bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comorbidities confounding the outcomes of surgery for third window syndrome: Outlier analysis
Authors: Wackym P. Ashley , Mackay‐Promitas Heather T. , Demirel Shaban , Gianoli Gerard J. , Gizzi Martin S. , Carter Dale M. , Siker David A. 
Published: August 2017

ObjectivePatients with third window syndrome and superior semicircular canal dehiscence (SSCD) symptoms whose surgical outcomes placed them as outliers were systematically studied to determine comorbidities that were responsible for their poor outcomes due to these confounding factors.Study DesignObservational analytic case‐control study in a tertiary referral center.MethodsTwelve adult patients with clinical SSCD syndrome underwent surgical management and had outcomes that did not resolve all of their subjective symptoms. In addition to one of the neurotologists, 2 neurologists (one specializing in migraine and the other a neuro‐ophthalmologist), and a psychologist clinician‐investigator completed comprehensive evaluations. Neuropsychology test batteries included: the Millon Behavioral Medicine Diagnostic; Patient Health Questionnaire (PHQ‐9) and Generalized Anxiety Disorder Screener (GAD‐7); Adverse Childhood Experiences Scale; the Wide Range Assessment of Memory and Learning, including the 3 domains of verbal memory, visual memory, and attention/concentration; Wechsler Adult Intelligence Scale; and the Delis‐Kaplan Executive Function System. The control cohort was comprised of 17 participants who previously underwent surgery for third window syndrome that resulted in the expected outcomes of resolution of their third window syndrome symptoms and cognitive dysfunction.ResultsThere was a high rate of psychological comorbidity (n = 6) in the outlier cohort; multiple traumatic brain injuries were also a confounding element (n = 10). One patient had elevated cerebrospinal fluid (CSF) pressure requiring ventriculoperitoneal shunting to control the recurrence of dehiscence and one patient with a drug‐induced Parkinson‐like syndrome and idiopathic progressive neurological degenerative process.ConclusionsComponents of the Millon Behavioral Medicine Diagnostic, PHQ‐9 and GAD‐7 results suggest that these instruments would be useful as screening tools preoperatively to identify psychological comorbidities that could confound outcomes. The identification of these comorbid psychological as well as other neurological degenerative disease processes led to alternate clinical management pathways for these patients.Level of Evidence2b.
Friedman tongue position and cone beam computed tomography in patients with obstructive sleep apnea
Authors: Harvey Rebecca , O'Brien Louise , Aronovich Sharon , Shelgikar Anita , Hoff Paul , Palmisano John , Stanley Jeffrey 
Published: August 2017

ObjectiveEvaluate the correlation between Friedman Tongue Position (FTP) and airway cephalometrics in patients with obstructive sleep apnea (OSA).Study DesignRetrospective review of adult patients with OSA undergoing Cone Beam Computed Tomography (CBCT).MethodsCollected data included age, sex, body mass index, apnea hypopnea index, FTP, and airway cephalometric parameters. Data analyses were performed using ANOVA, dichotomous t‐testing, and linear regression.Results203 patients were included in the analysis. (M:F 132:71). The mean posterior airway space (PAS) was inversely correlated (p = 0.001, r =.119) with higher FTP grades with means of 12.3 mm, 7.9 mm, 6.6 mm, and 4.3 mm, I‐IV respectively. Minimal cross‐sectional area for patients with FTP I‐IV was 245.7, 179.8, 137.6, and 74.2 mm, 2 respectively (p = 0.002, r = .095). Mean hyoid‐mandibular plane (H‐MP) for FTP I‐IV was 20.6 mm, 20.4 mm, 24.7 mm, and 28.9 mm respectively. No statistically significant difference between H‐MP values when comparing patients with FTP I or II (p = 0.22). There were statistically significant differences when these two groups were individually compared to FTP III and IV (p = 0.002). Linear regression analysis confirmed an independent association between FTP and PAS (β = −2.06, p < 0.001), minimal cross‐sectional area (β = −45.07, p = 0.02), and H‐MP (β = 3.03, p = 0.01) controlling for BMI, age, AHI, and sex.ConclusionsUse of FTP is supported by objective CBCT cephalometric results, in particular the PAS, minimal cross‐sectional area, and H‐MP. Understanding the correlation between objective measurements of retroglossal collapse should allow Otolaryngologists to more confidently select patients who may require surgery to address the retroglossal area, particularly when the ability to perform cephalometric analysis is not possibleLevel of Evidence4.
Novel autosomal dominant TNNT1 mutation causing nemaline myopathy
Authors: Konersman Chamindra G. , Freyermuth Fernande , Winder Thomas L. , Lawlor Michael W. , Lagier‐Tourenne Clotilde , Patel Shailendra B. 
Published: August 2017

