Background:
The purpose of this study is to report outcomes of transphyseal screw hemi-epiphysiodesis at the medial malleolus for the treatment of valgus ankle deformity.
Methods:
An institutional ...review board–approved retrospective review was done of 24 patient charts. Lateral distal tibial angle (LDTA) was measured preoperatively and at final follow-up.
Results:
The average change in LDTA was 8.3 degrees (SD 4.9 degrees; range 0-19 degrees). The average rate of correction was 0.4 degrees per month (SD 0.3; range 0-1.4).
Conclusion:
Medial malleolar transphyseal screw hemiepiphysiodesis is a simple, effective, and safe treatment for valgus ankle deformity in skeletally immature children.
Level of Evidence:
Level IV, case series.
AbstractConclusion: Switch-on within 24 h after cochlear implantation can be safely and practically performed. The minimally invasive approach presented here also brought about benefits such as ...nonstop rehabilitation programs and shorter duration of uncertainty/worry for patients and their families about surgical outcomes. Those were important factors for international patients. Our research invites further studies to show whether instant commencement of electrical stimulation helps to expedite long-term hearing/speech performance in cochlear implantees. Objectives: Initial switch-on generally could not launch until weeks after cochlear implantation due to factors associated with wound conditions. Commencement of electrical stimulation within 24 h after the surgery has long been performed in our department on a routine basis. The idea issued from the need to sew-and-go for international patients. This study presents the safety and feasibility of the procedure. Methods: Charts of 79 subjects with profound hearing impairment were studied. A minimally invasive approach was used for cochlear implantation, with an intention to control wound condition and tissue swelling. Hearing threshold was measured preoperatively and postoperatively. Results: Initial switch-on within 24 h was done in all patients. Good hearing gain was obtained. No major complication occurred. There was no significant difference in hearing postoperatively that was attributable to the early switch-on.
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DOBA, IJS, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Transport proteins function in the translocation of ions, solutes and macromolecules across cellular and organellar membranes. These integral membrane proteins fall into >600 families as tabulated in ...the Transporter Classification Database (www.tcdb.org). Recent studies, some of which are reported here, define distant phylogenetic relationships between families with the creation of superfamilies. Several of these are analyzed using a novel set of programs designed to allow reliable prediction of phylogenetic trees when sequence divergence is too great to allow the use of multiple alignments. These new programs, called SuperfamilyTree1 and 2 (SFT1 and 2), allow display of protein and family relationships, respectively, based on thousands of comparative BLAST scores rather than multiple alignments. Superfamilies analyzed include: (1) Aerolysins, (2) RTX Toxins, (3) Defensins, (4) Ion Transporters, (5) Bile/Arsenite/Riboflavin Transporters, (6) Cation:Proton Antiporters, and (7) the Glucose/Fructose/Lactose superfamily within the prokaryotic phosphoenol pyruvate-dependent Phosphotransferase System. In addition to defining the phylogenetic relationships of the proteins and families within these seven superfamilies, evidence is provided showing that the SFT programs outperform programs that are based on multiple alignments whenever sequence divergence of superfamily members is extensive. The SFT programs should be applicable to virtually any superfamily of proteins or nucleic acids.
Objectives/Hypothesis
Sound pressure level delivered through personal listening devices (PLDs) and reaching the ear drum might be affected by body size and jaw movements. This study aimed to ...investigate whether jaw movement and/or smaller body mass index (BMI) resulted in decrease of sound pressure level within the ear canals of PLD users via an earbud earphone.
Study Design
Case series.
Methods
Forty‐five normal‐hearing subjects (16 males; mean age, 23.3 years) participated in this study. A probe‐microphone system was used to measure sound pressure level in the external ear canal with music delivered from a media player via an earbud earphone. Test materials consisted of two 20‐second excerpts from a heavy metal music piece. Subjects were instructed to adjust the volume of the media player to conform to three conditions for sound pressure measurement: comfortable, loud, and maximum. Measurements were then repeated while subjects mimicked chewing action under the same listening conditions.
Results
Sound pressure levels were significantly lower when measured with jaw movement than without jaw movement (P < .05). Sound pressure levels monitored with/without jaw movement were generally lower in subjects with a BMI<23 than those with a BMI ≥23 (P < .05).
Conclusions
Jaw movement and low BMI (<23) reduced the overall sound level of PLDs at the ear canal. Sound pressure levels detected in the external ear canal of our subjects using earbud earphones were significantly lower under conditions of jaw movement/BMI <23. Our research invites further studies on a larger group of PLD users to correlate these variables with hearing threshold shifts over time.
