Clinical Nuclear Medicine

Hepatic Angiomyolipoma Having FDG Uptake at the Similar Level of the Normal Liver Parenchyma A middle-aged woman underwent a contrast CT to evaluate a palpable upper abdominal mass. The images showed large lesion in the left lobe of the liver, and malignancy was among differential diagnoses. For this reason, FDG PET/CT was performed. Surprisingly, the level of FDG uptake by the large hepatic lesion was similar to the normal part of the liver. Pathological examination demonstrated hepatic angiomyolipoma. Received for publication January 31, 2019; revision accepted February 6, 2019. Conflicts of interest and sources of funding: This work was sponsored in part by the National Natural Science Foundation of China (grant 81571713), Capital's Funds for Health Improvement and Research (grant 2016-2-40115), and CAMS Innovation Fund for Medical Sciences CIFMS) (grant 2016-I2M-4-003, 2018-I2M-3-001). None declared to all authors. Correspondence to: Li Huo, MD, PhD, Department of Nuclear Medicine, Peking Union Medical College Hospital, #1 Shuaifuyuan, Dongcheng District, Beijing, China 100730. E-mail: Huoli@pumch.cn. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Pittsburgh Compound-B Uptake in Meningioma With Histopathologic Correlation Previous studies have reported increased Pittsburgh compound-B (PiB) uptake in meningiomas; however, histological correlation to elucidate the underlying mechanism has not yet been done. We report a case of an 82-year-old woman with an incidental intracranial tumor that showed focal increased PiB uptake. Because of tumor growth, surgical resection was performed, yielding a histological diagnosis of meningioma. Any special and immunochemical staining for amyloid did not reveal amyloid deposition in the tumor. Our findings suggest that increased PiB uptake was not associated with amyloid in this instance. Received for publication January 10, 2019; revision accepted March 7, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Nobuo Kashiwagi, PhD, Department of Radiology, Kindai University Faculty of Medicine, 377–2 Ohno-Higashi, Osakasayama City, Osaka 589–8511, Japan. E-mail: k-nobuo@med.kindai.ac.jp. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

FDG-Avid Hürthle Cell Thyroid Adenoma Incidental thyroid uptake is found in approximately 2.5% of patients who undergo FDG PET for nonthyroid malignancy; approximately a third of the FDG PET thyroid incidentalomas are malignant, including primary thyroid malignancies and metastasis. We describe a 50-year-old woman, a potential heart transplant candidate with history of breast cancer, who was found by FDG PET/CT to harbor a large thyroid mass with intense FDG uptake. Biopsy and molecular study demonstrated that the thyroid mass was a Hürthle cell adenoma. This case highlights that Hürthle cell neoplasm should be included in the differential diagnosis of a thyroid nodule with very high FDG avidity. Received for publication March 3, 2019; revision accepted March 30, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Run Yu, MD, PhD, Division of Endocrinology, UCLA David Geffen School of Medicine, 200 Medical Plaza Dr, Suite 530, Los Angeles, CA 90095. E-mail: runyu@mednet.ucla.edu. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

18F-FDG PET/CT Imaging of Trichoblastic Carcinoma With Nodal Metastasis Trichoblastic carcinoma is an uncommon malignant neoplasm arising from follicular germinative cells. The high-grade trichoblastic carcinoma has been reported with lymphatic and hematogenous dissemination. The authors present a 59-year-old man with gluteal cleft trichoblastic carcinoma and highlight the useful role of serial 18F-FDG PET/CT examinations in the demonstration of initial and subsequent nodal metastasis in the inguina and pelvis. Received for publication August 5, 2018; revision accepted March 30, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Ba Duong Nguyen, MD, Department of Radiology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ 85259. E-mail: nguyen.ba@mayo.edu. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Comparison of Functional Deficit Zone Defined by FDG PET to the Epileptogenic Zones Described in Stereo-Electroencephalograph in Drug-Resistant Epileptic Patients Treated by Surgery Introduction The purpose of presurgical assessment is to delimit the epileptogenic zone and the functional deficit zone with a brain MRI, an electroencephalograph or even a stereo-electroencephalograph (SEEG), neuropsychological evaluation, and a cerebral FDG PET. Several studies concur that the hypometabolism of FDG PET seems to be consistent with epileptogenic zones. We compared the functional deficit zone defined by FDG PET with the results of the SEEG, for each cluster electrode contact (CEC) located in the gray matter. Methods The electrode diagram of the 15 patients (486 CECs) operated on for drug-resistant epilepsy was merged with MRI and FDG PET. The metabolisms of FDG PET and SEEG were compared using a logistic regression test. Results The presence of hypometabolism resulted in a significantly higher risk of being in the seizure onset zone and the irritative zone, particularly when it was intense. Of the deeply hypometabolic CECs, 47% were in the seizure onset zone and 76% in the irritative zone. Normal metabolism resulted in a significantly higher probability of being in the healthy zone. Conclusions This study demonstrated an association between the presence of normal metabolism and the location of CECs in the healthy zone, and between the presence of pathological metabolism and the location of CECs in the seizure onset zone and the irritative zone, with metabolism abnormalities progressively more present and more intense near the seizure onset zone. Received for publication September 28, 2018; revision accepted March 30, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Izzie Jacques Namer, MD, PhD, Service de Biophysique et de Médecine Nucléaire, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 1, Avenue Molière, 67098 Strasbourg Cedex 09, France. E-mail: Izzie.Jacques.NAMER@chru-strasbourg.fr. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Utility of 18F-FDG PET/CT in Infantile Myofibromatosis Infantile myofibromatosis, a rare, nonmalignant disease seen almost exclusively in the pediatric population, can involve skin, muscle, soft tissues, bone, or viscera in either solitary or multicentric pattern. Although nonmalignant, visceral involvement in infantile myofibromatosis is a key prognostic indicator, which is associated with mortality in 75% of patients. Those with pulmonary involvement have a particularly poor outcome. This case illustrates the diagnostic utility of 18F-FDG PET/CT in defining disease extent in this unusual entity and compares it to other commonly used imaging modalities. Received for publication February 14, 2019; revision accepted March 23, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Marguerite T. Parisi, MD, MS, Department of Radiology, MS# MA.7.770, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105. E-mail: meg.parisi@seattlechildrens.org. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

The Finding of the "Mini Brain" May Not Be a Unique Anatomic Appearance of Spinal Plasmacytoma MRI and 18F-FDG PET/CT were performed on a 37-year-old man who was suspected with malignant spinal tumor on x-ray examination. An FDG-avid expansile lytic lesion was found in his T12 vertebra. The lesion showed a characteristic "mini-brain" appearance on MRI and CT. This extremely high specificity sign and consistent manifestation on PET image indicated plasmacytoma as the most optimal diagnosis. But finally, a giant cell tumor was confirmed after surgery. The case cautions that the specificity of the diagnostic characteristics of "mini-brain" sign for plasmacytoma or multiple myeloma may not be as high as previously reported. Received for publication January 30, 2019; revision accepted April 10, 2019. Xiao Zhong and Zhiyun Jia attributed equally to the work. Conflicts of interest and sources of funding: none declared. Correspondence to: Minggang Su, MD, From the Department of Nuclear Medicine, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, China. E-mail: suminggang@sina.com. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Minimal-Invasive Robot-Assisted Image-Guided Resection of Prostate-Specific Membrane Antigen–Positive Lymph Nodes in Recurrent Prostate Cancer With the rapid expansion of robot-assisted surgical procedures, the need for robot-compliant image guidance technologies has also increased. Examples hereof are the integrated firefly fluorescence camera, the drop-in ultrasound probe, and the recently introduced DROP-IN gamma probe. Combined with 68Ga–prostate-specific membrane antigen–(PSMA)–11 PET/CT (staging) and 99mTc-PSMA-I&S SPECT/CT (preoperative imaging), the latter DROP-IN gamma probe technology recently allowed us to perform the first clinical cases of robot-assisted PSMA-guided salvage surgery of lymphatic metastases. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Received for publication December 7, 2018; revision accepted March 3, 2019. Conflicts of interest and sources of funding: This research was supported by an NWO-TTW-VICI grant (TTW 16141). Material support was provided by Eurorad (Eurorad S.A., Eckbolsheim, France) supporting our study with a prototype DROP-IN gamma probe. None declared to all authors. Correspondence to: Fijs W. B. van Leeuwen, PhD, Interventional Molecular Imaging Laboratory, Department of Radiology, C2-S zone, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, the Netherlands. E-mail: F.W.B.van_Leeuwen@lumc.nl; or Tobias Maurer, MD, PhD, FEBU, Leitender Arzt, Universitätsklinikum Hamburg-Eppendorf, Martini-Klinik am UKE GmbH, Martinistraße 52 Gebäude Ost 46, 20246 Hamburg, Germany. E-mail: t.maurer@uke.de. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