AbstractBackgroundNemaline myopathy (NEM) is one of the three major forms of congenital myopathy and is characterized by diffuse muscle weakness, hypotonia, respiratory insufficiency, and the presence of nemaline rod structures on muscle biopsy. Mutations in troponin T1 (TNNT1) is 1 of 10 genes known to cause NEM. To date, only homozygous nonsense mutations or compound heterozygous truncating or internal deletion mutations in TNNT1 gene have been identified in NEM. This extended family is of historical importance as some members were reported in the 1960s as initial evidence that NEM is a hereditary disorder.MethodsProband and extended family underwent Sanger sequencing for TNNT1. We performed RT‐PCR and immunoblot on muscle to assess TNNT1 RNA expression and protein levels in proband and father.ResultsWe report a novel heterozygous missense mutation of TNNT1 c.311A>T (p.E104V) that segregated in an autosomal dominant fashion in a large family residing in the United States. Extensive sequencing of the other known genes for NEM failed to identify any other mutant alleles. Muscle biopsies revealed a characteristic pattern of nemaline rods and severe myofiber hypotrophy that was almost entirely restricted to the type 1 fiber population.ConclusionThis novel mutation alters a residue that is highly conserved among vertebrates. This report highlights not only a family with autosomal dominant inheritance of NEM, but that this novel mutation likely acts via a dominant negative mechanism.
Radiofrequency saturation induced bias in aqueductal cerebrospinal fluid flow quantification obtained using two‐dimensional cine phase contrast magnetic resonance imaging
Authors: Ragunathan Sudarshan , Pipe James G. 
Published: August 2017

PurposeTo explore the extent of bias in cerebrospinal fluid flow estimates due to radiofrequency saturation, and its possible impact on the use of two‐dimensional cine phase contrast magnetic resonance imaging in the diagnosis and characterization of normal pressure hydrocephalus in patients.Theory and MethodsTheoretical signal equations were generated to describe saturation dependence on velocity. An experimental set of phase contrast magnetic resonance imaging scans with two different flip angles was used to show bias in flow estimates in a flow phantom, and in six different healthy volunteers. The cerebral aqueduct was targeted as the flow region of interest.ResultsData from a constant flow phantom showed a spatial distribution of voxels with significant bias in flow at the periphery of the flow region. The velocity difference (bias) maps of the cerebral aqueduct correlated with the spatial velocity gradients around peak systole and peak diastole, and high correlation with temporal velocity gradients during transition between systole and diastole. The aqueductal stroke volume for θ = 30° were found to be significantly higher than for θ = 10° using a Wilcoxon signed rank test.ConclusionThis work shows the extent of bias in cerebrospinal fluid flow quantification due to radiofrequency saturation effects. This clinical relevance of this error was presented with respect to shunt responsiveness among normal pressure hydrocephalus patients. Magn Reson Med 79:2067–2076, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
Empirical Vancomycin Dosing in Pediatric Patients with Congenital Heart Disease and the Impact of Cardiopulmonary Bypass on Trough Concentrations
Authors: Thomas Christopher A. , Picone Amy , Menon Sharad , Willis Brigham C. 
Published: August 2017

