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Long-latency auditory evoked potentials (LLAEPs) may help further advances in understanding consciousness under general anesthesia and promote more objective means of assessing sedation depth than conventional clinical signs. Among the LLAEP components, the auditory N1 shows promise as a measure of sedation depth and a marker of consciousness, but findings are so far inconclusive. Research with animals can help elucidate the effects of various anesthetics on the N1 and other LLAEPs, but investigations of LLAEPs under anesthesia in animals is lacking. To address this deficit, we examined the P1, N1, P2, and N2, along with their corresponding peak-to-peak complexes, in 10 Wistar rats anesthetized with 1.5–2 % isoflurane in pure oxygen and again after recovery. While under anesthesia, subdermal needle electrodes were inserted and secured for electroencephalographic (EEG) recordings. LLAEPs were assessed during a 20-min, passive, two-tone (500 ms inter-tone interval) paradigm with randomized short (1 s) and long (5 s) inter-pair intervals (IPIs). Overall, while the LLAEP peaks under isoflurane were less defined, they were not eliminated. The peak-to-peak amplitudes, particularly the P1-N1, were significantly smaller under isoflurane than during post-recovery. Our preliminary findings indicate that isoflurane produces global suppression across LLAEP components, presumably reflecting impaired integration of top-down and bottom-up attention and sensory systems under profound sedation with isoflurane.

OBJECTIVES This study investigated the development of aided long-latency response (ALLR) in children with cochlear implants (CI) within 18 months of implantation. MATERIALS AND METHODS ALLR was recorded in 33 children with CI who had an experience of less than 18 months with the implant. All the participants were in the age range of 3-7 years and were divided into 3 groups based on implant age, as 0-6 months, 6.1-12 months, and 12.1-18 months. Latency of the P1 component was recorded. RESULTS P1 latency was observed to be 142.105 ms at 0-6 months of implant age, 135.141 ms at 6.1-12 months of implant age, and 122.952 ms. at 12.1-18 months of implantation. CI recipients require 1 year of experience in order to obtain a significant difference in the P1 latency value. It was also found that gender does not influence P1 latency. CONCLUSION These preliminary findings suggest that with adequate stimulation, there is a gradual decrease in P1 latency, which indicates maturation of the central auditory structures. It was also found that the gender does not influence P1 latency.

Radiation therapy plays an important role in the multidisciplinary management of breast cancer. Recent years have seen improvements in breast cancer survival and a greater appreciation of potential long-term morbidity associated with the dose and volume of irradiated organs. Proton therapy reduces the dose to nontarget structures while optimizing target coverage. However, there remain additional financial costs associated with proton therapy, despite reductions over time, and studies have yet to demonstrate that protons improve upon the treatment outcomes achieved with photon radiation therapy. There remains considerable heterogeneity in proton patient selection and techniques, and the rapid technological advances in the field have the potential to affect evidence evaluation, given the long latency period for breast cancer radiation therapy recurrence and late effects. In this consensus statement, we assess the data available to the radiation oncology community of proton therapy for breast cancer, provide expert consensus recommendations on indications and technique, and highlight ongoing trials' cost-effectiveness analyses and key areas for future research. (c) 2021 Elsevier Inc. All rights reserved.

Prostate cancer is the most frequently diagnosed cancer in men and the second cause of death in those worldwide. The fact that is a tumor with a long latency period has led to a confusion in the convenience of its diagnosis and treatment in patients at an early stage. Classically, European and American societies have not recommended prostate cancer screening with PSA, allowing physicians take this decision. In 2012, after many years full of controversy, the American organization United States Preventive Task Force recommended to abandon its use. The results of these statements carried an increase in the incidence of the metastatic prostate cancer and, therefore, a rise in its mortality. In 2018, after these consequences, the European Association of Urology released new recommendations in favor of screening based on PSA for the first time. In 2019, guidelines were updated with no changes in its recommendations.

Bimanual coordination is essential for the performance of many everyday tasks. There are several types of bimanually coordinated movements, classified according to whether the arms are acting to achieve a single goal (cooperative) or separate goals (independent), and whether the arms are moving symmetrically or asymmetrically. Symmetric bimanual movements are thought to facilitate corticomotor excitability (CME), while asymmetric bimanual movements are thought to recruit interhemispheric inhibition to reduce functional coupling between the motor cortices. The influences of movement symmetry and goal conceptualisation on interhemispheric interactions have not been studied together, and not during bimanually active dynamic tasks. The present study used transcranial magnetic stimulation (TMS) to investigate the modulation of CME and short- and long-latency interhemispheric inhibition (SIHI and LIHI, respectively) during bimanually active dynamic tasks requiring different types of bimanual coordination. Twenty healthy right-handed adults performed four bimanual tasks in which they held a dumbbell in each hand (independent) or a custom device between both hands (cooperative) while rhythmically flexing and extending their wrists symmetrically or asymmetrically. Motor-evoked potentials were recorded from the right extensor carpi ulnaris. We found CME was greater during asymmetric tasks than symmetric tasks, and movement symmetry did not modulate SIHI or LIHI. There was no effect of goal conceptualisation nor any interaction with movement symmetry for CME, SIHI or LIHI. