Τετάρτη 14 Νοεμβρίου 2018

Fine-Scale Resolution of Runs of Homozygosity Reveal Patterns of Inbreeding and Substantial Overlap with Recessive Disease Genotypes in Domestic Dogs

Inbreeding leaves distinct genomic traces, most notably long genomic tracts that are identical by descent and completely homozygous. These runs of homozygosity (ROH) can contribute to inbreeding depression if they contain deleterious variants that are fully or partially recessive. Several lines of evidence have been used to show that long (> 5 megabase) ROH are disproportionately likely to harbor deleterious variation, but the extent to which long versus short tracts contribute to autozygosity at loci known to be deleterious and recessive has not been studied. In domestic dogs, nearly 200 mutations are known to cause recessive diseases, most of which can be efficiently assayed using SNP arrays. By examining genome-wide data from over 200,000 markers, including 150 recessive disease variants, we built high-resolution ROH density maps for nearly 2,500 dogs, recording ROH down to 500 kilobases. We observed over 678 homozygous deleterious recessive genotypes in the panel across 29 loci, 90% of which overlapped with ROH inferred by GERMLINE. Although most of these genotypes were contained in ROH over 5 Mb in length, 14% were contained in short (0.5 - 2.5 megabase) tracts, a significant enrichment compared to the genetic background, suggesting that even short tracts are useful for computing inbreeding metrics like the coefficient of inbreeding estimated from ROH (FROH). In our dataset, FROH differed significantly both within and among dog breeds. All breeds harbored some regions of reduced genetic diversity due to drift or selective sweeps, but the degree of inbreeding and the proportion of inbreeding caused by short versus long tracts differed between breeds, reflecting their different population histories. Although only available for a few species, large genome-wide datasets including recessive disease variants hold particular promise not only for disentangling the genetic architecture of inbreeding depression, but also evaluating and improving upon current approaches for detecting ROH.



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Diversity and mycotoxin production by Fusarium temperatum and Fusarium subglutinans as causal agents of pre-harvest Fusarium maize ear rot in Poland

Abstract

Maize ear rot is a common disease found worldwide, caused by several toxigenic Fusarium species. Maize ears and kernels infected by Fusarium subglutinans contained significant amounts of beauvericin, fusaproliferin, moniliformin, and enniatins. In 2011, F. subglutinans sensu lato has been divided into two species: Fusarium temperatum sp. nov. and F. subglutinans sensu stricto, showing different phylogeny and beauvericin production within the populations of maize pathogens in Belgium. Isolates of the new species—F. temperatum—were also identified and characterized in Spain, Argentina, Poland, France, and China as one of the most important pathogens of maize. Moreover, F. temperatum was proved to be pathogenic to maize seedlings and stalks. We identified Fusarium isolates obtained from diseased maize ears collected between 2013 and 2016 in Poland (321 isolates). Based on morphological analyses, six Fusarium species were identified. Molecular identification performed on the set of selected isolates (42 isolates) revealed 34 isolates to be F. temperatum and only five to be F. subglutinans. Interestingly, the phylogenetic analysis showed that the population of F. temperatum infecting maize in Poland remained quite uniform for over 30 years with only a few exceptions. For the first time, a single isolate of Fusarium ramigenum was detected from the area of Poland. Significant amounts of BEA were found in Fusarium-damaged kernels. The same kernel samples contained also enniatins A1, A, B1, and B. The results clearly demonstrate the occurrence of F. temperatum as maize pathogen in Poland for over the last three decades.



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Fraud in the field: Signature compliance

EMS providers should be on high alert for fraud and forgery in the patient care report

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Fraud in the field: Signature compliance

EMS providers should be on high alert for fraud and forgery in the patient care report

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AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie 2018; S 01 Article in Thieme...

AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie 2018; S 01

Article in Thieme eJournals:
Table of contents  |  Congress



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Traumatische Verletzungen des zentralen Nervensystems

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 668-681
DOI: 10.1055/s-0043-118969

Traumatische Verletzungen des zentralen Nervensystems stellen die Folge einer äußeren Gewalteinwirkung auf Gehirn oder Rückenmark dar. Sowohl das Schädel-Hirn-Trauma als auch das spinale Trauma sind dynamische Krankheitsbilder, die besondere Anforderungen an Diagnostik und Therapie stellen und somit in spezialisierten Zentren versorgt werden sollten.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Gefährliche Verzögerung: Warten erhöht Mortalität bei Sepsis

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 644-645
DOI: 10.1055/a-0727-4782



Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Neurointensivmedizin: aneurysmatische Subarachnoidalblutung – State of the Art

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 654-667
DOI: 10.1055/s-0043-118963

Die spontane, nicht traumatische Subarachnoidalblutung ist eine lebensbedrohliche Erkrankung, die mit vielfältigen Komplikationen und einer hohen Morbidität und Mortalität vergesellschaftet ist. In den ersten 24 Stunden hat die Ausschaltung der Blutungsursache Vorrang. Die Patienten sollen intensivmedizinisch überwacht und behandelt werden. Stringente Diagnostik und konsequente Behandlung verbessern das Outcome der Patienten nachweislich.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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ICU: längeres Überleben durch Delirprophylaxe mit Haloperidol?

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 645-645
DOI: 10.1055/a-0727-5752



Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Geburtshilfliche Anästhesie und postoperative Überwachung

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 696-702
DOI: 10.1055/s-0043-111309

Die von ASA (American Society of Anesthesiologists) und SOAP (Society for Obstetric Anesthesia and Perinatology) für das Jahr 2016 aktualisierten Leitlinien sind eine Handlungsempfehlung in erster Linie für Anästhesisten, die auf das anästhesiologische Management Gebärender, nicht operative und operative Entbindung sowie auf die postpartale Versorgung und Analgesie fokussiert.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Mukopolysaccharidose: hohes Anästhesierisiko bei Kindern

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 645-646
DOI: 10.1055/a-0727-6682



Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Neurointensivmedizin

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 652-653
DOI: 10.1055/a-0668-4925



Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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(Über-)Leben nach Lungenversagen: die DACAPO-Studie

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 646-647
DOI: 10.1055/a-0727-6029



Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Schmerztherapeutische Aspekte bei Tumoroperationen

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 704-717
DOI: 10.1055/s-0043-104600

Trotz einer Vielzahl von Therapieoptionen wird die Akutschmerztherapie nach onkologischen Operationen häufig als unzureichend beschrieben. Neben einer unzureichenden Akutschmerztherapie können weitere Faktoren eine Hypersensitivierung und Chronifizierung sowie den Verlauf der Tumorerkrankung beeinflussen. Dieser Beitrag erklärt pathophysiologische Hintergründe und erläutert geeignete Therapiemodalitäten.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Herzstillstand nach Infarkt: bessere Ergebnisse mit mechanischer Kreislaufunterstützung

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 647-648
DOI: 10.1055/a-0727-6465



Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Neuromonitoring und Therapieentscheidungen auf der Intensivstation

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 682-695
DOI: 10.1055/s-0043-118971

Bei Patienten mit einer akuten Hirnschädigung besteht das Risiko einer weiteren neurologischen Verschlechterung aufgrund der Entwicklung eines sekundären Hirnschadens. Ziel des Neuromonitorings ist es frühzeitig pathophysiologische Veränderung des Gehirns zu erkennen um adäquate diagnostische und therapeutische Maßnahmen einzuleiten, um die Entstehung eines sekundären Hirnschadens zu vermeiden. Neben der klassischen Methode des klinischen Neuromonitorings bei wachen Patienten werden invasive Methoden mit Implantation von Messsonden zur Bestimmung des Hirndruckes, des zerebralen Sauerstoffpartialdruckes sowie des Hirnmetabolismus bei komatösen Patienten angewendet. Ein elektrophysiologisches Monitoring mittels Elektrokortikografie oder evozierter Potenziale sowie die Messung des zerebralen Blutflusses liefert ergänzende Informationen. Die Indikationen und die klinische Relevanz der verschiedenen Monitoring-Techniken werden im Hinblick auf eine Optimierung der Behandlung von Patienten mit akuten zerebralen Schädigungen besprochen.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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„Ich muss genau hier sein!“

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 650-651
DOI: 10.1055/a-0663-1715



Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Metabolische Azidose unter Paracetamol – eine ungewöhnliche Nebenwirkung

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 718-722
DOI: 10.1055/a-0636-2595

Die metabolische Azidose ist bei hospitalisierten Patienten keine Rarität. Doch nur selten ist eine metabolische Azidose mit erweiterter Anionenlücke unter chronischer Paracetamol-Therapie und konsekutiver transienter 5-Oxoprolin-Akkumulation (Pyroglutaminsäure) bei Erwachsenen beschrieben 1, 2, 3, 4. Dieser Beitrag stellt einen solchen Fall dar und erläutert die wenig bekannte Pathogenese.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Recommendations of the International Society of Intraoperative Neurophysiology for intraoperative somatosensory evoked potentials

Somatosensory evoked potentials (SEPs) are an important part of intraoperative neurophysiologic monitoring (IONM) because they provide functional and localizing information about the dorsal somatosensory system and complement motor evoked potentials (MEPs). This document reviews relevant anatomy, physiology, methodology, interpretation and applications and forms recommendations of the International Society of Intraoperative Neurophysiology for intraoperative SEPs. It is also endorsed by the International Federation of Clinical Neurophysiology.

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Optimized Deep Neural Network Architecture for Robust Detection of Epileptic Seizures using EEG Signals

Epilepsy is a chronic neurological disorder of the brain that affects people of all ages. Approximately seventy million people worldwide possess epilepsy, making it typically the second most common neurological disease after a migraine (Rogers, 2010). The characterizing feature of epilepsy is repetitive seizures that strike abruptly. Symptoms may run from short suspension of awareness to violent convulsions and once in a while loss of consciousness (Acharya et al., 2013). Electroencephalogram (EEG) is the prime signal that has been widely used for the diagnosis of epilepsy.

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Neurophysiological effects of continuous cortical stimulation in epilepsy – spike and spontaneous ECoG activity

Epilepsy constitutes a wide range of brain disorders characterized by a predisposition of developing seizures. Approximately thirty percent of patients with focal epilepsy do not respond adequately to antiepileptic drugs and develop pharmacoresistant epilepsy, sometimes experiencing multiple daily seizures (Abramovici and Bagic 2016), as well as an increased risk of premature death, neurological deficits and reduced quality of life (Chen et al. 2016). Amongst focal drug-resistant epilepsies, surgical resection of the epileptogenic zone provides a good outcome in a majority of cases (West et al.

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Single Stage Epilepsy Surgery in Children and Adolescents with Focal Cortical Dysplasia Type II – Prognostic Value of the Intraoperative Electrocorticogram

With up to 80% of well-selected patients becoming seizure-free, epilepsy surgery has proved to be a successful therapeutic option for children and adolescents with drug-resistant epilepsies (Bittar et al., 2002; Dorfer et al., 2013; Gröppel et al., 2015; Jenny et al., 2016). However, seizure freedom after surgery depends on the complete resection/disconnection of the epileptogenic zone (Muthaffar et al., 2017; Rosenow and Luders, 2001). Currently, none of the available diagnostic tests applied during pre-surgical evaluation permit direct measurement of the epileptogenic zone.

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Kinect-based assessment of proximal arm non-use after a stroke

After a stroke, during seated reaching with their paretic upper limb, many patients spontaneously replace the use of their arm by trunk compensation movements, even though they are able to use their arm when f...

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Issue Information ‐ Editorial Board



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Front Cover

Clinical Genetics Front Cover

The cover image is based on the Original Article Genomic screening in rare disorders: New mutations and phenotypes, highlighting ALG14 as a novel cause of severe intellectual disability, by Malin Kvarnung et al., https://doi.org/10.1111/cge.13448.


The cover image is based on the Original Article Genomic screening in rare disorders: New mutations and phenotypes, highlighting ALG14 as a novel cause of severe intellectual disability, by Malin Kvarnung et al., https://doi.org/10.1111/cge.13448.



