Αρχειοθήκη ιστολογίου

Τρίτη 26 Απριλίου 2016

Current Tools for Norovirus Drug Discovery.

Current Tools for Norovirus Drug Discovery.

Expert Opin Drug Discov. 2016 Apr 25;

Authors: Weerasekara S, Prior AM, Hua DH

Abstract
INTRODUCTION: Rapid transmission of norovirus often occurs due to its low infectious dosage, high genetic diversity and its short incubation time. The viruses cause acute gastroenteritis and may lead to death. Presently, no effective vaccine or selective drugs accepted by the United States Food and Drug Administration (FDA) are available for the treatment of norovirus. Advances in the development of norovirus replicon cell lines, GII.4-Sydney HuNoV strain human B cells, and murine and gnotobiotic pig norovirus models have facilitated the discovery of effective small molecule inhibitors in vitro and in vivo. Areas covered: This review gives a brief discussion of the biology and replication of norovirus before highlighting the discovery of anti-norovirus molecules. The article coverage includes: an overview of the current state of norovirus drug discovery, the targeting of the norovirus life cycle, the inhibition of structural and nonstructural proteins of norovirus such as proteases and polymerase, and the blockage of virus entry into host cells. Finally, anti-norovirus drugs in the clinical development stage are described. Expert opinion: The current approach for the counteraction of norovirus focuses on the inhibition of viral RNA polymerase, norovirus 3C-like protease and the structural proteins VP1 as well as the blockade of norovirus entry. Broad-spectrum anti-norovirus molecules, based on the inhibition of 3C-like protease, have been developed. Other host factors and ways to overcome the development of resistance through mutation are also being examined. A dual approach in targeting viral and host factors may lead to an effective counteraction of norovirus infection. Current successes in developing norovirus replicon harboring cells and norovirus infected human cells, as well as murine norovirus models and other animal models such as piglets have facilitated the discovery of effective drugs and helped our understanding of its mechanism of action.

PMID: 27108716 [PubMed - as supplied by publisher]



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Human CD8+ T cells transduced with an additional receptor bispecific for both Mycobacterium tuberculosis and HIV-1 recognize both epitopes

Abstract

Tuberculosis (TB) and human immunodeficiency virus type 1 (HIV-1) infection are closely intertwined, with one-quarter of TB/HIV coinfected deaths among people died of TB. Effector CD8+ T cells play a crucial role in the control of Mycobacterium tuberculosis (MTB) and HIV-1 infection in coinfected patients. Adoptive transfer of a multitude of effector CD8+ T cells is an appealing strategy to impose improved anti-MTB/HIV-1 activity onto coinfected individuals. Due to extensive existence of heterologous immunity, that is, T cells cross-reactive with peptides encoded by related or even very dissimilar pathogens, it is reasonable to find a single T cell receptor (TCR) recognizing both MTB and HIV-1 antigenic peptides. In this study, a single TCR specific for both MTB Ag85B199-207 peptide and HIV-1 Env120-128 peptide was screened out from peripheral blood mononuclear cells of a HLA-A*0201+ healthy individual using complementarity determining region 3 spectratype analysis and transferred to primary CD8+ T cells using a recombinant retroviral vector. The bispecificity of the TCR gene-modified CD8+ T cells was demonstrated by elevated secretion of interferon-γ, tumour necrosis factor-α, granzyme B and specific cytolytic activity after antigen presentation of either Ag85B199-207 or Env120-128 by autologous dendritic cells. To the best of our knowledge, this study is the first report proposing to produce responses against two dissimilar antigenic peptides of MTB and HIV-1 simultaneously by transfecting CD8+ T cells with a single TCR. Taken together, T cells transduced with the additional bispecific TCR might be a useful strategy in immunotherapy for MTB/HIV-1 coinfected individuals.



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Mitogenomics reveals high synteny and long evolutionary histories of sympatric cryptic nematode species

Species with seemingly identical morphology but with distinct genetic differences are abundant in the marine environment and frequently co-occur in the same habitat. Such cryptic species are typically delineated using a limited number of mitochondrial and/or nuclear marker genes, which do not yield information on gene order and gene content of the genomes under consideration. We used next-generation sequencing to study the composition of the mitochondrial genomes of four sympatrically distributed cryptic species of the Litoditis marina species complex (PmI, PmII, PmIII, and PmIV). The ecology, biology, and natural occurrence of these four species are well known, but the evolutionary processes behind this cryptic speciation remain largely unknown. The gene order of the mitochondrial genomes of the four species was conserved, but differences in genome length, gene length, and codon usage were observed. The atp8 gene was lacking in all four species. Phylogenetic analyses confirm that PmI and PmIV are sister species and that PmIII diverged earliest. The most recent common ancestor of the four cryptic species was estimated to have diverged 16 MYA. Synonymous mutations outnumbered nonsynonymous changes in all protein-encoding genes, with the Complex IV genes (coxI-III) experiencing the strongest purifying selection. Our mitogenomic results show that morphologically similar species can have long evolutionary histories and that PmIII has several differences in genetic makeup compared to the three other species, which may explain why it is better adapted to higher temperatures than the other species.

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Evolutionary shifts in the melanin-based color system of birds

Melanin pigments contained in organelles (melanosomes) impart earthy colors to feathers. Such melanin-based colors are distributed across birds and thought to be the ancestral color-producing mechanism in birds. However, we have had limited data on melanin-based color and melanosome diversity in Palaeognathae, which includes the flighted tinamous and large-bodied, flightless ratites and is the sister taxon to all other extant birds. Here, we use scanning electron microscopy and spectrophotometry to assess melanosome morphology and quantify reflected color for 19 species within this clade. We find that brown colors in ratites are uniquely associated with elongated melanosomes nearly identical in shape to those associated with black colors. Melanosome and color diversity in large-bodied ratites is limited relative to other birds (including flightless penguins) and smaller bodied basal maniraptoran dinosaur outgroups of Aves, whereas tinamous show a wider range of melanosome forms similar to neognaths. The repeated occurrence of novel melanosome forms in the nonmonophyletic ratites suggests that melanin-based color tracks changes in body size, physiology, or other life history traits associated with flight loss, but not feather morphology. We further anticipate these findings will be useful for future color reconstructions in extinct species, as variation in melanosome shape may potentially be linked to a more nuanced palette of melanin-based colors.

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Modular color evolution facilitated by a complex nanostructure in birds

The way in which a complex trait varies, and thus evolves, is critically affected by the independence, or modularity, of its subunits. How modular designs facilitate phenotypic diversification is well studied in nonornamental (e.g., cichlid jaws), but not ornamental traits. Diverse feather colors in birds are produced by light absorption by pigments and/or light scattering by nanostructures. Such structural colors are deterministically related to the nanostructures that produce them and are therefore excellent systems to study modularity and diversity of ornamental traits. Elucidating if and how these nanostructures facilitate color diversity relies on understanding how nanostructural traits covary, and how these traits map to color. Both of these remain unknown in an evolutionary context. Most dabbling ducks (Anatidae) have a conspicuous wing patch with iridescent color caused by a two-dimensional photonic crystal of small (100-200 nm) melanosomes. Here, we ask how this complex nanostructure affects modularity of color attributes. Using a combination of electron microscopy, spectrophotometry, and comparative methods, we show that nanostructural complexity causes functional decoupling and enables independent evolution of different color traits. These results demonstrate that color diversity is facilitated by how nanostructures function and may explain why some birds are more color-diverse than others.

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Role of strike-slip faults in Late Paleozoic-Early Mesozoic tectonics and geodynamics of the Altai-Sayan and East Kazakhstan folded zone

Correlation and synthesis of published and new structural, paleomagnetic, geochronological, and paleogeographic data from the Altai-Sayan and East Kazakhstan orogenic areas in Central Asia show an important role of strike-slip faulting in their evolution. The pattern of major strike-slip faults outlines a terrane collage produced by a Late Devonian-Early Carboniferous collision of Gondwanian terranes (Altai-Mongolia and others) with Siberia and a Late Carboniferous-Permian collision of East Europe, Kazakhstan, and Siberia. The accreted continental margins were cut by strike-slip faults and conjugate thrusts into numerous terranes, which mixed with one another and disturbed the previous structural and facies framework. The first collision stage was accompanied by the formation of the Charysh-Terekta system of right-lateral transforms, followed by left-lateral strike-slip faulting in the Kurai and Kuznetsk-Teletsk-Bashkaus zones. The Siberia/Kazakhstan collision involved left-lateral motion along the Chara ophiolite belt and the Irtysh and North East shear zones. Deformations associated with each collision stage are progressively younger toward the center of Siberia; the amount of horizontal displacement decreases in the same direction from a few thousands to hundreds of kilometers.

