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The prognosis of patients with advanced squamous cell carcinoma of the external auditory canal and middle ear has been improved by advances in skull base surgery and multidrug chemoradiotherapy during the last two decades.
Ninety-five patients with squamous cell carcinoma of the external auditory canal and middle ear who were treated between 1998 and 2017 were enrolled. The number of patients with tumour stages T1, T2, T3 and T4 was 15, 22, 24 and 34, respectively. Oncological outcomes and prognostic factors were retrospectively investigated.
Among patients with T4 disease, invasion of the brain (p = 0.024), carotid artery (p = 0.049) and/or jugular vein (p = 0.040) were significant predictors of poor prognosis. The five-year overall survival rate of patients with at least one of these factors (T4b) was significantly lower than that of patients without these factors (T4a) (25.5 vs 65.5 per cent, p = 0.049).
It is proposed that stage T4 be subclassified into T4a and T4b according to the prognostic factors.
During the COVID-19 pandemic, the use of telemedicine as a way to reduce COVID-19 infections was noted and consequently deregulated. However, the degree of telemedicine regulation varies from country to country, which may alter the widespread use of telemedicine. This study aimed to clarify the telepsychiatry regulations for each collaborating country/region before and during the COVID-19 pandemic.
We used snowball sampling within a global network of international telepsychiatry experts. Thirty collaborators from 17 different countries/regions responded to a questionnaire on barriers to the use and implementation of telepsychiatric care, including policy factors such as regulations and reimbursement at the end of 2019 and as of May 2020.
Thirteen of 17 regions reported a relaxation of regulations due to the pandemic; consequently, all regions surveyed stated that telepsychiatry was now possible within their public healthcare systems. In some regions, restrictions on prescription medications allowed via telepsychiatry were eased, but in 11 of the 17 regions, there were still restrictions on prescribing medications via telepsychiatry. Lower insurance reimbursement amounts for telepsychiatry consultations v. in-person consultations were reevaluated in four regions, and consequently, in 15 regions telepsychiatry services were reimbursed at the same rate (or higher) than in-person consultations during the COVID-19 pandemic.
Our results confirm that, due to COVID-19, the majority of countries surveyed are altering telemedicine regulations that had previously restricted the spread of telemedicine. These findings provide information that could guide future policy and regulatory decisions, which facilitate greater scale and spread of telepsychiatry globally.
We have reported a blood flow increase in the prefrontal cortex during the performance of the computer version TMT. Although TMT-A was first performed and followed by TMT-B in the previous study, the order was reversed in the present study,i.e., TMT-B was first performed and then followed by TMT-A, and differences in the change of blood flow were compared between the two modes of TMT.
Nine healthy student volunteers (20.7 ± 1.6 yr) performed two different sets of TMT-B. After a resting period of 30 sec, they performed four different sets of TMT-A. Changes of oxyHb and deoxyHb were monitored by 22-channel NIRS from 30 sec before the start of TMT-B through 30 sec after the end of TMT-A. The mean changes of blood flow over a period of 10 sec just before the start of TMT-B and TMT-A, and over a period of 100 sec after the start of TMT-B and TMT-A were determined.
The increase of oxyHb was prominent in the right lateral prefrontal cortex.
The results suggest that the blood flow increases in the prefrontal cortex during the start of either TMT-A or TMT-B. The location of blood flow increase did not change whether TMT-B was performed first or after TMT-A. Therefore, the blood flow increase observed only in the right prefrontal cortex in the previous study could not be due to familiarization of the test. In contrast, TMT-A apparently exhibits a familiarization effect, since blood flow increase was not observed when TMT-A was performed after TMT-B.
We measured concentration changes of oxyHb and deoxyHb in the prefrontal cortex during the performance of the computer version Trail Making Test(TMT) by multichannel NIRS using near infrared light pairs which are more sensitive for detecting changes of oxyHb and deoxyHb.
