bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Directional Microphones in Bilateral/Bimodal Cochlear Implant Users—Impact of Spatial and Temporal Noise Characteristics
Authors: Weissgerber Tobias , Rader Tobias , Baumann Uwe
Published: November 2017

Objective:

To measure speech reception thresholds (SRTs) in co-located (S0N0) and diffuse noise conditions (multi-source noise field, MSNF) and to assess the impact of beamforming algorithms in MSNF in cochlear implant (CI) users.

Study Design:

Non-randomized, open, prospective study.

Setting:

Tertiary referral cochlear implantation center.

Patients:

Participants included 14 CI users (7 bimodal, 7 bilateral) and 14 normal hearing young adults.

Interventions:

Cochlear implantation.

Main Outcome Measures:

SRTs were assessed by means of a German matrix sentence test in either continuous or modulated noise. Loudspeakers were configured in two different conditions: S0N0 and MSNF (speech source in front, four speakers distributed at ±28.6 and ±151.4 degrees). In MSNF, the CI speech processor microphone was set in different directional sensitivity settings: standard (sub-cardioid), fixed (super-cardioid), and adaptive.

Results:

In continuous noise, SRTs of both CI groups were comparable. In modulated noise, bimodal CI users showed lower SRTs than bilateral CI group, but significant benefit from glimpsing was only demonstrated in normal hearing participants. All subject groups showed significant spatial release from masking (i.e., SRT improvement in MSNF compared with S0N0 condition) in continuous noise. A tendency of improved SRT (1 dB bimodal, 2 dB bilateral) with fixed and adaptive directional sensitivity was found which could not be statistically confirmed due to large between-subject variations.

Conclusions:

The absence of the glimpsing effect in CI users was reaffirmed in the present study. Although very effective in single noise source conditions, the beneficial impact of beamforming algorithms in multiple noise source conditions is poor.
Endoscopic Transcanal Transpromontorial Approach for Vestibular Schwannoma Resection: A Case Series
Authors: Wick Cameron C. , Arnaoutakis Demetri , Barnett Samuel L. , Rivas Alejandro , Isaacson Brandon
Published: November 2017

Objective:

To demonstrate successful surgical management of vestibular schwannomas via an exclusively endoscopic transcanal transpromontorial approach (EETTA).

Patients:

Four patients with vestibular schwannomas.

Interventions:

Surgical excision via EETTA.

Main Outcomes:

Technique refinements, tumor access, complete tumor removal, and patient morbidity.

Results:

Three tumors were Koos grade I and one tumor was Koos grade II. All ears had non-serviceable hearing prior to surgery. The EETTA enabled access to the internal auditory canal and porus acousticus as well as limited access to the cerebellopontine angle. Gross total tumor resection was achieved in all cases. There were no intraoperative or postoperative complications and the mean hospital duration was 2.8 days. After a mean follow-up of 5.0 months, all cases had a good facial nerve outcome.

Conclusions:

The EETTA can be successfully used for the management of small vestibular schwannomas in ears without serviceable hearing. Additional studies are needed to fully elucidate the risk-benefit profile of this minimally invasive approach.
Importance of Perimodiolar Electrode Position for Psychoacoustic Discrimination in Cochlear Implantation
Authors: Ramos Macias Angel , Perez Zaballos Maria Teresa , Ramos de Miguel Angel , Cervera Paz Javier
Published: November 2017

Hypothesis:

Modiolar proximity of the cochlear implant electrodes and low impedance values have a positive effect on electrical pitch discrimination.

Background:

The proximity of the cochlear electrode to the modiolar wall can determine changes in tissue and fluid environment. With the onset of soft-surgery techniques, the trauma caused during surgery has been reduced, minimizing fibrous growth.

Methods:

Computed tomography-scan measurements of electrode-inner wall distance and psychoacoustic electrode discrimination tests were done. Neural Response Telemery and impedance data were used in the study.

Results:

It was found that patients fitted with perimodiolar arrays have lower impedance values and smaller electrode-inner wall distances than those fitted with straight arrays. These variables were significantly correlated to electrode discrimination. It was found that a closer distance to the modiolus also results in better electrode discrimination.

Conclusion:

Perimodiolar electrodes could be a better solution in terms of pitch discrimination both because they are closer to the modiolus and because their impedance is lower.
Cochlear Implantation in Children With Congenital Unilateral Deafness: A Case Series
Authors: Beck Rainer Linus , Aschendorff Antje , Hassepaß Frederike , Wesarg Thomas , Kröger Stefanie , Jakob Till F. , Arndt Susan
Published: November 2017

Objectives:

Cochlear implant is regarded as a treatment option for hearing rehabilitation of adults with unilateral sensorineural hearing loss. A clear benefit has been experienced in regard to speech comprehension in noise, localization, and quality of life. The aim of this study was to investigate the benefit of cochlear implantation for children with congenital unilateral hearing loss.

Study Design:

Retrospective case series.

Setting:

Tertiary referral center; cochlear implant program.

Patients:

Ten children with congenital unilateral hearing loss.

Intervention:

After extensive consultation with the families and intensive counseling, the children received a cochlear implant.

Main Outcome Measures:

Categories of auditory performance, speech discrimination in open set, subjective assessment by Speech, Spatial and Qualities scale questionnaire.

