Architecture of the nervous system in metacercariae of Diplostomum pseudospathaceum Niewiadomska, 1984 (Digenea)

Abstract

The development of metacercariae of Diplostomum pseudospathaceum Niewiadomska, 1984 is accompanied by profound morphological transformations often characterized as metamorphosis, which makes these metacercariae an interesting case for studying the morphogenesis of the digenean nervous system. Although the nervous system of D. pseudospathaceum is one of the most extensively studied among digeneans, there are still gaps in our knowledge regarding the distribution patterns of some neuroactive substances, most notably neuropeptides. The present study addresses these gaps by studying pre-infective metacercariae of D. pseudospathaceum using immunochemical staining and confocal microscopy to characterize the distribution patterns of serotonin (5-HT) and two major groups of flatworm neuropeptides, FMRFamide-related (FaRPs) and substance P-related (SP) peptides. The general morphology of the nervous system was examined with antibodies to alpha-tubulin. The nervous system of the metacercariae was shown to conform to the most common morphology of the nervous system in the hermaphroditic generation, with three pairs of posterior nerve cords and four pairs of anterior nerves. The patterns of FaRP- and 5-HT immunoreactivity (IR) were similar to those revealed in earlier studies by cholinesterase activity, which is in accordance with the known role of these neurotransmitters in controlling muscle activity in flatworms. The SP-IR nervous system was significantly different and consisted of mostly bipolar cells presumably acting as mechanoreceptors. The architecture of the nervous system in D. pseudospathaceum metacercariae is discussed in comparison to that in cercariae of D. pseudospathaceum and metacercariae of related digenean species.

http://bit.ly/2ULmnKy

Quantitative proteomic characterization of lung tissue in idiopathic pulmonary fibrosis

Abstract

Background

Idiopathic pulmonary fibrosis (IPF) is a progressive, eventually fatal disease. IPF is characterized by excessive accumulation of the extracellular matrix (ECM) in the alveolar parenchyma and progressive lung scarring. The pathogenesis of IPF and whether the ECM involved in the process remain unknown.

Methods

To identify potential treatment target and ECM associated proteins that may be involved in the development of IPF, we employed isobaric tag for relative and absolute quantitation (iTRAQ) combined liquid chromatography–tandem mass spectrometry (LC–MS/MS) approach to examine protein expression in lung tissues from IPF patients.

Results

A total of 662 proteins with altered expression (455 upregulated proteins and 207 downregulated proteins) were identified in lung tissue of IPF patients compared with control. KEGG pathway enrichment analysis showed that the altered proteins in lung tissue mainly belonged to the PI3K-Akt signaling, focal adhesion, ECM-receptor interaction, and carbon metabolism pathways. According to the bioinformatic definition of the matrisome, 229 matrisome proteins were identified in lung tissue. These proteins comprised the ECM of lung, of which 104 were core matrisome proteins, and 125 were matrisome-associated proteins. Of the 229 ECM quantified proteins, 56 significantly differentially expressed proteins (19 upregulated proteins and 37 downregulated proteins) were detected in IPF lung tissue samples. In addition to proteins with well-known functions such as COL1A1, SCGB1A1, TAGLN, PSEN2, TSPAN1, CTSB, AGR2, CSPG2, and SERPINB3, we identified several novel ECM proteins with unknown function deposited in IPF lung tissue including LGALS7, ASPN, HSP90AA1 and HSP90AB1. Some of these differentially expressed proteins were further verified using Western blot analysis and immunohistochemical staining.

Conclusions

This study provides a list of proteomes that were detected in IPF lung tissue by iTRAQ technology combined with LC–MS/MS. The findings of this study will contribute better understanding to the pathogenesis of IPF and facilitate the development of therapeutic targets.

http://bit.ly/2RHiQeb

Plazomicin: A Novel Aminoglycoside for the Treatment of Resistant Gram-Negative Bacterial Infections

Abstract

Plazomicin is a novel semisynthetic parenteral aminoglycoside that inhibits bacterial protein synthesis. It was approved by the United States Food and Drug Administration for use in adults with complicated urinary tract infections (cUTI), including pyelonephritis. Plazomicin displays potent in vitro activity against Enterobacteriaceae, including both extended-spectrum β-lactamase-producing and carbapenem-resistant isolates. Plazomicin's enhanced Enterobacteriaceae activity is due to its stability to commonly encountered aminoglycoside-modifying enzymes that compromise the activity of traditional aminoglycosides. Plazomicin resistance in Enterobacteriaceae is via modification of the ribosomal binding site due to expression of 16S rRNA methyltransferases. Plazomicin does not display improved activity over traditional aminoglycosides against other problematic resistant Gram-negative bacteria, namely Pseudomonas aeruginosa and Acinetobacter baumannii. Plazomicin has been assessed in two phase III randomized controlled trials. The EPIC trial compared plazomicin and meropenem for the management of cUTI. In this trial, plazomicin demonstrated superiority in composite cure (81.7% vs 70.1%; difference 11.6%; 95% confidence interval [CI] 2.7–25.7) at the test-of-cure visit, which was driven by enhanced sustained microbiological eradication. The CARE trial compared plazomicin-based and colistin-based combinations in patients with serious infections due to carbapenem-resistant Enterobacteriaceae (CRE). In this analysis, plazomicin-based combinations were associated with numerically decreased mortality or serious disease-related complications when compared with colistin-based combinations (23.5% vs 50%, respectively; 90% CI −0.7 to 51.2). Furthermore, plazomicin was also associated with a lower incidence of nephrotoxicity than colistin. However, small sample sizes limit the interpretation of the findings in the CARE trial. Plazomicin is a novel aminoglycoside that offers clinicians an additional option for the management of CRE infections, with superior activity compared with traditional aminoglycosides and potentially improved efficacy and decreased toxicity compared with colistin.

http://bit.ly/2RHRcgX

Pilot Comparison of Adjustment Protocols of Personal Sound Amplification Products

Semin Hear 2019; 40: 026-036
DOI: 10.1055/s-0038-1676781

The Over-the-Counter Hearing Aid Act of 2017 was signed into law in August 2017 and facilitates the introduction of direct-to-consumer sales of hearing aids for adults with mild-to-moderate hearing loss. Among many questions surrounding over-the-counter sales is the ability of users to self-fit amplification. Many studies have conducted self-fitting procedures using guidance materials provided by audiologists. In this pilot, we explore the ability of users to self-adjust personal sound amplification devices using only materials provided by the manufacturer and contrast this with models that involve a hearing professional. Outcomes to assess adjustments included clinic-based speech-in-noise measures and ability to approximate NAL-NL2 prescriptive targets. We found that an audiologist-driven model provided the best outcomes. However, it is unknown if the difference is clinically meaningful.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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Novel Approaches to Fostering Hearing Loss Self-Management in Adults

Semin Hear 2019; 40: 003-006
DOI: 10.1055/s-0038-1677049

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Full text

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via IFTTT

Development and Formative Assessment of the Hearing Loss Toolkit for Self-Management

Semin Hear 2019; 40: 049-067
DOI: 10.1055/s-0038-1676783

Hearing aids are a demonstrated efficacious intervention for age-related hearing loss, and research suggests that good hearing loss self-management skills improve amplification satisfaction and outcomes. One way to foster self-management skills is through the provision of patient education materials. However, many of the available resources related to the management of hearing loss do not account for health literacy and are not suitable for use with adults from varying health literacy backgrounds. To address this issue, we developed the Hearing Loss Toolkit for Self-Management as part of a manualized, best practices hearing intervention used in large clinical trial. We incorporated health literacy recommendations from the U.S. Department of Health and Human Services, the Centers for Disease Control and Prevention, and the Agency for Healthcare Research and Quality in a series of modules that address a variety of common problem areas reported by adults with hearing loss. A formative assessment consisting of feedback questionnaires, semistructured interviews, and a focus group session with representatives from the target audience was conducted. Findings from the development assessment process demonstrate that the Hearing Loss Toolkit for Self-Management is suitable for use with adults with age-related hearing loss who have varying health literacy backgrounds and abilities.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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The Chronic Care Model and Chronic Condition Self-Management: An Introduction for Audiologists

Semin Hear 2019; 40: 007-025
DOI: 10.1055/s-0038-1676780

Hearing health care is biomedically focused, device-centered, and clinician-led. There is emerging evidence that these characteristics—all of which are hallmarks of a health care system designed to address acute, rather than chronic, conditions—may contribute to low rates of help-seeking and hearing rehabilitation uptake among adults with hearing loss. In this review, we introduce audiologists to the Chronic Care Model, an organizational framework that describes best-practice clinical care for chronic conditions, and suggest that it may be a viable model for hearing health care to adopt. We further introduce the concept of chronic condition self-management, a key component of chronic care that refers to the knowledge and skills patients use to manage the effects of a chronic condition on all aspects of daily life. Drawing on the chronic condition evidence base, we demonstrate a link between the provision of effective self-management support and improved clinical outcomes and discuss validated methods with which clinicians can support the acquisition and application of self-management skills in their patients. We examine the extent to which elements of chronic condition self-management have been integrated into clinical practice in audiology and suggest directions for further research in this area.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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via IFTTT

Translating Public Health Practices: Community-Based Approaches for Addressing Hearing Health Care Disparities