Sixteen healthy student volunteers performed four different TMT-A sets, and following 30 a sec resting period, two different TMT-B sets. Changes of oxyHb and deoxyHb were monitored by 22 channel NIRS from 30 sec before the start of TMT-A through 30 sec after the end of TMT-B. The mean changes in subjects over a period of 10 sec just before the start of TMT-A and TMT-B, and a period of 50 to 60 sec after the start of TMT-A and TMT-B were determined. OxyHb increased while deoxyHb decreased in the bilateral prefrontal cortices during the performance of TMT. The increase of oxyHb was prominent in the right lateral prefrontal cortex, especially during TMT-A.
On the other hand, deoxyHb significantly decreased in the bilateral prefrontal cortices especially during TMT-A.
The results suggest that blood flow increases in the prefrontal cortex during the performance of the computer version TMT.
We present ALMA detection of the [O iii] 88 μm line and 850 μm dust continuum emission in a Y-dropout Lyman break galaxy, MACS0416_Y1. The [O iii] detection confirms the object with a spectroscopic redshift to be z = 8.3118±0.0003. The 850 μm continuum intensity (0.14 mJy) implies a large dust mass on the order of 4×106M⊙. The ultraviolet-to-far infrared spectral energy distribution modeling, where the [O iii] emissivity model is incorporated, suggests the presence of a young (τage ≍ 4 Myr), star-forming (SFR ≍ 60M⊙yr−1), and moderately metal-polluted (Z ≍ 0.2Z⊙) stellar component with a stellar mass of 3 × 108M⊙. An analytic dust mass evolution model with a single episode of star formation does not reproduce the metallicity and dust mass in ≍ 4 Myr, suggesting an underlying evolved stellar component as the origin of the dust mass.
The present study focused on parents’ social cue use in relation to young children's attention. Participants were ten parent–child dyads; all children were 36 to 60 months old and were either typically developing (TD) or were diagnosed with autism spectrum disorder (ASD). Children wore a head-mounted camera that recorded the proximate child view while their parent played with them. The study compared the following between the TD and ASD groups: (a) frequency of parent's gesture use; (b) parents’ monitoring of their child's face; and (c) how children looked at parents’ gestures. Results from Bayesian estimation indicated that, compared to the TD group, parents of children with ASD produced more gestures, more closely monitored their children's faces, and provided more scaffolding for their children's visual experiences. Our findings suggest the importance of further investigating parents’ visual and gestural scaffolding as a potential developmental mechanism for children's early learning, including for children with ASD.
Pneumococcal serotype replacement is an important issue after the introduction of pneumococcal conjugate vaccine (PCV) in children. After the introduction of 13-valent PCV, the incidence of invasive pneumococcal diseases (IPD) caused by Streptococcus pneumoniae serotype 12F (Sp12F) have increased in some countries; however, an outbreak of Sp12F has not reported in the post-13-valent PCV era. We experienced a local outbreak of Sp12F during March through May 2016 in Tsuruoka city, Japan after the introduction of 13-valent PCV in 2013. The IPD patients were two children and seven adults, three of whom died with a rapid disease progress. Although the clear transmission route was not determined, eight of the nine patients (89%) had close contact with children, which suggests that transmitted colonisation of Sp12F among children and adults might be the source of transmission. Continuous monitoring of IPDs, along with the determination of pneumococcal serotypes, is warranted in the post–13-valent PCV era. New IPD control strategies may be needed if this fatal outbreak continues to occur.
Evidence suggests that cultural experiences and learning multiple languages have measurable effects on children's development of executive function (EF). However, the precise impact of how bilingualism and culture contribute to observed effects remains inconclusive. The present study aims to investigate how these factors shape the development of early EF constructs longitudinally, between monolingual and bilingual children at ages 3, 3½ and 4 years, with a set of EF tasks that are uniquely relevant to the effects of bilingualism and cultural practices. We hypothesize that the effects of bilingualism and cultural backgrounds (i.e., Eastern) are based on different, though related, cognitive control processes associated with different EF constructs. Results revealed a significant bilingualism effect on cognitive control processes measuring selective attention, switching, and inhibition; while an effect of culture was most pronounced on behavioral regulation/response inhibition. Contributions of bilingualism and cultural experiences on individual EF constructs across development are discussed.