Conclusion:

Eight of ten children use their cochlear implant consistently on a daily basis. Two children who were equipped with an implanted device at a later age tend to nonuse of the device. The evaluation of binaural hearing in small children is still difficult and methods have to be developed to allow objective assessment.
Analysis of Otologic Features of Patients With Primary Ciliary Dyskinesia
Authors: Takeuchi Kazuhiko , Kitano Masako , Sakaida Hiroshi , Usui Satoko , Masuda Sawako , Ogawa Satoru , Ikejiri Makoto , Nagao Mizuho , Fujisawa Takao , Nakatani Kaname
Published: November 2017

Objective:

To evaluate otologic features of primary ciliary dyskinesia (PCD), especially eardrum features, audiometric findings, and clinical course.

Study Design:

Retrospective patient review.

Setting:

Tertiary referral center.

Patients:

Fifteen patients (mean age, 16.9 years [range, 1–32 yr]; 8 males and 7 females) diagnosed with PCD at our university hospital in the last 12 years.

Intervention:

Diagnostic.

Main Outcome Measures:

Electron microscopy of nasal cilia, gene mutation analysis, endoscopy of 30 eardrums, pure-tone audiometry, and tympanometry.

Results:

All 15 patients showed ciliary ultrastructural abnormalities on electron microscopy and/or biallelic mutations in genes associated with ciliary function or structure. All 30 eardrums examined showed certain abnormalities. Fourteen patients had otitis media with effusion or its sequelae. The remaining patient had chronic otitis media. Pure-tone audiometry revealed the mean air conduction thresholds to be 25.0 and 26.4 dB in the right and left ears, respectively. In the ears with better hearing and worse hearing, the mean air conduction thresholds were 22.3 and 29.0 dB respectively.

Conclusion:

Otologic disease among patients with PCD essentially comprised otitis media with effusion, and the patients’ eardrums showed a variety of findings. Knowledge of these otologic features may lead to the early detection of PCD.
Effectiveness in Rehabilitation of Current Wireless CROS Technology in Experienced Bone-Anchored Implant Users
Authors: Snapp Hillary A. , Hoffer Michael E. , Liu Xuezhong , Rajguru Suhrud M.
Published: November 2017

Objective:

To compare the effectiveness of current contralateral routing of signal technology (CROS) to bone-anchored implants in experienced bone-anchored implant users with unilateral severe-profound sensorineural hearing loss.

Design:

Prospective, within-subject repeated-measures comparison study.

Setting:

Tertiary referral center.

Patients:

Adult, English-speaking patients (n = 12) with severe-profound unilateral sensorineural hearing loss implanted with a bone-anchored implant for the indication of single-sided deafness.

Intervention:

Subjects were fitted with contralateral routing of signal amplification and tested for speech in noise performance and localization error.

Outcome Measures:

Speech perception in noise was assessed using the BKB-SIN test materials. Localization was assessed using narrow band noises centered at 500 and 4000 Hz, as well as a broadband speech stimulus presented at random to the front hemifield by 19 speakers spatially separated by 10 degrees.

Results:

There was no improvement in localization ability in the aided condition and no significant difference in performance with CROS versus bone-anchored implants (BAI). There was a significant improvement in speech in noise performance for monaural listeners in the aided condition for speech poorer ear/noise better ear, speech front/noise front, and speech front/noise back. No significant difference was observed on performance with CROS versus BAI subjects.

Conclusion:

Contrary to earlier studies suggesting improved performance of BAIs over CROS, the current study found no difference in performance in BAI over CROS devices. Both CROS and BAI provide significant benefit for monaural listeners. The results suggest that noninvasive CROS solutions can successfully rehabilitate certain monaural listening deficits, provide improved hearing outcomes, and expand the reach of treatment in this population.
The prevalence and sociodemographic determinants of uninvestigated dyspepsia in the Czech Republic: a multicentre prospective study accomplished 10 years after the first study from the same geographical areas
Authors: Rejchrt Stanislav , Koupil Ilona , Kopáčová Marcela , Škodová Fendrichová Miluška , Seifert Bohumil , Voříšek Viktor , Špirková Jana , Douda Tomáš , Tachecí Ilja , Bureš Jan
Published: November 2017

Objective

The epidemiology of uninvestigated dyspepsia was studied in the Czech Republic for the first time in 2001. The aim of the current multicenter prospective study was to evaluate dyspepsia using the same methods in a representative sample of general unselected population from the same geographical areas 10 years later.

Participants and methods

A total of 38 147 individuals comprised the general population for a random two-step selection process. A total of 1836 participants (863 males and 973 females; aged 5–98 years) took part in the questionnaire-based study. Helicobacter pylori status was investigated in all participants by means of 13C-urea breath test.

Results

The overall prevalence of dyspepsia was 2.6% among children and adolescents aged 5–17 years and 16.0% among adults aged 18–98 years. We did not detect any statistically significant sex differences in the prevalence of total dyspepsia or its subtypes. Overall, 2.4% of H. pylori-negative children and adolescents aged less than 18 years reported dyspepsia, and 16.8% of H. pylori-negative adults reported it. Among H. pylori-positive children and adolescents and adults, dyspepsia was present in 8.3 and 15.8%, respectively. Type A dyspepsia (as the only long-lasting symptom) was statistically significantly associated with H. pylori status among children and adolescents. Among adults aged 18 years or older, we noted a lower prevalence of dyspepsia in adults with elementary education compared with university education. Current use of antibiotics was associated with an increased prevalence of dyspepsia in adults.