Semin Hear 2019; 40: 037-048
DOI: 10.1055/s-0038-1676782

Epidemiologic studies reveal disparities in hearing health care with lower prevalence of hearing aid use among older adults from racial/ethnic minority groups and lower socioeconomic positions. Recent national reports recommend exploring innovative delivery models to increase the accessibility and affordability of hearing health care, particularly for underserved and vulnerable populations. With an expected rise in the prevalence of age-related hearing loss over the next four decades due to a rapidly aging population, the condition is a growing public health imperative. This review describes key public health practices for developing and delivering community-based care that characterizes an emerging area of research in novel approaches of hearing loss management programs to reach underserved populations. With evolving technologies that enable care to extend beyond the clinic, adapting a long-utilized community health worker approach presents a strategy for the field of hearing health care to be actively involved in designing and leading initiatives for achieving hearing health equity. Principles from community-based participatory research offer a paradigm for the field to integrate into its research endeavors for addressing disparities. An interdisciplinary approach for engaging these challenges offers hearing health care researchers and providers an opportunity to advance the field and delivery of care.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader http://bit.ly/2GewqUU
via IFTTT

Evidence-Based Interventions for Adult Aural Rehabilitation: That Was Then, This Is Now

Semin Hear 2019; 40: 068-084
DOI: 10.1055/s-0038-1676784

More than a decade after Arthur Boothroyd published “Adult Aural Rehabilitation: What Is It and Does It Work?,” the four cornerstones of adult aural rehabilitation are re-examined in terms of research that we and others in the field have undertaken. The focus is on novel advances in high-quality research relating to interventions to support self-management for hearing aids and other listening devices (sensory management), knowledge and skill (instruction), auditory and cognitive training (perceptual training), and motivational engagement (counseling). Much of this new research has a theoretical underpinning (e.g., behavior change theory) to better guide the development and evaluation of interventions, with a focus on self-management and patient-centered approaches. New and emerging technologies that support e- and m-health delivery of interventions provide greater personalization and interactivity to promote self-management of hearing loss. Looking to the future, there remains a requirement for a set of relevant and appropriate outcome measures to evaluate the effectiveness of interventions trialed in clinical studies. There is a continuing need for high-quality evidence, underpinned by contemporary theory, to increase the likelihood that translational adult aural rehabilitation research that aims to benefit patients will be applied in future clinical practice.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader http://bit.ly/2DdxwMY
via IFTTT

Important Information Regarding Continuing Education Units for Seminars in Hearing through AAA and ASHA

Semin Hear 2019; 40: 001-002
DOI: 10.1055/s-0038-1679869

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Full text

from #Audiology via ola Kala on Inoreader http://bit.ly/2GaNB9X
via IFTTT

Pilot Comparison of Adjustment Protocols of Personal Sound Amplification Products

Semin Hear 2019; 40: 026-036
DOI: 10.1055/s-0038-1676781

The Over-the-Counter Hearing Aid Act of 2017 was signed into law in August 2017 and facilitates the introduction of direct-to-consumer sales of hearing aids for adults with mild-to-moderate hearing loss. Among many questions surrounding over-the-counter sales is the ability of users to self-fit amplification. Many studies have conducted self-fitting procedures using guidance materials provided by audiologists. In this pilot, we explore the ability of users to self-adjust personal sound amplification devices using only materials provided by the manufacturer and contrast this with models that involve a hearing professional. Outcomes to assess adjustments included clinic-based speech-in-noise measures and ability to approximate NAL-NL2 prescriptive targets. We found that an audiologist-driven model provided the best outcomes. However, it is unknown if the difference is clinically meaningful.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader http://bit.ly/2GcEmpR
via IFTTT

Novel Approaches to Fostering Hearing Loss Self-Management in Adults

Semin Hear 2019; 40: 003-006
DOI: 10.1055/s-0038-1677049

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Full text

from #Audiology via ola Kala on Inoreader http://bit.ly/2Da62Yy
via IFTTT

Development and Formative Assessment of the Hearing Loss Toolkit for Self-Management

Semin Hear 2019; 40: 049-067
DOI: 10.1055/s-0038-1676783

Hearing aids are a demonstrated efficacious intervention for age-related hearing loss, and research suggests that good hearing loss self-management skills improve amplification satisfaction and outcomes. One way to foster self-management skills is through the provision of patient education materials. However, many of the available resources related to the management of hearing loss do not account for health literacy and are not suitable for use with adults from varying health literacy backgrounds. To address this issue, we developed the Hearing Loss Toolkit for Self-Management as part of a manualized, best practices hearing intervention used in large clinical trial. We incorporated health literacy recommendations from the U.S. Department of Health and Human Services, the Centers for Disease Control and Prevention, and the Agency for Healthcare Research and Quality in a series of modules that address a variety of common problem areas reported by adults with hearing loss. A formative assessment consisting of feedback questionnaires, semistructured interviews, and a focus group session with representatives from the target audience was conducted. Findings from the development assessment process demonstrate that the Hearing Loss Toolkit for Self-Management is suitable for use with adults with age-related hearing loss who have varying health literacy backgrounds and abilities.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader http://bit.ly/2Gd8T6L
via IFTTT

The Chronic Care Model and Chronic Condition Self-Management: An Introduction for Audiologists

Semin Hear 2019; 40: 007-025
DOI: 10.1055/s-0038-1676780

Hearing health care is biomedically focused, device-centered, and clinician-led. There is emerging evidence that these characteristics—all of which are hallmarks of a health care system designed to address acute, rather than chronic, conditions—may contribute to low rates of help-seeking and hearing rehabilitation uptake among adults with hearing loss. In this review, we introduce audiologists to the Chronic Care Model, an organizational framework that describes best-practice clinical care for chronic conditions, and suggest that it may be a viable model for hearing health care to adopt. We further introduce the concept of chronic condition self-management, a key component of chronic care that refers to the knowledge and skills patients use to manage the effects of a chronic condition on all aspects of daily life. Drawing on the chronic condition evidence base, we demonstrate a link between the provision of effective self-management support and improved clinical outcomes and discuss validated methods with which clinicians can support the acquisition and application of self-management skills in their patients. We examine the extent to which elements of chronic condition self-management have been integrated into clinical practice in audiology and suggest directions for further research in this area.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader http://bit.ly/2DeQZgl
via IFTTT

Translating Public Health Practices: Community-Based Approaches for Addressing Hearing Health Care Disparities

Semin Hear 2019; 40: 037-048
DOI: 10.1055/s-0038-1676782

Epidemiologic studies reveal disparities in hearing health care with lower prevalence of hearing aid use among older adults from racial/ethnic minority groups and lower socioeconomic positions. Recent national reports recommend exploring innovative delivery models to increase the accessibility and affordability of hearing health care, particularly for underserved and vulnerable populations. With an expected rise in the prevalence of age-related hearing loss over the next four decades due to a rapidly aging population, the condition is a growing public health imperative. This review describes key public health practices for developing and delivering community-based care that characterizes an emerging area of research in novel approaches of hearing loss management programs to reach underserved populations. With evolving technologies that enable care to extend beyond the clinic, adapting a long-utilized community health worker approach presents a strategy for the field of hearing health care to be actively involved in designing and leading initiatives for achieving hearing health equity. Principles from community-based participatory research offer a paradigm for the field to integrate into its research endeavors for addressing disparities. An interdisciplinary approach for engaging these challenges offers hearing health care researchers and providers an opportunity to advance the field and delivery of care.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader http://bit.ly/2GewqUU
via IFTTT

Evidence-Based Interventions for Adult Aural Rehabilitation: That Was Then, This Is Now

Semin Hear 2019; 40: 068-084
DOI: 10.1055/s-0038-1676784

More than a decade after Arthur Boothroyd published “Adult Aural Rehabilitation: What Is It and Does It Work?,” the four cornerstones of adult aural rehabilitation are re-examined in terms of research that we and others in the field have undertaken. The focus is on novel advances in high-quality research relating to interventions to support self-management for hearing aids and other listening devices (sensory management), knowledge and skill (instruction), auditory and cognitive training (perceptual training), and motivational engagement (counseling). Much of this new research has a theoretical underpinning (e.g., behavior change theory) to better guide the development and evaluation of interventions, with a focus on self-management and patient-centered approaches. New and emerging technologies that support e- and m-health delivery of interventions provide greater personalization and interactivity to promote self-management of hearing loss. Looking to the future, there remains a requirement for a set of relevant and appropriate outcome measures to evaluate the effectiveness of interventions trialed in clinical studies. There is a continuing need for high-quality evidence, underpinned by contemporary theory, to increase the likelihood that translational adult aural rehabilitation research that aims to benefit patients will be applied in future clinical practice.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader http://bit.ly/2DdxwMY
via IFTTT

Important Information Regarding Continuing Education Units for Seminars in Hearing through AAA and ASHA

Semin Hear 2019; 40: 001-002
DOI: 10.1055/s-0038-1679869

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Full text

from #Audiology via ola Kala on Inoreader http://bit.ly/2GaNB9X
via IFTTT

Pilot Comparison of Adjustment Protocols of Personal Sound Amplification Products

Semin Hear 2019; 40: 026-036
DOI: 10.1055/s-0038-1676781

The Over-the-Counter Hearing Aid Act of 2017 was signed into law in August 2017 and facilitates the introduction of direct-to-consumer sales of hearing aids for adults with mild-to-moderate hearing loss. Among many questions surrounding over-the-counter sales is the ability of users to self-fit amplification. Many studies have conducted self-fitting procedures using guidance materials provided by audiologists. In this pilot, we explore the ability of users to self-adjust personal sound amplification devices using only materials provided by the manufacturer and contrast this with models that involve a hearing professional. Outcomes to assess adjustments included clinic-based speech-in-noise measures and ability to approximate NAL-NL2 prescriptive targets. We found that an audiologist-driven model provided the best outcomes. However, it is unknown if the difference is clinically meaningful.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader http://bit.ly/2GcEmpR