FDG PET/CT in a Case of Bilateral Tuberculous Epididymo-orchitis Isolated genital tuberculosis is rare. We present a case of bilateral tuberculous epididymo-orchitis showing high FDG uptake on FDG PET/CT. In addition, the patient had a prostatic FDG-avid lesion, consistent with tuberculous prostatitis. This case indicates tuberculous epididymo-orchitis, especially in tuberculosis-endemic regions, should be considered as a differential diagnosis in patients with hypermetabolic epididymal or testicular lesions, including benign and malignant tumors, bacterial epididymo-orchitis, abscess, idiopathic granulomatous orchitis, and sarcoidosis. Received for publication March 4, 2019; revision accepted March 21, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Pengcheng Ran, MM, Department of Nuclear Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Yuexiu District, Guangzhou 510120, Guangdong Province, China. E-mail: cmurpc@163.com. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

64CuCl2 PET/CT in a Hyperfunctioning Parathyroid Gland We report a case of incidental 64CuCl2 uptake at PET/CT imaging in a 61-year-old man with a biochemical recurrence of prostate cancer. Parathyroid hormone was slightly elevated (92.4 pg/mL; reference range, 18.4–80.1 pg/mL); serum calcium was in reference range (9.5 mg/dL; reference range, 8.6–10.6 mg/dL), whereas serum phosphate was slightly low (2.6 mg/dL; reference range, 2.7–4.5 mg/dL). This case highlights the ability of 64CuCl2, similar to radiolabeled choline, to identify the presence of hyperfunctioning parathyroid glands in patients undergoing PET/CT examination. Received for publication January 12, 2019; revision accepted March 24, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Laura Evangelista, MD, PhD, Nuclear Medicine Unit, Veneto Institute of Oncology IOV–IRCCS, Via Gattamelata, 64 35128 Padova, Italy. E-mail: laura.evangelista@iov.veneto.it. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Otology & Neurotology

Comprehensive Analysis of Factors Leading to Poor Performance in Prelingual Cochlear Implant Recipients Objective: To comprehensively analyze the prognostic factors responsible for affecting outcomes following cochlear implantation in prelinguals. Study Design: Retrospective cohort study from June 2004 to November 2015. Setting: Tertiary care center. Patients: Patients who had undergone cochlear implantation during June 2004 to November 2015 for prelingual sensorineural hearing loss with a minimum follow-up of 2 years. Intervention: Patients were evaluated for the presence of 20 risk factors possibly influencing postimplantation outcomes using a questionnaire. Main Outcome Measures: Assessment for speech and auditory function was done at the last follow-up with speech intelligibility ratings (SIR) and categories of auditory performance (CAP) scores, respectively. Results: One hundred fifty-one patients were included in this study. On univariate analysis for CAP, age at implantation, noncompliance to pre and postimplantation auditory and speech habilitation, poor parental motivation, socioeconomic status and literacy were found to be associated with lower scores (p < 0.05). Whereas, for SIR, additionally, attention deficit hyperactivity disorder and inner ear malformation were statistically significant negative predictors on univariate analysis. Finally, factors responsible for low CAP scores on multivariate analysis were poor parental literacy, poor socioeconomic status, irregular pre/postimplantation rehabilitation, and attention deficit hyperactivity disorder. While for SIR, additionally age at implantation was also a significant negative predictor. Increasing IQ and duration of implant use were associated with higher CAP (univariate) and SIR scores (univariate and multivariate) (p < 0.05). Conclusion: We were able to demonstrate negative impact of higher age at implantation, minimal cognitive disorder, adverse parental/socioeconomic profile, and poor compliance to pre/postimplantation auditory verbal habilitation on auditory and speech outcomes. Address correspondence and reprint requests to Kapil Sikka, M.S., Associate Professor, Department of Otorhinolaryngology and Head and Neck Surgery, Teaching Block, 4th Floor, All India Institute of Medical Sciences, Ansari Nagar, East, New Delhi 110029, India; E-mail: Kapil_sikka@yahoo.com The authors disclose no conflicts of interest. Copyright © 2019 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company

Evaluating the Long-Term Hearing Outcomes of Cochlear Implant Users With Single-Sided Deafness Objectives: To investigate the long-term outcomes of cochlear implantation in individuals with single-sided deafness (SSD) in terms of speech perception, subjective hearing performance, and sound localization. Methods: Thirty-four subjects with SSD were recruited across two large cochlear implant (CI) centers (Antwerp, Belgium and Perth, Australia). The long-term hearing outcomes (between 4 and 10 years of CI use) were evaluated using speech in noise tests, a subjective hearing performance questionnaire (Speech, Spatial and Qualities Questionnaire [SSQ12]), and sound localization tests. Results: Statistically significant improvements were observed in speech perception in noise and sound localization results postoperatively with the use of a CI in comparison to preoperative measurements. Subjective hearing abilities also significantly improved after long-term CI use. Conclusion: Access to binaural hearing is important for subjects with SSD. CI users with SSD experience long-term benefits in speech understanding, sound localization, and quality of life. Address correspondence and reprint requests to Dayse Távora-Vieira, Otolaryngology, Head & Neck Surgery, Medical School, University of Western Australia, Perth, 102 - 118 Murdoch Drive, Murdoch WA 6150, Australia; Fiona Stanley Hospital, Perth, Australia; E-mail: dayse.tavora@gmail.com The authors report no conflicts of interest Copyright © 2019 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company

Application of Kaizen Principles to a Large Cochlear Implant Practice: A Continuous Quality Improvement Initiative at Mayo Clinic Objective: To remove barriers and improve access for patients seeking cochlear implantation. Study Design: Prospective quality improvement study at a large tertiary academic care center. Methods: A Kaizen quality improvement model was applied over the course of a year. Four weeklong meetings were used to identify areas for improvement and remediation. Data were collected at baseline, 90-days, and 1-year postcompletion of the project. Outcome measures included lead times, defined as the wait time between first contact with the clinic and the first appointment, and the wait time between surgery and activation, and cycle times defined as the total test time needed to determine cochlear implant candidacy, and total time needed to complete initial activation. The total inventory kept as clinic stock was also calculated Results: Kaizen team members collected data for each outcome measure. After the Kaizen principles were applied, the following outcomes were observed: median lead times between first contact with the clinic to candidacy testing, candidacy testing to surgery, and surgery to activation of the implant remained stable from baseline to 1-year follow-up. Median cycle time for candidacy testing decreased from 7.3 hours at baseline to 3.0 hours at 1-year follow-up. Cycle times for initial activation of the device did not change over time. The total inventory of clinic stock was reduced by 31%. Conclusions: Though outcomes for lead and cycle times varied, implementation of Kaizen principles was found to be an effective method for completing this quality improvement project at a large cochlear implant program overall. Level of Evidence: 3a Address correspondence and reprint requests to Douglas P. Sladen, Ph.D., Department of Communication Sciences and Disorders, Western Washington University, 516 High Street, Bellingham, WA 98225; E-mail: douglas.sladen@wwu.edu This project was funded through a grant provided by MED EL GMBH. M.L.C. is a consultant for Advanced Bionics Corp., Cochlear Corp., and MED-EL GmbH. M.D.D. is a consultant for MED-EL GmbH. The authors disclose no conflicts of interest. Supplemental digital content is available in the text. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://journals.lww.com/otology-neurotology). Copyright © 2019 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company