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Homolytic cleavage of O-Cu(II) bond: XAFS and EPR spectroscopy evidence for one electron reduction of Cu(II) to Cu(I)

CrossMark.jpg

Chem. Commun., 2016, Accepted Manuscript
DOI: 10.1039/C6CC01413E, Communication
Hong Yi, Guanghui Zhang, Jie Xin, Yi Deng, Jeffrey T Miller, A. Jeremy Kropf, Emilio E. Bunel, Xiaotian Qi, Yu Lan, Jyh-Fu Lee, Aiwen Lei
The investigation into the active copper(I) catalysts from copper(II) precursors has become a fundamental and important task in copper catalysis. In this work, we demonstrate that the tBuO- anion not...
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Coordination polymer gels: soft metal-organic supramolecular materials and versatile applications

CrossMark.jpg

Chem. Commun., 2016, Accepted Manuscript
DOI: 10.1039/C6CC01955B, Feature Article
Papri Sutar, Tapas Kumar Maji
In recent time, significant attention has been paid towards the development of functional coordination polymer gels (CPGs) from rationally designed low molecular weight gelators (LMWGs) and metal ions. Coordination of...
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Comparison of two silica based nonviral gene therapy vectors for breast carcinoma: evaluation of the p53 delivery system in Balb/c mice.

Comparison of two silica based nonviral gene therapy vectors for breast carcinoma: evaluation of the p53 delivery system in Balb/c mice.

Artif Cells Nanomed Biotechnol. 2016 Apr 25;:1-6

Authors: Rejeeth C, Vivek R

Abstract
Silica nanoparticles as a nonviral vector for in vivo gene therapy neither surface functionalized SiNp1 is neither "a cationic ion" nor a surface (encapsulation) nor SiNp2 (adsorption). p53 gene expression in the breast upon (i.v) administration. SiNp1 showed a 50- and 100-fold transfection activity, tumor growth inhibition, animal survival (80%), and high levels of p53 and Bax were detected in the sera of treated animals compared to SiNp2 or naked pCMV/p53, respectively. These results demonstrate for improvements in the both systems. This study suggests that nonviral vector systems will have important roles in achieving the impermanent gene transfer in vivo.

PMID: 27111431 [PubMed - as supplied by publisher]



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Evaluation of masticatory activity during unilateral single tooth clenching using muscle functional magnetic resonance imaging

Summary

Masticatory muscle activity during teeth clenching is affected by occlusal pattern. However, few studies have performed simultaneous evaluation of all masticatory activities during teeth clenching under various occlusal conditions. The aim of this study was to use muscle functional magnetic resonance imaging (mfMRI) to evaluate the effects of changes in occlusal point on masticatory activity during single tooth clenching. Changes in mean proton transverse relaxation time (∆T2) as an index of activity in all masticatory muscles during left unilateral clenching at the first molar or first premolar for 1 min were examined in nine healthy volunteers. Bite force was maintained at 40% of the maximum voluntary clenching force. The ∆T2 values of the masseter and lateral pterygoid muscles were analysed separately for superficial and deep layers, and for superior and inferior heads. The ∆T2 values for the ipsilateral deep masseter were significantly lower, and for the superior head of the ipsilateral lateral pterygoid muscles were significantly higher, after left first premolar clenching compared to left first molar clenching. These results quantitatively demonstrate a significant increase in activity of the superior head of the ipsilateral lateral pterygoid muscle and a significant decrease in activity of the ipsilateral deep masseter muscle with forward displacement of the occlusal contact point during unilateral tooth clenching.



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Clinical management of achalasia: current state of the art.

Clinical management of achalasia: current state of the art.

Clin Exp Gastroenterol. 2016;9:71-82

Authors: Krill JT, Naik RD, Vaezi MF

Abstract
Achalasia is a primary disorder of esophageal motility. It classically presents with dysphagia to both solids and liquids but may be accompanied by regurgitation and chest pain. The gold standard for the diagnosis of achalasia is esophageal motility testing with manometry, which often reveals aperistalsis of the esophageal body and incomplete lower esophageal sphincter relaxation. The diagnosis is aided by complimentary tests, such as esophagogastroduodenoscopy and contrast radiography. Esophagogastroduodenoscopy is indicated to rule out mimickers of the disease known as "pseudoachalasia" (eg, malignancy). Endoscopic appearance of a dilated esophagus with retained food or saliva and a puckered lower esophageal sphincter should raise suspicion for achalasia. Additionally, barium esophagography may reveal a dilated esophagus with a distal tapering giving it a "bird's beak" appearance. Multiple therapeutic modalities aid in the management of achalasia, the decision of which depends on operative risk factors. Conventional treatments include medical therapy, botulinum toxin injection, pneumatic dilation, and Heller myotomy. The last two are defined as the most definitive treatment options. New emerging therapies include peroral endoscopic myotomy, placement of self-expanding metallic stents, and endoscopic sclerotherapy.

PMID: 27110134 [PubMed]



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Complication and Reoperation Rates Following Surgical Management of Cervical Spondylotic Myelopathy in Medicare Beneficiaries.

Complication and Reoperation Rates Following Surgical Management of Cervical Spondylotic Myelopathy in Medicare Beneficiaries.

Spine (Phila Pa 1976). 2016 Apr 20;

Authors: Puvanesarajah V, Jain A, Cancienne JM, Shimer AL, Singla A, Shen F, Hassanzadeh H

Abstract
STUDY DESIGN: Retrospective database review.
OBJECTIVE: To compare complication and reoperation rates following anterior cervical discectomy and fusion (ACDF), posterior cervical fusion (PCFs), and anterior cervical corpectomy and fusion (ACCF) for cervical spondylotic myelopathy (CSM) using a large national database of Medicare beneficiaries.
SUMMARY OF BACKGROUND DATA: Cervical spondylotic myelopathy (CSM) is the most common cause of myelopathy in patients over 55 years and is considered the most common cause of spinal cord dysfunction in the world. Surgical treatment includes ACDF, PCF, or ACCF procedures.
METHODS: The PearlDiver database (2005-2012) was utilized to determine revision rates following surgical treatment of CSM by one of the aforementioned surgical treatments. Specifically, 1-2 level ACDF, ACCF, and PCF and 3+ level PCF cohorts were included. Each cohort was stratified by the age of 65 years. Survivorship curves were graphed and compared.
RESULTS: Of the patients younger than 65 years of age, there were 10,557 patients treated with 1-2 level ACDF procedures, 1,319 patients with 1-2 level PCF procedures, 1,203 patients with 1-2 level ACCF procedures, and 2,312 patients treated with 3+ level PCF procedures. Of the elderly patients, 24,310 patients were treated with 1-2 level ACDFs, 4,776 with 1-2 level PCF procedures, 3,109 with 1-2 level ACCFs, and 7,760 with 3+ level PCFs. Patients younger than 65 years of age were significantly more likely to have a reoperation procedure, than those 65 years or older when analyzing ACCF, ACDF, and 3+ level PCF procedures. ACCFs were significantly more likely than ACDFs to require reoperation. Patients treated with PCF were consistently more likely to have non-dysphagia related complications than those treated with ACDF. Rates of transfusion, dysphagia, and hematoma/seroma formation were significantly increased with ACCF compared to ACDF within the elderly population.
CONCLUSIONS: The elderly are significantly less likely to have a revision surgery following surgical treatment for CSM. Patients treated with ACCF are more likely to need a revision than those treated with ACDF.
LEVEL OF EVIDENCE: 3.

PMID: 27111765 [PubMed - as supplied by publisher]



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Clinical management of achalasia: current state of the art.

Clinical management of achalasia: current state of the art.

Clin Exp Gastroenterol. 2016;9:71-82

Authors: Krill JT, Naik RD, Vaezi MF

Abstract
Achalasia is a primary disorder of esophageal motility. It classically presents with dysphagia to both solids and liquids but may be accompanied by regurgitation and chest pain. The gold standard for the diagnosis of achalasia is esophageal motility testing with manometry, which often reveals aperistalsis of the esophageal body and incomplete lower esophageal sphincter relaxation. The diagnosis is aided by complimentary tests, such as esophagogastroduodenoscopy and contrast radiography. Esophagogastroduodenoscopy is indicated to rule out mimickers of the disease known as "pseudoachalasia" (eg, malignancy). Endoscopic appearance of a dilated esophagus with retained food or saliva and a puckered lower esophageal sphincter should raise suspicion for achalasia. Additionally, barium esophagography may reveal a dilated esophagus with a distal tapering giving it a "bird's beak" appearance. Multiple therapeutic modalities aid in the management of achalasia, the decision of which depends on operative risk factors. Conventional treatments include medical therapy, botulinum toxin injection, pneumatic dilation, and Heller myotomy. The last two are defined as the most definitive treatment options. New emerging therapies include peroral endoscopic myotomy, placement of self-expanding metallic stents, and endoscopic sclerotherapy.

PMID: 27110134 [PubMed]



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INTERACTIVE MEDICAL CASE. Eye of the Beholder.

Related Articles

INTERACTIVE MEDICAL CASE. Eye of the Beholder.