Novel Approaches to Fostering Hearing Loss Self-Management in Adults

Semin Hear 2019; 40: 003-006
DOI: 10.1055/s-0038-1677049

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Full text

from #Audiology via ola Kala on Inoreader http://bit.ly/2Da62Yy

Development and Formative Assessment of the Hearing Loss Toolkit for Self-Management

Semin Hear 2019; 40: 049-067
DOI: 10.1055/s-0038-1676783

Hearing aids are a demonstrated efficacious intervention for age-related hearing loss, and research suggests that good hearing loss self-management skills improve amplification satisfaction and outcomes. One way to foster self-management skills is through the provision of patient education materials. However, many of the available resources related to the management of hearing loss do not account for health literacy and are not suitable for use with adults from varying health literacy backgrounds. To address this issue, we developed the Hearing Loss Toolkit for Self-Management as part of a manualized, best practices hearing intervention used in large clinical trial. We incorporated health literacy recommendations from the U.S. Department of Health and Human Services, the Centers for Disease Control and Prevention, and the Agency for Healthcare Research and Quality in a series of modules that address a variety of common problem areas reported by adults with hearing loss. A formative assessment consisting of feedback questionnaires, semistructured interviews, and a focus group session with representatives from the target audience was conducted. Findings from the development assessment process demonstrate that the Hearing Loss Toolkit for Self-Management is suitable for use with adults with age-related hearing loss who have varying health literacy backgrounds and abilities.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader http://bit.ly/2Gd8T6L

The Chronic Care Model and Chronic Condition Self-Management: An Introduction for Audiologists

Semin Hear 2019; 40: 007-025
DOI: 10.1055/s-0038-1676780

Hearing health care is biomedically focused, device-centered, and clinician-led. There is emerging evidence that these characteristics—all of which are hallmarks of a health care system designed to address acute, rather than chronic, conditions—may contribute to low rates of help-seeking and hearing rehabilitation uptake among adults with hearing loss. In this review, we introduce audiologists to the Chronic Care Model, an organizational framework that describes best-practice clinical care for chronic conditions, and suggest that it may be a viable model for hearing health care to adopt. We further introduce the concept of chronic condition self-management, a key component of chronic care that refers to the knowledge and skills patients use to manage the effects of a chronic condition on all aspects of daily life. Drawing on the chronic condition evidence base, we demonstrate a link between the provision of effective self-management support and improved clinical outcomes and discuss validated methods with which clinicians can support the acquisition and application of self-management skills in their patients. We examine the extent to which elements of chronic condition self-management have been integrated into clinical practice in audiology and suggest directions for further research in this area.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader http://bit.ly/2DeQZgl

Translating Public Health Practices: Community-Based Approaches for Addressing Hearing Health Care Disparities

Semin Hear 2019; 40: 037-048
DOI: 10.1055/s-0038-1676782

Epidemiologic studies reveal disparities in hearing health care with lower prevalence of hearing aid use among older adults from racial/ethnic minority groups and lower socioeconomic positions. Recent national reports recommend exploring innovative delivery models to increase the accessibility and affordability of hearing health care, particularly for underserved and vulnerable populations. With an expected rise in the prevalence of age-related hearing loss over the next four decades due to a rapidly aging population, the condition is a growing public health imperative. This review describes key public health practices for developing and delivering community-based care that characterizes an emerging area of research in novel approaches of hearing loss management programs to reach underserved populations. With evolving technologies that enable care to extend beyond the clinic, adapting a long-utilized community health worker approach presents a strategy for the field of hearing health care to be actively involved in designing and leading initiatives for achieving hearing health equity. Principles from community-based participatory research offer a paradigm for the field to integrate into its research endeavors for addressing disparities. An interdisciplinary approach for engaging these challenges offers hearing health care researchers and providers an opportunity to advance the field and delivery of care.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader http://bit.ly/2GewqUU

Evidence-Based Interventions for Adult Aural Rehabilitation: That Was Then, This Is Now

Semin Hear 2019; 40: 068-084
DOI: 10.1055/s-0038-1676784

More than a decade after Arthur Boothroyd published "Adult Aural Rehabilitation: What Is It and Does It Work?," the four cornerstones of adult aural rehabilitation are re-examined in terms of research that we and others in the field have undertaken. The focus is on novel advances in high-quality research relating to interventions to support self-management for hearing aids and other listening devices (sensory management), knowledge and skill (instruction), auditory and cognitive training (perceptual training), and motivational engagement (counseling). Much of this new research has a theoretical underpinning (e.g., behavior change theory) to better guide the development and evaluation of interventions, with a focus on self-management and patient-centered approaches. New and emerging technologies that support e- and m-health delivery of interventions provide greater personalization and interactivity to promote self-management of hearing loss. Looking to the future, there remains a requirement for a set of relevant and appropriate outcome measures to evaluate the effectiveness of interventions trialed in clinical studies. There is a continuing need for high-quality evidence, underpinned by contemporary theory, to increase the likelihood that translational adult aural rehabilitation research that aims to benefit patients will be applied in future clinical practice.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from #Audiology via ola Kala on Inoreader http://bit.ly/2DdxwMY

Important Information Regarding Continuing Education Units for Seminars in Hearing through AAA and ASHA

Semin Hear 2019; 40: 001-002
DOI: 10.1055/s-0038-1679869

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Full text

from #Audiology via ola Kala on Inoreader http://bit.ly/2GaNB9X

Tropical peatlands under siege: the need for evidence-based policies and strategies

Abstract

It is widely known that tropical peatlands, including peat swamp forests (PSFs), provide numerous ecosystem services in both spatial and temporal dimensions. These include their role as large stores for organic carbon, which when not managed well could be released as carbon dioxide and methane, accelerating climate warming. Massive destruction and conversion of peatlands occur at an alarming rate in some regions. We hope that the lessons learned from those regions currently under siege from conversion can inform other regions that are at the precipice of mass conversion to agriculture. Much has been learned about high latitude, northern hemisphere peatlands but less is known about tropical peatlands. We collate, analyze, and synthesize the evidence revealed from the set of articles in this special issue. This special issue is a step forward, presenting new information generated from a considerable amount of field data collected from peatlands across the tropics in Asia, Africa, and Latin America. The hard data collected using comparable scientific methodologies are analyzed and compared with existing published data to form a larger dataset as scientific evidence. The synthesis is then interpreted to generate new knowledge to inform the policy community on how to strategize the sustainable management of tropical peatlands. Carbon (C) stocks in tropical peatland ecosystems can be as large as 3000 Mg C ha⁻¹, but the rate of loss is also phenomenal, causing substantial emissions of greenhouse gases of more than 20 Mg C ha⁻¹ year⁻¹. These losses have mainly taken place in Southeast Asia, particularly Indonesia, where peatland development for oil palm and pulpwood has accelerated over the past few decades. Although peatlands in the Amazon and Congo Basin are less developed, it is possible that the same unsustainable pathway would be followed in these regions, if lessons from the dire situation in Southeast Asia are not learned. Strong policies to halt further loss of tropical peatlands may be drawn up and combined with incentives that promote a global agenda under the United Nations Framework Convention on Climate Change 21st Conference of the Parties, Paris, France, Agreement. However, we also propose a framework to address national and local agendas that can be implemented under the nationally determined contributions (NDCs) by balancing conversion/development and conservation/restoration objectives.

http://bit.ly/2GqERvD

Effect of Copper Oxide Nanoparticles on the Physiology, Bioactive Molecules, and Transcriptional Changes in Brassica rapa ssp. rapa Seedlings

Abstract

Global deterioration of water, air, and soil quality by the release of toxic chemicals from anthropogenic pollutants is becoming a serious global problem. The extensive use of copper oxide nanoparticles (CuO NPs) can be environmentally hazardous when these NPs enter the atmosphere. The present study aimed to evaluate the role of CuO NPs on plant growth, photosynthetic capacity, and bioactive compounds, as well as their transcriptional level changes in Brassica rapa seedlings. Chlorophyll, carotenoid, and sugar content decreased, while proline and anthocyanins were significantly enhanced in the CuO NP-treated seedlings compared with the untreated controls. Reactive oxygen species (ROS), malondialdehyde (MDA), and hydrogen peroxide (H₂O₂) production were also enhanced in the seedlings exposed to CuO NPs, which could have caused DNA damage that was detected by a DNA laddering assay. The glucosinolate (GSL) and phenolic compound content were significantly increased in CuO NP-treated seedlings compared with that in control seedlings. Transcriptional variation of genes associated with oxidative stress (CAT, POD, and GST), R2R3-type MYB involved in GSL (BrMYB28, BrMYB29, BrMYB34, and BrMYB51), and phenolic compounds (ANS, PAP1, PAL, and FLS) biosynthesis was analyzed using real-time polymerase chain reaction. Significant upregulation of CAT, POD, GST, BrMYB28, BrMYB29, BrMYB34, BrMYB51, ANS, PAP1, PAL, and FLS genes was observed in seedlings exposed to different concentrations of CuO NPs relative to the untreated seedlings. Therefore, we suggest that the use of CuO NPs could stimulate the toxic effects and enhance phytochemicals (i.e., glucosinolates and phenolic compounds) in B. rapa.

http://bit.ly/2WMq0Bo

Evaluation of facial appearance in patients with repaired cleft lip and palate: comparing the assessment of laypeople and healthcare professionals

Abstract

Background

The present study aimed to determine whether laypeople and professionals rate the facial appearance of individuals with repaired complete unilateral or bilateral cleft lip and palate (UCLP, BCLP) similarly based on viewing full facial images.