Quality of Life in Jugular Paraganglioma Following Radiosurgery Objective: The treatment paradigm for jugular paraganglioma (JP) has changed considerably over time with the wider adoption of stereotactic radiosurgery (SRS). To the best of the authors' knowledge, there are no published studies that use validated patient-reported outcome measures to ascertain quality of life (QoL) outcomes following SRS for JP when used in single or combined modality treatment regimens. Study Design: Cross-sectional survey. Setting: Tertiary referral center. Patients: Adult patients with JP treated with primary SRS or SRS following primary surgery between 1990 and 2017. Interventions(S): Surgery and/or Gamma Knife SRS. Main Outcome Measures: Global and treatment-related QoL and differences in QoL based on treatment approach. Results: Sixty-nine surveys were distributed and a total of 26 completed surveys were received (38% response rate). Among respondents, the median age at SRS was 53 years and 16 of the 26 patients (62%) were female. Median follow-up was 97 months. Nineteen patients (73%) were treated with primary SRS or staged SRS following intentional subtotal resection (STR; hereafter referred to as "staged SRS"), while the remainder (n = 7, 27%) were treated with SRS for recurrent JP. Median physical and mental health QoL PROMIS-10 T-scores regardless of treatment strategy were 39.8 and 38.8, respectively, while median SF36 physical and mental component subscores were similar to national averages and non-tumor controls. When comparing general physical and mental health QoL scores, there was no significant difference between patients treated with primary or staged SRS and those treated with SRS for recurrent JP. However, age-adjusted swallowing function among patients treated with primary or staged SRS was better than in those patients treated with SRS for recurrent JP (p = 0.05). Conclusions: Patients treated with primary or staged SRS for JP tend to exhibit better swallowing outcomes than those treated with SRS for recurrent JP. However, the majority of overall and disease-specific quality of life measures were not different between groups. Based on the low incidence of new cranial neuropathy following SRS, it is likely that initial surgical morbidity is the primary contributor to this outcome. Disease-specific overall quality of life measures, akin to those already used for other benign skull base tumors, are necessary to better gauge physical and mental health outcomes following treatment for JP. Though limited by small sample size, this represents the first study to gauge QoL outcomes following treatment for JP. Address correspondence and reprint requests to Matthew L. Carlson, M.D., Department of Otolaryngology – Head and Neck Surgery, Mayo Clinic, 200 1st St SW, Rochester, MN 55905; E-mail: carlson.matthew@mayo.edu Internal departmental funding was used without commercial sponsorship or support. Mayo Clinic IRB Approval 16-002291. Presented at the 2018 American Academy of Otolaryngology – Head and Neck Surgery Meeting, October 7–10, Atlanta, GA. The authors disclose no conflicts of interest. Copyright © 2019 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company

Bilateral Posterior Canal Benign Paroxysmal Positional Vertigo Tends to Reoccur Objective: We analyzed the clinical characteristics of quite a large cohort of patients with bilateral posterior canal benign paroxysmal positional vertigo (bil-BPPV) with respect to the rate and types of recurrence. Study Design: Retrospective case review. Setting: Outpatient dizziness clinic. Patients: About 2,050 patients diagnosed with BPPV during the years 2003 to 2018 were reviewed. Results: Sixty (2.9%) were diagnosed with bil-BPPV. Fifty three (88%) were idiopathic and seven (12%) posttraumatic. Multiple BPPV episodes were encountered in 28 (47%) patients. Patients with bil-BPPV and multiple BPPV episodes were comparable with patients with a single attack of bil-BPPV except for older age and longer follow up. The most frequent type of recurrence following a bil-BPPV episode was posterior canal canalolithiasis (37.5%) and bil-BPPV (31.3%). Combined (posterior and horizontal) BPPV was encountered in 12.5% while horizontal canal involvement was found in only 7% of recurrences. Conclusions: The prevalence of bil-BPPV amongst all BPPV patients was lower than previously reported possibly due to stricter selection criteria. Older age and longer follow up of patients with multiple BPPV episodes than those with a single episode of bil-BPPV is in accordance with the theory of degenerative otoconia loosening. In contrast to the general consensus regarding random recurrences of BPPV side and subtypes, bil-BPPV recurred more frequently than expected. This might be the consequence of individual vulnerability to head movements, increased bone metabolism or an underlying vestibular pathology. Address correspondence and reprint requests to Lea Pollak, M.D., Kibutz Galuyot 4, Nes Ziona 74012, Israel; E-mail: lea.pollak@gmail.com The authors declare no funding sources or acknowledgments. The authors have no conflicts of interest to disclose. Copyright © 2019 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company

Serum Bilirubin Level as a Potential Marker for the Hearing Outcome in Severe-Profound Bilateral Sudden Deafness Objective: To investigate the association of serum bilirubin level with hearing outcomes in bilateral sudden sensorineural hearing loss (BSSHL) patients. Participants: One hundred thirteen in-patient BSSHL patients were consecutively enrolled between July 2008 and December 2015 in a tertiary center. Main Outcome Measures: Multivariable linear regression, generalized estimating equations (GEE), and stratified analyses were applied to examine the association between serum bilirubin level and hearing outcome measures such as final hearing threshold and absolute and relative hearing gains in BSSHL. Results: After full adjustment for potential confounders, total bilirubin levels (TBIL) were observed to be positively and independently associated with hearing outcomes as measured by final hearing (β [95% confidence interval {CI}]: −1.5 [−2.7, −0.2] dB HL per 1 μmol/L increase in TBIL) and absolute and relative hearing gains (β [95% CI]: 1.4 [0.2, 2.7] dB and 1.6 [0.2, 3.1] dB, respectively) in the severe to profound hearing loss subpopulation. Conclusions: Higher TBIL levels, within the normal or mildly elevated ranges, were independently and significantly associated with better hearing outcome in BSSHL patients with severe to profound hearing loss. Given bilirubin elevation treatments exist, our finding suggests a novel pharmacological strategy for this specific subpopulation. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 Address correspondence and reprint requests to Qiu-Ju Wang, M.D., Ph.D., Department of Otolaryngology–Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, 100853, Beijing, China; E-mail: wqcr301@vip.sina.com Source of Funding: The work was supported by the National Natural Science Foundation of China (No.81530032 and No.81500794), the National Key Basic Research Program of China (No.2014CB943001), the China Postdoctoral Science Foundation (No. 2017M613326) and the New Researcher Foundation of the PLA General Hospital (No. 14KMZ04). The authors have no conflicts of interest to disclose. Supplemental digital content is available in the text. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://journals.lww.com/otology-neurotology). Copyright © 2019 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company

Incus Necrosis and Blood Supply: A Micro-CT and Synchrotron Imaging Study Background: Incus necrosis is a common complication following stapes surgery and is associated with impaired microcirculation. The objective of this study was to investigate the vascular anatomy of the human incus by using light microscopy, micro-computed tomography (micro-CT), and synchrotron phase-contrast imaging (SR-PCI) for a novel three-dimensional (3D) analysis of the middle ear, mucosal folds, major vascular pathways, and intraosseous vascular bone channels. Methods: One-hundred-and-fifty temporal bones from the Uppsala collection were analyzed under light microscopy. Twenty temporal bones underwent high-resolution micro-CT scanning, and an additional seven specimens underwent SR-PCI at the Canadian Lightsource in Saskatoon, Canada. One of these specimens was from an individual who had undergone stapes surgery. Data were processed with volume-rendering software to create 3D reconstructions using scalar opacity mapping for bone transparency, cropping, and soft tissue analyses. Results: Micro-CT and SR-PCI with 3D rendering revealed the extensive vascular plexus within the un-decalcified incus bone communicating with the exterior surface. The relationship between the vessels, lenticular process, and incudostapedial joint were clearly observed. SR-PCI allowed for histologic-level detail while preserving the specimen and its 3D relationships. Conclusion: SR-PCI with 3D reconstructions confirmed the main vascular supply to the lenticular process along the intraosseous lenticular vessels. This is the first synchrotron analysis of a patient having undergone stapes surgery, and it suggests that incus necrosis associated with stapes surgery may be caused by a disruption of the lenticular blood flow induced by the prosthesis loop, and not by strangulation of mucosal vessels as has been previously described. Address correspondence and reprint requests to Helge Rask-Andersen, M.D., Ph.D., Department of Surgical Sciences, Head and Neck Surgery, Section of Otolaryngology, and Departments of Otolaryngology, Uppsala University Hospital, SE-751 85, Uppsala, Sweden; E-mail: helge.rask-andersen@surgsci.uu.se H.M.L., H.R.-A., and S.A. are co-senior authors. Funding: This study was supported by ALF grants from Uppsala University Hospital, Uppsala University and by the Foundation of "Tysta Skolan," the Swedish Deafness Foundation (Hörselskadades Riksförbund – HRF), the Ingrid Löwenström Foundation. Part of the research described in this article was performed at the BioMedical Imaging and Therapy (BMIT) facility at the Canadian Light Source, which is funded by the Canada Foundation for Innovation, the Natural Sciences and Engineering Research Council of Canada, the National Research Council Canada, the Canadian Institutes of Health Research, the Government of Saskatchewan, the Western Economic Diversification Canada, and the University of Saskatchewan. The authors disclose no conflicts of interest. Supplemental digital content is available in the text. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://journals.lww.com/otology-neurotology). Copyright © 2019 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company