Conclusion

Despite the substantial decrease of H. pylori infection in the Czech Republic over the past 10 years, the prevalence and sociodemographic determinants of uninvestigated dyspepsia did not change significantly.
Expediting Drug Development for Pediatric Inflammatory Bowel Disease
Authors: Mulberg Andrew E. , Bousvaros Athos , Colletti Richard , Hyams Jeffrey , Lee Kerry Jo , Musaus Joachim , Robinson Anne M. , Rosh Joel , Saeed Shehzad , Taylor‐Zapata Perdita , Zuckerman Eric , Winter Harland S.
Published: November 2017

Lack of scientific consensus on efficacy endpoints and outcome assessments presents a hurdle for global drug development in pediatric inflammatory bowel disease (IBD). Multiple stakeholders participated in a meeting November 2015, sponsored by The Pediatric IBD Foundation, which is a 501c3 organization formed by parents of children with IBD whose mission is to improve the lives of children with Crohn disease and ulcerative colitis by supporting innovative research and educational programs (www.pedsibd.org). With representatives of the Food and Drug Administration, European Medicines Agency, pediatric gastroenterologists, and representatives of the pharmaceutical industry, this meeting was organized to harmonize present thinking about various aspects of global drug development in pediatric IBD. The meeting was designed to be interactive, allowing participants from the pharmaceutical industry, regulatory agencies, academia, and clinical practice an opportunity to collaborate in a public forum and to identify potential strategies to expedite drug evaluation in children.

Before the meeting, a questionnaire focused on the hurdles hindering approval of medications used to treat children with IBD was sent to all participants and other pediatric gastroenterologists in North America and Europe with expertise in IBD. Responses were reviewed by the steering committee and results presented at the meeting. Following the presentation of the survey, participants were divided into small groups composed of representatives from academia, industry, regulatory agencies, and members of the Pediatric IBD Foundation and assigned the task of working together to find solutions to the hurdles that had been identified.

Hurdles hindering approval included pediatric trials start later in the development process; lack of enrollment in pediatric trials; lack of monitoring safety registries that might expedite approval; different priorities among stakeholders.

This 1‐day meeting discussed how to expedite pediatric drug development in IBD therapy. Hurdles for achieving approvals of pediatric indications for treatments of IBD were identified.
Premature Infants have Lower Gastric Digestion Capacity for Human Milk Proteins than Term Infants
Authors: Demers‐Mathieu Veronique , Qu Yunyao , Underwood Mark A. , Borghese Robyn , Dallas David Charles
Published: November 2017

Objectives:

Whether premature infants have lower gastric protein digestive capacity than term infants and the extent to which human milk proteases contribute to overall gastric digestion are unknown and were investigated in this study.

Methods:

Human milk and infant gastric samples were collected from 16 preterm (24–32 wk gestational age) and 6 term (38–40 wk gestational age) mother–infant pairs within a range of 5 to 42 days postnatal age. For each pair, an aliquot of human milk was adjusted to pH 4.5 and incubated for 2 hours at 37 °C to simulate the gastric conditions without pepsin (milkinc). Their gastric protein digestion capacity was measured as proteolysis (free N‐terminals) and protease activities. Two‐way analysis of variance followed by Tukey post hoc test was applied to compare measurements between preterm and term infants as well as among human milk, milkinc, and gastric samples.

Results:

Measurements of gastric protein digestion were significantly lower in preterm infants than term infants. Overall milk protease activity did not differ between human milk samples from term‐ and preterm‐delivering mothers. As protease activity did not increase with simulated gastric incubation, milk proteases likely contributed minimally to gastric digestion.

Conclusions:

Preterm infants have lower gastric protein digestion capacity than term infants, which could impair nutrient acquisition. Human milk proteases contribute minimally to overall gastric digestion. The limited activity of milk proteases suggests that these enzymes cannot compensate for the premature infant's overall lower gastric protein digestion.
Prophylactic rtPA in the Prevention of Line‐associated Thrombosis and Infection in Short Bowel Syndrome
Authors: Malec Lynn M. , Cooper James , Rudolph Jeffrey , Michaels Marian G. , Ragni Margaret V.
Published: November 2017

Background:

Central venous access devices (CVADs) are essential for total parenteral nutrition administration in patients with short bowel syndrome (SBS). They are, however, fraught with complications including infection and venous thromboembolism (VTE), which increases associated morbidity and mortality in this population. There is evidence linking the development of CVAD‐associated thrombosis and line‐related infection. Thus, it has been postulated that prevention of catheter‐related clot formation could minimize the risk of infection originating from the catheter. Recombinant tissue plasminogen activator (rtPA, alteplase), lyses clots by binding plasmin‐bound fibrin in a clot and cleaving plasminogen to plasmin; moreover, it is widely used to clear occluded CVADs.