Methods

The study followed a cross-sectional analytical design where five young patients aged 10 to 14 years, who had completed all stages of their unilateral or bilateral cleft lip and palate treatment (bilateral: three, unilateral: two), were evaluated by two groups. The assessment was done by laypeople and 97 qualified professionals (33 orthodontists, 32 plastic surgeons, and 32 oral and maxillofacial surgeons). Professionals were not involved in any stage of the patients' treatment.

Results

The facial appearance assessment of the professional groups on different facial aesthetics was significantly lower than that of laypeople, and they had higher perceived need for further treatment. On the other hand, laypeople had higher aesthetic ratings and lower perceived need for further treatment. Differences were also observed between the assessments of the professional groups. Participants who had lower aesthetic assessments of the repair tended to report a higher influence of cleft lip and palate on social activities and professional life.

Conclusion

Differences in perception exist between healthcare professionals and laypeople. The discrepancies between the professional groups could be attributed to different treatment modalities and protocols.

http://bit.ly/2RJB2Uk

Predictive factors for exacerbation and re-exacerbation in chronic obstructive pulmonary disease: an extension of the Cox model to analyze data from the Swiss COPD cohort

Abstract

Background

The Swiss COPD cohort was established in 2006 to collect data in a primary care setting. The objective of this study was to evaluate possible predictive factors for exacerbation and re-exacerbation.

Methods

In order to predict exacerbation until the next visit based on the knowledge of exacerbation since the last visit, a multistate model described by Therneau and Grambsch was performed.

Results

Data of 1,247 patients (60.4% males, 46.6% current smokers) were analyzed, 268 (21.5%) did not fulfill spirometric diagnostic criteria for COPD. Data of 748 patients (63% males, 44.1% current smokers) were available for model analysis. In order to predict exacerbation an extended Cox Model was performed. Mean FEV₁/FVC-ratio was 53.1% (±11.5), with a majority of patients in COPD GOLD classes 2 or 3. Hospitalization for any reason (HR1.7; P = 0.04) and pronounced dyspnea (HR for mMRC grade four 3.0; P < 0.001) at most recent visit as well as prescription of short-acting bronchodilators (HR1.7; P < 0.001), inhaled (HR1.2; P = 0.005) or systemic corticosteroids (HR1.8; P = 0.015) were significantly associated with exacerbation when having had no exacerbation at most recent visit. Higher FEV₁/FVC (HR0.9; P = 0.008) and higher FEV₁ values (HR0.9; P = 0.001) were protective. When already having had an exacerbation at the most recent visit, pronounced dyspnea (HR for mMRC grade 4 1.9; P = 0.026) and cerebrovascular insult (HR2.1; P = 0.003) were significantly associated with re-exacerbation. Physical activity (HR0.6; P = 0.031) and treatment with long-acting anticholinergics (HR0.7; P = 0.044) seemed to play a significant protective role. In a best subset model for exacerbation, higher FEV₁ significantly reduced and occurrence of sputum increased the probability of exacerbation. In the same model for re-exacerbation, coronary heart disease increased and hospitalization at most recent visit seemed to reduce the risk for re-exacerbation.

Conclusion

Our data confirmed well-established risk factors for exacerbations whilst analyzing their predictive association with exacerbation and re-exacerbation. This study confirmed the importance of spirometry in primary care, not only for diagnosis but also as a risk evaluation for possible future exacerbations.

Trial registration

Our study got approval by local ethical committee in 2006 (EK Nr. 170/06) and was registered retrospectively on ClinicalTrials.gov (NCT02065921, 19^th of February 2014).

http://bit.ly/2t3iNj0

Adsorption Behavior of Cobalt onto Saline Soil with/without a Biosurfactant: Kinetic and Isotherm Studies

Abstract

Cobalt (Co) adsorption onto saline soil was investigated in this study. The effect of pH, interaction time, and initial concentration of Co on adsorption were evaluated empirically to screen the appropriate operating conditions. Three biosurfactant products (i.e., surfactin, trehalose lipids, rhamnolipid) each at two concentrations (1 and 2 critical micelle concentrations (CMCs)) were applied during Co adsorption. The adsorption kinetic models were explored and results indicated that the pseudo-second-order kinetic model fit the experimental data the best. Four isotherms, including Langmuir, Freundlich, Temkin, and Redlich-Peterson were used for regulating the Co adsorption with and without the addition of each biosurfactant. The research results show that Co has low mobility even with the existence of a biosurfactant. The findings help to better understand the adsorption behaviour of Co in saline soil so as to develop applicable remediation options.

http://bit.ly/2DUltpm

A Two-Parametric Model for Gas Flow in Low-Permeable Porous Materials

Abstract

Capillary flow at low pressure gradients is determined by the pore structure of the matrix and the viscosity of the fluid. Traditionally, the conductivity of porous materials is characterized by a single parameter—the coefficient of permeability—which includes all geometric and structural resistances of the capillary structure. The fluid is described by its dynamic viscosity, which is independent of pressure in liquids. Gases, on the other hand, are highly compressible which means that their coefficient of permeability is becoming pressure dependent. The Klinkenberg effect takes account of this behaviour by introducing the notion of intrinsic permeability; nevertheless, it remains applicable only to a limited pressure range. At low- and high-pressure gradients, the Klinkenberg linearization deviates considerably from the real flow behaviour. This paper demonstrates that microporous capillary resistance to gas flow cannot be adequately described by a single material parameter. On the basis of ideal gas law conditions, the mass flow is derived by a two-parametric power law. Pore pressure decline is characterized by a permeability exponent n and a reference velocity v₁, replacing both dynamic viscosity of the fluid and permeability. The actual pressure distribution over the flow path is expressed by means of an equation of motion which leads to a logarithmic linearization of the material parameters. Velocity and acceleration vectors are derived and discussed in relation to the actual pressure distribution. The two parameters n and v₁ remain constant throughout and independent of pore pressure and are thus used to describe the flow rates over the entire pressure range. This model is then validated by means of flow analyses based on data given in the literature and compared to the classical theory of permeability.

http://bit.ly/2WFyz10

Objective assessment of WHO/ECOG performance status

Abstract

Purpose

Performance status is an important factor in determining quality of life, the choice of treatment, and prognostic tool in patients. All scoring systems currently in use measure the patient's performance subjectively. A new method of objective assessment of performance ECOG/WHO grades 2 and 3 was constructed and tested.

Methods

A performance meter—an adapted USB data logger with a mercury tilt switch—was constructed. The device was tested in a feasibility study on 33 residents of a retirement home. Parallel to the objective assessment, each resident gave their own estimate of their performance, and each resident was in turn assessed by the nursing staff.

Results

With the performance meter, 4 residents (12%) were assessed as PS ≥ 3 in comparison with 8 (24%) and 7 (21%) residents with an ECOG score ≥ 3 estimated by patients themselves and nursing staff respectively.

Conclusion

Subjective scoring—estimated by patients themselves and by nursing staff—showed underestimation of patients' performance. In 12% of patients, a better performance score was observed with objective measurement in comparison with subjective assessment. Performance meter could be a useful tool for health care professionals for type of care decisions.

http://bit.ly/2MPoMkq

Construction and Characterization of a Medium Copy Number Expression Vector Carrying Auto-Inducible dps Promoter to Overproduce a Bacterial Superoxide Dismutase in Escherichia coli

Abstract

Medium copy number expression vector and auto-inducible promoter could be a solution for producing recombinant therapeutic proteins in industrial scale regarding plasmid stability, cost, and product quality. This work aimed to construct a medium copy number pBR322-based expression vector carrying auto-inducible promoter, determine its ability to express heterologous gene, and study its segregational stability. Three stationary-phase promoters of Escherichia coli genes (gadA, dps and sbmC) were used to produce a superoxide dismutase from Staphylococcus equorum (rMnSODSeq) coding region from pBR322Δtet (pBR322-mini). Four plasmids were constructed with different promoters, i.e., T7 (pBMsod), gadA (pMCDsod), dps (pCADsod), and sbmC (pCDSsod) using pBR322-mini as backbone. Results showed that rMnSODSeq expression from pBMsod was significantly higher than that from pJExpress414sod (high copy number plasmid). Meanwhile, rMnSODSeq from pCADsod (auto-inducible promoter) was as high as from pBMsod (IPTG-inducible T7 promoter). rMnSODSeq expressed from pCADsod when bacterial cells entered stationary phase appeared as an active protein band of 23.5 kDa when analyzed by zymography and SDS-PAGE. pCADsod displayed the highest stability compared with pBMsod and pJEXpress414sod by plasmid retention assay. We demonstrate the use of an auto-inducible dps promoter to express high level of heterologous protein, an SOD of S. equorum, from a stable expression vector with medium copy number.

http://bit.ly/2Gp7hq4

Correction to: Adsorption, Kinetics and Equilibrium Studies on Removal of Catechol and Resorcinol from Aqueous Solution Using Low-Cost Activated Carbon Prepared from Sunflower ( Helianthus annuus ) Seed Hull Residues

In the original publication, the given name of the fourth author was mispelled as Adolp instead of Adolph. The correct name of the fourth author is Adolph Anga Muleja.

http://bit.ly/2DSUx9B

Therapeutic potential of menstrual blood-derived endometrial stem cells in cardiac diseases

Abstract

Despite significant developments in medical and surgical strategies, cardiac diseases remain the leading causes of morbidity and mortality worldwide. Numerous studies involving preclinical and clinical trials have confirmed that stem cell transplantation can help improve cardiac function and regenerate damaged cardiac tissue, and stem cells isolated from bone marrow, heart tissue, adipose tissue and umbilical cord are the primary candidates for transplantation. During the past decade, menstrual blood-derived endometrial stem cells (MenSCs) have gradually become a promising alternative for stem cell-based therapy due to their comprehensive advantages, which include their ability to be periodically and non-invasively collected, their abundant source material, their ability to be regularly donated, their superior proliferative capacity and their ability to be used for autologous transplantation. MenSCs have shown positive therapeutic potential for the treatment of various diseases. Therefore, aside from a brief introduction of the biological characteristics of MenSCs, this review focuses on the progress being made in evaluating the functional improvement of damaged cardiac tissue after MenSC transplantation through preclinical and clinical studies. Based on published reports, we conclude that the paracrine effect, transdifferentiation and immunomodulation by MenSC promote both regeneration of damaged myocardium and improvement of cardiac function.

http://bit.ly/2WLnUBM

Is there a causal relationship between obstructive sleep apnea and the pathophysiology of intracranial aneurysm?