Level of Evidence
4. Laryngoscope, 123:1983–1987, 2013
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Photon counting detector (PCD)-CT has demonstrated promise to reduce ionizing radiation exposure further and improve spatial resolution. However, when the radiation exposure or the detector pixel ...size is reduced, image noise is elevated, and the CT number becomes more inaccurate. This exposure level-dependent CT number inaccuracy is referred to as statistical bias. The issue of CT number statistical bias is rooted in the stochastic nature of the detected photon number, N, and a log transformation used to generate the sinogram projection data. Due to the nonlinear nature of the log transform, the statistical mean of the log-transformed data is different from the desired sinogram, the log transform of the statistical mean of N. Consequently, when a single instance of N is measured, as in clinical imaging, the log-transform leads to an inaccurate sinogram and statistically biased CT numbers after reconstruction. This work presents a nearly unbiased and closed-form statistical estimator of sinogram as a simple yet highly effective method to address the statistical bias issue in PCD-CT. Experimental results validated that the proposed approach addresses the CT number bias problem and improves the quantification accuracy of both non-spectral and spectral PCD-CT images. Additionally, the process can slightly reduce noise without adaptive filtering or iterative reconstruction.
Efficient separation of sub-micrometer synthetic or biological components is imperative in particle-based drug delivery systems and purification of extracellular vesicles for point-of-care ...diagnostics. Herein, we report a novel phenomenon in spiral inertial microfluidics, in which the particle transient innermost distance (Dinner ) varies with size during Dean vortices-induced migration and can be utilized for small microparticle (MP) separation; aptly termed as high-resolution Dean flow fractionation (HiDFF). The developed technology was optimized using binary bead mixtures (1-3 μm) to achieve ~100- to 1000-fold enrichment of smaller particles. We demonstrated tunable size fractionation of polydispersed drug-loaded poly(lactic-co-glycolic acid) particles for enhanced drug release and anti-tumor effects. As a proof-of-concept for microvesicles studies, circulating extracellular vesicles/MPs were isolated directly from whole blood using HiDFF. Purified MPs exhibited well-preserved surface morphology with efficient isolation within minutes as compared with multi-step centrifugation. In a cohort of type 2 diabetes mellitus subjects, we observed strong associations of immune cell-derived MPs with cardiovascular risk factors including body mass index, carotid intima-media thickness and triglyceride levels (P<0.05). Overall, HiDFF represents a key technological progress toward high-throughput, single-step purification of engineered or cell-derived MPs with the potential for quantitative MP-based health profiling.
Bimodal stimulation (BMS) has been shown to be beneficial for the performance of pitch ranking in postlingually deafened adults. However, the contribution of nonimplanted ears to pitch perception ...with respect to duration of hearing aid (HAs) use for prelingually cochlear implantees remained unclear. This study aimed to investigate whether experiences/duration of HAs use in the nonimplanted ear improved pitch perception ability in this population of subjects.
Twenty-nine children with congenital/prelingual deafness of profound degree were studied. Test stimuli consisted of 2 sequential piano tones, ranging from C (256 Hz) to B (495 Hz). Children were asked to identify the pitch relationship between the 2 tones (i.e., same, higher, or lower).
Duration of HAs use was the major factor related to the correct rate for pitch perception. Overall correct rate for pitch perception (O) could be best predicted by duration of HAs use (DuA) (O = 0.561XDuA, r = 0. 315, p = 0.002).
Experiences of HAs use appear to improve pitch perception ability in prelingually cochlear implantees. This suggests that incorporation of HAs use early in life and through the postoperative rehabilitation program for prelingually deafened children with cochlear implants would be beneficial, although an association does not guarantee causality. A longitudinal study is needed to show whether improvement of music performance with duration of HAs use in these children is measurable using auditory evoked potentials.
Raltegravir is the first integrase strand transfer inhibitor approved for the treatment of HIV‐1 infection. As the first agent in this new class of antiretroviral therapies, raltegravir has ...demonstrated safety and efficacy in treatment‐naive as well as heavily pretreated HIV‐infected patients failing therapy with multidrug‐resistant virus. Raltegravir has a favorable drug interaction profile that permits both administration to a wide, demographically diverse patient population and coadministration with many other therapeutic agents, including antiretroviral agents and supportive medications, without restrictions or dose adjustment. Data through 96 weeks of follow‐up in three phase III studies, protocol 021 (STARTMRK) in treatment‐naive patients, and protocols 018 (BENCHMRK‐1) and 019 (BENCHMRK‐2) in treatment‐experienced patients, demonstrated the potent and durable antiretroviral and immunologic effects and the favorable long‐term safety profile of raltegravir in both treatment‐naive and treatment‐experienced patients. Raltegravir represents an important addition to the current armamentarium for the treatment of HIV infection.
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BFBNIB, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UL, UM, UPUK
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