Across-frequency combination of interaural time difference in bilateral cochlear implant listeners

The current study examined how cochlear implant (CI) listeners combine temporally interleaved envelope-ITD information across two sites of stimulation. When two cochlear sites jointly transmit ITD information, one possibility is that CI listeners can extract the most reliable ITD cues available. As a result, ITD sensitivity would be sustained or enhanced compared to single-site stimulation. Alternatively, mutual interference across multiple sites of ITD stimulation could worsen dual-site performance compared to listening to the better of two electrode pairs. Two experiments used direct stimulation to examine how CI users can integrate ITDs across two pairs of electrodes. Experiment 1 tested ITD discrimination for two stimulation sites using 100-Hz sinusoidally modulated 1000-pps-carrier pulse trains. Experiment 2 used the same stimuli ramped with 100 ms windows, as a control condition with minimized onset cues. For all stimuli, performance improved monotonically with increasing modulation depth. Results show that when CI listeners are stimulated with electrode pairs at two cochlear sites, sensitivity to ITDs was similar to that seen when only the electrode pair with better sensitivity was activated. None of the listeners showed a decrement in performance from the worse electrode pair. This could be achieved either by listening to the better electrode pair or by truly integrating the information across cochlear sites

A Retrospective Administrative Claims Database Evaluation of the Utilization of Belimumab in US Managed Care Settings

AbstractPurposeBelimumab is an approved therapy for the treatment of systemic lupus erythematosus (SLE). This study examined the real-world utilization patterns of belimumab and standard SLE therapies in patients after regulatory approval of belimumab in the United States.MethodsA retrospective, observational study of belimumab users in the HealthCore Integrated Research Database was conducted using administrative claims data (GlaxoSmithKline Clinical Study Register Study ID: 114955). The overall population for analysis was composed of patients who were prescribed belimumab, had ≥6 months pre- and ≥6 months post-index medical and pharmacy eligibility, and at least 1 medical claim for SLE. Patients’ clinical and demographic characteristics, treatment history, treatment patterns of belimumab, utilization of other medications, all-cause resource utilization, and costs were assessed. No hypotheses were tested.FindingsAll patients who were prescribed belimumab had an SLE claim. Patients who met all eligibility criteria (n = 155) were primarily female (94.2%; mean [SD] age, 44 [12] years) and 94.2% had used standard SLE therapies during the pre- and post-index periods. The majority had moderate SLE disease severity pre-index, and there was a small shift (approximately 8%) from moderate to mild SLE after initiation of belimumab. Two thirds of patients remained on belimumab therapy at 6 months post-index. The percentage of patients with any claim for oral corticosteroids remained stable; however, the point estimate for mean daily dose decreased slightly in months 3 to 6 post-index. Inpatient hospital admissions decreased slightly in the post-index period. The point estimate for total costs (excluding belimumab) decreased after initiation of belimumab, although overall total health care costs (including belimumab) increased.ImplicationsAll patients with a belimumab prescription had an SLE diagnosis on at least 1 medical claim, and the vast majority of those meeting all eligibility criteria had previously used a standard SLE therapy. Disease severity improved for a number of patients while on belimumab treatment and modest corticosteroid dose reductions were observed in later months. After initiating belimumab, health care costs (excluding belimumab) decreased. GlaxoSmithKline Clinical Study Register Study ID: 114955

High thymidylate synthase gene expression predicts poor outcome after resection of hepatocellular carcinoma.

IntroductionPrognosis after resection of hepatocellular carcinoma (HCC) is highly variable. Compared to clinicopathologic factors, the use of molecular markers to predict outcome has not been well studied. We investigated the prognostic importance of thymidylate synthase (TS) gene expression and polymorphisms in patients after resection of HCC.MethodsPatients who underwent complete resection of HCC for whom tissue was available were identified. TS gene expression level and polymorphisms were determined in HCC specimens. Prognostic factors were evaluated using Kaplan-Meier curves and Cox proportional hazard models.ResultsThe study included 67 patients. In univariate analysis, variables that negatively influenced survival included TNM stage, microvascular invasion, and high TS expression. For the high TS expression group, median survival was 54 months and 5-year actuarial survival was 47%. For the low TS expression group, median survival was not reached and the 5-year actuarial survival was 91%. In multivariate analysis, only high TS expression remained an independent predictor of poor survival (HR = 10.77, 95% CI 1.36-84.91; P = 0.02). TS gene polymorphisms were not associated with TS expression or overall survival.ConclusionsHigh TS expression predicts poor outcome after resection of HCC. Molecular markers might be robust predictors of patient outcome after resection of HCC

Role of ROCK isoforms in regulation of stiffness induced myofibroblast differentiation in lung fibrosis