Abstract

Rupture of an intracranial aneurysm (IA) leads to a rare subtype of intracranial bleeding, i. e., subarachnoid hemorrhage (SAH). However, SAH is associated with high long-term morbidity and mortality. Risk factors for the development and rupture of IA include modifiable factors, i. e., smoking and arterial hypertension. Symptoms of obstructive sleep apnea (OSA) are commonly reported following the rupture of an IA. The purpose of this review is to summarize the currently available evidence on the prevalence and effect of OSA in patients with IA. With an exploratory intent, we further identified potential mechanisms by which OSA might promote the development, growth, and rupture of IA.

http://bit.ly/2BmNG6C

Assessment of ability to drive in obstructive sleep apnea patients using a driving simulator

Abstract

Excessive daytime sleepiness, as a cardinal symptom of obstructive sleep apnea, leads to a reduced ability to drive, particularly among professional drivers. Alongside test procedures used in sleep medicine such as the Multiple Sleep Latency Test (MSLT) and Maintenance of Wakefulness Test (MWT), driving simulators that provide realistic simulation of road traffic can also be used to diagnose performance. The aim of this study was to use reaction time in a driving simulator as an indicator of the ability to drive in patients with obstructive sleep apnea.

http://bit.ly/2Tw1UsQ

Endophyte-mediated synthesis of silver nanoparticles and their biological applications

Abstract

Biosynthesis has emerged as a frontier technology for fabrication of functionally diverse nanoparticles that possess tremendous therapeutic implications. Various biological resources have already demonstrated their potential to produce nanoparticles with interesting features. Endophytic microbes live in a symbiotic relationship with plants possessing a unique and versatile reservoir of potentially therapeutic secondary metabolites having the tendency to reduce metallic ions into nanoparticles. Successful biosynthesis of AgNPs using endophytic organisms has already been reported; however, the overall picture about its synthesis and applications is still not clear. In the current article, a comprehensive review of literature was performed for comparing different physical and biological properties of endophytic microbe-derived AgNPs. In addition, the present paper mechanistically explains the synthesis of AgNPs and their diverse pharmacognostic properties. Further studies are encouraged to understand the mechanism of biopharmaceutical effects of these endophyte-mediated NPs.

http://bit.ly/2GsVeIp

Fast video encoding based on random forests

Abstract

Machine learning approaches have been increasingly used to reduce the high computational complexity of high-efficiency video coding (HEVC), as this is a major limiting factor for real-time implementations, due to the decision process required to find optimal coding modes and partition sizes for the quad-tree data structures defined by the standard. This paper proposes a systematic approach to reduce the computational complexity of HEVC based on an ensemble of online and offline Random Forests classifiers. A reduced set of features for training the Random Forests classifier is proposed, based on the rankings obtained from information gain and a wrapper-based approach. The best model parameters are also obtained through a consistent and generalizable method. The proposed Random Forests classifier is used to model the coding unit and transform unit-splitting decision and the SKIP-mode prediction, as binary classification problems, taking advantage from the combination of online and offline approaches, which adapts better to the dynamic characteristics of video content. Experimental results show that, on average, the proposed approach reduces the computational complexity of HEVC by 62.64% for the random access (RA) profile and 54.57% for the low-delay (LD) main profile, with an increase in BD-Rate of 2.58% for RA and 2.97% for LD, respectively. These results outperform the previous works also using ensemble classifiers for the same purpose.

http://bit.ly/2UFURhd

A fast coding method for distortion-free data hiding in high dynamic range image

Abstract

Reversible data hiding (RDH) technique allows the original cover to be lossless restored after the secret message is extracted, and high dynamic range (HDR) images are becoming more and more popular. We found that the existing RDH schemes for HDR image will cause serious stream expansion, which means that the storage size of the cover HDR image will expand. Noticing that we proposed a fast coding method named reverse-Golomb code for message embedding in all-zero cover to reduce the number of the alteration of pixel's status, and thus reduce the stream expansion of cover HDR images. The experimental results show the superiority of our method.

http://bit.ly/2S8XdZt

Morphological and molecular characterization of a new species Myxobolus gutturocola n. sp. (Myxozoa: Myxobolidae) from the throat of Hypophthalmichthys molitrix in China

Abstract

Myxobolus gutturocola n. sp. was isolated from the throat of silver carp, Hypophthalmichthys molitrix, in Chongqing, China. Myxospore valves are unsymmetrical and smooth. Mature spores are ellipsoidal in frontal view, measuring 12.5 ± 0.2 μm (n = 25) in length, 8.4 ± 0.2 μm (n = 25) in width and 7.1 ± 0.2 μm (n = 25) in thickness. Each spore has two pyriform and unequal sizes polar capsules, the large one with 5.7 ± 0.2 μm in length × 3.6 ± 0.2 μm in width and the small one with 4.6 ± 0.2 μm in length × 2.6 ± 0.1 μm in width. Polar filaments are coiled seven or eight turns in the large polar capsule and four or five turns in the small polar capsule. The coils are arranged almost perpendicularly to the longitudinal axis of the polar capsule. Morphological analysis revealed that M. gutturocola n. sp. is distinct from related species of Myxobolus Bütschli, 1882. Molecular analysis has demonstrated that its SSU rDNA sequences do not match with any available sequences in GenBank. Phylogenetic analysis of the SSU rDNA sequences indicated this species clustered in a clade composed exclusively of parasites infecting the fishes of the Leucisini lineage and most closely related to Myxobolus pavlovskii isolated from the gill filaments of silver carp in Hungary.

http://bit.ly/2t5ydDf

New sampling theorem and multiplicative filtering in the FRFT domain

Abstract

Having in consideration a fractional convolution associated with the fractional Fourier transform (FRFT), we propose a novel reconstruction formula for bandlimited signals in the FRFT domain without using the classical Shannon theorem. This may be considered the main contribution of this work, and numerical experiments are implemented to demonstrate the effectiveness of the proposed sampling theorem. As a second goal, we also look for the designing of multiplicative filters. Indeed, we also convert the multiplicative filtering in FRFT domain to the time domain, which can be realized by fast Fourier transform. Two concrete examples are included where the use of the present results is illustrated.

http://bit.ly/2G7Y2eo

Ruminal Microbial Populations and Fermentation Characteristics in Beef Cattle Grazing Tropical Forage in Dry Season and Supplemented with Different Protein Levels

Abstract

We tested the hypothesis that supplementation with protein improves fermentation parameters without damaging the rumen microbial populations of beef cattle grazing Urochloa brizantha cv. Marandu during the dry season. Four rumen-cannulated Nellore bulls (571 ± 31 kg of body weight) were used in a 4 × 4 Latin square design. The treatments were not supplemented with concentrate (only free-choice mineral salt ad libitum) and supplemented (supplements with low-LPSU, medium-MPS, and high protein supplement—HPS), supplying 155, 515, and 875 g/animal/day of crude protein (CP), respectively. The abundance of each target taxon was calculated as a fraction of the total 16S rRNA gene copies in the samples, using taxon-specific and domain bacteria primers. There was no difference (P > 0.05) across treatments for intakes of dry matter (DM), forage and neutral detergent fiber (NDF), digestibility of DM and NDF, and ruminal pH. Animals supplemented with concentrate had greater (P < 0.05) intakes and digestibility of CP, ether extract and non-fibrous carbohydrate contents of the substrates (EE + NFC), and ruminal ammonia nitrogen (RAN) compared to control. Bulls that received only mineral salt had lower proportions of Butyrivibrio fibrisolvens and had greater (P < 0.05) proportions of Fibrobacter succinogenes, Ruminococcus albus, Ruminococcus flavefaciens, Methanogen archaea than bulls supplemented with concentrate. The MPS animals had greater (P < 0.05) intake and digestibility of CP, RAN concentration, and had lower (P < 0.05) proportions of Fibrobacter succinogenes, Ruminococcus flavefaciens, and Selenomonas ruminantium than LPSU animals. The HPS provided higher (P < 0.05) intake of CP, RAN and proportion of Ruminococcus albus when compared with MPS. In conclusion, supply of 515 g/animal/day of protein via supplement provides better ruminal conditions for the growth of cellulolytic bacteria of bulls on pasture during dry season.

http://bit.ly/2Sy5dlQ

SOFA Score Can Effectively Predict the Incidence of Sepsis and 30-Day Mortality in Liver Transplant Patients: A Retrospective Study

Abstract

Introduction

This study aims to evaluate the early predictive value for postoperative sepsis and 30-day mortality in liver transplant patients using sequential organ failure assessment (SOFA).