N Engl J Med. 2016 Apr 14;374(15):e18

Authors: MacFarlane L, Osman N, Vaidya A, Amato AA, Ritter S

PMID: 27074086 [PubMed - indexed for MEDLINE]



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Clinical significance of laryngopharyngeal reflux in patients with chronic obstructive pulmonary disease.

http:--http://ift.tt/1Fkw4zC Related Articles

Clinical significance of laryngopharyngeal reflux in patients with chronic obstructive pulmonary disease.

Int J Chron Obstruct Pulmon Dis. 2015;10:1343-51

Authors: Jung YH, Lee DY, Kim DW, Park SS, Heo EY, Chung HS, Kim DK

Abstract
BACKGROUND: Although chronic obstructive pulmonary disease (COPD) is closely associated with gastroesophageal reflux disease (GERD), the clinical significance of laryngopharyngeal reflux (LPR) is not fully understood in COPD.
METHODS: Prospective cohorts were established among 118 patients with COPD from March 2013 to July 2014. Thirty-two age-matched and sex-matched normal controls, who had routine health check-ups during the study period, were included. Laryngopharyngeal reflux finding scores (RFS) and reflux symptom index (RSI) for LPR were subjected to association analysis with severity and acute exacerbation of COPD during the 1-year follow-up.
RESULTS: The mean age of patients enrolled in the study was 69.2±8.8 years, with 93.2% being male. Positive RFS (>7) and RSI (>13) were observed in 51 (42.5%) and six patients (5.0%), respectively. RFS and RSI were significantly higher in patients with COPD than in normal, healthy patients (P<0.001). RFS was significantly correlated with residual volume/total lung capacity (%, P=0.048). Scores for diffuse laryngeal edema, erythema, and hyperemia were significantly higher in the high-risk group (Global Initiative for Chronic Obstructive Lung Disease classification C and D; P=0.025 and P=0.049, respectively), while RSI was significantly higher in the more symptomatic group (Global Initiative for Chronic Obstructive Lung Disease classification B and D; P=0.047). RSI and RFS were significant predictors for severe acute exacerbation of COPD (P=0.03 and P=0.047, respectively), while only RSI was associated with severity of dyspnea.
CONCLUSION: Laryngeal examination and evaluation of laryngeal reflux symptom could be a surrogate clinical indicator related to severe acute exacerbation of COPD. Further studies of LPR in COPD patients should be considered.

PMID: 26203240 [PubMed - indexed for MEDLINE]



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Quality of life after total laryngectomy: functioning, psychological well-being and self-efficacy.

http:--media.wiley.com-assets-7315-19-Wi Related Articles

Quality of life after total laryngectomy: functioning, psychological well-being and self-efficacy.

Int J Lang Commun Disord. 2015 Jul;50(4):467-75

Authors: Perry A, Casey E, Cotton S

Abstract
BACKGROUND: Quality of life (QoL) is an important construct when assessing treatment outcomes.
AIMS: To examine the relative contributions of functioning, psychological well-being and self-efficacy on self-perceived QoL with a sample of total laryngectomy patients in Australia who had surgery for advanced laryngeal cancer.
METHODS & PROCEDURES: In a cross-sectional study, 113 members of the Laryngectomy Associations of New South Wales and of Victoria, Australia, were recruited, and each was sent a series of questionnaires for postal return. Four psychometrically validated measures were used for participants to document their QoL, functioning (speech, swallowing), psychological well-being and general self-efficacy.
OUTCOMES & RESULTS: Eighty-six (77%) questionnaires were returned and 83 were analysed. The cohort consists of 70 men and 13 women aged between 46 and 88 years. Overall, this sample of total laryngectomy survivors demonstrated significantly reduced physical health QoL (p < 0.001) and social relationship QoL (p = 0.011) and higher levels of depression (p = 0.008) and anxiety (p = 0.001) when compared with normative samples. This was in the context of them having higher than normal self-efficacy scores and, at worst, mild (self-rated) impairment of speech and of swallowing. Psychological well-being (sr(2) = 0.43, p < 0.001) had a stronger association than functioning (speech, swallowing, sr(2) = 0.08, p < 0.05) for their psychological QoL. Psychological well-being (sr(2) = 0.17, p < 0.001) and not functioning (sr(2) = 0.05, p > 0.05) were significantly associated with social relationship QoL. Self-efficacy scores were significantly higher than norms in this cohort, but were not associated with either their psychological QoL or social relationship QoL, after controlling for psychological well-being and functioning.
CONCLUSIONS & IMPLICATIONS: For survivors of laryngeal cancer treated by total laryngectomy, it is important to be aware of the impact of psychological well-being (depression, anxiety, stress) on self-perceived QoL. In addition to rehabilitating function (speech, swallowing), specific interventions to assist these individuals better manage their psychological well-being will likely improve their perceived life satisfaction/QoL.

PMID: 25703153 [PubMed - indexed for MEDLINE]



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Central nervous system involvement in ALK-rearranged NSCLC: promising strategies to overcome crizotinib resistance.

Central nervous system involvement in ALK-rearranged NSCLC: promising strategies to overcome crizotinib resistance.

Expert Rev Anticancer Ther. 2016 Apr 23;

Authors: Russo A, Franchina T, Ricciardi GR, Ferraro G, Scimone A, Bronte G, Russo A, Rolfo C, Adamo V

Abstract
ALK rearranged Non Small Cell Lung Cancers (NSCLCs) represent a distinct subgroup of patients with peculiar clinic-pathological features. These patients exhibit dramatic responses when treated with the ALK tyrosine kinase inhibitor Crizotinib, albeit Central Nervous System (CNS) activity is much less impressive than that observed against extracranial lesions. CNS involvement has become increasingly observed in these patients, given their prolonged survival. Several novel generation ALK inhibitors have been developing to increase CNS penetration and to provide more complete ALK inhibition. The CNS activity of Crizotinib and novel generation ALK inhibitors will be summarized in this review, evaluating the strengths and weaknesses of the therapeutic strategies developed to date in this specific subgroup of NSCLCs with a look towards the future.

PMID: 27109446 [PubMed - as supplied by publisher]



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Multi-site capacity planning and business optimisation for process industries.

Levis, A.; (2005) Multi-site capacity planning and business optimisation for process industries. Doctoral thesis, University of London. Green open access

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Death and das Man: Authenticity in Heidegger's being and time.

Leonard, S.; (2005) Death and das Man: Authenticity in Heidegger's being and time. Masters thesis, University of London. Green open access

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An international comparison of the deinstitutionalisation of mental health care: Development and findings of the Mental Health Services Deinstitutionalisation Measure (MENDit)

Taylor Salisbury, T; Killaspy, H; King, M; (2016) An international comparison of the deinstitutionalisation of mental health care: Development and findings of the Mental Health Services Deinstitutionalisation Measure (MENDit). BMC Psychiatry , 16 (54) 10.1186/s12888-016-0762-4 . Green open access

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Early screening for potential literacy difficulties and intervening in nursery/reception.

Legg, V.A.; (2005) Early screening for potential literacy difficulties and intervening in nursery/reception. Doctoral thesis, University of London. Green open access

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Are depression and poor sexual health neglected comorbidities? Evidence from a population sample

Field, N; Prah, P; Mercer, CH; Rait, G; King, M; Cassell, JA; Tanton, C; Field, N; Prah, P; Mercer, CH; Rait, G; King, M; Cassell, JA; Tanton, C; Heath, L; Mitchell, KR; Clifton, S; Datta, J; Wellings, K; Johnson, AM; Sonnenberg, P; - view fewer (2016) Are depression and poor sexual health neglected comorbidities? Evidence from a population sample. BMJ Open , 6 (3) , Article e010521. 10.1136/bmjopen-2015-010521 . Green open access

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Sustainable urban transport in Kuala Lumpur - A backcasting scenario approach.

Lee, P.N.; (2005) Sustainable urban transport in Kuala Lumpur - A backcasting scenario approach. Doctoral thesis, University of London. Green open access

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Living conditions and quality of care in residential units for people with long-term mental illness in Portugal - a cross-sectional study

Cardoso, G; Papoila, A; Tomé, G; Killaspy, H; King, M; Caldas-de-Almeida, JM; (2016) Living conditions and quality of care in residential units for people with long-term mental illness in Portugal - a cross-sectional study. BMC Psychiatry , 16 (34) 10.1186/s12888-016-0743-7 . Green open access

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Orbital complications associated with paranasal sinus infections – A 10-year experience in Israel

Publication date: July 2016
Source:International Journal of Pediatric Otorhinolaryngology, Volume 86
Author(s): Nili Segal, Roni Nissani, Sofia Kordeluk, Meni Holcberg, Shay Hertz, Firas Kassem, Anwar Mansour, Avichai Segal, Ofer Gluck, Yehudah Roth, Tal Honigman, Moshe Ephros, Ranan Cohen Kerem
ObjectiveOrbital involvement is the most common complication of sinus infections. The epidemiology of the disease is continuously changing in the antibiotic era.Materials and methodsData on patients who were hospitalized due to acute sinusitis and orbital complications were retrospectively collected and analyzed from four medical centers in Israel during the years 2002–2012.Results288 patients were included in the study, the average age was 14.4 years, 180 were males, and 220 were children. No significant annual increase in the number of patients was noted. The lowest number of patients was found during the summer 19.4%. A linear direct correlation was found between older age and prolonged hospital stay. Children were presented with a significantly higher Chandler score than adults. No patient had cavernous sinus thrombosis. 101 (35%) patients received antibiotics before hospital admission. Their average hospital stay was similar to those who were not treated prior to admission. 106 patients (39.8%) had fever. A direct correlation was found between older age and the presence of fever. 102 (35.4%) patients had leukocytosis. The difference in white blood cell count between patients younger than two years of age to the other groups was statistically significant. Forty four (15.3%) patients underwent surgical intervention. A direct correlation was found between leukocytosis and older age to surgery.ConclusionsPeriorbital cellulitis occurs mainly in children and males and is less frequent in the summer. Children tend to have worse orbital involvement with lower temperatures than adults. Older age and leukocytosis are associated with surgical intervention.