From Mid 16th Century French Court to End 18th Century Danish Court: The Fatal Power of the Mammillary Process Objectives/Hypothesis: Two Royal events marked the history of the mastoid process between the 16th and 18th centuries. The first was the death of François II, King of France, following a complication of a chronic running left ear at the age of 16 years, and the second the death of Justus von Berger, Court physician of Christian VII, King of Denmark, after a trepanation of the mastoid process to heal his right-sided deafness at the age of 68 years. The aim of this study is to analyze these two events again with only original references and to replace them in their historical context. Method: Historical review of original literature dealing with the subject. Results/Conclusion: These two Royal events marked the history of the mastoid process, but they were unlikely to have been avoided during their specific era. Medical knowledge was insufficient to avoid these fatal outcomes. Because of their societal impact, they were known of and largely discussed, notably in the medical world, leading to the eventual modification of medical practice during that time. François II's death had no medical impact but von Berger's death practically stopped, for more than a half century, the development of mastoid surgery. Address correspondence and reprint requests to Albert Mudry, M.D., Ph.D., School of Medicine, Stanford University, Stanford, CA 94305-5739; E-mail: amudry@stanford.edu The author discloses no conflicts of interest. Copyright © 2019 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company

Datalogging Statistics and Speech Recognition During the First Year of Use in Adult Cochlear Implant Recipients Objective: To examine device datalogging characteristics and postoperative speech recognition performance in adult cochlear implant (CI) recipients. Study Design: Retrospective study examining datalogging characteristics throughout the first year of device use and postoperative speech recognition outcomes measured at 1 year. Patients: One hundred seventy-seven adults who received a Cochlear CI. Main Outcome Measures: Average values for environmental scene classification (hours of device use per day, and percent of hours per day in quiet, noise, and speech) as reported by Cochlear datalogging over the first year of device use. Speech recognition was assessed at 1 year postactivation. Results: During the first year of devices use, CI listeners >80 years of age used their device significantly less (average = 10.97 h/d) than the youngest adult listeners (18–30 yrs), who used their device an average of 13.29 hours/d. There was no consistent effect of age on the number of hours a CI user listened to speech in noise each day. Correlational and regression analyses suggest that the number of average hours of device use is the primary factor that accounts for variance observed in postoperative consonant-nucleus-consonant word scores. Conclusion: Results suggest that the average number of hours listening to speech in noise is not related to postoperative performance, but the average number of hours of device use per day is correlated with postoperative performance. Further research is needed to determine if these findings are merely correlational or causal in nature. Address correspondence and reprint requests to Kara C. Schvartz-Leyzac, Au.D., Ph.D., Hearing Rehabilitation Center, Department of Otolaryngology, University of Michigan Health Systems, 475 West Market Place, Building 1, Suite A, Ann Arbor, MI 48108; E-mail: kleyzac@med.umich.edu The authors disclose no conflicts of interest. Copyright © 2019 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company

Episodic Vestibular Symptoms in Children With a Congenital Cytomegalovirus Infection: A Case Series Objective: Congenital cytomegalovirus (cCMV) infection is the most common non-genetic cause of sensorineural hearing loss in children. Although cCMV-induced vestibular loss is demonstrated in several studies, the occurrence of vertigo has been described in only two cases to date. The aim of this paper is to discuss the underlying pathophysiology of recurrent vestibular symptoms in children with cCMV, based on five cases investigated in our center and an extensive research of the literature. Study Design: Retrospective case series. Setting: Tertiary referral center. Patients: This case series describes five pediatric cCMV-patients (three boys, two girls). Four of them were symptomatic at birth, one was asymptomatic. Three patients underwent cochlear implantation. The age of onset of the vestibular symptoms varied from 2;0 to 7;3 years of age. Intervention: None. Main Outcome Measures: Details regarding the patient history and results of cranial imaging, audiological, vestibular, and neurological assessments were collected retrospectively. Results: The selected cases suffered from recurrent vestibular symptoms. All patients had delayed onset, fluctuating, and/or progressive hearing loss. In all cases, the attacks were accompanied with nausea and vomiting and occurred without clear-cut trigger. Migraine and epilepsy often were proposed as first diagnosis, although they could not be confirmed eventually. Four out of five patients were diagnosed with a peripheral vestibular deficit. Conclusions: Diagnosis of vestibular symptoms in children with cCMV is complex, given the multiple morbidities than can occur. Peripheral vestibular causes should be considered in the diagnosis, as important vestibular deficits are demonstrated in this population. Address correspondence and reprint requests to Cleo Dhondt, M.Sc., Department of Head and Skin, Ghent University Hospital, Ghent University, Corneel Heymanslaan 10 (1P1), B – 9000 Ghent, Belgium; E-mail: Cleo.Dhondt@UGent.be This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors disclose no conflicts of interest. Copyright © 2019 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Higher Education

Correction to: The Role of Family Support in Facilitating Academic Success of Low-Income Students The original version of this article unfortunately contained a mistake in the acknowledgement section. Some of the vital information is missing in the published article. The complete information is presented with this erratum.

Fractions in College: How Basic Math Remediation Impacts Community College Students Abstract This study investigates the link between basic math skills, remediation, and the educational opportunity and outcomes of community college students. Capitalizing on a unique placement policy in one community college that assigns students to remedial coursework based on multiple math skill cutoffs, I first identify the skills that most commonly inhibit student access to higher-level math courses; these are procedural fluency with fractions and the ability to solve word problems. I then estimate the impact of "just missing" these skill cutoffs using multiple rating-score regression discontinuity design. Missing just one fractions question on the placement diagnostic, and therefore starting college in a lower-level math course, had negative effects on college persistence and attainment. Missing other skill cutoffs did not have the same impacts. The findings suggest the need to reconsider the specific math expectations that regulate access to college math coursework.

Does Inducing Students to Schedule Lecture Watching in Online Classes Improve Their Academic Performance? An Experimental Analysis of a Time Management Intervention Abstract Time management skills are an essential component of college student success, especially in online classes. Through a randomized control trial of students in a for-credit online course at a public 4-year university, we test the efficacy of a scheduling intervention aimed at improving students' time management. Results indicate the intervention had positive effects on initial achievement scores; students who were given the opportunity to schedule their lecture watching in advance scored about a third of a standard deviation better on the first quiz than students who were not given that opportunity. These effects are concentrated in students with the lowest self-reported time management skills. However, these effects diminish over time such that we see a marginally significant negative effect of treatment on the last week's quiz grade and no difference in overall course scores. We examine the effect of the intervention on plausible mechanisms to explain the observed achievement effects. We find no evidence that the intervention affected cramming, procrastination, or the time at which students did work.

The Role of Family Support in Facilitating Academic Success of Low-Income Students Abstract While college education is a key to upward mobility, low-income students are substantially less likely to earn bachelor's degrees than their more economically advantaged peers. Prior higher education literature illuminates various factors contributing to student success, but few studies consider the role of family support after students enter higher education. We examine how two different forms of family support—emotional and financial—are related to academic outcomes (grades, credit accumulation, and persistence) among low-income college students. Our analyses, based on a sample of 728 first-year low-income students attending eight four-year institutions, indicate that family emotional support plays an important role in fostering positive academic outcomes. Family emotional support is beneficial for academic outcomes as it promotes psychological well-being and facilitates greater student engagement. Financial support is not related to the outcomes examined in the sample as a whole. However, interaction models point to variation by first-generations status wherein continuing-generation students benefit more from family financial support than their first-generation peers. Presented findings offer valuable insights into the role of families in supporting low-income students in college and can inform institutional policies and practices aimed at facilitating their success.

