regain was mentioned in 77 papers; only 21 papers provided a definition. The recent literature regarding definitions of these outcomes is highly inconsistent. To compare the literature international consensus is required.

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The effects of a 12-week jump rope exercise program on abdominal adiposity, vasoactive substances, inflammation, and vascular function in adolescent girls with prehypertension

Abstract

Introduction

Childhood obesity is strongly associated with cardiovascular disease (CVD) development. It is necessary to combat unfavorable outcomes of obesity at a young age by utilizing effective interventions, such as exercise.

Purpose

We sought to examine the effects of a jump rope exercise program on CVD risk factors, including body composition, vasoactive substances, inflammation, and vascular function in prehypertensive adolescent girls.

Methods

Forty girls (age 14–16) were recruited and randomly assigned to a jump rope exercise group (EX, n = 20) or control group (CON, n = 20). Body composition, nitrate and nitrite levels, endothelin-1 (ET-1), C-reactive protein (CRP), systolic blood pressure and diastolic blood pressure (SBP, DBP), and arterial stiffness were measured before and after 12 weeks.

Results

There were significant group by time interactions following the 12-week program for body composition (from 33.8 ± 3.6 to 30.2 ± 3.1%), central adiposity (from 86.4 ± 4 to 83.3 ± 5 cm), SBP (from 126 ± 3.3 to 120 ± 2.1 mmHg), and brachial-to-ankle pulse wave velocity (from 8.2 ± 1.0 to 7.4 ± 0.2 m/s). Nitrate/nitrite levels increased (from 54.5 ± 5.1 to 57.2 ± 5.2 µmol) along a reduction in CRP levels (from 0.5 ± 0.4 to 0.2 ± 0.1 mg/L). There were no significant changes in ET-1 (P = 0.22).

Conclusions

These findings indicate that jump rope exercise may be an effective intervention to improve these CVD risk factors in prehypertensive adolescent girls. Jumping rope is an easily accessible exercise modality that may have important health implications for CVD prevention in younger populations.

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Influence of biodegradation on the tensile and wear resistance properties of bio-derived CaCO 3 /epoxy composites

Abstract

This research work investigated the influence of palm kernel shell-derived calcium carbonate (CaCO₃) fillers and biodegradation on the tensile and wear properties of epoxy composites. CaCO₃ fillers were obtained from pulverised charred palm kernel shell (CPKS) particles. The composites contained between 2 wt.% and 20 wt.% of CaCO₃ fillers. The samples were characterised for microstructural examination, phase analysis, tensile, and wear properties. The results revealed that the composite samples possessed enhanced properties compared with the neat matrix due to the presence of CaCO₃ fillers. No particle debonding was observed on the fracture surfaces of the composite samples, which suggested that a strong interface existed between the fillers and the matrix. This could be attributed to the elimination of amorphous content from the CPKS particles during the pyrolysis process, which yielded highly crystalline CaCO₃. This was strongly supported by the XRD results. Furthermore, the effect of biodegradation on the composite properties was studied on the samples interred for 90 days in natural soil. Degradation increased as the fraction of CaCO₃ fillers increased due to the microbial degradation of CaCO₃ fillers and the investigated properties deteriorated as compared with samples that were not buried. It was concluded that bio-derived CaCO₃ fillers could function as reinforcement particles in an epoxy matrix and enhance its degradation when added in large quantities to the matrix.

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Computed tomographic colonography with a reduced dose of laxative using a novel barium sulfate contrast agent in Japan

Abstract

Purpose

To test the tagging efficacy, patient acceptability, and accuracy of computed tomographic colonography (CTC) with a reduced dose of laxative using a novel barium sulfate (BaSO₄) contrast agent.

Materials and methods

CTC followed by optical colonoscopy (OC) was performed on 73 patients with positive results in fecal occult blood tests. They were administrated a BaSO₄ suspension and a magnesium citrate solution for bowel preparation. Patients completed a questionnaire about the acceptability of bowel preparation. Tagging efficacy was estimated using a novel categorization system, which classified all segments into 8 categories. The accuracy of detecting protruded lesions ≥ 6 mm was calculated from the comparison of CTC and OC results, using the latter as a reference standard.