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FLAD1, encoding FAD synthase, is mutated in a patient with myopathy, scoliosis and cataracts

Clinical Genetics FLAD1, encoding FAD synthase, is mutated in a patient with myopathy, scoliosis and cataracts


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An Open Label Pilot Study of a Dexmedetomidine‐Remifentanil‐Caudal Anesthetic for Infant Lower Abdominal/Lower Extremity Surgery: The T REX Pilot Study

Abstract

Background

Concern over potential neurotoxicity of anesthetics has led to growing interest in prospective clinical trials using potentially less toxic anesthetic regimens, especially for prolonged anesthesia in infants. Preclinical studies suggest that dexmedetomidine may have a reduced neurotoxic profile compared to other conventional anesthetic regimens; however, coadministration with either anesthetic drugs (e.g. remifentanil) and/or regional blockade is required to achieve adequate anesthesia for surgery. The feasibility of this pharmacological approach is unknown. The aim of this study was to determine the feasibility of a remifentanil/dexmedetomidine/ neuraxial block technique in infants scheduled for surgery lasting longer than 2 hours.

Methods

Sixty infants (age 1‐12 months) were enrolled at seven centers over 18 months. A caudal local anesthetic block was placed after induction of anesthesia with sevoflurane. Next, an infusion of dexmedetomidine and remifentanil commenced, and the sevoflurane was discontinued. Three different protocols with escalating doses of dexmedetomidine and remifentanil were used.

Results

One infant was excluded due to a protocol violation and consent was withdrawn prior to anesthesia in another. The caudal block was unsuccessful in 2 infants. Of the 56 infants who completed the protocol 45 (80%) had at least one episode of hypertension (Mean Arterial Pressure >80 mmHg) and/or movement that required adjusting the anesthesia regimen. In the majority of these cases the remifentanil and/or dexmedetomidine doses were increased although six infants required rescue 0.3% sevoflurane and one required a propofol bolus. Ten infants had at least one episode of mild hypotension (Mean Arterial Pressure 40 ‐50 mmHg) and 4 had at least one episode of moderate hypotension (Mean Arterial Pressure <40 mmHg).

Conclusion

A dexmedetomidine/remifentanil neuraxial anesthetic regimen was effective in 87.5% of infants. These findings can be used as a foundation for designing larger trials that assess alternative anesthetic regimens for anesthetic neurotoxicity in infants

This article is protected by copyright. All rights reserved.



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Too Many Thyroid Ultrasound Exams Lead to an Increase in the Diagnosis of Low-Risk Thyroid Cancer

Clinical Thyroidology, Volume 30, Issue 11, Page 519-522, November 2018.


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Randomized, Controlled Trials Show That Treatment of Subclinical Hypothyroidism Does Not Improve Quality of Life, Cognition, Blood Pressure, or BMI

Clinical Thyroidology, Volume 30, Issue 11, Page 496-499, November 2018.


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Which Factors Predict the Outcome of Ablative Radioactive Iodine Treatment of Hyperthyroid Graves' Disease?

Clinical Thyroidology, Volume 30, Issue 11, Page 500-504, November 2018.


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Levothyroxine Treatment Improves Miscarriage Risk, But Not Live Birth Rates, in Women with Subclinical Hypothyroidism or TPO Antibody Positivity Undergoing ART

Clinical Thyroidology, Volume 30, Issue 11, Page 526-528, November 2018.


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A Thyroid Hormone Transporter Mutant Causes Delayed Hypothyroidism Selectively in the Brain

Clinical Thyroidology, Volume 30, Issue 11, Page 505-507, November 2018.


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Vemurafenib Restores Radioiodine Uptake in Some Metastatic Thyroid Cancers

Clinical Thyroidology, Volume 30, Issue 11, Page 516-518, November 2018.


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High-Dose Radioactive Iodine Ablation Decreases Local Recurrence for High-Risk Papillary Thyroid Cancer

Clinical Thyroidology, Volume 30, Issue 11, Page 508-510, November 2018.


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Symptoms Strongly Drive the Consideration of Alternative Thyroid Hormone–Replacement Options in Patients with Hypothyroidism

Clinical Thyroidology, Volume 30, Issue 11, Page 523-525, November 2018.


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Low-Dose Radioiodine Ablation Is Equally Effective as High-Dose Ablation in Patients with Low-Risk Thyroid Cancer on Long-Term Follow-up

Clinical Thyroidology, Volume 30, Issue 11, Page 511-515, November 2018.


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CASE REPORT: An Extensively Necrotic Hürthle-Cell Carcinoma Mimicked a Thyroid Abscess

Clinical Thyroidology, Volume 30, Issue 11, Page 529-533, November 2018.


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Characterization of Quinolone-Resistant Determinants in Tribe Proteeae Isolated from Pet Turtles with High Prevalence of qnrD and Novel gyrB Mutations

Microbial Drug Resistance, Ahead of Print.


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First Report of Whole-Genome Sequence of Colistin-Resistant Klebsiella quasipneumoniae subsp. similipneumoniae Producing KPC-9 in India

Microbial Drug Resistance, Ahead of Print.


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Verizon announces 5G First Responder Lab

Verizon seeks innovators to accelerate 5G technology development for first responders

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Nonalcoholic Fatty Liver Disease and Bone Mineral Density in Children and Adolescents: Specific Considerations for Future Studies



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Acidic Pharyngeal Reflux Does Not Correlate with Symptoms and Laryngeal Injury Attributed to Laryngopharyngeal Reflux

Abstract

Background

Laryngopharyngeal reflux (LPR) is suspected when the symptoms are attributed to the penetration of acidic gastroesophageal reflux (GER) into the larynx. However, the relationships between the intensity of LPR and symptoms and laryngeal injury have not been elucidated. Several factors confound the study of LPR, namely pH is monitored in the pharynx (pharyngeal reflux) but the pharyngeal acidity (pH) required to induce laryngeal injury is unknown, the GER origin of pharyngeal acid is not always established, and a recent treatment with proton pump inhibitors (PPI) confounds the analysis.

Aims

We aimed to limit these confounding factors to analyze the relationship between LPR and symptoms and laryngeal injury.

Methods

We used dual pharyngeal and distal esophageal 24-h pH/impedance monitoring to establish GER origin of pharyngeal reflux, we used an unbiased approach to analysis by evaluating a whole range of acidity (pH < 6, pH < 5.5, pH < 5.0, pH < 4.5 and pH < 4.0) in patients with suspected LPR without PPI for  > 30 days.

Results

Pharyngeal reflux was (median[IQR]) 14[8–20.5] and 4[1.5–6.5] pharyngeal reflux episodes with pH < 6.0 and pH < 5.5, respectively. Pharyngeal reflux with pH < 5.0 was rare. Comprehensive analysis did not reveal any correlation between symptoms (reflux symptom index) or laryngeal injury (reflux finding score) and the number of pharyngeal reflux episodes or duration of pharyngeal acid exposure at any pH level.

Conclusion

Unbiased comprehensive approach did not reveal any relationship between acidic pharyngeal reflux and the symptoms or laryngeal injury attributed to LPR. Limited clinical usefulness of pharyngeal monitoring reported by others is unlikely due to confounding factors.



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Cancer chromatin accessed

Cancer chromatin accessed

Cancer chromatin accessed, Published online: 14 November 2018; doi:10.1038/s41576-018-0075-1

A study in Science reports the genome-wide chromatin accessibility profiles across 23 cancer types from The Cancer Genome Atlas and notably increases the number of known gene regulatory elements.

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A reinterpretation of “Homing pigeons’ flight over and under low stratus” based on atmospheric propagation modeling of infrasonic navigational cues

Abstract

Pigeons flying above temperature inversion and related low-stratus layers appear to lack important navigational cues, and a reinterpretation of Wagner's 1978 study suggests that these cues are low-frequency acoustic signals (infrasound). Wagner released homing pigeons above opaque stratus over the Swiss Plateau to determine whether they could locate their loft beneath it. Birds above the clouds appeared lost, while those that descended beneath them returned home directly. Atmospheric propagation modeling of infrasonic waves virtually transmitted from the loft area shows that these signals would have been ducted beneath the inversion layer, and would not have reached the release sites above it. The absence of homeward infrasonic cues above temperature inversions could explain the disorientation of Wagner's birds, especially if such signals are the predominant cues used by pigeons to home. The possible generation of infrasonic navigational signals in the loft area and recent queries concerning the infrasound navigational "map" hypothesis are also discussed.



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Single Stage Epilepsy Surgery in Children and Adolescents with Focal Cortical Dysplasia Type II – Prognostic Value of the Intraoperative Electrocorticogram

Publication date: Available online 14 November 2018

Source: Clinical Neurophysiology

Author(s): Gudrun Gröppel, Christian Dorfer, Sharon Samueli, Anastasia Dressler, Angelika Mühlebner, Daniela Prayer, Thomas Czech, Martha Feucht

Abstract
Objective

To evaluate prospectively the informative/prognostic value of epileptic discharges in the post-resection ECoGs of children with drug-resistant epilepsies and Focal Cortical Dysplasia type II (FCD-II).

Methods

Included were consecutive patients with focal epilepsies and suspected FCD-II who were planned for single-stage epilepsy surgery based on non-invasive presurgical evaluation results. Intraoperative ECoGs were recorded using a 32-channel system with strip- and/or grid-electrodes. Spikes were defined as transients with a mainly negative component and duration of 20-70ms. Fast activity was defined as rhythmic bursts of polyspikes > 13Hz. All ECoGs were analysed visually. The significance of both spikes and fast activity in the post-resection ECoG for seizure outcomes 24 months after surgery was evaluated.

Results

Data from 18 patients (five girls) were analysed. 10/18 patients (55.6%) showed spikes in their post-resection ECoGs, five of them showed additional fast activity. 24 months after surgery, 12/18 patients (66.7%) were seizure-free. There was a significant correlation between unfavorable seizure outcomes and fast activity in the post-resection ECoGs (p=0.009), whereas spikes alone were not predictive (p=0.502).

Conclusion

Even when recorded with non-sophisticated techniques, presence of fast activity in post-resection ECoGs might be a valid negative outcome-predictor after surgery in paediatric patients with FCD-II associated drug-resistant epilepsies.

Significance

Fast activity recorded with a relatively simple ECoG equipment seems also to have prognostic significance and by this might be an alternative to HFOs recorded with highly sophisticated and expensive technologies.



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Multifocal Visual Evoked Potentials and Contrast Sensitivity Correlate with Ganglion Cell-Inner Plexiform Layer Thickness in Multiple Sclerosis

Publication date: Available online 13 November 2018

Source: Clinical Neurophysiology

Author(s): Divya Narayanan, Han Cheng, Rosa A.Tang, Laura J. Frishman

Abstract
Objective

To examine the relationship between optical coherence tomography (OCT) macular ganglion cell-inner plexiform layer thickness (GCIPLT), peripapillary retinal nerve fiber layer thickness (RNFLT) and visual function in relapsing remitting multiple sclerosis (RRMS).

Methods

Cirrus OCT, VERIS 60-sector multifocal visual evoked potential (mfVEP) and Pelli-Robson contrast sensitivity (CS) were obtained for 53 eyes with last optic neuritis (ON)>6 months and 105 non-ON eyes in 90 patients. One eye (43 ON, 73 non-ON) was used for correlations when both had the same history. Global (G, 60 sectors) and central 5.6° (C, 24 sectors) mfVEP amplitude and latency were calculated as mean logSNR and median latency.

Results

Eyes showing abnormal mfVEP (amplitude or latency) vs OCT (GCIPLT or RNFLT) was 77% vs 69% (p=0.33) in ON, 45% vs 22% (p<0.0005) in non-ON. In ON and non-ON, mfVEP measures and CS correlated with GCIPLT and RNFLT (r=-0.24 to 0.78, p=0.03 to 0.0001). In ON, mfVEP amplitude (C,G) correlated better with GCIPLT (r=0.78, 0.76) than RNFLT (r=0.43, 0.58; p< 0.001, 0.01).

Conclusions

MfVEP measures and CS correlated well with GCIPLT and RNFLT in ON and non-ON. MfVEP amplitudes were more highly correlated with GCIPLT than RNFLT in ON. MfVEP detected significantly more defects than OCT in non-ON.

Significance

GCIPLT, mfVEP and CS provide useful measures of optic nerve integrity in RRMS.