Methods

A total of 96 liver transplant patients were enrolled into this study from February 2015 to June 2018. The general information, biochemical findings, and postoperative 30-day mortality of these patients were statistically analyzed.

Results

The SOFA scores, C-reactive protein (CRP), and procalcitonin (PCT) at postoperative day (POD) 3, 5, and 7 were significantly higher in the sepsis group than in the non-sepsis group, and the differences were statistically significant. Receiver operating characteristic (ROC) curve showed that SOFA scores at POD 1, 3, 5, and 7 had higher sensitivity and specificity in predicting the incidence of sepsis within 30 days. The difference in 30-day survival rate between patients with SOFA scores of > 5 and patients with SOFA scores of ≤ 5 at POD 1–7 was statistically significant (P < 0.05).

Conclusion

SOFA scores at POD 1–7 can effectively predict the incidence of sepsis and 30-day mortality in liver transplant patients on the basis of CRP and PCT.

http://bit.ly/2BlgtIF

A cross-sectional population-based survey looking at the impact of cancer survivorship care plans on meeting the needs of cancer survivors in the posttreatment stage

Abstract

Purpose

The purpose of this study was to determine the impact of receiving a survivorship care plan (SCP) on meeting cancer survivors' overall, informational, physical, emotional, and practical needs. Since the recommendation for implementation of SCPs, there have been numerous studies on their effectiveness with mostly inconclusive results.

Methods

All Nova Scotia survivors meeting specific inclusion and exclusion criteria were identified from the Nova Scotia Cancer Registry and sent the 83-item survey to assess experiences and needs across five domains (overall, informational, physical, emotional, and practical). Descriptive statistics (frequencies, percentages) and chi-square analyses were used to examine and report survey findings.

Results

The response rate was 44.6%, with 1514 respondents. SCPs were significantly associated (p < 0.00001) with receiving timely help and support to meet survivors' overall, informational, physical, emotional, and practical needs posttreatment. For the most part, survivors' clinical characteristics, such as cancer type, time since treatment, chronic comorbidities, and metastases, did not result in differences among the five outcomes.

Conclusions

Those who received a SCP reported higher agreement on all five outcomes in comparison to those who did not receive a SCP. Further work should evaluate the delivery of SCPs and the components of SCPs that are most likely to contribute to positive survivor outcomes.

http://bit.ly/2WKu7hl

Extra-parenchymal splenic abnormalities not vascular injury predict need for primary splenectomy

Abstract

Purpose

Radiographic indications for primary splenectomy (PS) in blunt splenic injury (BSI) after radiographic diagnosis are unknown. Improved understanding of radiographic characteristics of patients requiring splenectomy will help to appropriately triage patients to PS or non-operative management (NOM).

Methods

A retrospective, single-center review was performed of BSI diagnosed with computerized tomography (CT). Patients undergoing splenectomy prior to CT diagnosis were excluded.

Results

BSI was identified in 195 patients. On logistic regression, only subcapsular hematoma presence (OR 7.521, p = 0.002) and left upper quadrant hemoperitoneum (OR 6.146, p = 0.03) were associated with need for PS, while splenic laceration length, number of pseudoaneurysms (PSA), and active contrast extravasation (NS for all) were not.

Conclusions

Need for PS is predicted by extra-parenchymal pathology in subcapsular hematoma and hemoperitoneum. Splenic vascular injuries through PSA and active contrast extravasation do not predict the need for PS and can be considered for NOM.

http://bit.ly/2Gr3mc3

Sleep apnea and galectin-3: possible sex-specific relationship

Abstract

Purpose

Sleep apnea is associated with increased risk of cardiovascular disease. Elevated plasma galectin-3 levels, a biomarker associated with myocardial fibrosis, are also associated with adverse cardiovascular events, including heart failure. Our objective was to determine the relationship between severity of sleep apnea and plasma levels of galectin-3 and to determine whether this relationship was modified by sex.

Methods

We performed a cross-sectional study of 471 Mexican Americans from Starr County, TX who underwent an overnight, in-home sleep evaluation, and plasma measurement of galectin-3. Severity of sleep apnea was based on apnea hypopnea index (AHI). Multivariable linear regression modeling was used to determine the association between categories of sleep apnea and galectin-3. We also tested for interactions by sex.

Results

The mean age was 53 years, and 74% of the cohort was female. The prevalence of moderate to severe sleep apnea (AHI > 15 apnea–hypopnea events per hour) was 36.7%. Moderate to severe sleep apnea was associated with increased levels of galectin-3 in the entire population, but we identified a statistically significant interaction between galectin-3 levels and category of sleep apnea by sex (p for interaction = 0.02). Plasma galectin levels were significantly higher in women with moderate or severe sleep apnea than women with no/mild sleep apnea (multivariable adjusted p < 0.001), but not in men (p = 0.5).

Conclusions

Sleep apnea is associated elevated galectin-3 levels in women but not men. Our findings highlight a possible sex-specific relationship between sleep apnea and galectin-3, a biomarker of potential myocardial fibrosis that has been associated with increased cardiovascular risk.

http://bit.ly/2UICUid

Reliability of peak foot pressure in patients with previous diabetic foot ulceration

Publication date: Available online 4 February 2019

Source: Gait & Posture

Author(s): Pei-Yueng Lee, Pui-Wah Kong, Yong-Hao Pua

Abstract

Background

Previous reliability studies on peak plantar pressure measurements in patients with previous diabetic foot ulceration (DFU) did not stratify their analyses according to whether the foot had a previous ulcer.

Research question

Does test-retest reliability of peak foot pressure measurements from the various foot regions differ between the ulcerated and non-ulcerated feet?

Methods

Data from 23 participants with peripheral neuropathy and healed plantar DFU were analysed in this test-retest reliability comparison study. Plantar pressure was evaluated on two sessions using Pedar^®-X in-shoe system, with a mean of 7.2 days (SD = 1.6) between sessions.

Results

The intraclass correlation coefficient (ICC) and coefficient of variation (CV) were calculated for 10 foot regions. Overall, test-retest reliability was excellent (ICCs, 0.82 to 0.95) for all peak pressure variables. CV ranged between 6.3% and 18.3%, and exceeded 15% over the hallux and medial forefoot regions in the ulcer foot (18.3% and 16.4%, respectively). Hallux peak pressure CV was significantly higher over the ulcer foot than over the non-ulcer foot (5.7%, 95% CI, 1.7% to 10.2%). Peak pressure CV over the forefoot also tended to be higher over the ulcer foot (medial forefoot: 6.1%, 95% CI, -0.5% to 14.5%; lateral forefoot: 4.1%, 95%CI, -0.7% to 11.1%).

Significance

Peak plantar foot pressure may be useful to distinguish between groups of patients with peripheral neuropathy and healed plantar DFU. However, clinical decisions based on ulcer foot hallux and forefoot peak pressure measurements should be interpreted with caution.

from #Audiology via ola Kala on Inoreader http://bit.ly/2Typ95t
via IFTTT

Reliability of peak foot pressure in patients with previous diabetic foot ulceration

Publication date: Available online 4 February 2019

Source: Gait & Posture

Author(s): Pei-Yueng Lee, Pui-Wah Kong, Yong-Hao Pua

Abstract

Background

Previous reliability studies on peak plantar pressure measurements in patients with previous diabetic foot ulceration (DFU) did not stratify their analyses according to whether the foot had a previous ulcer.

Research question

Does test-retest reliability of peak foot pressure measurements from the various foot regions differ between the ulcerated and non-ulcerated feet?

Methods

Data from 23 participants with peripheral neuropathy and healed plantar DFU were analysed in this test-retest reliability comparison study. Plantar pressure was evaluated on two sessions using Pedar^®-X in-shoe system, with a mean of 7.2 days (SD = 1.6) between sessions.

Results

The intraclass correlation coefficient (ICC) and coefficient of variation (CV) were calculated for 10 foot regions. Overall, test-retest reliability was excellent (ICCs, 0.82 to 0.95) for all peak pressure variables. CV ranged between 6.3% and 18.3%, and exceeded 15% over the hallux and medial forefoot regions in the ulcer foot (18.3% and 16.4%, respectively). Hallux peak pressure CV was significantly higher over the ulcer foot than over the non-ulcer foot (5.7%, 95% CI, 1.7% to 10.2%). Peak pressure CV over the forefoot also tended to be higher over the ulcer foot (medial forefoot: 6.1%, 95% CI, -0.5% to 14.5%; lateral forefoot: 4.1%, 95%CI, -0.7% to 11.1%).

Significance

Peak plantar foot pressure may be useful to distinguish between groups of patients with peripheral neuropathy and healed plantar DFU. However, clinical decisions based on ulcer foot hallux and forefoot peak pressure measurements should be interpreted with caution.

from #Audiology via ola Kala on Inoreader http://bit.ly/2Typ95t
via IFTTT

Reliability of peak foot pressure in patients with previous diabetic foot ulceration

Publication date: Available online 4 February 2019

Source: Gait & Posture

Author(s): Pei-Yueng Lee, Pui-Wah Kong, Yong-Hao Pua

Abstract

Background

Previous reliability studies on peak plantar pressure measurements in patients with previous diabetic foot ulceration (DFU) did not stratify their analyses according to whether the foot had a previous ulcer.

Research question

Does test-retest reliability of peak foot pressure measurements from the various foot regions differ between the ulcerated and non-ulcerated feet?