ObjectivesTo determine the optimal vancomycin dosing regimen to achieve empirical goal trough concentrations in pediatric patients with congenital heart disease and to examine the impact of cardiopulmonary bypass on vancomycin dosing requirements.MethodsPatients younger than 18 years admitted to the pediatric cardiovascular intensive care unit (CVICU) at our institution from October 1, 2012–December 31, 2014, who received at least one dose of vancomycin, were reviewed retrospectively. Included patients had a steady‐state vancomycin trough concentration drawn during the study period. The first steady‐state vancomycin trough drawn after being initiated on empirical vancomycin therapy was analyzed for each patient. Excluded patients were those who received mechanical circulatory support, any form of renal replacement therapy, or had a serum creatinine result greater than 1.0 mg/dl on the day of vancomycin initiation.ResultsOverall, 77 patients met inclusion criteria, of which 57.1% had undergone cardiopulmonary bypass (CPB) before CVICU admission. Median age was 62 days (interquartile range [IQR] 8.3–176 days). Median daily vancomycin dose was 36.25 mg/kg/day (IQR 29–40 mg/kg/day), resulting in a median steady‐state trough of 10.0 μg/ml (IQR 6.3–12.9 μg/ml). Therapeutic troughs occurred in 50.6% of patients; supratherapeutic and subtherapeutic concentrations were attained in 18.2% and 31.2% of patients, respectively. A subgroup analysis of patients who were post‐CPB revealed that the only additional variable to affect vancomycin trough concentrations was aortic cross‐clamp time (median 56 min, IQR 0–123.3 min, p=0.02).ConclusionsEmpirical vancomycin dosing to achieve troughs of 8–15 μg/dl in patients with congenital heart disease without evidence of significant acute kidney injury should be 30 mg/kg/day for neonates, 35–40 mg/kg/day for infants, and 45 mg/kg/day in children, with adjustments required for patients with elevated creatinine or significant aortic cross‐clamp time. The receipt and duration of CPB did not affect total daily vancomycin dose requirements.
Identification of complexes involving thallium(I) and thallium(III) with EDTA and DTPA ligands by electrospray ionization mass spectrometry
Authors: Zembrzuska Joanna , Karbowska Bozena 
Published: August 2017

RationaleThallium is considered to be an environmental threat; however, its hazardous properties depend on its oxidation state. Tl(III) is approx. 1000‐times more toxic compared with Tl(I), therefore identification of each species is essential in order to properly evaluate the associated health hazard. Electrospray ionization mass spectrometry (ESI‐MS) allows determination of speciation in solution due to its soft mode of ionization while selective complexation with ligands can distinguish the Tl species. Selective complexation of Tl(I) and Tl(III) ions requires the use of two selective complexing agents and selection of appropriate conditions for this process.MethodsTl(I) and Tl(III) ions as well as two ligands (EDTA and DTPA) were used to form binary (single ion + single ligand), ternary (one ion + both ligands) and quaternary systems (both ions and both ligands) under different pH conditions (7 and 8). These mixtures were subjected to the determination of Tl species using ESI‐MS operating in positive and negative ion mode.ResultsTl(I) complexes with DTPA were identified at pH 7 and 8, whereas, in the case of EDTA, the complexes were detected only at pH 8. In contrast, Tl(III) formed distinct complexes with EDTA at pH 7 and 8, while with DTPA the complexes were detected only at pH 8. Analysis of the quaternary system (which contained both ions and both ligands) revealed that Tl(I) formed complexes with EDTA, while Tl(III) formed complexes with DTPA at pH 7 and 8.ConclusionsThe obtained results confirmed that the increase in the solution complexity allowed simultaneous identification of different complexes in solutions containing both Tl species. The initial analyses carried out for binary and ternary solutions facilitated the simultaneous determination of specific complexes (Tl(I) with EDTA and Tl(III) with DTPA) in the quaternary system.
Microstructure and Texture Evolutions of Biomedical Ti-13Nb-13Zr Alloy Processed by Hydrostatic Extrusion
Authors: Ozaltin K. , Panigrahi A. , Chrominski W. , Bulutsuz A. G. , Kulczyk M. , Zehetbauer M. J. , Lewandowska M. 
Published: August 2017

Abstract
A biomedical β-type Ti-13Nb-13Zr (TNZ) (wt pct) ternary alloy was subjected to severe plastic deformation by means of hydrostatic extrusion (HE) at room temperature without intermediate annealing. Its effect on microstructure, mechanical properties, phase transformations, and texture was investigated by light and electron microscopy, mechanical tests (Vickers microhardness and tensile tests), and XRD analysis. Microstructural investigations by light microscope and transmission electron microscope showed that, after HE, significant grain refinement took place, also reaching high dislocation densities. Increases in strength up to 50 pct occurred, although the elongation to fracture left after HE was almost 9 pct. Furthermore, Young’s modulus of HE-processed samples showed slightly lower values than the initial state due to texture. Such mechanical properties combined with lower Young’s modulus are favorable for medical applications. Phase transformation analyses demonstrated that both initial and extruded samples consist of α′ and β phases but that the phase fraction of α′ was slightly higher after two stages of HE.
Investigation of Lipid Oxidation in High‐ and Low‐Lipid‐Containing Topical Skin Formulations
Authors: Thomsen B. R. , Horn A. F. , Hyldig G. , Taylor R. , Blenkiron P. , Jacobsen C. 
Published: August 2017