A new species of Roscoea is described and illustrated. Roscoea megalantha Tosh.Yoshida & R.Yangzom occurs in the Eastern Zone of Bhutan and neighbouring Arunachal Pradesh in India. A distribution map and an IUCN conservation assessment are given. A key to the three species of Roscoea found in Bhutan is provided.
Little is known about the economic benefits of cognitive remediation and supported employment (CR + SE). The present study aimed to investigate the cost-effectiveness of CR + SE compared with traditional vocational services (TVS).
Individuals with mental illness and low cognitive function were recruited at six sites in Japan. A total of 111 participants were randomly allocated to the CR + SE group or the TVS group. Clinical and vocational outcomes were assessed at baseline and 12-month follow-up. Service utilization data were collected monthly. The data on outcomes and costs were combined to examine cost-effectiveness.
The data were obtained from a total of 92 participants. The CR + SE group resulted in better vocational and clinical outcomes (employment rate, 62.2%; work tenures, 78.6 days; cognitive improvement, 0.5) than the TVS group (19.1%, 24.9 days and 0.2). There was no significant difference in mean total costs between the groups (CR + SE group: $9823, s.d. = $6372, TVS group: $11 063, s.d. = $11 263) with and without adjustment for covariates. However, mean cost for medical services in the CR + SE group was significantly lower than that in the TVS group after adjusting covariates (Β = −$3979, 95% confidence interval −$7816 to −$143, p = 0.042). Cost-effectiveness acceptability curves for vocational outcomes illustrated the high probabilities (approximately 70%) of the CR + SE group being more cost-effective than TVS when society is not willing to pay additional costs.
CR + SE appears to be a cost-effective option for people with mental illness who have low cognitive functioning when compared with TVS.
In this paper we present the results of spectroscopic observations for 34 emission-line stars (ELSs) in the Orion belt region, which were detected in an extensive survery. Spectral classification and the intensities of Hα and Hβ emission have revealed that the observed ELSs are probably T-Tauri type stars.
Bone contouring is currently the best treatment for fibro-osseous lesions after bone growth arrest. Navigation systems available for this surgery allow intra-operative visualisation with improved cosmetic outcomes. However, conventional navigation systems using superficial skin registration cannot prevent subtle discrepancies.
To address this problem, we used a non-invasive cranial bone registration that uses patient-specific dental templates to maintain exact registration. We created the preset goal using the mirror image of the unaffected side for unilateral lesions, and using images obtained before the onset of symptoms for bilateral lesions. This system achieved precise pre-operative simulation. A sound aid in the navigation system provided information regarding proximity to critical structures and to the preset goal.
We used this system to contour fibro-osseous lesions in three patients. All patients achieved good facial contours and improvement in symptoms.
This method offers a safe, rapid surgical aid in treating orbital fibro-osseous lesions.
To report magnetic resonance imaging findings in a patient with an SLC26A4 gene mutation who had low-frequency sensorineural hearing loss.
A 13-year-old girl had bilateral and symmetric low-frequency sensorineural hearing loss. Upon genetic testing, a heterozygous c.1105A > G (p.K369E) mutation of the SLC26A4 gene was detected. Mild endolymphatic hydrops in the right cochlea and marked endolymphatic hydrops in the left vestibulum were seen by magnetic resonance imaging 4 hours after an intravenous gadolinium injection.
This is the first reported case of a patient with the SLC26A4 gene mutation c.1105A > G (p.K369E) who had low-frequency sensorineural hearing loss. Co-occurrence of cochlear and vestibular endolymphatic hydrops suggests an association with that pathology.