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Editorial Board

Publication date: December 2018

Source: International Journal of Psychophysiology, Volume 134

Author(s):



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International Organization of Psychophysiology

Publication date: December 2018

Source: International Journal of Psychophysiology, Volume 134

Author(s):



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Availability of Safe Childbirth Supplies in 284 Facilities in Uttar Pradesh, India

Abstract

Objectives Vital to implementation of the World Health Organization (WHO) Safe Childbirth Checklist (SCC), designed to improve delivery of 28 essential birth practices (EBPs), is the availability of safe birth supplies: 22 EBPs on the SCC require one or more supplies. Mapping availability of these supplies can determine the scope of shortages and need for supply chain strengthening. Methods A cross-sectional survey on the availability of functional and/or unexpired supplies was assessed in 284 public-sector facilities in 38 districts in Uttar Pradesh, India. The twenty-three supplies were categorized into three non-mutually exclusive groups: maternal (8), newborn (9), and infection control (6). Proportions and mean number of supplies available were calculated; means were compared across facility types using t-tests and across districts using a one-way ANOVA. Log-linear regression was used to evaluate facility characteristics associated with supply availability. Results Across 284 sites, an average of 16.9 (73.5%) of 23 basic childbirth supplies were available: 63.4% of maternal supplies, 79.1% of newborn supplies, and 78.7% of infection control supplies. No facility had all 23 supplies available and only 8.5% had all four medicines assessed. Significant variability was observed by facility type and district. In the linear model, facility type and distance from district hospital were significant predictors of higher supply availability. Conclusions for Practice In Uttar Pradesh, more remote sites, and primary and community health centers, were at higher risk of supply shortages. Supply chain management must be improved for facility-based delivery and quality of care initiatives to reduce maternal and neonatal harm.



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Cancer chromatin accessed



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Impairments in Postural Control and Re-test Reliability of Dynamic Posturographic Measures after Lung Transplantation

Objective To classify impairments in postural control using computerized posturography in lung transplant recipients (LuTXr) undergoing subacute rehabilitation, and to examine the re-test reliability of these measures. Methods In a prospective repeated-measures study, 50 LuTXr underwent clinical and quantitative posturographic testing (SMART EquiTest), which included the Sensory Organisation Test (SOT), Motor Control Test (MCT) and Limits of Stability Test (LOS). Testing was repeated after 1-to-2 days and upon completion of rehabilitation, two months later. Main outcome measures were: SOT-composite score, MCT-latency and amplitude scaling, LOS-movement velocity (LOS-MV) and end-point-excursion (LOS-EPE)/maximum-excursion (LOS-MXE). Results At the beginning of rehabilitation, the mean SOT-CS and LOS, but not the MCT scores were below normative reference values, and did not return to normal after rehabilitation. Intra-class correlation coefficients (ICC2,1) yielded excellent relative reliability for all posturographic tests. The smallest detectable differences observed for the SOT and LOS exceeded the mean changes observed upon completion of rehabilitation. Conclusion Impairments in sensory and anticipatory postural control was insufficiently restored after subacute LuTX rehabilitation. The little sensitivity of the SOT-CS or LOS scores to detect a minimal change in performance due to rehabilitation limits the clinical applicability of these tests as objective outcome measures in LuTX rehabilitation. Part of this work was supported by the Slovak Research and Development Agency under the contract No. SK-AT-2015-0031. Corresponding author: Gerold Ebenbichler, MD, Department of Physical Medicine, Rehabilitation & Occupational Medicine, Vienna Medical University, General Hospital of Vienna, Wahringer Gurtel 18-20, 1090 Vienna, Austria, Gerold.ebenbichler@meduniwien.ac.at, +43 1 40400 23080 Financial disclosure statement: No party having a direct interest in the results of this research has or will confer a benefit on us or on any organization with which we are associated. Acknowledgement: This study was the master thesis of Stephan Doblhammer, MD and Melanie Pachner, MD who both published major findings of this research as master theses. We would like to thank Grace Achim, MD and Jennifer Gibley, MD for their generous help with data collection, Oliver Braumann for his help with data processing, and Haley Milko for editing the manuscript. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Is aerobic exercise training beneficial for adults with fibromyalgia? - A Cochrane Review summary with commentary

No abstract available

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