AbstractLipid oxidation can impact the odour of skin care products during storage. A study was conducted to identify and monitor representative markers for lipid oxidation in skin care products over time. Four lip care formulations and three skin care formulations with different lipid contents were stored at various cosmetic industry‐relevant conditions for 84 days. The skin care products were analysed for lipid hydroperoxides and secondary volatile oxidation products. A trained sensory panel performed an odour difference (triangle) test and odour‐profiled the products to detect and describe odour changes during storage. Several potential markers for lipid oxidation were identified. In skin care formulations, peroxide value (PV) analysis was a useful marker for lipid oxidation if the product was exposed to light during storage, but no clear changes were observed for PV in samples stored under other conditions. Furthermore, concentrations of several secondary volatile oxidation products increased during storage, and the highest increase was observed for products exposed to light. Pentanal and heptanal were found to be reliable markers for secondary volatile oxidation products in the skin care formulations (especially during exposure to light), whereas in the lip care formulations the best candidates were pentanal (especially during exposure to light and iron), 2‐methyl furan and 3‐methyl‐3‐buten‐2‐one (especially during exposure to light, iron and high temperatures).
Plasma apolipoprotein E levels and risk of dementia: A Mendelian randomization study of 106,562 individuals
Authors: Rasmussen Katrine L. , Tybjærg‐Hansen Anne , Nordestgaard Børge G. , Frikke‐Schmidt Ruth 
Published: August 2017

AbstractIntroductionIn recent prospective studies, low plasma levels of apolipoprotein E (apoE) are associated with high risk of dementia. Whether this reflects a causal association remains to be established.MethodsUsing a Mendelian randomization approach, we studied 106,562 and 75,260 individuals from the general population in observational and genetic analyses, respectively.ResultsIn observational analyses risk of Alzheimer's disease and all dementia increased stepwise as a function of stepwise lower apoE levels (P for trend, 2 × 10−17 and 9 × 10−21). APOE‐weighted allele scores were associated with stepwise decreases in apoE (P for trend, <1 × 10−300). In instrumental variable analysis, the causal risk ratios for a 1 mg/dL genetically determined lower apoE were 1.41 (1.27–1.57) for Alzheimer's disease and 1.33 (1.25–1.43) for all dementia (F‐statistics = 3821).DiscussionGenetic and hence lifelong low apoE is associated with high risk of dementia in the general population. The concordance between observational and genetic estimates suggests a potential causal relationship.
Sexual dimorphism and sexual selection in cytheroidean ostracodes from the Late Cretaceous of the U.S. Coastal Plain
Authors: Hunt Gene , Martins M. João Fernandes , Puckett T. Markham , Lockwood Rowan , Swaddle John P. , Hall Christine M. S. , Stedman James 
Published: August 2017

AbstractSexual dimorphism is common in many extant animals, but it is difficult to demonstrate in fossil species. Working with material from the Late Cretaceous of the U.S. Coastal Plain, we herein analyze sexual dimorphism in ostracodes from the superfamily Cytheroidea, a group whose extant members have males that are relatively more elongate than females. We digitized outlines of more than 6000 individual ostracode valves or carapaces, extracted size (area) and shape (length-to-height ratio) information, and used finite mixture models to assess hypotheses of sexual dimorphism. Male and female clusters can be discerned in nearly all populations with sufficient data, resulting in estimates of size and shape dimorphism for 142 populations across 106 species; an additional nine samples are interpreted to consist only of females. Dimorphism patterns varied across taxa, especially for body size: males range from 30% larger to 20% smaller than females. Magnitudes of sexual dimorphism are generally stable within species across time and space; we can demonstrate substantial evolutionary changes in dimorphism in only one species,Haplocytheridea renfroensis. Several lines of evidence indicate that patterns of sexual dimorphism in these ostracodes reflect male investment in reproduction, suggesting that this study system has the potential to capture variation in sexual selection through the fossil record.
State-dependent microstructural white matter changes in drug-naïve patients with first-episode psychosis
Authors: Serpa M. H. , Doshi J. , Erus G. , Chaim-Avancini T. M. , Cavallet M. , van de Bilt M. T. , Sallet P. C. , Gattaz W. F. , Davatzikos C. , Busatto G. F. , Zanetti M. V. 
Published: August 2017