Methods:

Prophylactic rtPA lock therapy in children with SBS was evaluated as a single site pilot study to minimize line‐associated VTE, infection, need for line replacement, and hospitalization at the Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center. rtPA lock therapy was administered by parents/caregivers on a weekly basis over a 6‐month time period in place of heparin lock therapy. Comparisons were made between line‐associated complications in the cohort in the 6 months before study versus during the study period.

Results:

Six out of 8 subjects completed the study over a 1‐year time period. As a group, subjects experienced a significant decrease in the number of line‐associated bloodstream infections from a mean of 1.9 infections in the 6 months before the study to a mean of 0.5 infections (P = 0.025). There was no change in the need for line replacement amongst subjects while on study. The primary outcome of VTE was not found in the cohort, and it is unclear whether rtPA lock therapy contributed to the lack of thrombosis development. Given the success of rtPA in this pilot study in reducing bloodstream infections, further investigation or rtPA lock therapy in patients with SBS is warranted.
Case Report: Adenocarcinoma of the Lacrimal Gland Presenting as an Abduction Deficit
Authors: DeLuca Crystal L. , Zimmers Regina E.
Published: November 2017

SIGNIFICANCE

It is imperative to follow the clinical guidelines for abduction deficits to ensure prompt diagnosis of potentially serious etiologies and monitor only those in which a microvascular etiology is most likely. This case reports highlights a rare diagnosis of a malignant tumor of the lacrimal gland presenting as an abduction deficit.

PURPOSE

Tumors of the lacrimal gland can cause abduction deficits, which may mimic an abducens nerve palsy. Abducens nerve palsies are often encountered by optometrists. This case report highlights the appropriate workup of an abduction deficit and reviews the literature of adenocarcinoma not otherwise specified.

CASE REPORT

A 67-year-old white man was transferred to the optometry clinic with a presumed ischemic abducens palsy. He was found to have an isolated left abduction deficit without vascular risk factors that prompted neuroimaging revealing a mass of the lacrimal gland. After an en bloc resection, a diagnosis of adenocarcinoma not otherwise specified was made. The patient underwent aggressive surgical exenteration followed by radiation.

CONCLUSIONS

Using the guidelines for evaluation of an abduction deficit, this serious malignancy was diagnosed. An adenocarcinoma not otherwise specified of the lacrimal gland is rare, and there are limited data on its clinical course, prognosis, and treatment. Recurrence and metastases occur at high rates; therefore, prompt diagnosis and aggressive intervention are crucial.
Failure of Invasive Airway Placement on the First Attempt Is Associated With Progression to Cardiac Arrest in Pediatric Acute Respiratory Compromise*
Authors: Stinson Hannah R. , Srinivasan Vijay , Topjian Alexis A. , Sutton Robert M. , Nadkarni Vinay M. , Berg Robert A. , Raymond Tia T.
Published: November 2017

Objectives:

The aim of this study was to describe the proportion of acute respiratory compromise events in hospitalized pediatric patients progressing to cardiopulmonary arrest, and the clinical factors associated with progression of acute respiratory compromise to cardiopulmonary arrest. We hypothesized that failure of invasive airway placement on the first attempt (defined as multiple attempts at tracheal intubation, and/or laryngeal mask airway placement, and/or the creation of a new tracheostomy or cricothyrotomy) is independently associated with progression of acute respiratory compromise to cardiopulmonary arrest.

Design:

Multicenter, international registry of pediatric in-hospital acute respiratory compromise.

Setting:

American Heart Association’s Get with the Guidelines-Resuscitation registry (2000–2014).

Patients:

Children younger than 18 years with an index (first) acute respiratory compromise event.

Interventions:

None.

Measurements and Main Results:

Of the 2,210 index acute respiratory compromise events, 64% required controlled ventilation, 26% had return of spontaneous ventilation, and 10% progressed to cardiopulmonary arrest. There were 762 acute respiratory compromise events (34%) that did not require an invasive airway, 1,185 acute respiratory compromise events (54%) with successful invasive airway placement on the first attempt, and 263 acute respiratory compromise events (12%) with failure of invasive airway placement on the first attempt. After adjusting for confounding variables, failure of invasive airway placement on the first attempt was independently associated with progression of acute respiratory compromise to cardiopulmonary arrest (adjusted odds ratio 1.8 [95% CIs, 1.2–2.6]).

Conclusions:

More than 1 in 10 hospitalized pediatric patients who experienced an acute respiratory compromise event progressed to cardiopulmonary arrest. Failure of invasive airway placement on the first attempt is independently associated with progression of acute respiratory compromise to cardiopulmonary arrest.
Neutrophil Activation and Enhanced Release of Granule Products in HIV-TB Immune Reconstitution Inflammatory Syndrome
Authors: Nakiwala Justine K. , Walker Naomi F. , Diedrich Collin R. , Worodria William , Meintjes Graeme , Wilkinson Robert J. , Mayanja-Kizza Harriet , Colebunders Robert , Kestens Luc , Wilkinson Katalin A. , Lowe David M.
Published: November 2017

Background:

Tuberculosis immune reconstitution inflammatory syndrome (TB-IRIS) remains incompletely understood. Neutrophils are implicated in tuberculosis pathology but detailed investigations in TB-IRIS are lacking. We sought to further explore the biology of TB-IRIS and, in particular, the role of neutrophils.

Setting:

Two observational, prospective cohort studies in HIV/TB coinfected patients starting antiretroviral therapy (ART), 1 to analyze gene expression and subsequently 1 to explore neutrophil biology.

Methods:

nCounter gene expression analysis was performed in patients with TB-IRIS (n = 17) versus antiretroviral-treated HIV/TB coinfected controls without IRIS (n = 17) in Kampala, Uganda. Flow cytometry was performed in patients with TB-IRIS (n = 18) and controls (n = 11) in Cape Town, South Africa to determine expression of neutrophil surface activation markers, intracellular cytokines, and human neutrophil peptides (HNPs). Plasma neutrophil elastase and HNP1-3 were quantified using enzyme-linked immunosorbent assay. Lymph node immunohistochemistry was performed on 3 further patients with TB-IRIS.

Results:

There was a significant increase in gene expression of S100A9 (P = 0.002), NLRP12 (P = 0.018), COX-1 (P = 0.025), and IL-10 (P = 0.045) 2 weeks after ART initiation in Ugandan patients with TB-IRIS versus controls, implicating neutrophil recruitment. Patients with IRIS in both cohorts demonstrated increases in blood neutrophil count, plasma HNP and elastase concentrations from ART initiation to week 2. CD62L (L-selectin) expression on neutrophils increased over 4 weeks in South African controls whereas patients with IRIS demonstrated the opposite. Intense staining for the neutrophil marker CD15 and IL-10 was seen in necrotic areas of the lymph nodes of the patients with TB-IRIS.

Conclusions:

Neutrophils in TB-IRIS are activated, recruited to sites of disease, and release granule contents, contributing to pathology.
Are HIV Seroconversions Among Young Men Who Have Sex With Men Associated With Social Network Proximity to Recently or Long-Term HIV-Infected Individuals?
Authors: Morgan Ethan , Skaathun Britt , Duvoisin Rebeccah , Michaels Stuart , Schneider John A.
Published: November 2017

Debate remains as to the relative HIV transmission contributions from individuals who are recently HIV-infected and individuals who have long-term infections. In this study, we examine the relationship between new HIV seroconversions occurring among young black men who have sex with men and network proximity to recently or long-term HIV-infected individuals. A cohort of young black men who have sex with men (N = 618) was generated through respondent-driven sampling across 3 waves. A recent HIV infection was defined as either: (1) a confirmed seroconversion ≤9 months before interview date or (2) a laboratory confirmed acute infection; long-term HIV-infected individuals were defined as a diagnosis date ≥9 months before interview date. Respondent-driven sampling-weighted logistic regression was used to examine network proximity of HIV transmission events to HIV-infected individuals in the network. Within the cohort, 343 (55.5%) participants were identified as HIV seronegative at baseline. Of these, 33 (9.6%) seroconverted during the study period. The odds of seroconversion increased significantly with each additional recent HIV-infected individual in one's network [adjusted odds ratio = 12.96; 95% confidence interval: 5.69 to 29.50], but were not significantly altered by the number of long-term infected individuals in one's network. In addition, for each member of one's network who used pre-exposure prophylaxis, the odds of seroconversion decreased significantly (adjusted odds ratio = 0.44; 95% confidence interval: 0.20 to 0.96). Early diagnosis and treatment is a critical first step in the HIV care continuum and together with pre-exposure prophylaxis awareness and use are critical targets for disrupting the transmission of HIV through most at-risk networks.
18F-FDG PET/CT of Generalized Arteritis
Authors: Maffione Anna Margherita , Rampin Lucia , Grassetto Gaia , Marzola Maria Cristina , Chondrogiannis Sotirios , Rubello Domenico , Colletti Patrick M
Published: November 2017

A 75-year-old man presented with significant weight loss, persistent cough, single episode of frontotemporal pulsatile headache, and leg weakness. A paraneoplastic syndrome was suspected, and 18F-FDG PET/CT was performed. Diffuse, moderate-to-intense tracer symmetrical uptake of many large and medium arteries was unexpectedly noted. The peculiarity of this case is the extensive involvement of both large and medium head and neck and extremity vessels, whereas the aorta was relatively spared.
Solitary Orbital Metastasis in Carcinoma Esophagus
Authors: Mahajan Sonia , Dunphy Mark P. , Haque Sofia , Pandit-Taskar Neeta
Published: November 2017

Orbital metastasis is an uncommon and atypical presentation of recurrent esophageal cancer that has been only seldom reported in literature. 18F-FDG PET/CT is routinely performed for staging and response assessment in patients with esophageal carcinoma. This case demonstrates use of follow-up FDG PET/CT scans in characterizing solitary metastatic disease in orbit and in evaluating response to therapy. It also highlights a key teaching point that postradiation-related inflammatory/infective changes may interfere in accurate assessment of PET/CT scan; however, frequently used clinical and radiological correlation may not be entirely sufficient to rule out pathological involvement.
68Ga-DOTATATE Uptake in Ischemic Stroke
Authors: Vallée Émilie , Paquet Nancy , Buteau James Patrick , Turcotte Éric
Published: November 2017

A 76-year-old man known to have a pancreatic neuroendocrine tumor with hepatic and lymph nodes metastasis had a follow-up 68Ga-DOTATATE PET/CT before 177Lu-DOTATATE therapy. A new cerebral lesion expressing somatostatin receptors was discovered in the right temporal lobe, suggestive of an ischemic stroke territory. This was later confirmed from the hospital chart where an ischemic stroke was described a month ago.
Governments’ social media use for external collaboration
Authors: Wang Cancan , Medaglia Rony
Published: November 2017

Purpose

As social media technologies permeate public life, the current forms of collaboration between government and non-government stakeholders are changing. The purpose of this paper is to investigate how social media use reconfigures the organizing practices around such collaboration. A case study of a collaborative e-government project showcases how emergent organizing practices through external social media differ from existing ones along the dimensions of time, task, team and transition.