Results

Tagging efficacy was good in 77.3% of colonic segments where residue was observed. The acceptability of bowel preparation for CTC was significantly higher than that for OC. The sensitivity, specificity, and positive and negative predictive values were 0.778, 0.945, 0.824, and 0.929, respectively. All lesions ≥ 7 mm were successfully detected by CTC.

Conclusion

CTC with a reduced dose of laxative using a novel BaSO₄ contrast agent has a favorable tagging efficacy, patient acceptability, and accuracy.

https://ift.tt/2BhYqSO

Cancer control planning: self-assessment for pre-planning, development, implementation and evaluation of national cancer control plans

Abstract

The development of cancer control plans as a clearly defined concept began in the U.S. in the early 1990s. On an international level, the same concept has been described as "national cancer control planning" or national cancer control plan (NCCP) development and implementation. Recent efforts by the National Cancer Institute's Center for Global Health and its partners have increased international and country-level interest in NCCPs. Central to the development of these plans has been a need for countries to understand the crucial factors and foundational elements necessary to develop and successfully implement a national cancer plan. This article describes the process by which a tool developed by the International Cancer Control Partnership (ICCP) helps countries and international partners assess their efforts to develop and implement a NCCP.

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Systemic sclerosis induced by the use of cocaine: is there an association?

Abstract

The association between cocaine abuse and systemic sclerosis (SSc) is rarely described. Two new cases of this association are presented: two young adults, after using inhaled cocaine for a few years, were diagnosed with SSc. While a 24 year-old white female patient presented with diffuse SSc with multiple digital ulcers and scleroderma renal crisis (SRC), a 27 year-old male patient presented limited SSc with skin ulcers and digital gangrene, rapidly evolving to death due to massive intestinal hemorrhage. The authors performed a literature search and found only eight previously published cases. The clinical picture of these patients shows a predominance of vascular involvement, including multiple ulcers and SRC. There is no association with specific SSc autoantibodies. The concomitance of alcohol and other drugs abuse, as well as the presence of drug adulterers, complicates a clear understanding of the role of cocaine in SSc patients.

https://ift.tt/2Gk0Sy5

Systemic sclerosis induced by the use of cocaine: is there an association?

Abstract

The association between cocaine abuse and systemic sclerosis (SSc) is rarely described. Two new cases of this association are presented: two young adults, after using inhaled cocaine for a few years, were diagnosed with SSc. While a 24 year-old white female patient presented with diffuse SSc with multiple digital ulcers and scleroderma renal crisis (SRC), a 27 year-old male patient presented limited SSc with skin ulcers and digital gangrene, rapidly evolving to death due to massive intestinal hemorrhage. The authors performed a literature search and found only eight previously published cases. The clinical picture of these patients shows a predominance of vascular involvement, including multiple ulcers and SRC. There is no association with specific SSc autoantibodies. The concomitance of alcohol and other drugs abuse, as well as the presence of drug adulterers, complicates a clear understanding of the role of cocaine in SSc patients.

https://ift.tt/2Gk0Sy5

LARGE expression in different types of muscular dystrophies other than dystroglycanopathy

Abstract

Background

Alpha-dystroglycan (αDG) is an extracellular peripheral glycoprotein that acts as a receptor for both extracellular matrix proteins containing laminin globular domains and certain arenaviruses. An important enzyme, known as Like-acetylglucosaminyltransferase (LARGE), has been shown to transfer repeating units of -glucuronic acid-β1,3-xylose-α1,3- (matriglycan) to αDG that is required for functional receptor as an extracellular matrix protein scaffold. The reduction in the amount of LARGE-dependent matriglycan result in heterogeneous forms of dystroglycanopathy that is associated with hypoglycosylation of αDG and a consequent lack of ligand-binding activity. Our aim was to investigate whether LARGE expression showed correlation with glycosylation of αDG and histopathological parameters in different types of muscular dystrophies, except for dystroglycanopathies.