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The assessment of the impact of anorexia nervosa on the vocal apparatus in adolescent girls – A preliminary report

Publication date: June 2016
Source:International Journal of Pediatric Otorhinolaryngology, Volume 85
Author(s): Barbara Maciejewska, Aleksandra Rajewska-Rager, Zofia Maciejewska-Szaniec, Michał Michalak, Andrzej Rajewski, Bożena Wiskirska-Woźnica
BackgroundChronic undernourishment in the course of anorexia nervosa leads to various metabolic and hormonal changes, which translates to the impaired functioning of the majority of systems and internal organs. The impact of eating disorders on the condition of the vocal apparatus has been described in the literature; nevertheless, it concerns mainly bulimia nervosa.Objectivesassessment of the vocal apparatus in adolescent girls diagnosed with anorexia nervosa from the point of view of possible influence on the function and structure of the larynx, low body mass accompanying anorexia, as well as energy deficiency, hormonal and emotional disturbances.Materials and methodsThe research included 41 girls aged 12–19 years, diagnosed with anorexia, who were assessed for the condition of the vocal apparatus, using the perceptual assessment of voice according to GRBAS scale, videolarynostroboscopy, acoustic assessment, and voice self-assessment in Jacobson's VHI scale (voice handicap index).ResultsThe perceptual assessment of voice using the GRBAS scale revealed that changes in voice were mainly weak, asthenic in nature (70.73%) and there was also the feature of puffing perceived in voice (41.46%). In voice self-assessment with the use of VHI, most subjects seemed to point to changes of voice self-perception in emotional subscale (68%). Videolaryngostroboscopy revealed some features of functional disturbances of voice in more than half of subjects, mainly in the form of hyperfunctional dysphonia (31.78%). The maximal phonation time was significantly shorter, in proportion to duration of the primary disease. In the acoustic analysis, the decrease in the basic frequency F0 and narrowing of the voice scale were observed. 55% of older, post-adolescent patients presented with the structure of the larynx that was inappropriate for their age.ConclusionsThese results might indicate that anorexia nervosa could have led to the structural and functional changes in the vocal apparatus. Such disturbances may be explained by the hormonal dysfunctions as well as starvation. Hormonal substitution at the appropriate time might be beneficial for the structure and phonation function of the larynx in girls with AN.



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Characterization of Leptospiral Chemoreceptors Using a Microscopic Agar Drop Assay.

Characterization of Leptospiral Chemoreceptors Using a Microscopic Agar Drop Assay.

Curr Microbiol. 2016 Apr 25;

Authors: Affroze S, Islam MS, Takabe K, Kudo S, Nakamura S

Abstract
Bacterial chemotaxis is induced by sensing chemical stimuli via chemoreceptors embedded in the cytoplasmic membrane, enabling the cells to migrate toward nutrients or away from toxins. The chemoreceptors of Escherichia coli and Salmonella spp. have been well studied and are functionally classified on the basis of detectable substrates. The spirochete Leptospira possesses more than ten chemoreceptors and shows attractive or repellent responses against some sugars, amino acids, and fatty acids. However, the roles of these chemoreceptors have not been investigated. In this study, we conducted a chemotaxis assay called microscopic agar drop assay in combination with competition experiments, determining whether two kinds of attractants are recognized by the same type of chemoreceptor in the saprophytic Leptospira strain, Leptospira biflexa. Analyzing the competition effect observed between several pairs of chemicals, we found that L. biflexa senses sugars via chemoreceptors different from those that sense amino acids and fatty acids.

PMID: 27109059 [PubMed - as supplied by publisher]



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Navigation-guided Endoscopic Intraventricular Injectable Tumor Model: Cadaveric Tumor Resection Model for Neurosurgical Training.

Navigation-guided Endoscopic Intraventricular Injectable Tumor Model: Cadaveric Tumor Resection Model for Neurosurgical Training.

World Neurosurg. 2016 Apr 21;

Authors: Ashour AM, Elbabaa SK, Caputy AJ, Gragnaniello C

Abstract
BACKGROUND: Intraventricular tumors present difficult challenges to the neurosurgeon. Neurosurgeons have begun to explore the possibilities of using the endoscope in the radical resection of solid intraventricular lesions. There is a steep learning curve when dealing with such lesions with an endoscope.
OBJECTIVE: The aim of this study was to create a laboratory training model for pathological intraventricular neuroendoscopic surgery guided by the navigation system. We believe this technique is more reliable than the traditional approach using contrast injection with C-arm x-ray guidance.
MATERIALS AND METHODS: Five formalin-fixated, latex-injected cadaveric heads were used. The arterial system was injected with red latex through the common carotid arteries, and the venous system was injected with blue latex through the internal jugular veins at the C6 vertebral level. The contrast-enhancing tumor polymer, Stratathane resin ST-504 derived polymer (SRSDP), was injected into the lateral ventricle via Frazier's point under direct endoscopic visualization and real-time neuronavigation guidance. When navigation was used for trajectory planning, the peel-away sheath was registered using a frameless navigational system (BrainLAB, Feldkirchen, Germany). A questionnaire was distributed to all the participants of an endoscopic cadaveric course where the models were used to evaluate the endoscopic tumor model.
RESULTS: Neurosurgeon participating at a course performed an endoscopic approach to resect the intraventricular tumor model through an ipsilateral frontal burr hole. The properties of the SRSDP mixture could be manipulated through varying concentrations of the materials used, in order to reach the desired consistency of a nodular solid lesion and possibility for piecemeal resection. The tumor model allowed participants to compare between normal and pathological endoscopic anatomy in the same cadaveric head.
CONCLUSION: This injectable tumor model with the combination of neuroendoscopy and navigation can improve the accuracy of the endoscopic approach and minimize the risk of cadaveric brain specimen damage that in return augments the feeling of lifelike conditions. Using this endoscopic injectable tumor model technique can assist neurosurgeons` preparation for the challenges associated with an endoscopic piecemeal resection of a solid lesion in the lateral or third ventricle.

PMID: 27109629 [PubMed - as supplied by publisher]



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A Case of Hyper acute Onset of Vasospasm after Aneurismal SAH and Refractory Vasospasm treated with Intravenous and Intraventricular Nitric Oxide: A mini review.

A Case of Hyper acute Onset of Vasospasm after Aneurismal SAH and Refractory Vasospasm treated with Intravenous and Intraventricular Nitric Oxide: A mini review.

World Neurosurg. 2016 Apr 21;

Authors: Ehlert A, Manthei G, Hesselmann V, Mathias K, Bein B, Pluta R

Abstract
We report a 65-year old woman admitted within 1 hour after aneurismal SAH (Hunt&Hess III°, Fisher modified by Frontera IV°) with arteriographically confirmed hyperacute vasospasm, whose severe clinical course of vasospasm was successfully treated with NO donors. A source of SAH, the right MCA aneurysm was immediately coiled and the patient was placed on standard anti-vasospastic therapy. However, within 48 hours after aneurysm repair she developed cerebral vasospasms with clinical deterioration (delayed cerebral ischemia; DCI). Since the standard therapy failed to control clinical symptoms of DCI and to address severe vasospasm, an individualized rescue treatment with nitric oxide (NO) donors, was initiated. An intravenous continuous Molsidomine infusion had been started and clinical stabilization was achieved for a week (HH I°, WFNS I°) when vasospasm and DCI recurred, which required escalation of NO donor therapy by adding intraventricular boluses of sodium nitroprusside (SNP). Over the course of 22 days, 7 transient clinical vasospasm-related deteriorations were treated with boluses of SNP during continued Molsidomine therapy and each time vasospasm and DCI were completely reversed. Despite severe complications of aneurismal SAH that usually result in a poor outcome, the clinical outcome of this patient was excellent. At 3, 6, and 12 months follow up her mNIH-SS and mRS were 0. We present and discuss the use NO donors in cases of resistant severe vasospasm and DCI.

PMID: 27109628 [PubMed - as supplied by publisher]



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Diagnosis and Treatment of Intracranial Aneurysms using 320-detector Row Volumetric CT Angiography.