Design/methodology/approach

This paper presents a case study of a collaborative e-government project on open data, organized by Shanghai Municipality, local businesses, universities and non-governmental organizations, using an external social media platform, WeChat. Adopting the theoretical lens of temporary organization, the paper identifies the key aspects of change emerged in the organizing practices of this collaboration.

Findings

The findings outline how the use of external social media reconfigures the collaboration between government and non-government stakeholders along the four dimensions of time, task, team and transition. The new form of collaboration is reconfigured along the lines of (1) an ad hoc and non-linear management of time; (2) discursive task creation, assignment and engagement among stakeholders; (3) a serendipitous engagement of team members based on expertise; and (4) a shift in formal and informal organizing practices.

Originality/value

This paper provides insights on the use of external social media for collaboration in e-government research and develops the concept of temporary organization in a sociomaterial setting. It also provides practical suggestions on how to manage new forms of public projects leveraging on the capacity of external social media.
Are government employees adopting local e-government transformation?
Authors: Batara Enrique , Nurmandi Achmad , Warsito Tulus , Pribadi Ulung
Published: November 2017

Purpose

This study aims to examine the association of technology acceptance variables with the intention of adopting e-government transformation, as defined by four dimensions, namely, using new technology systems, redesigning of governmental processes, restructuring of governmental organization and changing the organizational culture and behavior, from the perspective of city government employees in Indonesia and the Philippines.

Design/methodology/approach

Quantitative approach was used in the conduct of this research. Variables were operationalized into indicators, which were transmuted into a self-reported survey questionnaire. Survey data obtained from purposively sampled city government employees were analyzed using structural equation modeling.

Findings

Findings suggest that attitude is a pivotal predictor of intention to adopt e-government transformation across all four dimensions, while performance expectancy, social influence and facilitating conditions also positively influence the intention to adopt process redesign, organizational structuring and cultural and behavioral change in the city government. Respondents’ length of work experience appears as a significant moderating variable.

Research limitations/implications

This study reports only on the findings from two cities in two countries, Surabaya in Indonesia and Davao in the Philippines. The determination of the sample size was done through purposive sampling, so the application of results should be done with prudence. The constructs used for the research model were chosen because of their prominence in the literature. This study made use of a simple linear regression model in hypothesizing the relationships of the constructs.

Practical implications

For e-government transformation to be adoptable and efficacious, supporting and facilitating conditions are necessary. Structural, technical and financial support, as well as legal framework, for local e-government transformation should be in place. Maintaining and sustaining the positive attitude toward it should be done.

Originality/value

Although many studies have been conducted on adoption of ICT-enabled government services from the citizens’ viewpoint, little has been done from the local government employees’ perspective, and no prior cross-country study has been made. This study fills those gaps in the e-government adoption literature. Further, this study has shown that technology acceptance variables’ roles as predictors of behavioral intention can be extended to other dimensions of e-government.
Plant community composition but not plant traits determine the outcome of soil legacy effects on plants and insects
Authors: Heinen Robin , van der Sluijs Martijn , Biere Arjen , Harvey Jeffrey A. , Bezemer T. Martijn
Published: November 2017

Plants leave species‐specific legacies in the soil they grow in that can represent changes in abiotic or biotic soil properties. It has been shown that such legacies can affect future plants that grow in the same soil (plant–soil feedback, PSF). Such processes have been studied in detail, but mostly on individual plants. Here, we study PSF effects at the community level and use a trait‐based approach both in the conditioning phase and in the feedback phase to study how 12 individual soil legacies influence six plant communities that differ in root size.

We tested if (1) grassland perennial species with large root systems would leave a stronger legacy than those with small root systems, (2) grass species would leave a more positive soil legacy than forbs, and (3) communities with large root systems would be more responsive than small‐rooted communities. We also tested (4) whether a leaf‐chewing herbivore and a phloem feeder were affected by soil legacy effects in a community framework.

Our study shows that the six different plant communities that we used respond differently to soil legacies of 12 different plant species and their functional groups. Species with large root systems did not leave stronger legacies than species with small root systems, nor were communities with large root systems more responsive than communities with root systems.

Moreover, we show that when communities are affected by soil legacies, these effects carry over to the chewing herbivore Mamestra brassicae (Lepidoptera: Noctuidae) through induced behavioural changes resulting in better performance of a chewing herbivore on forb‐conditioned soils than on grass‐conditioned soils, whereas performance of the phloem feeder Rhopalosiphum padi (Hemiptera: Aphididae) remained unaffected.