Methods

Data from 23 participants with peripheral neuropathy and healed plantar DFU were analysed in this test-retest reliability comparison study. Plantar pressure was evaluated on two sessions using Pedar^®-X in-shoe system, with a mean of 7.2 days (SD = 1.6) between sessions.

Results

The intraclass correlation coefficient (ICC) and coefficient of variation (CV) were calculated for 10 foot regions. Overall, test-retest reliability was excellent (ICCs, 0.82 to 0.95) for all peak pressure variables. CV ranged between 6.3% and 18.3%, and exceeded 15% over the hallux and medial forefoot regions in the ulcer foot (18.3% and 16.4%, respectively). Hallux peak pressure CV was significantly higher over the ulcer foot than over the non-ulcer foot (5.7%, 95% CI, 1.7% to 10.2%). Peak pressure CV over the forefoot also tended to be higher over the ulcer foot (medial forefoot: 6.1%, 95% CI, -0.5% to 14.5%; lateral forefoot: 4.1%, 95%CI, -0.7% to 11.1%).

Significance

Peak plantar foot pressure may be useful to distinguish between groups of patients with peripheral neuropathy and healed plantar DFU. However, clinical decisions based on ulcer foot hallux and forefoot peak pressure measurements should be interpreted with caution.

from #Audiology via ola Kala on Inoreader http://bit.ly/2Typ95t

Hypertrophic pachymeningitis: idiopathic or secondary?

http://bit.ly/2WKzBcj

Intracranial arterial dolichoectasia and skull damage in a girl with Jaffe-Campanacci syndrome: a case report

Abstract

ᅟJaffe-Campanacci is a rare syndrome characterised by axillary freckles, multiple non-ossifying fibromas of the long bones and jaw, and café-au-lait spots, associated with some features of neurofibromatosis type 1 (NF1). Cherix et al. and Colby and Saul suggested that Jaffe-Campanacci syndrome (JCS) might be a distinct form of NF1. Intracranial arterial dolichoectasia (IADE) is defined as an increase in the length and diameter of at least one intracranial artery. Affected intracranial arteries are dilated, elongated and sometimes tortuous. But in this rare disease of JCS, neither skull damage nor IADE has been previously reported. Here, we introduce the case of an 11-year-old Chinese girl with IADE, skull damage and features of JCS.

http://bit.ly/2RCzLOR

On the functional compartmentalization of the normal middle ear. Morpho-histological modelling parameters of its mucosa.

Publication date: Available online 5 February 2019

Source: Hearing Research

Author(s): Simona Padurariu, Christof Röösli, Rasmus Røge, Allan Stensballe, Mogens Vyberg, Alex Huber, Michael Gaihede

Abstract

Background

Middle ear physiology includes both sound pressure transmission and homeostasis of its static air pressure. Pressure gradients are continuously created by gas exchange over the middle ear mucosa as well as by ambient pressure variations. Gas exchange models require actual values for regional mucosa thickness, blood vessel density, and diffusion distance. Such quantitative data have been scarce and limited to few histological samples from the tympanic cavity (TC) and the antrum. However, a detailed regional description of the morphological differences of the TC and mastoid air cell system (MACS) mucosa has not been available. The aim of the present study was to provide such parameters.

Methods

The study included sets of three histological H&E-slides from 15 archived healthy temporal bones. We performed a comparison of the mucosa morphology among the following regions: (1) anterior TC; (2) inferior TC; (3) posterior TC; (4) superior TC; (5) MACS antrum; (6) superior MACS; (7) central MACS; (8) inferior MACS.

Results

Regions (1) - (3), situated below the inter-attico-tympanic diaphragm, had the largest proportion of high respiratory epithelium, cilia and loose lamina propria within the mucosa, as well as the thickest mucosa and the largest diffusion distance. Regions (6) - (8), situated above the diaphragm, had the thinnest mucosa, the shortest distance to the blood vessels, together with the largest proportion of flat epithelium and very few cilia. Regions (4) - (5), still supradiaphragmatic, had intermediary values for these parameters, but generally closer to regions (6) - (8). The blood vessel density and the proportion of active mucosa were not significantly different among the regions.

Conclusion

Mucosa of regions (1), (2) and (3) represented a predominantly clearance-specific morphology, whereas in regions (4) - (8) it seemed adapted to gas exchange. However, the lack of statistically significant differences in blood vessel density and proportion of active mucosa indicated that all regions could be involved in gas exchange with the highest adaptation in the superior MACS. This pattern divides the middle ear functionally along the inter-attico-tympanic diaphragm rather than the anatomical division into TC and MACS.

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On the functional compartmentalization of the normal middle ear. Morpho-histological modelling parameters of its mucosa.

Publication date: Available online 5 February 2019

Source: Hearing Research

Author(s): Simona Padurariu, Christof Röösli, Rasmus Røge, Allan Stensballe, Mogens Vyberg, Alex Huber, Michael Gaihede

Abstract

Background

Middle ear physiology includes both sound pressure transmission and homeostasis of its static air pressure. Pressure gradients are continuously created by gas exchange over the middle ear mucosa as well as by ambient pressure variations. Gas exchange models require actual values for regional mucosa thickness, blood vessel density, and diffusion distance. Such quantitative data have been scarce and limited to few histological samples from the tympanic cavity (TC) and the antrum. However, a detailed regional description of the morphological differences of the TC and mastoid air cell system (MACS) mucosa has not been available. The aim of the present study was to provide such parameters.

Methods

The study included sets of three histological H&E-slides from 15 archived healthy temporal bones. We performed a comparison of the mucosa morphology among the following regions: (1) anterior TC; (2) inferior TC; (3) posterior TC; (4) superior TC; (5) MACS antrum; (6) superior MACS; (7) central MACS; (8) inferior MACS.

Results

Regions (1) - (3), situated below the inter-attico-tympanic diaphragm, had the largest proportion of high respiratory epithelium, cilia and loose lamina propria within the mucosa, as well as the thickest mucosa and the largest diffusion distance. Regions (6) - (8), situated above the diaphragm, had the thinnest mucosa, the shortest distance to the blood vessels, together with the largest proportion of flat epithelium and very few cilia. Regions (4) - (5), still supradiaphragmatic, had intermediary values for these parameters, but generally closer to regions (6) - (8). The blood vessel density and the proportion of active mucosa were not significantly different among the regions.

Conclusion

Mucosa of regions (1), (2) and (3) represented a predominantly clearance-specific morphology, whereas in regions (4) - (8) it seemed adapted to gas exchange. However, the lack of statistically significant differences in blood vessel density and proportion of active mucosa indicated that all regions could be involved in gas exchange with the highest adaptation in the superior MACS. This pattern divides the middle ear functionally along the inter-attico-tympanic diaphragm rather than the anatomical division into TC and MACS.

from #Audiology via ola Kala on Inoreader http://bit.ly/2Bkud6l

On the functional compartmentalization of the normal middle ear. Morpho-histological modelling parameters of its mucosa.

Publication date: Available online 5 February 2019

Source: Hearing Research

Author(s): Simona Padurariu, Christof Röösli, Rasmus Røge, Allan Stensballe, Mogens Vyberg, Alex Huber, Michael Gaihede

Abstract

Background

Middle ear physiology includes both sound pressure transmission and homeostasis of its static air pressure. Pressure gradients are continuously created by gas exchange over the middle ear mucosa as well as by ambient pressure variations. Gas exchange models require actual values for regional mucosa thickness, blood vessel density, and diffusion distance. Such quantitative data have been scarce and limited to few histological samples from the tympanic cavity (TC) and the antrum. However, a detailed regional description of the morphological differences of the TC and mastoid air cell system (MACS) mucosa has not been available. The aim of the present study was to provide such parameters.

Methods

The study included sets of three histological H&E-slides from 15 archived healthy temporal bones. We performed a comparison of the mucosa morphology among the following regions: (1) anterior TC; (2) inferior TC; (3) posterior TC; (4) superior TC; (5) MACS antrum; (6) superior MACS; (7) central MACS; (8) inferior MACS.

Results

Regions (1) - (3), situated below the inter-attico-tympanic diaphragm, had the largest proportion of high respiratory epithelium, cilia and loose lamina propria within the mucosa, as well as the thickest mucosa and the largest diffusion distance. Regions (6) - (8), situated above the diaphragm, had the thinnest mucosa, the shortest distance to the blood vessels, together with the largest proportion of flat epithelium and very few cilia. Regions (4) - (5), still supradiaphragmatic, had intermediary values for these parameters, but generally closer to regions (6) - (8). The blood vessel density and the proportion of active mucosa were not significantly different among the regions.