To decrease the amount of precious metal usage for Pd-catalyzed aerobic alcohol oxidation, various amount of Cu-contained Pd bimetallic nanoparticle-supported solid base hydrotalcite catalyst (PdxCuy-PVP/HTs) were prepared and applied for aerobic benzyl alcohol oxidation. It was found that the addition of Cu atoms into Pd in the range of 0-40% provided a similar or a little superior activity to that of Pd100-PVP catalyst, whereas a large quantity of co-existence Cu (>40%) gradually decreased their activity of the catalyst. The aerobic benzyl alcohol oxidation over Pd80Cu20-PVP/HT served 77% yield and 95% selectivity towards benzaldehyde at 313 K for 5 h in toluene under O2 flow. X-ray adsorption spectroscopy (XAS) studies and scanning transmission electron microscopy-high angle annuar dark field (STEM-HAADF) with energy dispersive X-ray spectroscopy (EDS) analyses suggested that Cu atoms doping into Pd(0) NP influenced not only localized nanostructure but also oxidation state around Pd atoms. We suggested that substitution of precious metal with small amount of transition metals such as Cu lead to geometric/electronic changes in active sites would be one of nice strategies for reducing the cost for the catalyst in the oxidation process.
Two single nucleotide polymorphisms (SNP TXNIP and SNP ARNT), both on chromosome 4, have been reported to be associated with roundworm (Ascaris suum) burden in pigs. In the present study, we selected pigs with two SNP TXNIP genotypes (AA; n = 24 and AB; n = 24), trickle-infected them with A. suum from 8 weeks of age until necropsy 8 weeks later, and tested the hypothesis that pigs with the AA genotype would have higher levels of resistance than pigs of AB genotype. We used different indicators of resistance (worm burden, fecal egg counts (FEC), number of liver white spots and A. suum-specific serum IgG antibody levels). Pigs of the AA genotype had lower mean macroscopic worm burden (2·4 vs 19·3; P = 0·06), lower mean total worm burden (26·5 vs 70·1; P = 0·09) and excreted fewer A. suum eggs at week 8 PI (mean number of eggs/g feces: 238 vs 1259; P = 0·14) than pigs of the AB genotype, as expected based on prior associations. The pigs were also genotyped at another locus (SNP ARNT) which showed a similar trend. This study provides suggestive evidence that resistant pigs may be selected using a genetic marker, TXNIP, and provides further support to the quantitative trait locus on chromosome 4.
In the previous investigation, piezoelectric properties of the ‘Aligned-type’ in which the piezoelectric-ceramic particles are formed in linear aggregates in the rubber, remarkable piezoelectric properties were confirmed. In this investigation, to further enhance the piezoelectric properties of the Aligned-type, the influence of the matrix properties was investigated. The properties on which we focused were the dielectric constant and the Young’s modulus. Four kinds of matrix materials whose dielectric constant and Young’s modulus are different from each other; Silicone gel, Silicone rubber, Urethane rubber and Poly-methyl-methacrylate were investigated. As a result of measurement of the piezoelectric strain constant d33 of the Aligned-Type, it was confirmed that though the influence of the dielectric constant of the matrix material was small, the lower the Young’s modulus of the matrix was, the higher d33 was.
Hydroxyapatite-chondroitin sulfate (HAp/ChS) composites were synthesized with calcium hydroxide suspension and phosphoric acid solution containing ChS through a precipitation method, and the microparticles were then fabricated by a spray dry method with the suspension of the composites. Bovine serum albumin (BSA) with negative charge or lysozyme (LYZ) with positive charge at pH7.0 was adsorbed onto the HAp/ChS microparticles. However, the HAp/ChS microparticles adsorbed LYZ more than the HAp microparticles compared with BSA due to the electrostatic interaction from negatively-charged sulfate or carboxyl group of ChS in the composites. The release property of BSA from the HAp/ChS microparticles was evaluated in Dulbecco’s phosphate buffered saline (pH7.2). The HAp/ChS microparticles released quickly 100% of the adsorbed BSA, while HAp microparticles released 45% of BSA. These results indicated that incorporation of ChS in the microparticles controls the adsorption and release properties of protein due to the electrostatic interaction. The HAp/ChS microparticles therefore are a candidate of a carrier for drugs like vaccines.