Synthesis. The results of this study shed light on the variability of soil effects found in previous work on feedbacks in communities. Our study suggests that the composition of plant communities determines to a large part the response to soil legacies. Furthermore, the responses to soil legacies of herbivores feeding on the plant communities that we observed, suggests that in natural ecosystems, the vegetation history may also have an influence on contemporary herbivore assemblages. This opens up exciting new areas in plant–insect research and can have important implications for insect pest management.
The Many Dimensions of Child Poverty: Evidence from the UK Millennium Cohort Study*
Authors: Dickerson Andrew , Popli Gurleen
Published: November 2017

In this paper, we use a multidimensional framework to characterise child poverty in the UK. We examine the interdependencies amongst the different dimensions of multidimensional poverty and the relationship between multidimensional poverty and income poverty. We also explore the links between multidimensional poverty, income poverty and children's cognitive and non‐cognitive development. Our findings suggest that multidimensional poverty identifies many but not all of the same children classified using standard income poverty measures. Approximately 20 per cent of children are classified as poor on one measure but not the other. Children in workless households and ethnic minority children face the highest odds of growing up in both multidimensional poverty and income poverty. We find similar levels of persistence in multidimensional poverty and income poverty, with 17 per cent (18 per cent) of children experiencing persistent multidimensional (income) poverty and 10 per cent of children experiencing both persistent multidimensional poverty and persistent income poverty. Multidimensional poverty (both episodic and persistent) also has a detrimental impact on children's development over and above the negative impact of income poverty.
Pilot study on preventing anastomotic leakage in stapled gastroesophageal anastomosis
Authors: Zhang Shijie , Huang Weiming , Liu Xiangzheng , Li Jian
Published: November 2017

Background

This study explored how to improve the surgical technique to reduce or avoid anastomotic leakage.

Methods

From January 2012 to December 2016, 101 consecutive patients with cancer of the esophagus or gastroesophageal junction underwent stapled gastroesophageal anastomosis. The procedure included creating a tube‐type stomach, fixing an inserted anvil, inspecting mucosa‐to‐mucosa alignment in the lumen under direct vision after firing the stapler, and, if found, manually repairing a rupture of the mucous membrane of the anastomosis.

Results

A rupture of the mucous membrane of the anastomosis was found in four out of the 101 patients and manually repaired. No postsurgical anastomotic leakage occurred. All patients recovered well and the average postoperative stay was 10.4 days. There was no mortality within 30 days after surgery.

Conclusion

It is critical to inspect the integrality of the luminal mucous membrane of the anastomosis under direct vision in order to prevent anastomotic leakage in surgical resection of esophageal and gastroesophageal junction malignancies.
SIRT3 deregulation is linked to mitochondrial dysfunction in Alzheimer's disease
Authors: Lee Junghee , Kim Yunha , Liu Tian , Hwang Yu Jin , Hyeon Seung Jae , Im Hyeonjoo , Lee Kyungeun , Alvarez Victor E. , McKee Ann C. , Um Soo‐Jong , Hur Manwook , Mook‐Jung Inhee , Kowall Neil W. , Ryu Hoon
Published: November 2017

Alzheimer's disease (AD) is the leading cause of dementia in the elderly. Despite decades of study, effective treatments for AD are lacking. Mitochondrial dysfunction has been closely linked to the pathogenesis of AD, but the relationship between mitochondrial pathology and neuronal damage is poorly understood. Sirtuins (SIRT, silent mating type information regulation 2 homolog in yeast) are NAD‐dependent histone deacetylases involved in aging and longevity. The objective of this study was to investigate the relationship between SIRT3 and mitochondrial function and neuronal activity in AD. SIRT3 mRNA and protein levels were significantly decreased in AD cerebral cortex, and Ac‐p53 K320 was significantly increased in AD mitochondria. SIRT3 prevented p53‐induced mitochondrial dysfunction and neuronal damage in a deacetylase activity‐dependent manner. Notably, mitochondrially targeted p53 (mito‐p53) directly reduced mitochondria DNA‐encoded ND2 and ND4 gene expression resulting in increased reactive oxygen species (ROS) and reduced mitochondrial oxygen consumption. ND2 and ND4 gene expressions were significantly decreased in patients with AD. p53‐ChIP analysis verified the presence of p53‐binding elements in the human mitochondrial genome and increased p53 occupancy of mitochondrial DNA in AD. SIRT3 overexpression restored the expression of ND2 and ND4 and improved mitochondrial oxygen consumption by repressing mito‐p53 activity. Our results indicate that SIRT3 dysfunction leads to p53‐mediated mitochondrial and neuronal damage in AD. Therapeutic modulation of SIRT3 activity may ameliorate mitochondrial pathology and neurodegeneration in AD.
Opioid dependence and pregnancy in early twentieth‐century America
Authors: Tauger Nathan
Published: November 2017

Background and Aims

Research on Neonatal Abstinence Syndrome has prompted discussion over how to ensure best outcomes for pregnant women who use drugs and for drug‐dependent newborns. Before Neonatal Abstinence Syndrome and the 1980s panic of “crack babies,” turn‐of‐the‐century American medical journals discussed infants born to drug‐using mothers. This paper aimed to determine whether women who used drugs while pregnant in early twentieth‐century America were subject to the stigma many face today.