Can Transfer Guides Improve the Uptake of Major Prerequisites? Evidence from Ohio's Transfer and Articulation Policy Reform Abstract This study investigates the use of transfer guides to help students identify transferrable prerequisite credits for academic majors. Employing administrative data of students enrolled in Ohio community colleges, I examine the impact of these curricular roadmaps, called Transfer Assurance Guides (TAG), which were featured in reforms of the state's articulation policy. Leveraging variation in the availability of TAGs as a natural experiment, I estimate the impact of these guides on prerequisite course-taking in the fields of history, business, and economics. I also consider whether the effect varies for first-year students compared to returning students. I find that effects on prerequisite course-taking differed across academic majors, and the effects were lower for students enrolled in their first year compared to returning students. The findings suggest that transfer guides may affect student course-taking, but the impact is small and varies by the preparedness level of students.

Framing and Labeling Effects in Preferences for Borrowing for College: An Experimental Analysis Abstract Evidence from behavioral economics suggests that the framing and labeling of choices affect financial decisions. Through a randomized control trial of over six thousand high school seniors, community college students, and adults without a college degree, we identify the existence of both framing and labeling effects in respondents' preferences for borrowing for postsecondary education. How financially equivalent contracts are framed alters the preferences of high school and community college students. Furthermore, simply labeling a contract a "loan" reduces the likelihood of selecting that option by 8–11 percentage points among those samples. These effects are more pronounced among Black high school respondents and Hispanic high school and community college respondents who are both twice as likely as White respondents to avoid the loan option when it is labeled a "loan." Finally, we provide suggestive evidence that this labeling effect is driven by more risk averse respondents. Our findings imply that the federal government, states, and institutions should be attentive to the language used when offering and explaining financial aid packages for higher education.

Connecting School and Home: Examining Parental and School Involvement in Readiness for College Through Multilevel SEM Abstract Parental involvement is widely acknowledged as a critical factor influencing the college choice process among families. What is not clear, though, is whether this parental driven factor also takes place at the school level along with school related factors. Using a national sample of 9th grade students drawn from about 900 schools, we found that parental involvement also operates at the school context along with a high school's academic press. Moreover, at both individual- and school-level contexts, parental involvement creates a "college-going" cultural capital in the form of attainment of milestones towards college.

Parenting on the Path to the Professoriate: A Focus on Graduate Student Mothers Abstract This study presents new findings on tenure-track job outcomes for mothers who parented children during graduate school. Using NSF Survey of Earned Doctorates (2000–2005) and Survey of Doctorate Recipients data (2000–2013), I explore how PhD mothers' accumulation of career-related resources in graduate school influences their likelihood of attaining tenure-track jobs.

The Impact of an Interest-Major Fit Signal on College Major Certainty Abstract Students' choice of college major is related to their interests (Porter and Umbach in Res High Educ 47:429–449, 2006), and students whose major is well-aligned with their interests are more likely to persist in that major (Allen and Robbins in Res Higher Educ 49(1):62–79, 2008) and complete a college degree in a timely manner (Allen and Robbins in J Couns Psychol 51(1):23–35, 2010). This study investigates whether a specific signal (i.e., Low, Medium, or High fit) that high school students receive about the alignment between their initial choice of planned major and their measured interests has an impact on the subsequent certainty of their initial choice of planned major. A regression discontinuity design was used to investigate the stability/increase in planned major certainty across two ACT administrations for students with Medium versus Low fit and High versus Medium fit. Results did not provide evidence that the signal is effective; possible explanations and recommended future research are discussed.

Examining the Relationship Between 2-year College Entry and Baccalaureate Aspirants' Academic and Labor Market Outcomes: Impacts, Heterogeneity, and Mechanisms Abstract Using the Education Longitudinal Study of 2002 (ELS:2002), this paper analyzes students' baccalaureate attainment and early labor market performance, comparing 2-year college and 4-year institution entrants and exploring the potential heterogeneous treatment effects of initiating one's college experience in a 2-year college by individual pre-college academic preparation. Utilizing propensity score matching on a rich set of student demographic characteristics, academic and high school attributes, we find that 2-year college entry sharply reduces baccalaureate aspirants' likelihood of earning a baccalaureate, and such negative effects are particularly pronounced for students in the highest quartile of pre-college math ability. In terms of labor market outcomes, female 2-year college entrants are less likely to gain full-time employment, as compared to their female 4-year institution counterparts. We also examine various mechanisms that may hinder 2-year college entrants' baccalaureate completion, including the impact of 2-year college attendance on early academic progress, challenges of the transfer process, loss of credits at the point of transfer, and post-transfer academic shock. Our results provide suggestive evidence in support of all four mechanisms.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Environmental Science and Pollution Research

Estimation of methane and nitrous oxide emission from wetland rice paddies with reference to global warming potential Abstract Methane (CH4) and nitrous oxide (N2O) are two important greenhouse gases (GHG) and contribute largely to global warming and climate change. The impact of physiological characteristics of rice genotypes on global warming potential (GWP) and greenhouse gas intensity (GHGI) is not well documented. A 2-year field experiment was conducted with eight summer rice varieties: Dinanath, Joymoti, Kanaklata, Swarnabh, IR 64, Tapaswami (modern varieties), Number 9, and Jagilee Boro (indigenous varieties) for two successive seasons (December–June, 2015–2016 and December–June, 2016–2017) to estimate their GWP and GHGI. The GWP of the rice varieties ranged from 841.52 to 1288.67 kg CO2-equiv. ha−1 and GHGI from 0.184 to 0.854 kg CO2-equiv. kg−1 grain yield. Significant differences (p < 0.05) in seasonal GHG emission, GWP, GHGI, CEE (carbon equivalent emission), photosynthetic efficiency, stomatal conductance, transpiration rate, and grain productivity among the rice varieties were observed during the investigation. A good correlation of GWP (p < 0.01) was recorded with rate of stomatal conductance and transpiration rate of the varieties. The present study reveals a strong relationship between plant biomass (p < 0.01) with GWP and CEE of the rice varieties. The variety IR 64 and Number 9 are identified as the most suitable variety with lowest GWP (909.85 and 876.68 kg CO2-equiv. ha−1 respectively) and GHGI (0.192 and 0.227 kg CO2-equiv. kg−1 grain yield respectively) accompanied by higher grain productivity (4839 and 3867 kg ha−1 respectively). Observations from the study suggest that agricultural productivity and GHG mitigation can be simultaneously achieved by proper selection of rice genotypes.

Optimisation of bioscrubber systems to simultaneously remove methane and purify wastewater from intensive pig farms Abstract The use of bioscrubber is attracting increasing attention for exhaust gas treatment in intensive pig farming. However, the challenge is to improve the methane (CH4) removal efficiency as well as the possibility of pig house wastewater treatment. Three laboratory-scale bioscrubbers, each equipped with different recirculation water types, livestock wastewater (10-times-diluted pig house wastewater supernatant), a methanotroph growth medium (10-times-diluted), and tap water, were established to evaluate the performance of CH4 removal and wastewater treatment. The results showed that enhanced CH4 removal efficiency (25%) can be rapidly achieved with improved methanotrophic activity due to extra nutrient support from the wastewater. The majority of the CH4 was removed in the middle to end part of the bioscrubbers, which indicated that CH4 removal could be potentially optimised by extending the length of the reactor. Moreover, 52–86% of the ammonium (NH4+-N), total organic carbon (TOC), and phosphate (PO43−-P) removal were simultaneously achieved with CH4 removal in the present study. Based on these results, this study introduces a low-cost and simple-to-operate method to improve CH4 removal and simultaneously treat pig farm wastewater in bioscrubbers.

Ambient air pollution and risk of type 2 diabetes in the Chinese Abstract We performed a time series analysis to investigate the potential association between exposure to ambient air pollution and type 2 diabetes (T2D) incidence in the Chinese population. Monthly time series data between 2008 and 2015 on ambient air pollutants and incident T2D (N = 25,130) were obtained from the Environment Monitoring Center of Ningbo and the Chronic Disease Surveillance System of Ningbo. Relative risks (RRs) and 95% confidence intervals (95% CIs) of incident T2D per 10 μg/m3 increases in ambient air pollutants were estimated from Poisson generalized additive models. Exposure to particulate matter < 10 μm (PM10) and sulfur dioxide (SO2) was associated with increased T2D incidence. The relative risks (RRs) of each increment in 10 μg/m3 of PM10 and SO2 were 1.62 (95% CI, 1.16–2.28) and 1.63 (95% CI, 1.12–2.38) for overall participants, whereas for ozone (O3) exposure, the RRs were 0.78 (95% CI, 0.68–0.90) for overall participants, 0.78 (95% CI, 0.69–0.90) for males, and 0.78 (95% CI, 0.67–0.91) for females, respectively. Exposure to PM10 and SO2 is positively associated with T2D incidence, whereas O3 is negatively associated with T2D incidence.