Diagnosis and Treatment of Intracranial Aneurysms using 320-detector Row Volumetric CT Angiography.

World Neurosurg. 2016 Apr 21;

Authors: Chen W, Xing W, Peng Y, He Z, Wang C, Wang Q

Abstract
OBJECTIVES: The objective of the study was to determine the clinical utility of 320-detector row volume computed tomographic angiography (VCTA) in the management of intracranial aneurysms.
METHODS: Between February 2011 and May 2015, 550 patients successfully underwent 320-detector row VCTA for suspected intracranial aneurysms. Three-dimensional (3D) digital subtraction angiography (DSA) was employed as the ultimate reference standard, and the sensitivity, specificity, and accuracy of both non-subtracted and subtracted VCTA in identifying aneurysms were analyzed.
RESULTS: Non-subtracted VCTA identified 417 aneurysms (n=2 false positive readings, n=12 false negative readings). The diagnostic sensitivity, specificity, and accuracy of non-subtracted VCTA, on a per-aneurysm basis, were 97.2%, 99.0% and 97.6%, respectively. Subtracted VCTA identified 426 aneurysms (n=2 false positive readings, n=3 false negative readings). The sensitivity, specificity, and accuracy of subtracted VCTA, on a per-aneurysm basis, were 99.3%, 99.0% and 99.2%, respectively. No differences in diagnostic accuracy were found between subtracted VCTA and 3D DSA. However, non-subtracted VCTA was observed to be significantly less sensitive than 3D DSA and subtracted VCTA. Twenty-six aneurysm cases were referred for surgical treatment based on VCTA imaging. All aneurysms were deemed completely occluded during surgical clipping. Based on VCTA imaging, 299 aneurysms were found suitable for endovascular coiling, of which, 293 aneurysms (98%) were successfully treated.
CONCLUSIONS: The 320-detector row subtracted VCTA technique is an effective, first-line diagnostic imaging modality for surgical and endovascular treatment of aneurysms. The non-subtracted VCTA was less accurate than the subtracted VCTA, especially for intracranial aneurysms adjoining bone tissue.

PMID: 27109627 [PubMed - as supplied by publisher]



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Immune Checkpoint Therapy in Head and Neck Cancers.

Immune Checkpoint Therapy in Head and Neck Cancers.

Cancer J. 2016 Mar-Apr;22(2):108-116

Authors: Msaouel P, Massarelli E

Abstract
Most patients with head and neck squamous cell cancer (HNSCC) will present with advanced disease characterized by poor prognosis and limited treatment options. Our growing understanding of the complex crosstalk between tumor cells and the immune system has facilitated the development of promising therapies targeting immune checkpoints, such as programmed death 1 and the cytotoxic T-lymphocyte antigen 4, which are producing considerable clinical responses. However, HNSCC tissues use diverse strategies to avoid immunosurveillance, thus limiting our ability to fully harness the immune system to achieve consistent and durable antitumor activity. This may be counteracted by optimizing the dosing, sequence, and timing of immune checkpoint therapies and by combining these regimens with other modalities such as radiation therapy, cancer vaccines, cytotoxic chemotherapies, and molecularly targeted agents. The present review summarizes the pathophysiological role of immune regulation in HNSCC and provides a concise update on the clinical translation of immune checkpoint therapies in this tumor type.

PMID: 27111906 [PubMed - as supplied by publisher]



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Identifying cutoff scores for the EORTC QLQ-C30 and the head and neck cancer-specific module EORTC QLQ-H&N35 representing unmet supportive care needs in patients with head and neck cancer.

Identifying cutoff scores for the EORTC QLQ-C30 and the head and neck cancer-specific module EORTC QLQ-H&N35 representing unmet supportive care needs in patients with head and neck cancer.

Head Neck. 2016 Apr;38(S1):E1493-E1500

Authors: Jansen F, Snyder CF, Leemans CR, Verdonck-de Leeuw IM

Abstract
BACKGROUND: This study investigates cutoff scores for the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-questions (EORTC QLQ-C30) and head and neck cancer-specific module (QLQ-H&N35) to identify patients with head and neck cancer who may require clinical attention.
METHODS: Ninety-six patients with head and neck cancer completed the EORTC QLQ-C30/H&N35 and questions on supportive care needs. For all EORTC domains with the ability to discriminate between patients with and without unmet needs (area under the receiver operating characteristic curve [AUC] ≥0.70), the accuracy (eg, sensitivity and specificity) of potential cutoff scores were calculated.
RESULTS: Cutoff scores (sensitivity ≥0.80 and specificity ≥0.60) of 90 (functioning domains) and 5 to 10 (symptom domains) were found on 7 of 28 continuous EORTC QLQ-C30/H&N35 domains. Borderline cutoff scores (sensitivity ≥0.70 and specificity ≥0.60 or sensitivity ≥0.80 and specificity ≥0.50) were found on 5 other domains.
CONCLUSIONS: This study provided cutoff scores on the EORTC QLQ-C30 and H&N35 based on patients' perceptions of their needs for supportive care. Future research is needed on the replicability of these cutoff scores. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1493-E1500, 2016.

PMID: 27111696 [PubMed - as supplied by publisher]



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Tinnitus Suppression by Intracochlear Electrical Stimulation in Single Sided Deafness - A Prospective Clinical Trial: Follow-Up.

Tinnitus Suppression by Intracochlear Electrical Stimulation in Single Sided Deafness - A Prospective Clinical Trial: Follow-Up.

PLoS One. 2016;11(4):e0153131

Authors: Arts RA, George EL, Janssen M, Griessner A, Zierhofer C, Stokroos RJ

Abstract
INTRODUCTION: Earlier studies show that a Cochlear Implant (CI), capable of providing intracochlear electrical stimulation independent of environmental sounds, appears to suppress tinnitus at least for minutes. The current main objective is to compare the long-term suppressive effects of looped (i.e. repeated) electrical stimulation (without environmental sound perception) with the standard stimulation pattern of a CI (with environmental sound perception). This could open new possibilities for the development of a "Tinnitus Implant" (TI), an intracochlear pulse generator for the suppression of tinnitus.
MATERIALS AND METHODS: Ten patients with single sided deafness suffering from unilateral tinnitus in the deaf ear are fitted with a CI (MED-EL Corporation, Innsbruck, Austria). Stimulation patterns are optimized for each individual patient, after which they are compared using a randomized crossover design, with a follow-up of six months, followed by a 3 month period using the modality of patient's choice.
RESULTS: Results show that tinnitus can be suppressed with intracochlear electrical stimulation independent of environmental sounds, even long term. No significant difference in tinnitus suppression was found between the standard clinical CI and the TI.
CONCLUSION: It can be concluded that coding of environmental sounds is no requirement for tinnitus suppression with intracochlear electrical stimulation. It is therefore plausible that tinnitus suppression by CI is not solely caused by an attention shift from the tinnitus to environmental sounds. Both the standard clinical CI and the experimental TI are potential treatment options for tinnitus. These findings offer perspectives for a successful clinical application of the TI, possibly even in patients with significant residual hearing.
TRIAL REGISTRATION: TrialRegister.nl NTR3374.

PMID: 27111333 [PubMed - as supplied by publisher]



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Programmed death ligand-1 expression is associated with poor disease free survival in salivary gland carcinomas.

Programmed death ligand-1 expression is associated with poor disease free survival in salivary gland carcinomas.

J Surg Oncol. 2016 Apr 25;

Authors: Mukaigawa T, Hayashi R, Hashimoto K, Ugumori T, Hato N, Fujii S

Abstract
BACKGROUND AND OBJECTIVES: The immune checkpoint ligand programmed death ligand-1 (PD-L1) is expressed in various carcinomas and allows carcinoma cells to elude the immune system. PD-L1 expression is associated with the response to anti-programmed death 1 (PD-1)/PD-L1 drugs. This study aimed to clarify the relationship between PD-L1 expression and clinicopathological factors of salivary gland carcinomas (SGCs) and identify its clinical significance.
METHODS: PD-L1 expression was examined by immunohistochemical analysis using a tissue microarray comprised of 219 surgically resected SGC specimens. Detailed clinicopathological factors, including patient outcome, were available for all cases.
RESULTS: A case showing complete membranous expression of PD-L1 in more than 1% of whole carcinoma cells was considered positive by ROC analysis. A total of 50 (22.8%) patients showed PD-L1 expression in SGC cells. Positive PD-L1 expression was significantly associated with poor disease free survival (P < 0.001) and overall survival (P < 0.001). Multivariate analysis revealed that positive PD-L1 expression was one of the independent predictors for poor disease free survival (hazard ratio = 2.287, 95% confidence interval = 1.24-4.15; P = 0.008).
CONCLUSIONS: Positive PD-L1 expression was significantly associated with poor disease free survival of SGCs, suggesting that antibody therapies targeting PD-1/PD-L1 may have potential application in SGCs. J. Surg. Oncol. © 2016 Wiley Periodicals, Inc.