Methods

Records from early twentieth century medical journals, narcotic maintenance clinics, prisons that held drug users, and conferences on narcotics were examined. Dr. Charles Terry's outspokenness on drug addiction and pregnancy merited closer examination of his work, particularlyThe Opium Problem.

Results

Some physicians saw drug‐dependent newborns as scientific proof that addiction was a physiological disease and not subject to questions of morality. This theory was discarded in the 1920s. In that decade, beliefs that children born to drug‐using parents threatened national well‐being proliferated. Following formal medicine's retreat from addiction treatment, research on drug addiction and pregnancy fell into obscurity until decades later.

Conclusions

The precedent that women who use drugs while pregnant deserve humane treatment extends to the early twentieth century in the US. From 1910 to 1930, perceptions of infants of drug‐using women changed from hopeful to fearful.
NUT Co Reactivity ‐ ACquiring Knowledge for Elimination Recommendations (NUT CRACKER) study
Authors: Elizur A. , Appel M. Y. , Nachshon L. , Levy M. B. , Epstein‐Rigbi N. , Golobov K. , Goldberg M. R.
Published: November 2017

Background

Ambiguities exist regarding the diagnosis of tree‐nut allergy, necessitating either their elimination or the performance of oral food challenges (OFCs).

Objective

To examine the coincidences of allergies among tree‐nuts and improve diagnostic testing to minimize the need for OFC.

Methods

Eighty‐three patients prospectively evaluated for walnut, pecan, cashew, pistachio, hazelnut, and almond allergy. A history of previous reactions was obtained, and standardized skin prick tests (SPTs) using finely ground tree‐nut solution and basophil activation tests (BAT) were performed. Patients underwent OFC for each tree‐nut they eliminated and to which a reaction in the previous 2 years was not documented.

Results

While most patients were sensitized to 5‐6 tree‐nuts, over 50% were allergic to only 1‐2 tree‐nuts. The highest rate of allergy in sensitized patients was observed for walnut (74.6%) and cashew (65.6%). The rate of co‐allergy for most tree‐nuts was <30%. Two‐thirds of walnut‐ and cashew‐allergic patients were also allergic to pecan and pistachio, respectively, while all pecan‐ and pistachio‐allergic patients were allergic to walnut and cashew, respectively. Receiver‐operating characteristic analysis for SPT and BAT was tree‐nut dependent and yielded area under the curve (AUC) values ranging from 0.75 to 0.94. Knowledge of coincident allergies in these pairs along with the combination of SPT and BAT correctly distinguished allergic from tolerant patients for walnut (87%), pecan (66%), cashew (71%), and pistachio (79%).

Conclusion

The data presented here should assist in differentiating between allergic and tolerant patients, decrease the need for OFC, and allow for appropriate elimination recommendations.
Age‐related macular degeneration: using morphological predictors to modify current treatment protocols
Authors: Ashraf Mohammed , Souka Ahmed , Adelman Ron A.
Published: November 2017

To assess predictors of treatment response in neovascular age‐related macular degeneration (AMD) in an attempt to develop a patient‐centric treatment algorithm. We conducted a systematic search using PubMed, EMBASE and Web of Science for prognostic indicators/predictive factors with the key words: ‘age related macular degeneration’, ‘neovascular AMD’, ‘choroidal neovascular membrane (CNV)’, ‘anti‐vascular endothelial growth factor (anti‐VEGF)’, ‘aflibercept’, ‘ranibizumab’, ‘bevacizumab’, ‘randomized clinical trials’, ‘post‐hoc’, ‘prognostic’, ‘predictive’, ‘response’ ‘injection frequency, ‘treat and extend (TAE), ‘pro re nata (PRN)’, ‘bi‐monthly’ and ‘quarterly’. We only included studies that had an adequate period of follow‐up (>1 year), a single predefined treatment regimen with a predetermined re‐injection criteria, an adequate number of patients, specific morphological [optical coherence tomography (OCT)] criteria that predicted final visual outcomes and injection frequency and did not include switching from one drug to the other. We were able to identify seven prospective studies and 16 retrospective studies meeting our inclusion criteria. There are several morphological and demographic prognostic indicators that can predict response to therapy in wet AMD. Smaller CNV size, subretinal fluid (SRF), retinal angiomatous proliferation (RAP) and response to therapy at 12 weeks (visual, angiographic or OCT) can all predict good visual outcomes in patients receiving anti‐VEGF therapy. Patients with larger CNV, older age, pigment epithelial detachment (PED), intraretinal cysts (IRC) and vitreomacular adhesion (VMA) achieved less visual gains. Patients having VMA/VMT required more intensive treatment with increased treatment frequency. Patients with both posterior vitreous detachment (PVD) and SRF require infrequent injections. Patients with PED are prone to recurrences of fluid activity with a reduction in visual acuity (VA). A regimen that involves less intensive therapy and extended follow‐up intervals (4 weekly) can be suggested for patients who show adequate visual response and have both SRF and PVD at baseline. In addition, patients with poor prognostic indicators such as IRC, VMA, large CNV size, older age and poor response at 12 weeks should be extended very cautiously with the possibility of fixed monthly/bimonthly (every 2 months) treatments if they fail to achieve dryness. Patients with PED at baseline should receive monthly/bimonthly injections of anti‐VEGF therapy or can be extended very cautiously (two weekly intervals) using a TAE protocol.