BackgroundDiffusion tensor imaging (DTI) studies have consistently shown white matter (WM) microstructural abnormalities in schizophrenia. Whether or not such alterations could vary depending on clinical status (i.e. acute psychosisv.remission) remains to be investigated.MethodsTwenty-five treatment-naïve first-episode psychosis (FEP) patients and 51 healthy-controls (HC) underwent MRI scanning at baseline. Twenty-one patients were re-scanned as soon as they achieved sustained remission of symptoms; 36 HC were also scanned twice. Rate-of-change maps of longitudinal DTI changes were calculated for in order to examine WM alterations associated with changes in clinical status. We conducted voxelwise analyses of fractional anisotropy (FA) and trace (TR) maps.ResultsAt baseline, FEP presented reductions of FA in comparison with HC [p< 0.05, false-discovery rate (FDR)-corrected] affecting fronto-limbic WM and associative, projective and commissural fasciculi. After symptom remission, patients showed FA increase over time (p< 0.001, uncorrected) in some of the above WM tracts, namely the right anterior thalamic radiation, right uncinate fasciculus/inferior fronto-occipital fasciculus, and left inferior fronto-occipital fasciculus/inferior longitudinal fasciculus. We also found significant correlations between reductions in PANSS scores and FA increases over time (p< 0.05, FDR-corrected).ConclusionsWM changes affecting brain tracts critical to the integration of perceptual information, cognition and emotions are detectable soon after the onset of FEP and may partially reverse in direct relation to the remission of acute psychotic symptoms. Our findings reinforce the view that WM abnormalities in brain tracts are a key neurobiological feature of acute psychotic disorders, and recovery from such WM pathology can lead to amelioration of symptoms.
Intergenerational friendships of older adults: why do we know so little about them?
Authors: ELLIOTT O'DARE CATHERINE , TIMONEN VIRPI , CONLON CATHERINE 
Published: August 2017

ABSTRACTIntergenerational projects bringing together older adults and younger adults are increasingly common, but there is little research on unstructured, naturally occurring interaction, and in particular friendship between different generations. The aim of this article is to interrogate why we know so little about adult intergenerational friendship. A systematic literature search on this topic, covering a 30-year period, yielded only six articles which satisfied the inclusion criteria. This prompted us to examine how the topics of intergenerational friendship and friendship in old age have been approached in the literature to date. We argue that the paucity of research on intergenerational friendship reflects the focus of existing research on homophily, and consequently friendships among olderoryounger adults; and that this in turn reflects a social construction of older adults as unsuited to friendship with younger adults. Investigations of intergenerational friendship can help challenge the images and models of ageing and older adults that both research and societies currently operate with, and are constrained by. We conclude by calling for research that explores the views and experiences of older adults as parties to intergenerational relationships that are non-kin, chosen and based on mutual enjoyment.
Long-term care service needs and planning for the future: a study of middle-aged and older adults in Hong Kong
Authors: HE ALEX JINGWEI , CHOU KEE-LEE 
Published: August 2017

ABSTRACTLong-term care (LTC) planning is important in helping the older people tackle their future needs better. The needs for LTC services represent generational characteristics as they may be different between the current and upcoming cohorts of older adults. However, very few studies have examined the cohort differences in terms of their expected utilisation of LTC services, while understanding the patterns is crucial in helping policy makers prepare for the development of LTC services. This study fills the research gap by examining the plans and expectations for LTC services of 1,613 middle-aged and older persons in Hong Kong with data collected from a telephone survey. By applying the Andersen Model to examine LTC expectations, this study analyses the LTC needs and plans of the middle-aged and older cohorts of Hong Kong adults, as well as their associated factors, with a multiple logistic regression method. Both gender and birth cohort were examined individually and in combination. Birth cohort and gender have been found to exert an impact on all aspects of LTC needs and planning to varying degrees. The findings are interpreted and contrasted with those of a key study based in the West, with reference to the contextual characteristics of Hong Kong. This study furthers the scholarly understanding on LTC needs and planning and their cohort effect, and draws evidence-based recommendations for LTC development in Hong Kong, a rapidly ageing East Asian society.