PMID: 27111278 [PubMed - as supplied by publisher]



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Benefits of Immediate Extubation Following Free Tissue Transfer for Head and Neck Reconstruction.

Benefits of Immediate Extubation Following Free Tissue Transfer for Head and Neck Reconstruction.

J Reconstr Microsurg. 2016 Apr 25;

Authors: Tamplen ML, Ricceri S, Hemmat S, Seth R, Ryan WR, Knott PD

Abstract
Background Immediate postprocedure extubation (cessation of mechanical ventilation) after free tissue transfer for head and neck reconstruction may improve outcomes, reduce intensive care unit and hospital length of stay, and reduce overall cost compared with delayed extubation in the intensive care unit. Methods Medical records of 180 consecutive patients undergoing free tissue transfer for head and neck reconstruction were reviewed. Patients immediately extubated in the operating room (immediate group, N = 63) were compared with patients who were extubated in the intensive care unit (delayed group, N = 117) by univariate and multivariate analysis. Results Medical complication rates and intensive care unit length of stay were significantly higher in the delayed extubation group (55.5 vs. 12.7%, p < 0.001, and 4.4 vs. 2.9 days, p < 0.001, respectively). Although the rate of preoperative alcohol use was similar between the two groups, significantly fewer patients underwent treatment for alcohol withdrawal or agitation in the immediate extubation group (3.2 vs. 27.4%, p = 0.001). There were no significant differences in surgical complication rates. Conclusion Immediate postprocedure extubation is associated with shorter intensive care unit length of stay, reduced medical complications, and reduced incidence of treatment for agitation/alcohol withdrawal for patients undergoing free tissue transfer for head and neck reconstruction.

PMID: 27110906 [PubMed - as supplied by publisher]



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Direct Cost-Analysis of Mohs Micrographic Surgery and Traditional Excision for Basal Cell Carcinoma at Initial Margin Clearance.

Direct Cost-Analysis of Mohs Micrographic Surgery and Traditional Excision for Basal Cell Carcinoma at Initial Margin Clearance.

Dermatol Surg. 2016 Apr 21;

Authors: Sebaratnam DF, Choy B, Lee M, Paver R, Fernández Peñas P

Abstract
BACKGROUND: The literature provides mixed results regarding cost comparisons of Mohs micrographic surgery (MMS) and traditional excision (TE).
OBJECTIVE: To complete a prospective cohort study comparing true costs of MMS with projected costs of TE for head and neck basal cell carcinoma (BCC).
METHODS: Patients referred for MMS of biopsy-proven BCC were eligible for inclusion. For each case, surgery with TE was planned before the patient proceeded to MMS. The true costs of MMS were compared with projected costs of TE. All TE patients with inadequate excision were assumed to have subsequent TE, and the cost of the subsequent procedure was assumed to be equal to the first.
RESULTS: The mean cost of MMS was $628.47 (95% CI: $617.73-$639.21) compared with $587.51 (95% CI: $558.42-$616.59) for TE. This difference of $40.96 to initial margin clearance was significant (z = 4.48, p < .001).
CONCLUSION: On average, MMS was found to be $40.96 more expensive than TE in treating BCC-a small but appreciable difference. This being the case, any fiscal comparison must also be tempered with a consideration of effectiveness. Accordingly, further work in the form of a cost-utility study is required to truly define the cost-effectiveness of MMS compared with TE in this setting.

PMID: 27110895 [PubMed - as supplied by publisher]



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Factors associated with self-reported outcome in adaptation of hearing aid.

Factors associated with self-reported outcome in adaptation of hearing aid.

Acta Otolaryngol. 2016 Apr 25;:1-7

Authors: Chang YS, Choi J, Moon IJ, Hong SH, Chung WH, Cho YS

Abstract
OBJECTIVE: This investigation evaluated the associated factors with self-reported outcome in hearing aid users by adopting the Korean version of International Outcome Inventory for Hearing Aids (IOI-HA) and Hearing Handicap Inventory for the Elderly (HHIE).
METHODS: Two hundred and eight participants were enrolled in this study. Participants completed the HHIE at pre-fitting, HHIE and the IOI-HA at 1 and 3 months after fitting. The outcomes of both questionnaires were analyzed with regard to the variable factors reported or expected to be associated with the outcome of hearing aid use.
RESULTS: The hearing-related handicap evaluated by HHIE score at pre-fitting had significant associations with age and the severity of hearing impairment. The IOI-HA score with hearing aid use was significantly correlated with WRS and the severity of hearing impairment. The improvement of HHIE score showed a significant correlation with WRS.
CONCLUSION: Word recognition score (WRS) is the most significantly associated factor for outcome of hearing aid use. In addition, audiometric configuration, previous experience of hearing aid use, and initial hearing handicap should be considered as associated factors with hearing aid outcome.

PMID: 27110845 [PubMed - as supplied by publisher]



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A small molecule mitigates hearing loss in a mouse model of Usher syndrome III.

A small molecule mitigates hearing loss in a mouse model of Usher syndrome III.

Nat Chem Biol. 2016 Apr 25;

Authors: Alagramam KN, Gopal SR, Geng R, Chen DH, Nemet I, Lee R, Tian G, Miyagi M, Malagu KF, Lock CJ, Esmieu WR, Owens AP, Lindsay NA, Ouwehand K, Albertus F, Fischer DF, Bürli RW, MacLeod AM, Harte WE, Palczewski K, Imanishi Y

Abstract
Usher syndrome type III (USH3), characterized by progressive deafness, variable balance disorder and blindness, is caused by destabilizing mutations in the gene encoding the clarin-1 (CLRN1) protein. Here we report a new strategy to mitigate hearing loss associated with a common USH3 mutation CLRN1(N48K) that involves cell-based high-throughput screening of small molecules capable of stabilizing CLRN1(N48K), followed by a secondary screening to eliminate general proteasome inhibitors, and finally an iterative process to optimize structure-activity relationships. This resulted in the identification of BioFocus 844 (BF844). To test the efficacy of BF844, we developed a mouse model that mimicked the progressive hearing loss associated with USH3. BF844 effectively attenuated progressive hearing loss and prevented deafness in this model. Because the CLRN1(N48K) mutation causes both hearing and vision loss, BF844 could in principle prevent both sensory deficiencies in patients with USH3. Moreover, the strategy described here could help identify drugs for other protein-destabilizing monogenic disorders.

PMID: 27110679 [PubMed - as supplied by publisher]



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Molecularly targeted therapy for the treatment of head and neck cancer: a review of the ErbB family inhibitors.

Molecularly targeted therapy for the treatment of head and neck cancer: a review of the ErbB family inhibitors.

Onco Targets Ther. 2016;9:1927-43

Authors: Sacco AG, Worden FP

Abstract
The majority of patients with head and neck squamous cell carcinoma (HNSCC) present with locally advanced disease, which requires site-specific combinations of surgery, radiation, and chemotherapy. Despite aggressive therapy, survival outcomes remain poor, and treatment-related morbidity is not negligible. For patients with recurrent or metastatic disease, therapeutic options are further limited and prognosis is dismal. With this in mind, molecularly targeted therapy provides a promising approach to optimizing treatment efficacy while minimizing associated toxicity. The ErbB family of receptors (ie, epidermal growth factor receptor [EGFR], ErbB2/human epidermal growth factor receptor [HER]-2, ErbB3/HER3, and ErbB4/HER4) is known to contribute to oncogenic processes, such as cellular proliferation and survival. EGFR, specifically, is upregulated in more than 90% of HNSCC, has been implicated in radiation resistance, and correlates with poorer clinical outcomes. The central role of EGFR in the pathogenesis of HNSCC suggests that inhibition of this pathway represents an attractive treatment strategy. As a result, EGFR inhibition has been extensively studied, with the emergence of two classes of drug therapy: monoclonal antibodies and tyrosine kinase inhibitors. While the monoclonal antibody cetuximab is currently the only US Food and Drug Administration-approved EGFR inhibitor for the treatment of HNSCC, numerous investigational drugs are being evaluated in clinical trials. This paper will review the role of the ErbB family in the pathogenesis of HNSCC, as well as the evidence-based data for the use of ErbB family inhibition in clinical practice.

PMID: 27110122 [PubMed]



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Balance in subjects with congenital or early onset strabismus: influence of age.

Balance in subjects with congenital or early onset strabismus: influence of age.

Neurosci Lett. 2016 Apr 21;

Authors: Dickmann A, Di Sipio E, Simbolotti C, Agresta A, Germanotta M, Tredici C, Petroni S, Padua L, Aprile I

Abstract
Few studies have investigated the relationship between strabismus and balance, and those that do exist focused on patients within a limited age range, while no studies on possible age-related changes have yet been conducted. Therefore, the aim of our study was to investigate whether the balance strategies adopted by patients with congenital or early onset strabismus change with age. Forty strabismic patients and 36 healthy subjects were enrolled in the study. Both patients and healthy subjects were divided into three subgroups according to age (children, adolescents, and adults) and underwent a stabilometric evaluation. When we compared the whole group of strabismic patients with the group of healthy subjects, we found that the center of pressure area and the trunk oscillations in the former were significantly different from those in the latter; when we considered the three age groups separately, only values in children with strabismus were different from those in the age-matched control group of healthy subjects. Strabismus was found to affect balance in children by inducing a postural strategy characterized by a reduction in physiological trunk oscillations. Gaining a better insight into postural control in strabismic subjects and its evolution with age may be crucial to improving rehabilitation in such patients and planning tailored rehabilitation treatment.