Methods

The expression level of LARGE and glycosylation status of αDG were examined in skeletal muscle biopsies from 26 patients with various forms of muscular dystrophy [Duchenne muscular dystrophy (DMD), Becker muscular dystrophy (BMD), sarcoglycanopathy, dysferlinopathy, calpainopathy, and merosin and collagen VI deficient congenital muscular dystrophies (CMDs)] and correlation of results with different histopathological features was investigated.

Results

Despite the fact that these diseases are not caused by defects of glycosyltransferases, decreased expression of LARGE was detected in many patient samples, partly correlating with the type of muscular dystrophy. Although immunolabelling of fully glycosylated αDG with VIA4–1 was reduced in dystrophinopathy patients, no significant relationship between reduction of LARGE expression and αDG hypoglycosylation was detected. Also, Merosin deficient CMD patients showed normal immunostaining with αDG despite severe reduction of LARGE expression.

Conclusions

Our data shows that it is not always possible to correlate LARGE expression and αDG glycosylation in different types of muscular dystrophies and suggests that there might be differences in αDG processing by LARGE which could be regulated under different pathological conditions.

https://ift.tt/2rCikDu

Residential Mobility and Flourishing Among United States School-Age Children, 2011/2012 National Survey of Children’s Health

Abstract

Objectives To investigate the association of residential mobility with flourishing among school-age children. Methods Data from the 2011/2012 National Survey of Children's Health were used to examine parent/caregiver-reported information on flourishing and residential mobility for children age 6–17 (N = 63,333). Residential mobility was the number of times the child moved categorized as: none, 1–2, and 3+. Children who were reported to show interest/curiosity, finish tasks, stay calm/in control, care about doing well in school, and do all homework were coded as flourishing. Sex-specific multivariable models were used to model the relative risk of mobility on flourishing. Interactions of mobility with age and poverty were tested. Results Among US school-age children, 22% had no moves, 39% had 1–2 moves and 39% had 3+ moves in their lifetime. Nearly half (45%) were flourishing. Both boys and girls who moved 3+ times were less likely to flourish compared to children with no moves. Among poor boys moving 3+ times was associated with less flourishing (aRR 0.83, 95% CI 0.71, 0.98) with no association for non-poor boy. Among girls the pattern was reversed (aRR 0.88, 95% CI 0.81, 0.95 for non-poor girls and no association for poor girls). Conclusions for Practice Residential mobility may lead to lower rates of flourishing. The patterns, when stratified by age or poverty, are different for boys and girls.

https://ift.tt/2UNAjnP

Residential Mobility and Flourishing Among United States School-Age Children, 2011/2012 National Survey of Children’s Health

Abstract

Objectives To investigate the association of residential mobility with flourishing among school-age children. Methods Data from the 2011/2012 National Survey of Children's Health were used to examine parent/caregiver-reported information on flourishing and residential mobility for children age 6–17 (N = 63,333). Residential mobility was the number of times the child moved categorized as: none, 1–2, and 3+. Children who were reported to show interest/curiosity, finish tasks, stay calm/in control, care about doing well in school, and do all homework were coded as flourishing. Sex-specific multivariable models were used to model the relative risk of mobility on flourishing. Interactions of mobility with age and poverty were tested. Results Among US school-age children, 22% had no moves, 39% had 1–2 moves and 39% had 3+ moves in their lifetime. Nearly half (45%) were flourishing. Both boys and girls who moved 3+ times were less likely to flourish compared to children with no moves. Among poor boys moving 3+ times was associated with less flourishing (aRR 0.83, 95% CI 0.71, 0.98) with no association for non-poor boy. Among girls the pattern was reversed (aRR 0.88, 95% CI 0.81, 0.95 for non-poor girls and no association for poor girls). Conclusions for Practice Residential mobility may lead to lower rates of flourishing. The patterns, when stratified by age or poverty, are different for boys and girls.

https://ift.tt/2UNAjnP

Vitamin D Supplements Don’t Reduce Cancer Incidence

Vitamin D Supplements Don't Reduce Cancer Incidence, Trial Shows
12/13/2018
	In the largest-ever randomized trial testing vitamin D for cancer prevention, the supplement did not lower the risk of developing cancer. The Vitamin D and Omega-3 Trial (VITAL) includes a nationally representative sample of nearly 26,000 participants.