The relief effects of organic acids on Scirpus triqueter L. under pyrene–lead stress Abstract During phytoremediation of polycyclic aromatic hydrocarbons (PAHs) and heavy metals, the phytoremediation plants are often stressed by pollutants, which would reduce the efficiency of phytoremediation. The addition of organic acids from root exudates could alleviate the stress. In this study, three organic acids (citric acid, succinic acid, glutaric acid) were added to investigate the effects of organic acids on the stress response of Scirpus triqueter L. at two pyrene–lead concentrations. The activities of reactive oxygen species, malondialdehyde, plasma membrane H+-ATPase, and vacuolar H+-ATPase and PPase activity, as well as the activities of antioxidant enzymes (SOD, POD, and CAT) in Scirpus triqueter L. were determined. The addition of organic acids could effectively reduce the activities of reactive oxygen species, malondialdehyde, plasma membrane H+-ATPase, and vacuolar H+-ATPase and PPase activities. Under higher pollution, the damage of plant plasma membrane is more serious, but the addition of citric acid can alleviate this situation and even more effective than the relief under low pollution. The effect of citric acid was more significant than that of succinic acid and glutaric acid. These results demonstrated that organic acids could attenuate the stress of pyrene and lead to Scirpus triqueter L.

The release mechanism of heavy metals from lab-scale vertical flow constructed wetlands treating road runoff Abstract Constructed wetlands (CWs) have been applied to remediate heavy metal pollution effectively in practice. However, the heavy metal release from CWs has not been paid enough attention. In this study, a 5-month experiment was carried out with three parallel lab-scale vertical flow constructed wetlands (VFCWs) with zeolites as fillers. The artificial rainwater was pumped into VFCWs to study the release characteristic and mechanisms of heavy metals (Cu, Zn, Cr, and Pb). The results showed that significant amounts of Zn and Cu were released from the VFCWs at the end of the experiment while Pb and Cr rarely escaped. The upper layer (0–30 cm) of the VFCWs was the most effective area for heavy metal removal due to the presence of sediments, but it was also the most active area for heavy metal release. To explain this result, the sediments were analyzed before and after being leached by the tap water. The results indicated that Zn and Cu existed mainly in the exchangeable state, and they had strong leachability and bioavailability, causing its releases. Also, competitive adsorption of different metals meant that the metal ions with strong adsorption to zeolite caused the metal ions with weak adsorption to be desorbed from zeolites, and thus, a large amount of Zn escaped from VFCWs. The escape of heavy metals from CWs illustrated that it should be paid more attention in the management.

Concentration, spatiotemporal distribution, and sources of mercury in Mt. Yulong, a remote site in southeastern Tibetan Plateau Abstract The unique geographic location of Mt. Yulong in the Tibetan Plateau (TP) makes it a favorable site for mercury (Hg) study. Various snow samples, such as surface snow, snow pit, and snowmelt water were collected from Mt. Yulong in the southeastern TP. The average concentration of Hg was found to be 37 ± 26 ng L−1 (mean ± SD), comparable to Hg concentration from other parts of TP in the same year, though it was comparatively higher than those from previous years, suggesting a possible increase of Hg concentration over the TP. The concentration of Hg was higher in the lower elevation of the glaciers possibly due to the surface melting concentration of particulates. Higher concentration of Hg was observed in the fresh snow, suggesting the possibility of long-range transportation. The average concentration of Hg from the snow pit was 1.49 ± 0.78 ng L−1, and the concentration of Hg in the vertical profile of the snow pit co-varied with calcium ion (Ca2+) supporting the fact that the portion of Hg is from the crustal origin. In addition, the principal component analysis (PCA) confirmed that the source of Hg is from the crustal origin; however, the presence of anthropogenic source in the Mt. Yulong was also observed. In surface water around Mt. Yulong, the concentration of HgT was found in the order of Lashihai Lake > Reservoirs > Rivers > Swamps > Luguhu Lake. In lake water, the concentration of HgT showed an increasing trend with depth. Overall, the increased concentration of Hg in recent years from the TP can be of concern and may have an adverse impact on the downstream ecosystem, wildlife, and human health.

Evaluation of management procedures for a length-frequency data-limited fishery Abstract Management procedures (MPs) based on data-limited methods (DLMs) recently developed to give management advices for data-limited stocks worldwide are scarce or yet to be implemented on freshwater species. In this study, case studies (CSs) were developed using length-frequency data (LFD) of common carp species harvested from Dianshan Lake to estimate life-history parameters from existing methods. These CSs were later used to examine their influences when tested with various MPs under scenarios when operating models (OMs) were subjected to observation and estimation uncertainties. The results after management strategy evaluation (MSE) was run for various defined OMs showed that three MPs emerged best for providing managing advice. For high yield to be maintained during short-term periods, MinlenLopt1 suggested the smallest length at full retention (sLFR) to be 42.11 cm; while Slotlim and matlenlim2 suggested that to maintain biomass and stable spawning biomass (SBMSY) and also avoid overfishing from occurring in this fishery, sLFR should be 56.1 cm. Values given by these MPs allowed the removal of species that spawned at least once. Also, life-history parameters derived from CS4 presented the best results, being more reliable in presenting better inputs for effective management of the said fishery.

Remediation of cobalt-polluted soil after application of selected substances and using oat ( Avena sativa L.) Abstract The aim of the study was to determine the effectiveness of soil application of manure, clay, charcoal, zeolite, and calcium oxide in remediation of soil polluted with cobalt (0, 20, 40, 80, 160, 320 mg Co kg−1 of soil). The following were determined: weight of harvested plants as well as the content of cobalt in grain, straw, and roots of oat. In addition, tolerance index (Ti), cobalt bioconcentration (BCF), translocation (TF), and transfer (TFr) coefficients were derived. In the series without amendments, the increasing doses of cobalt had a significant effect by decreasing the yields of oat grain and straw and the mass of its roots. Also, lower tolerance index values were noted in the objects polluted with cobalt, especially with its highest dose. The application of manure had the strongest effect on increasing the mass of particular organs of the test plant, while the application of charcoal led to a significant decrease in this respect. The application of all substances to the soil, and especially manure and calcium oxide, resulted in higher tolerance index Ti values. The growing contamination of soil with cobalt caused a significant increase in the content of this element in oat and in the values of the translocation coefficient, in contrast to the effects noted with respect to the bioconcentration and transfer coefficients. All the substances applied to soil reduced the content of cobalt and its bioconcentration in oat straw, in opposition to grain and roots, limited its translocation, but elevated the transfer of this element from soil to plants. Soil contamination with cobalt promoted the accumulation of lead and copper in grain, cadmium, lead, nickel, zinc, manganese, and iron in straw, as well as cadmium, nickel, zinc, and manganese in oat roots. As the cobalt dose increased, the content of other trace elements in oat organs either decreased or did not show any unambiguous changes. Of all the tested substances, the strongest influence on the content of trace elements was produced by calcium oxide in straw and roots and by zeolite in roots, whereas the weakest effect was generated by manure in oat grain. Oat is not the best plant for phytoremediation of soils contaminated with cobalt.

Target and non-target botanical pesticides effect of Trichodesma indicum (Linn) R. Br. and their chemical derivatives against the dengue vector, Aedes aegypti L. Abstract The effects of crude ethanol derived leaf extract Trichodesma indicum (Linn) (Ex-Ti) and their chief derivatives were accessed on the survival and development of the dengue mosquito Ae. aegypti also their non-toxic activity against mosquito predator. T. indicum is recognized to be the vital weed plant and a promising herb in the traditional ayurvedic medicine. In this study, the GC-MS chromatogram of Ex-Ti showed higher peak area percentage for cis-10-Heptadecenoic acid (21.83%) followed by cycloheptadecanone (14.32%). The Ex-Ti displayed predominant mortality in larvae with 96.45 and 93.31% at the prominent dosage (200 ppm) against III and IV instar. Correspondingly, sub-lethal dosage against the enzymatic profile of III and IV instar showed downregulation of α,β-carboxylesterase and SOD protein profiles at the maximum concentration of 100 ppm. However, enzyme level of GST as well as CYP450 increased significantly dependent on sub-lethal concentration. Likewise, fecundity and hatchability of egg rate of dengue mosquito decreased to the sub-lethal concentration of Ex-Ti. Repellent assay illustrates that Ex-Ti concentration had greater protection time up to 210 min at 100 ppm. Also, activity of Ex-Ti on adult mosquito displayed 100% mortality at the maximum dosage of 600, 500 and 400 ppm within the period of 50, 60 and 70 min, respectively. Photomicrography screening showed that lethal dosage of Ex-Ti (100 ppm) produced severe morphological changes with dysregulation in their body parts as matched to the control. Effects of Ex-Ti on the Toxorhynchites splendens IV instar larvae showed less mortality (43.47%) even at the maximum dosage of 1500 ppm as matched to the chemical pesticide Temephos. Overall, the present research adds a toxicological valuation on the Ex-Ti and their active constituents as a larvicidal, repellent and adulticidal agents against the global burdening dengue mosquito.