PMID: 27109787 [PubMed - as supplied by publisher]



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Prognostic microRNA signatures derived from The Cancer Genome Atlas for head and neck squamous cell carcinomas.

Prognostic microRNA signatures derived from The Cancer Genome Atlas for head and neck squamous cell carcinomas.

Cancer Med. 2016 Apr 25;

Authors: Wong N, Khwaja SS, Baker CM, Gay HA, Thorstad WL, Daly MD, Lewis JS, Wang X

Abstract
Identification of novel prognostic biomarkers typically requires a large dataset which provides sufficient statistical power for discovery research. To this end, we took advantage of the high-throughput data from The Cancer Genome Atlas (TCGA) to identify a set of prognostic biomarkers in head and neck squamous cell carcinomas (HNSCC) including oropharyngeal squamous cell carcinoma (OPSCC) and other subtypes. In this study, we analyzed miRNA-seq data obtained from TCGA patients to identify prognostic biomarkers for OPSCC. The identified miRNAs were further tested with an independent cohort. miRNA-seq data from TCGA was also analyzed to identify prognostic miRNAs in oral cavity squamous cell carcinoma (OSCC) and laryngeal squamous cell carcinoma (LSCC). Our study identified that miR-193b-3p and miR-455-5p were positively associated with survival, and miR-92a-3p and miR-497-5p were negatively associated with survival in OPSCC. A combined expression signature of these four miRNAs was prognostic of overall survival in OPSCC, and more importantly, this signature was validated in an independent OPSCC cohort. Furthermore, we identified four miRNAs each in OSCC and LSCC that were prognostic of survival, and combined signatures were specific for subtypes of HNSCC. A robust 4-miRNA prognostic signature in OPSCC, as well as prognostic signatures in other subtypes of HNSCC, was developed using sequencing data from TCGA as the primary source. This demonstrates the power of using TCGA as a potential resource to develop prognostic tools for improving individualized patient care.

PMID: 27109697 [PubMed - as supplied by publisher]



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Preparation and performance of a pH-sensitive cisplatin-loaded magnetic nanomedicine that targets tumor cells via folate receptor mediation.

Preparation and performance of a pH-sensitive cisplatin-loaded magnetic nanomedicine that targets tumor cells via folate receptor mediation.

Mol Med Rep. 2016 Apr 21;

Authors: Chen SJ, Zhang HZ, Wan LC, Jiang SS, Xu YM, Liu F, Zhang T, Ma D, Xie MQ

Abstract
The present study aimed to prepare cisplatin (CDDP)-loaded magnetic nanoparticles (MNPs), which target folate receptors via a pH-sensitive release system (FA‑PEG‑NH‑N=MNPs‑CDDP). This is of interest for the development of intelligent drug delivery systems that target tumors of the head and neck. The chemical coprecipitation method was used to prepare ferroferric oxide MNPs. These were modified with aldehyde sodium alginate complexed with the chemotherapeutic agent, CDDP on the surface of the nanoparticles. Double hydrazine‑poly(ethylene glycol; PEG) was also prepared by attaching the carboxyl group of hydrazine‑folate on one side of the double hydrazine‑PEG, obtaining folate‑hydrazine‑PEG‑diazenyl. This binds the aldehyde group of sodium alginic acid on the MNP to enclose CDDP, in order that it is sequestered within the carrier. This method obtained a pH‑sensitive, FA‑modified CDDP‑loaded MNP (FA‑PEG‑NH‑N=MNPs‑CDDP), which acts as an intelligent tumor targeting drug delivery system. The mean size of the MNPs was ~10.2±1.5 nm, the mean hydrodynamic diameter detected by laser particle sizing instruments was 176.6±1.1 nm, and the ζ‑potential was ‑20.91±1.76 mV. The CDDP content was 0.773 mg/ml, the iron content was ~1.908 mg/ml and the maximum saturation magnetization was 16.3±0.2 emu/g. The current study produced a pH‑sensitive FA‑modified CDDP‑loaded MNP that is stable and exhibits magnetic responsiveness, which releases CDDP in a low pH environment.

PMID: 27109546 [PubMed - as supplied by publisher]



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Cochlear function tests in estimation of speech dynamic range.

Cochlear function tests in estimation of speech dynamic range.

Acta Otolaryngol. 2016 Apr 25;:1-5

Authors: Han JJ, Park SY, Park SN, Na MS, Lee P, Han JS

Abstract
OBJECTIVES: The loss of active cochlear mechanics causes elevated thresholds, loudness recruitment, and reduced frequency selectivity. The problems faced by hearing-impaired listeners are largely related with reduced dynamic range (DR). The aim of this study was to determine which index of the cochlear function tests correlates best with the DR to speech stimuli.
METHODS: Audiological data on 516 ears with pure tone average (PTA) of ≤55 dB and word recognition score of ≥70% were analyzed. PTA, speech recognition threshold (SRT), uncomfortable loudness (UCL), and distortion product otoacoustic emission (DPOAE) were explored as the indices of cochlear function. Audiometric configurations were classified. Correlation between each index and the DR was assessed and multiple regression analysis was done.
RESULTS: PTA and SRT demonstrated strong negative correlations with the DR (r = -0.788 and -0.860, respectively), while DPOAE sum was moderately correlated (r = 0.587). UCLs remained quite constant for the total range of the DR. The regression equation was Y (DR) = 75.238 - 0.719 × SRT (R(2 )=( )0.721, p < 0.001). The other variables such as audiometric configurations and DPOAE sum were excluded from the final model.
CONCLUSION: SRT was the most predictive of the DR among the indices of the cochlear function tests. A reduced DR in cochlear hearing loss was the product of an elevated audiometric threshold and a relatively constant UCL level. The results enable prediction of the DR from SRT and possibly PTA using the suggested regression equation.

PMID: 27109439 [PubMed - as supplied by publisher]



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Human papillomavirus-related oropharyngeal cancer in the HIV-infected population.

Human papillomavirus-related oropharyngeal cancer in the HIV-infected population.

Oral Dis. 2016 Apr;22 Suppl 1:98-106

Authors: Wang CC, Palefsky JM

Abstract
Human papillomavirus (HPV) is a common sexually transmitted virus and an important etiologic factor in head and neck cancers. HIV-infected individuals are at increased risk of developing oropharyngeal cancers (OPC) compared with the general population. HPV-positive OPC are also increasingly a significant cause of morbidity and mortality for HIV-infected individuals in the era of effective combination antiretroviral therapy. The epidemiology and natural history of oral HPV infection have not been well established, but it appears that oral HPV infection is less common than anal infection, and more common among HIV-infected persons than the general population. Prevention of OPC is therefore increasingly important in HIV-infected individuals. Although not demonstrated in randomized controlled trials, HPV vaccination may prevent oral HPV infection as well. The focus of organized HPV cancer prevention programs should include prophylactic HPV vaccination to reduce the burden of high-risk HPV and low-risk HPV types who have not yet been exposed.

PMID: 27109278 [PubMed - in process]



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Cochlear implant and inflammation reaction: safety study of a new steroid-eluting electrode.

Cochlear implant and inflammation reaction: safety study of a new steroid-eluting electrode.

Hear Res. 2016 Apr 21;

Authors: Astolfi L, Simoni E, Giarbini N, Giordano P, Pannella M, Hatzopoulos S, Martini A

Abstract
Dexamethasone is a common anti-inflammatory agent added to cochlear implants to reduce hearing loss due to electrode insertion trauma. We evaluated the safety of eluting silicone rods containing 10% dexamethasone in a Guinea pig model. Animals were implanted with a dexamethasone eluting silicone electrode (DER) or with a non-eluting electrode (NER). The control group only underwent a cochleostomy (CS). Prior to implantation and during the two weeks following implantation, the hearing status of the animals was assessed by means of Compound Action Potentials (CAPs) with an electrode placed near the round window. Two weeks after implantation, the mean click threshold shifts were 1dB +/- 10dB in the DER group, 10dB +/- 10dB in the NER group and -4dB +/- 10dB in the control group. After two weeks the bullae of each animal were extracted to verify the presence of macrophages, the percent of tissue growth in the scala tympani and the tissue sealing around cochleostomy. Silicone electrodes samples were also explanted and examined for bacterial infection. Neither bacterial infection nor enhanced number of macrophages were observed. A limited, but not significant, tissue growth was found in the scala tympani between the experimental and the control group. The data suggest that, in the Guinea pig model, the use of DER is apparently safe as an anti-inflammatory slow-release additive to the cochlear implant.