Conclusion

Mucosa of regions (1), (2) and (3) represented a predominantly clearance-specific morphology, whereas in regions (4) - (8) it seemed adapted to gas exchange. However, the lack of statistically significant differences in blood vessel density and proportion of active mucosa indicated that all regions could be involved in gas exchange with the highest adaptation in the superior MACS. This pattern divides the middle ear functionally along the inter-attico-tympanic diaphragm rather than the anatomical division into TC and MACS.

from #Audiology via ola Kala on Inoreader http://bit.ly/2Bkud6l
via IFTTT

Activation of SIRT1 by l -serine increases fatty acid oxidation and reverses insulin resistance in C2C12 myotubes ( l -serine activates SIRT1 in C2C12 myotubes)

Abstract

Silent information regulator 1 (SIRT1) is a nicotinamide adenine dinucleotide (NAD⁺)-dependent deacetylase, and the function is linked to cellular metabolism including mitochondrial biogenesis. Hepatic l-serine concentration is decreased significantly in fatty liver disease. We reported that the supplementation of the amino acid ameliorated the alcoholic fatty liver by enhancing l-serine-dependent homocysteine metabolism. In this study, we hypothesized that the metabolic production of NAD⁺ from l-serine and thus activation of SIRT1 contribute to the action of l-serine. To this end, we evaluated the effects of l-serine on SIRT1 activity and mitochondria biogenesis in C2C12 myotubes. l-Serine increased intracellular NAD⁺ content and led to the activation of SIRT1 as determined by p53 luciferase assay and western blot analysis of peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α) acetylation. l-Serine treatment increased the expression of the genes associated with mitochondrial biogenesis and enhanced mitochondrial mass and function. In addition, l-serine reversed cellular insulin resistance determined by insulin-induced phosphorylation of Akt and GLUT4 expression and membrane translocation. l-Serine-induced mitochondrial gene expression, fatty acid oxidation, and insulin sensitization were mediated by enhanced SIRT1 activity, which was verified by selective SIRT1 inhibitor (Ex-527) and siRNA directed to SIRT1. l-Serine effect on cellular NAD⁺ level is dependent on the l-serine metabolism to pyruvate that is subsequently converted to lactate by lactate dehydrogenase. In summary, these data suggest that l-serine increases cellular NAD⁺ level and thus SIRT1 activity in C2C12 myotubes.

http://bit.ly/2SaaQYc

Cotransport of Suspended Colloids and Nanoparticles in Porous Media

Abstract

The objective of this study is to develop a model for cotransport of colloids and nanoparticles (NPs) in porous media under two particle capture mechanisms. The particle capture rate is proportional to the capture probability, which is a function of retained concentration, called the filtration function. Laboratory bench-scale experiments of individual transport of NPs and colloidal-size kaolinite clay particles through packed columns produced breakthrough curves (BTCs) that monotonically increased with time and stabilised at some value lower than the injected concentration. We discuss the filtration function that corresponds to BTCs stabilising at the concentration lower than the injected value. This so-called binary filtration function incorporates two particle capture mechanisms. The analytical transport model with a binary filtration function was capable to fit successfully BTCs obtained from individual transport experiments using kaolinite and NPs conducted by Chrysikopoulos et al. (Transp Porous Med 119(1):181–204, 2017). Assuming that the electrostatic particle–solid matrix interaction and the fraction of the solid matrix surface area occupied by a single attached particle (kaolinite or NP) are the same for individual transport of either kaolinite particles or NPs and for simultaneous cotransport of kaolinite particles and NPs, the proposed binary filtration function was extended for the cotransport case. Although the breakthrough data from cotransport experiments with kaolinite particles and NPs have six degrees of freedom, the developed cotransport model successfully matches the BTCs by tuning two constants only. This validates the developed model for cotransport of two colloidal populations with different attachments and straining rates.

http://bit.ly/2ScqeTM

Observational study of newborn infant parasympathetic evaluation as a comfort system in awake patients admitted to a pediatric intensive care unit

Abstract

To compare the newborn infant parasympathetic evaluation system (NIPE) scores with a validated clinical scale using two different nebulizers in children with bronchiolitis admitted to a PICU. Comfort was evaluated using the COMFORT-behavior scale (CBS) before (T1), during (T2) and after (T3) each nebulization. In order to compare NIPE and CBS values during the whole T1 to T3 period, the variable Dif-CBS was defined as the difference between maximal and minimal CBS scores, and Dif-NIPE as the difference between 75th and 25th percentile NIPE values. Analyses were carried out, firstly for the total of nebulizations and secondly comparing two different nebulization systems: a jet nebulizer (JN) and a nebulizer integrated in high flow nasal cannulas (NHF). 84 nebulizations were recorded on 14 patients with a median [25th–75th percentile] age of 6 months (3.1–9.5). A Dif-CBS of 4 points (2–7), as well as changes in CBS scores between T1 and T2, defined the nebulization as a discomfort stimulus. The NIPE system, represented as the Dif-NIPE, showed a median variation of 9 points (7–10), and was poorly correlated to Dif-CBS [r_s 0.162 (P = 0.142)]. Discomfort during nebulization, assessed by CBS was greater with the JN system compared to NHF: 17 (13–22) vs 13 (9–15) (P = 0.001). NIPE monitoring detected no significant differences between both nebulization systems (P = 0.706). NIPE monitoring showed a variation in comfort during nebulization in the patient with bronchiolitis, though correlation with CBS was poor. Further research is required before NIPE can be suggested as a comfort monitoring system for the awake infant.

http://bit.ly/2WHu9XC

Acoustic Field of Phased-Array Ultrasound Transducer with the Focus/Foci Shifting

Abstract

Background

High-intensity focused ultrasound (HIFU) is becoming popular in the treatment of solid tumors because of its non-invasiveness with few complications. The acoustic field is of importance in evaluating the safe focus shifting distance and determining the treatment plan.

Methods

The propagation of finite-amplitude acoustic wave from a 331-element HIFU phased-array with focus steering along and transverse to the transducer axis and 4-foci shifting on the focal plane was simulated using the angular spectrum approach (ASA) with a marching second-order operator-splitting scheme. In addition, the acoustic field produced by a truncated asymmetric transesophageal HIFU annular array was also simulated, and the effects of driving frequency and the number of concentric rings were investigated.

Results

Because of the nonlinear effects, the peak negative pressure is lower than that of peak positive pressure at the main lobe but has a larger beam size. However, the peak positive and negative pressures at the grating lobe are quite similar. The effects of the focus shifting distances on the main and grating lobe (both acoustic pressure and − 6 dB beam size) were evaluated. With the focus shifting axially away from the transducer surface, the main lobe has decreased acoustic pressure by ~ 1.9 fold and increased beam size by ~ 4.5 fold while the grating lobe has the increased acoustic pressure by ~ 1.8 fold. The focus shifting laterally leads to the reduced pressure at the main lobe by ~ 1.4 fold but the slight decrease at the grating lobe by ~ 1.1 fold. In comparison, the shifting of multi-foci has similar influences on the main lobe but increases the pressure at the grating lobe. Driving frequency of annular array is found to have greater influences on the peak pressure and beam size.

Conclusion

Our algorithm can simulate the acoustic field of phased-array in arbitrary shape and optimize the transducer design, and the focus shifting distance and strategy should be selected appropriately for the safe HIFU exposure.

http://bit.ly/2RHpXDo

An exploratory clinical evaluation of a head-worn display based multiple-patient monitoring application: impact on supervising anesthesiologists’ situation awareness

Abstract

Purpose

Supervising anesthesiologists overseeing several operating rooms must be aware of the status of multiple patients, so they can consult with the anesthetist in single operating rooms or respond quickly to critical events. However, maintaining good situation awareness can be challenging when away from patient bedsides or a central monitoring station. In this proof-of-concept study, we evaluated the potential of a head-worn display that showed multiple patients' vital signs and alarms to improve supervising anesthesiologists' situation awareness.

Methods

Eight supervising anesthesiologists each monitored the vital signs of patients in six operating rooms for 3 h with the head-worn display, and for another 3 h without the head-worn display. In interviews with each anesthesiologist, we assessed in which situations the head-worn display was used and whether the continuous availability of the vital signs improved situation awareness. We also measured situation awareness quantitatively from six of the eight anesthesiologists, by instructing them to press a button whenever they noticed a patient alarm.

Results

The median number of patient alarms occurring was similar when the anesthesiologists monitored with the head-worn display (42.0) and without the head-worn display (40.5). However, the anesthesiologists noticed significantly more patient alarms with the head-worn display (66.7%) than without (7.1%), P = 0.028, and they reported improved situation awareness with the head-worn display. The head-worn display helped the anesthesiologists to perceive and comprehend patients' current status and to anticipate future developments. A negative effect of the head-worn display was its tendency to distract during demanding procedures.

Conclusions

Head-worn displays can improve supervising anesthesiologists' situation awareness in multiple-patient monitoring situations. The anesthesiologists who participated in the study expressed enthusiasm about monitoring patients with a head-worn display and wished to use and evaluate it further.

http://bit.ly/2UBlgNk

Assessment of the tau protein concentration in patients with tick-borne encephalitis

Abstract

There have been suggestions that tick-borne encephalitis (TBE) may cause neurodenenerative changes in the brain. The aim of this study was the assessment of the tau protein concentration in cerebrospinal fluid (CSF) of patients with different clinical forms of TBE. The concentration of tau protein in CSF was determined using Fujirebio tests (Ghent, Belgium) in 35 patients with TBE: group I—patients with meningitis (n = 16); group II—patients with meningoencephalitis (n = 19). None of the patients reported any neurodegenerative disorder that could affect the results of the study. The control group (CG) consisted of 10 patients in whom inflammatory process in central nervous system was excluded. Tau protein concentration in CSF before treatment did not differ significantly between the examined groups, while its concentration was significantly higher in encephalitis group than in CG after 14 days of treatment. Significant increase in tau protein concentration after treatment was observed in both examined groups. The comparison between the group of patients who fully recovered and patients who presented with persistent symptoms on discharge showed significant differences in tau protein concentration before and after treatment. ROC curve analysis indicates that CSF tau protein concentration before treatment may predict complicated course of the disease with 90.9% specificity and 80% sensitivity, while after treatment, specificity became 72.7% and 71.4% for sensitivity. Correlation analysis showed that in TBE patients (both meningoencephalitis and meningitis groups), CSF pleocytosis before treatment correlated negatively with tau protein concentration in CSF. (1) Neurodegeneration process is present in TBE encephalitis. (2) Tau protein concentration may be used as a predictor of complicated course of TBE.

http://bit.ly/2UHe1Dk