58 research outputs found

    Some Permanent Hearing Loss is Missed When Switched Ear Passes Are Used to Determine Screening Results

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    A common practice in Universal Newborn Hearing Screen (UNHS) programs is rolling up non-simultaneous passing results in each ear (SW_EAR) from repeat automated screens into a bilateral pass. This study aims to provide evidence-based criteria for best practices regarding SW_EAR screens. From January 2010 to May 2013, infants with SW_EARs results were prospectively monitored by MEDNAX-Pediatrix’s nationwide UNHS program, which combine inpatient/outpatient screens utilizing automated auditory brainstem response (AABR). The tracked audiologic evaluations of 16,129 refer infants (2,334 due to SW_EAR) out of the total infant population screened (2,492,314) were analyzed retrospectively. A high proportion of hearing loss (354/2334, 15%) was identified in infants with SW_EAR screens. Of those identified, 159 infants had a permanent hearing loss (PHL), 98 infants were fit with hearing aids and 7 received cochlear implants. When including SW_EARs as a criterion for referral, the screening protocol identified one more infant with PHL in every one hundred screened positive, maintaining referral and false positive rates of \u3c 0.7 % an

    Validación de un modelo de predicción de hipertensión arterial en la adultez desde la adolescencia. Resultados del estudio PESESCAD-HTA

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    Introducción: La predicción cardiovascular ha ido ganado cada vez más seguidores a nivel mundial. En Cuba existe ausencia de estudios longitudinales que permitan la predicción de la hipertensión arterial en la adultez desde la adolescencia con adecuada precisión. Objetivos: Evaluar la plausibilidad y la novedad científica del modelo de predicción propuesto. Métodos: Se realiza una valoración por expertos del modelo de predicción mediante un árbol de decisiones utilizando la técnica de CHAID (chi square automatic interaction detector). Se midió el coeficiente de competencia según lo exigido por el software IND_COMP_EX_2010. Se utilizó para la validación el criterio de expertos y se aplicó el método Delphi. Resultados: El índice de competencia de cada experto estuvo por encima del valor de 0,9. La comunidad de preferencia de los expertos en relación con los indicadores estudiados se manifestó entre alto y muy alto. La relación entre la suma de las valoraciones que dieron los expertos y el valor máximo que podrían haber dados todos ellos estuvo por encima de 0,80; lo que se consideró como satisfactorio. Conclusiones: Se evidenció una comunidad de preferencia de los expertos consultados de "muy alta" y "alta" sobre el modelo de predicción para el vaticinio de hipertensión arterial en la adultez desde la adolescencia.Palabras claves: hipertensión arterial, método Delphi, predicción cardiovascular, validación por criterio expertos

    Separability of neural responses to standardised mechanical stimulation of limbs

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    Abstract Considerable scientific and technological efforts are currently being made towards the development of neural prostheses. Understanding how the peripheral nervous system responds to electro-mechanical stimulation of the limb, will help to inform the design of prostheses that can restore function or accelerate recovery from injury to the sensory motor system. However, due to differences in experimental protocols, it is difficult, if not impossible, to make meaningful comparisons between different peripheral nerve interfaces. Therefore, we developed a low-cost electronic system to standardise the mechanical stimulation of a rat’s hindpaw. Three types of mechanical stimulations, namely, proprioception, touch and nociception were delivered to the limb and the electroneurogram signals were recorded simultaneously from the sciatic nerve with a 16-contact cuff electrode. For the first time, results indicate separability of neural responses according to stimulus type as well as intensity. Statistical analysis reveal that cuff contacts placed circumferentially, rather than longitudinally, are more likely to lead to higher classification rates. This flexible setup may be readily adapted for systematic comparison of various electrodes and mechanical stimuli in rodents. Hence, we have made its electro-mechanical design and computer programme available onlin

    Transducin Duplicates in the Zebrafish Retina and Pineal Complex : Differential Specialisation after the Teleost Tetraploidisation

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    Gene duplications provide raw materials that can be selected for functional adaptations by evolutionary mechanisms. We describe here the results of 350 million years of evolution of three functionally related gene families: the alpha, beta and gamma subunits of transducins, the G protein involved in vision. Early vertebrate tetraploidisations resulted in separate transducin heterotrimers: gnat1/gnb1/gngt1 for rods, and gnat2/gnb3/gngt2 for cones. The teleost- specific tetraploidisation generated additional duplicates for gnb1, gnb3 and gngt2. We report here that the duplicates have undergone several types of subfunctionalisation or neofunctionalisation in the zebrafish. We have found that gnb1a and gnb1b are co-expressed at different levels in rods; gnb3a and gnb3b have undergone compartmentalisation restricting gnb3b to the dorsal and medial retina, however, gnb3a expression was detected only at very low levels in both larvae and adult retina; gngt2b expression is restricted to the dorsal and medial retina, whereas gngt2a is expressed ventrally. This dorsoventral distinction could be an adaptation to protect the lower part of the retina from intense light damage. The ontogenetic analysis shows earlier onset of expression in the pineal complex than in the retina, in accordance with its earlier maturation. Additionally, gnb1a but not gnb1b is expressed in the pineal complex, and gnb3b and gngt2b are transiently expressed in the pineal during ontogeny, thus showing partial temporal subfunctionalisation. These retina-pineal distinctions presumably reflect their distinct functional roles in vision and circadian rhythmicity. In summary, this study describes several functional differences between transducin gene duplicates resulting from the teleost-specific tetraploidisation
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