PMID: 27109196 [PubMed - as supplied by publisher]



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Predisposing factors and management of complications in acute tonsillitis.

Predisposing factors and management of complications in acute tonsillitis.

Acta Otolaryngol. 2016 Apr 25;:1-5

Authors: Gahleitner C, Hofauer B, Stark T, Knopf A

Abstract
CONCLUSION: RPA and NF was diagnosed with a sensitivity/specificity of 100%/94% in patients with acute tonsillitis and without suspicion for disease complication after ENT examination, but an age >35 years and serum CRP >15.5mg/dl.
BACKGROUND: Acute tonsillitis represents a frequent disease in the otorhinolaryngology. Some patients exhibit disease aggravations resulting in (descending) peritonsillar abscess (PTA, dPTA), para-/retropharyngeal abscess (PPA, RPA), or necrotising fasciitis (NF). The study analyses the underlying predisposing factors.
METHODS: The retrospective cohort study includes a total of 1636 patients comprising 852 outpatients with acute bacterial tonsillitis, 279 in-patients with acute bacterial tonsillitis, 452 patients with PTA, 31 patients with dPTA/PPA, 12 patients with RPA, and 10 patients with NF. Patients were analysed for disease-related data.
RESULTS: While leucocytes do not distinguish the sub-groups, C-reactive protein demonstrated a significant increase resulting in the highest level for RPA and NF (p < 0.0001). PTA and RPA are usually caused by streptococcus, dPTA/PPA by anaerobic bacterias, and NF mixed infections (p < 0.0001). Patients with PTA were younger than dPTA/PPA (p = 0.002) or RPA/NF (p < 0.0001). Subsequently, the rate of internistic comorbidities was significantly increased in RPA/NF (p < 0.0001). ROC-analysis identified cut-offs for age <36 years and CRP <15.5mg/dl to distinguish acute bacterial tonsillitis from RPA.

PMID: 27109151 [PubMed - as supplied by publisher]



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Integrative Genomics and Transcriptomics Analysis Reveals Potential Mechanisms for Favorable Prognosis of Patients with HPV-Positive Head and Neck Carcinomas.

Integrative Genomics and Transcriptomics Analysis Reveals Potential Mechanisms for Favorable Prognosis of Patients with HPV-Positive Head and Neck Carcinomas.

Sci Rep. 2016;6:24927

Authors: Zhang W, Edwards A, Fang Z, Flemington EK, Zhang K

Abstract
Patients with HPV-positive head neck squamous cell carcinomas (HNSCC) usually have a better prognosis than the HPV-negative cases while the underlying mechanism remains far from being well understood. We investigated this issue by an integrative analysis of clinically-annotated multi-omics HNSCC data released by the Cancer Genome Atlas. As confirmatory results, we found: (1) Co-occurrence of mutant TP53 and HPV infection was rare; (2) Regardless of HPV status, HNSCCs of wild-type TP53 implied a good survival chance for patients and had fewer genome-wide somatic mutations than those with a mutation burden on the gene. Our analysis further led to some novel observations. They included: (1) The genes involved in "DNA mismatch repair" pathway were up-regulated in HPV-positive tumors compared to normal tissue samples and HPV-negative cases, and thus constituted a strong predictive signature for the identification of HPV infection; (2) HPV infection could disrupt some regulatory miRNA-mRNA correlations operational in the HPV-negative tumors. In light of these results, we proposed a hypothesis for the favorable clinical outcomes of HPV-positive HNSCC patients. That is, the replication of HPV genome and/or its invasion into the genomes of cancer cells may enhance DNA repair mechanisms, which in turn limit the accumulation of lethal somatic mutations.

PMID: 27108969 [PubMed - in process]



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[Interactions between dopamine receptor and NMDA/type A γ-aminobutyric acid receptors].

[Interactions between dopamine receptor and NMDA/type A γ-aminobutyric acid receptors].

Sheng Li Xue Bao. 2016 Apr 25;68(2):185-93

Authors: Chen HY, Wei TJ, Weng JJ, Qin JY, Huang X, Su JP

Abstract
Type A γ-aminobutyric acid receptors (GABAAR) and N-methyl-D-aspartate receptors (NMDAR) are the major inhibitory and excitatory receptors in the central nervous system, respectively. Co-expression of the receptors in the synapse may lead to functional influence between receptors, namely receptor interaction. The interactions between GABAAR and NMDAR can be either positive or negative. However, the mechanisms of interaction between the two receptors remain poorly understood, and potential mechanisms include (1) through a second messenger; (2) by receptors trafficking; (3) by direct interaction; (4) by a third receptor-mediation. Dopamine is the most abundant catecholamine neurotransmitter in the brain, and its receptors, dopamine receptors (DR) can activate multiple signaling pathways. Earlier studies on the interaction between DR and GABAAR/NMDAR have shown some underlying mechanisms, suggesting that DR could mediate the interaction between GABAAR and NMDAR. This paper summarized some recent progresses in the studies of the interaction between DR and NMDAR/GABAAR, providing a further understanding on the interaction between NMDAR and GABAAR mediated by DR.

PMID: 27108906 [PubMed - in process]



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Ionizing radiation promotes advanced malignant traits in nasopharyngeal carcinoma via activation of epithelial-mesenchymal transition and the cancer stem cell phenotype.

Ionizing radiation promotes advanced malignant traits in nasopharyngeal carcinoma via activation of epithelial-mesenchymal transition and the cancer stem cell phenotype.

Oncol Rep. 2016 Apr 25;

Authors: Su Z, Li G, Liu C, Ren S, Tian Y, Liu Y, Qiu Y

Abstract
Post-irradiation residual mass and recurrence always suggest a worse prognosis for nasopharyngeal carcinoma (NPC). Our study aimed to investigate the malignant behaviors of post-irradiation residual NPC cells, to identify the potential underlying mechanisms and to search for appropriate bio-targets to overcome this malignancy. Two NPC cell lines were firstly exposed to 60 Gy irradiation, and residual cells were collected. In our previous study, colony formation assay detected the radioresistance of these cells. Here, the CCK-8 assay examined the cell sensitivity to paclitaxel and cisplatin. Wound-healing and Transwell assays were performed to investigate cell motility and invasion capabilities. Inverted phase-contrast microscopy was used to observe and photograph the morphology of cells. Expression levels of epithelial-mesenchymal transition (EMT)-related proteins were detected by western blot assay in NPC cells and tissues. The mRNA levels of cancer stem cell (CSC)-related genes were detected via qRT-PCR. The results revealed that residual NPC cells exhibited enhanced radioresistance and cross-resistance to paclitaxel and cisplatin. Higher capacities of invasion and migration were also observed. An elongated morphology with pseudopodia formation and broadening in the intercellular space was observed in the residual cells. Downregulation of E-cadherin and upregulation of vimentin were detected in the residual NPC cells and tissues. CSC-related Lgr5 and c-myc were significantly upregulated in the CNE-2-Rs and 6-10B-Rs radioresistance cells. Higher proportions of Lgr5+ cells were observed in radioresistant cells via immunofluorescent staining and flow cytometry. In conclusion, our study demonstrated that residual NPC cells had an advanced malignant transition and presented with both EMT and a CSC phenotype. This provides a possible clue and treatment strategy for advanced and residual NPC.

PMID: 27108809 [PubMed - as supplied by publisher]



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The Voice Track multiband single-channel modified Wiener-filter noise reduction system for cochlear implants: patients' outcomes and subjective appraisal.

The Voice Track multiband single-channel modified Wiener-filter noise reduction system for cochlear implants: patients' outcomes and subjective appraisal.

Int J Audiol. 2016 Apr 25;:1-8

Authors: Guevara N, Bozorg-Grayeli A, Bebear JP, Ardoint M, Saaï S, Gnansia D, Hoen M, Romanet P, Lavieille JP

Abstract
OBJECTIVE: The aim of this study was to evaluate the potential improvements of speech perception and sound quality provided by a multiband single channel noise-reduction algorithm based on the modified Wiener-filter adapted to cochlear implant sound processing.
DESIGN: This study was a longitudinal trial with a repeated-measures design. Outcome measures were performed on the first day when the noise reduction feature was provided and after a one month habituation period. Objective measures included pure-tone thresholds and vocal audiometry assessments. Speech perception was measured in quiet and in the presence of two types of noise: a stationary speech shaped noise and a two-talker cocktail noise. Subjective sound quality was assessed using a ten item questionnaire.
STUDY SAMPLE: Thirteen post-lingual deaf adults, experienced users of a cochlear implant system, took part in this study.
RESULTS: The noise-reduction algorithm provided a benefit for the perception of speech presented in a stationary speech shaped noise and an overall improvement in subjective sound quality ratings.
CONCLUSIONS: It was shown that a single channel noise reduction system based on a modified Wiener-filter approach can improve speech in noise perception performance and subjective sound quality in cochlear implant patients.

PMID: 27108635 [PubMed - as supplied by publisher]



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