Fibrosis is a major cause of progressive organ dysfunction in several chronic pulmonary diseases. Rho associated coiled-coil forming kinase (ROCK) has shown to be involved in myofibroblast differentiation driven by altered matrix stiffness in fibrotic state. There are two known ROCK isoforms in human, ROCK1 (ROKβ) and ROCK2 (ROKα), but specific role of each isoform in myofibroblast differentiation in lung fibrosis remains unknown. To study this, we developed a Gelatin methacryloyl (GelMA) hydrogel based culture system with different stiffness levels relevant to healthy and fibrotic lungs. We have shown that stiff matrix and not soft matrix, can induce myofibroblast differentiation with high αSMA expression. Furthermore, our data confirm that the inhibition of ROCK signalling by a pharmacological inhibitor (i.e. Y27632) attenuates stiffness induced αSMA expression and fibre assembly in myofibroblasts. To assess the role of ROCK isoforms in this process we used siRNA to knock down the expression of each isoform. Our data showed that knocking down either ROCK1 or ROCK2 did not result in a reduction in αSMA expression in myofibroblasts on stiff matrix as opposed to soft matrix where αSMA expression was reduced significantly. Paradoxically, on stiff matrix, the absence of one isoform (particularly ROCK2) exaggerated αSMA expression and led to thick fibre assembly. Moreover complete loss of αSMA fibre assembly was seen only in the absence of both ROCK isoforms suggesting that both isoforms are implicated in this process. Overall our results indicate the differential role of ROCK isoforms in myofibroblast differentiation on soft and stiff matrices

Short and long-term clinical outcomes of use of beta-interferon or glatiramer acetate for people with clinically isolated syndrome : a systematic review of randomised controlled trials and network meta-analysis

Source of funding: This work is part of a larger report commissioned by the NIHR HTA Programme as project number ID809. A.C. and G.J.M.T. are partly supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care West Midlands at the University Hospitals Birmingham NHS Foundation Trust.Peer reviewedPublisher PD

Comparative effectiveness of beta-interferons and glatiramer acetate for relapsing-remitting multiple sclerosis : systematic review and network meta-analysis of trials including recommended dosages

This work is part of a larger report commissioned by the NIHR HTA Programme as project number ID809. Aileen Clarke and G.J. Melendez-Torres are partly supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care West Midlands at the University Hospitals Birmingham NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NHS, NIHR, NICE or the Department of Health and Social Care.Peer reviewedPublisher PD

Investigating Perceptual Congruence Between Data and Display Dimensions in Sonification

The relationships between sounds and their perceived meaning and connotations are complex, making auditory perception an important factor to consider when designing sonification systems. Listeners often have a mental model of how a data variable should sound during sonification and this model is not considered in most data:sound mappings. This can lead to mappings that are difficult to use and can cause confusion. To investigate this issue, we conducted a magnitude estimation experiment to map how roughness, noise and pitch relate to the perceived magnitude of stress, error and danger. These parameters were chosen due to previous findings which suggest perceptual congruency between these auditory sensations and conceptual variables. Results from this experiment show that polarity and scaling preference are dependent on the data:sound mapping. This work provides polarity and scaling values that may be directly utilised by sonification designers to improve auditory displays in areas such as accessible and mobile computing, process-monitoring and biofeedback

On a hyperconvex manifold without non-constant bounded holomorphic functions

An example is given of a hyperconvex manifold without non-constant bounded holomorphic functions, which is realized as a domain with real-analytic Levi-flat boundary in a projective surface.Comment: 10 pages, final version, to appear in "Geometric Complex Analysis", Springer Proceedings in Mathematics & Statistic

Evasion of anti-growth signaling: a key step in tumorigenesis and potential target for treatment and prophylaxis by natural compounds

The evasion of anti-growth signaling is an important characteristic of cancer cells. In order to continue to proliferate, cancer cells must somehow uncouple themselves from the many signals that exist to slow down cell growth. Here, we define the anti-growth signaling process, and review several important pathways involved in growth signaling: p53, phosphatase and tensin homolog (PTEN), retinoblastoma protein (Rb), Hippo, growth differentiation factor 15 (GDF15), AT-rich interactive domain 1A (ARID1A), Notch, insulin-like growth factor (IGF), and Krüppel-like factor 5 (KLF5) pathways. Aberrations in these processes in cancer cells involve mutations and thus the suppression of genes that prevent growth, as well as mutation and activation of genes involved in driving cell growth. Using these pathways as examples, we prioritize molecular targets that might be leveraged to promote anti-growth signaling in cancer cells. Interestingly, naturally-occurring phytochemicals found in human diets (either singly or as mixtures) may promote anti-growth signaling, and do so without the potentially adverse effects associated with synthetic chemicals. We review examples of naturally-occurring phytochemicals that may be applied to prevent cancer by antagonizing growth signaling, and propose one phytochemical for each pathway. These are: epigallocatechin-3-gallate (EGCG) for the Rb pathway, luteolin for p53, curcumin for PTEN, porphyrins for Hippo, genistein for GDF15, resveratrol for ARID1A, withaferin A for Notch and diguelin for the IGF1-receptor pathway. The coordination of anti-growth signaling and natural compound studies will provide insight into the future application of these compounds in the clinical setting