Severe malaria in children leads to a significant impairment of transitory otoacoustic emissions--a prospective multicenter cohort study.

BACKGROUND: Severe malaria may influence inner ear function, although this possibility has not been examined prospectively. In a retrospective analysis, hearing impairment was found in 9 of 23 patients with cerebral malaria. An objective method to quickly evaluate the function of the inner ear are the otoacoustic emissions. Negative transient otoacoustic emissions are associated with a threshold shift of 20 dB and above. METHODS: This prospective multicenter study analyses otoacoustic emissions in patients with severe malaria up to the age of 10 years. In three study sites (Ghana, Gabon, Kenya) 144 patients with severe malaria and 108 control children were included. All malaria patients were treated with parental artesunate. RESULTS: In the control group, 92.6 % (n = 108, 95 % confidence interval 86.19-6.2 %) passed otoacoustic emission screening. In malaria patients, 58.5 % (n = 94, malaria vs controls p < 0.001, 95 % confidence interval 48.4-67.9 %) passed otoacoustic emission screening at the baseline measurement. The value increased to 65.2 % (n = 66, p < 0.001, 95 % confidence interval 53.1-75.5 %) at follow up 14-28 days after diagnosis of malaria. The study population was divided into severe non-cerebral malaria and severe malaria with neurological symptoms (cerebral malaria). Whereas otoacoustic emissions in severe malaria improved to a passing percentage of 72.9 % (n = 48, 95 % confidence interval 59-83.4 %) at follow-up, the patients with cerebral malaria showed a drop in the passing percentage to 33 % (n = 18) 3-7 days after diagnosis. This shows a significant impairment in the cerebral malaria group (p = 0.012 at days 3-7, 95 % confidence interval 16.3-56.3 %; p = 0.031 at day 14-28, 95 % confidence interval 24.5-66.3 %). CONCLUSION: The presented data show that 40 % of children have involvement of the inner ear early in severe malaria. In children, audiological screening after severe malaria infection is not currently recommended, but is worth investigating in larger studies

Manuscript Architect: a Web application for scientific writing in virtual interdisciplinary groups

BACKGROUND: Although scientific writing plays a central role in the communication of clinical research findings and consumes a significant amount of time from clinical researchers, few Web applications have been designed to systematically improve the writing process. This application had as its main objective the separation of the multiple tasks associated with scientific writing into smaller components. It was also aimed at providing a mechanism where sections of the manuscript (text blocks) could be assigned to different specialists. Manuscript Architect was built using Java language in conjunction with the classic lifecycle development method. The interface was designed for simplicity and economy of movements. Manuscripts are divided into multiple text blocks that can be assigned to different co-authors by the first author. Each text block contains notes to guide co-authors regarding the central focus of each text block, previous examples, and an additional field for translation when the initial text is written in a language different from the one used by the target journal. Usability was evaluated using formal usability tests and field observations. RESULTS: The application presented excellent usability and integration with the regular writing habits of experienced researchers. Workshops were developed to train novice researchers, presenting an accelerated learning curve. The application has been used in over 20 different scientific articles and grant proposals. CONCLUSION: The current version of Manuscript Architect has proven to be very useful in the writing of multiple scientific texts, suggesting that virtual writing by interdisciplinary groups is an effective manner of scientific writing when interdisciplinary work is required

Impact of postoperative fluorodeoxyglucose positron emission tomography/computed tomography on adjuvant head and neck cancer treatment

BackgroundResidual or recurrent cancer after surgery but prior to adjuvant therapy occurs in a proportion of patients with head and neck cancer and may warrant treatment changes. 18-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) may help to identify residual or recurrent disease but is not routinely obtained. We evaluated the relevance of postoperative FDG-PET/CT in this clinical context.MethodsThis single-institution, retrospective study identified patients with head and neck cancer who underwent definitive surgery between January 1, 2013, and April 1, 2023, and received a postoperative FDG-PET/CT prior to adjuvant treatment. We measured the rates of management changes resulting from postoperative FDG-PET/CT findings and the association between having a postoperative FDG-PET/CT which resulted in a management change and oncologic outcomes with selected multivariable competing-risks and proportional hazards regressions.ResultsOf 150 patients, 66 (44.0%) had a management change because of the postoperative FDG-PET/CT findings; 62 (93.8%) had radiotherapy plan changes, 20 (30.3%) underwent additional diagnostic testing, 11 (16.7%) had systemic therapy added or changed, 3 (4.6%) underwent reresection, and 15 (10.0%) switched to palliative-intent treatment. Having a postoperative FDG-PET/CT that resulted in a management change was not significantly associated with cancer recurrence or overall survival (both P &gt; .05).ConclusionsIn patients with resected head and neck cancer, postoperative, pre-adjuvant therapy FDG-PET/CT can alter clinical management and may enable additional personalization of treatment. When practical to obtain without delaying treatment, postoperative FDG-PET/CT may have clinical utility though requires careful interpretation due to the risks of false positives

On publishing in Mycorrhiza

The first issue of Mycorrhiza appeared in September, 1991, thus the journal recently has passed its 25th, Bsilver^ anniversary year. As the world has changed, so has our journal grown, prospered, and most importantly, evolved in response to the progress of mycorrhiza research and the needs of Bmycorrhizasts.^ Herein, we briefly reprise the journal’s past and look forward to the future with especial attention to the important question of how to get your manuscript published in Mycorrhiza