Integrated lipid production, CO 2 fixation, and removal of SO 2 and NO from simulated flue gas by oleaginous Chlorella pyrenoidosa Abstract CO2, SO2, and NO are the main components of flue gas and can cause serious environmental issues. Utilization of these compounds in oleaginous microalgae cultivation not only could reduce air pollution but could also produce feedstock for biodiesel production. However, the continuous input of SO2 and NO inhibits microalgal growth. In this study, the toxicity of simulated flue gas (15% CO2, 0.03% SO2, and 0.03% NO, balanced with N2) was reduced through automatic pH feedback control. Integrated lipid production and CO2 fixation with the removal of SO2 and NO was achieved. Using this technique, a lipid content of 38.0% DW was achieved in Chlorella pyrenoidosa XQ-20044. The lipid composition and fatty acid profile indicated that lipid production by C. pyrenoidosa XQ-20044 cultured with flue gas is suitable as a biodiesel feedstock; 81.2% of the total lipids were neutral lipids and 99.5% of the total fatty acids were C16 and C18. The ratio of saturated fatty acids to monounsaturated fatty acids in the microalgal lipid content was 74.5%. In addition, CO2, SO2, and NO from the simulated flue gas were fixed and converted to biomass and lipids with a removal efficiency of 95.9%, 100%, and 84.2%, respectively. Furthermore, the utilization efficiencies of CO2, SO2, and NO were equal to or very close to their removal efficiencies. These results provide a novel strategy for combining biodiesel production with biofixation of flue gas.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Behavioral Medicine

Moderation of Mood in the Transfer of Self-Regulation From an Exercise to an Eating Context: Short- and Long-Term Effects on Dietary Change and Obesity in Women Abstract Background Behavioral obesity treatments require an improved understanding of the dynamics of associated psychological changes. This study aimed to clarify previous research on self-regulatory skills' transfer from an exercise to eating context, effects of mood on self-regulatory strength, and related effects on a targeted eating behavior. Methods Women with obesity participated in a yearlong community-based cognitive-behavioral treatment that first focused on self-regulatory skills development for exercise maintenance, then use of similar self-regulatory skills and improved mood to facilitate short- and long-term increases in fruit/vegetable intake and reduction in weight. Groups were based on high (≥ 5% of baseline weight; n = 51) and low (< 5%; n = 49) weight reduction 2 years post-initiation. Results Improvements in eating self-regulation and fruit/vegetable intake were greatest in the high weight-reduction group. Using lagged variable analyses to assess directionality, mood significantly moderated the prediction of eating self-regulation change by exercise self-regulation change. The effect of increased exercise self-regulation on fruit/vegetable intake change over 6 months was significantly mediated by eating self-regulation change. Participants' initial weight moderated the effect of eating self-regulation change on fruit/vegetable intake. Change in eating self-regulation over 6 months predicted self-regulation at 24 months. Short-term change in fruit/vegetable intake predicted weight change over 2 years through its association with long-term fruit/vegetable consumption. Conclusions Findings supported the expected carry-over of self-regulation from an exercise to eating context, mood effects on self-regulatory strength, and associations of exercise with eating and weight changes via effects on psychological variables. Results have implications for sustained effects associated with behavioral treatments.

Pre-surgical Caregiver Burden and Anxiety Are Associated with Post-Surgery Cortisol over the Day in Caregivers of Coronary Artery Bypass Graft Surgery Patients Abstract Background The relationship between pre-surgical distress and diurnal cortisol following surgery has not been investigated prospectively in caregivers of coronary artery bypass graft (CABG) patients before. We aimed to examine the relationship between pre-surgical anxiety and caregiver burden and diurnal cortisol measured 2 months after the surgery in the caregivers of CABG patients. Method We used a sample of 103 caregivers of elective CABG patients that were assessed 28.86 days before and 60.94 days after patients' surgery. Anxiety and caregiver burden were assessed using the anxiety subscale of the Hospital Anxiety and Depression Scale and the Oberst Burden Scale respectively. Saliva samples were collected to measure cortisol area under the curve with respect to ground (AUCg) and diurnal cortisol slope. Anxiety and caregiver burden were entered into linear regression models simultaneously. Results While high levels of pre-surgical anxiety were positively associated with increased follow-up levels of AUCg (β = 0.30, p = 0.001), greater pre-surgery perceived burden score was associated with steeper cortisol slope (β = 0.27, p = 0.017) after controlling for a wide range of covariates. Conclusion These outcomes support the utility of psychological interventions aimed to increase the awareness of caregiving tasks and demands in informal caregivers.

Sleep Quality and Inflammation in Married Heterosexual Couples: an Actor-Partner Analysis Abstract Background Subjective sleep quality is a predictor of important health outcomes, but little work has examined the social context of sleep that might inform theoretical models and intervention approaches. The present study tested actor-partner models of sleep quality and its links to inflammatory markers. Method Participants were 84 middle-age to older adult heterosexual married couples who completed the Pittsburgh Sleep Quality Index and had blood drawn for determination of CRP and IL-6 levels. Results Main results indicated that only actor levels of poor global sleep quality predicted higher CRP levels. No actor × partner or gender × actor/partner interactions were significant. These results were also not moderated by relationship quality. Secondary analyses, focused on the different components of sleep quality, revealed marginally significant evidence for partner's poor sleep (i.e., sleep disturbances, sleep latency) on one's own inflammatory outcomes. Conclusion These results suggest the promise of modeling sleep quality as a dyadic process that can impact inflammation and potentially related health outcomes.

Physical Activity After Breast Cancer Surgery: Does Depression Make Exercise Feel More Effortful than It Actually Is? Abstract Background Prior to treatment, breast cancer patients are less physically fit compared to peers; during cancer treatment, their fitness typically declines. Depressive symptoms are associated with reduced activity up to 5 years post-treatment, but research has not identified mechanisms linking depression and lower activity. The current study assessed relationships among breast cancer patients' depression and perceived exertion during exercise as well as heart rate, an objective indicator of exertion. Methods Participants were 106 breast cancer patients, stages I–IIIA, who completed surgery but had not started adjuvant treatment. Heart rate and self-rated exertion, measured using the Borg Scale of Perceived Exertion, were assessed every 2 min during a graded exercise test. Depression was assessed using the CES-D and a structured clinical interview. Results Compared to women below the CES-D clinical cutoff, women with significant depressive symptoms reported steeper increases in exertion during the exercise test (p = .010) but had similar heart rates (p = .224) compared to women below the cutoff. Major depression history was unrelated to perceived exertion (ps > .224) and heart rate (ps > .200) during exercise. Conclusions Women with currently elevated depressive symptoms experienced exercise as more difficult compared to women below the CES-D cutoff, but these self-perceptions did not reflect actual heart rate differences. Depression may make exercise feel more demanding, which could ultimately decrease patients' likelihood of engaging in regular exercise. Results support the use of depression screening tools following breast cancer surgery to identify and intervene on individuals at risk for decreased physical activity during survivorship.

Young Thai People's Exposure to Alcohol Portrayals in Society and the Media: A Qualitative Study for Policy Implications Abstract Background Although previous quantitative studies have documented the association between exposure to alcohol portrayals and drinking attitudes in Western countries, few qualitative studies have explored this matter in Thailand. A better understanding of the association in young Thais is required for a more efficient alcohol policy development. This study aims to explore the information young Thais have learnt from exposure to alcohol portrayals in society and the media, examine how this exposure shapes their drinking attitudes, and investigate the alignment of policy-makers' views on drinking with those of young people. Methods Two qualitative research methods were employed. Seventy-two university students (38 men, 34 women) aged 20–24 participated in focus groups conducted on campus. Semi-structured interviews were conducted with academia, civil society and representatives from government who were involved in alcohol policy. Recorded data were transcribed verbatim, systematically coded and analysed using content analysis. Results Young Thais were regularly exposed to alcohol portrayals, particularly on social media and in their social environment. Being increasingly exposed to alcohol portrayals, particularly on social media, and the role of the alcohol industry emerged as concerning matters to the academia and civil society sectors. In response to the concerns, the government social media monitoring and alcohol censorship had become more challenging. Conclusions This study reflects the growing concerns from academia and civil society sectors of the impacts of increased alcohol exposure and the role that the industry may have on young people's drinking attitudes. It highlights the need for response to significant policy challenges to reduce these impacts.

Perceptions of Physical Activity Promotion, Transportation Support, Physical Activity, and Body Mass: an Insight into Parent-Child Dyadic Processes Abstract Background Socio-ecological models indicate that family, school, and community environment explains children's physical activity and body weight. This study investigated whether parental perceptions of school/community-based physical activity (PA) promotion programs as well as parental and child perceptions of parental instrumental support for child PA (transportation provision) would predict child body weight. Child moderate-to-vigorous physical activity (MVPA) was hypothesized to mediate these associations. Method Data of 879 parent-child dyads were collected at two measurement points: the baseline (T1) and the 7–8-month follow-up (T2). Parents were 23–68 years old (83.3% women), while children were 5–11 years old (52.4% girls). Parents and children reported their perceptions of environment, support (T1), and MVPA (T1, T2). Parental and child body weight and height were measured objectively (T1, T2). Results Path analyses indicated indirect effects of parental perceptions of school/community-based PA policies (T1) and parental perceptions of transportation provision (T1) on child body weight (T2), with child MVPA (T2) operating as the mediator. There were no direct or indirect effects of child perceptions of parental transportation provision (T1) on child MVPA or body weight (T2). Similar patterns of associations were found for the total sample and the subsample of children with overweight/obesity. Conclusion Parental perceptions of school/community-based PA policies and transportation provision may explain changes in child MVPA and body weight. Interventions aimed at prevention of child overweight/obesity may benefit from a focus on parental transportation provision to PA facilities and parental awareness of PA promotion at local environment.

Psychosocial Syndemics and Sexual Risk Practices Among U.S. Adolescents: Findings from the 2017 U.S. Youth Behavioral Survey Abstract Background The present study aims to (1) identify classes of psychosocial syndemics among adolescents in the U.S. based on psychological factors, such as depression and suicidal ideation, and social factors, such as binge drinking, alcohol use, and drug use; (2) identify correlates of psychosocial syndemics; and (3) examine the independent associations between psychosocial syndemic factors and sexual risk practices. Method We used latent class analysis and a sample of 14,762 U.S. high school students who participated in the 2017 Youth Risk Behavior Surveillance System to examine youth population profiles based on shared characteristics of syndemics. Adjusting for sociodemographic factors, we conducted logistic regression to explore the connections between psychosocial syndemic factors and three sexual risk practices, namely, early initiation of sexual intercourse, condom use, and sex with multiple partners. Results The study results indicate that three classes of risk exist among the sample: substance misuse (class 1, n = 3872, 26.2%), normative (class 2, n = 8791, 59.6%), and mental health problems (class 3, n = 2099, 14.2%). Class membership of psychosocial syndemics was significantly different by gender, age group, and race. The odds of initiating sexual intercourse before age 13 were positively associated with participants belonging in the substance misuse class and the mental health problem class. The odds of using condoms during the last sexual intercourse for currently sexually active adolescents were lower for participants classified in the substance misuse class. The likelihood of reporting having sex with four or more partners in a lifetime was higher among participants belonging to the substance misuse class. Conclusion The study advances our understanding of the heterogeneity of class membership associated with psychosocial syndemic risk factors among adolescents and extends our understanding of syndemics in the area of adolescent health. Thus, practitioners and policymakers can design multicomponent and multilevel school-based HIV/STI prevention programs that meet the needs of adolescents.

Pathways to Health: an Examination of HIV-Related Stigma, Life Stressors, Depression, and Substance Use Abstract Background Despite antiretroviral treatment (ART) being an efficacious treatment for HIV, essentially making it a chronic non-terminal illness, two related and frequent concerns for many people living with HIV/AIDS (PLWHA) continue to be HIV-related stigma and life stress. These two variables are frequently associated with depression, substance use, and poorer functional health. Studies to date have not fully examined the degree to which these constructs may be associated within one model, which could reveal a more nuanced understanding of how HIV-related stigma and life stress affect functional health in PLWHA. Methods The current study employed hybrid structural equation modeling to examine the interconnectedness and potential indirect relationships of HIV-related stigma and life stress to worse health through substance use and depression, controlling for ART adherence and age. Participants were 240 HIV-infected individuals who completed a biopsychosocial assessment battery upon screening for an RCT on treating depression in those infected with HIV. Results Both HIV-related stigma and stressful life events were directly related to depression, and depression was directly related to health. There were significant indirect effects from stigma and stress to health via depression. There were no significant effects involving substance use. Conclusion It is important to continue to develop ways to address stigma, stressful life events, and their effects on distress in those living with HIV. Expanding our knowledge of disease progression risk factors beyond ART adherence is important to be able to design adjuvant interventions, particularly because treatment means that people living with HIV have markedly improved life expectancy and that successful treatment means that HIV is not transmittable to others.

Association Between Deviation of Fairness Perceptions from Group Average and Serious Psychological Distress in Japanese Worksites: a Cross-Sectional Study Abstract Background Workers with deviating fairness perceptions are likely to be excluded and become isolated at worksites, leading to psychological distress. The study aimed to examine the cross-sectional association between deviation of fairness perception from the group average and serious psychological distress in Japanese worksites. Methods Secondary data analysis of an existing Japanese occupational cohort data using a multilevel logistic regression model was conducted for 8701 workers from 12 companies in Japan who participated in the baseline survey (from April 2010 to March 2012). Individual perception of interactional and procedural fairness was measured with the Japanese version of the Organizational Justice Scale. Group averages were calculated within workers' reference groups, categorized by company affiliation, age group, gender, and occupational class. Psychological distress was measured using the K6 scale, and serious psychological distress was defined as a total K6 score of 13 or more. Results Both low deviation and high deviation of interactional fairness perception were significantly and positively associated with serious psychological distress (odds ratio (OR) = 1.24, 95% confidence intervals (CI); 1.03–1.49 and OR = 1.57, 95% CI; 1.12–2.19), independently of individual-level fairness perception, group-level mean fairness perception, demographic characteristics, and health-related behaviors. Only high deviation of procedural fairness perception was significantly and positively related to serious psychological distress (OR = 1.51, 95% CI; 1.11–2.06). Conclusions The results indicated that divergent perceptions of fairness at worksites may deserve further exploration for equal achievement of workers' psychological well-being.

Relations of Subjective Social Status and Brooding with Blood Pressure Abstract Background Brooding, a type of rumination, and subjective social status (SSS) may be two interacting factors for cardiovascular disease (CVD). Our goal was to examine the relations of brooding and SSS with systolic blood pressure (SBP) and diastolic blood pressure (DBP), two measures of CVD. We predicted that [1] brooding and SSS are each related to SBP and DBP and [2] the interaction of brooding and SSS is linked to SBP and DBP. Method In this cross-sectional study, college student participants (n = 240; 58.6% female, age: M = 23.95 years, SD = 8.62) completed demographics questionnaires, the Ruminative Response Scale, and MacArthur Subjective Social Status scale, and gave blood pressure samples. Results Linear models suggested that, for participants low in SSS, high brooding and DBP were positively related. For participants high in SSS, high brooding and low DBP were negatively related. There were no relations between SSS, brooding, and SBP. Conclusions As predicted, for individuals with low SSS, more brooding was associated with higher DBP. Yet, in individuals with high SSS, more brooding was associated with lower DBP. There was no relation between SSS, brooding, and SBP. Our results suggest that brooding may serve as diathesis for some symptoms of CVD (i.e., high DBP but not high SBP) in individuals with low SSS. We discuss how other factors, like burnout or defensive pessimism, may contribute to the relation between high SSS, high brooding, and low DBP.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com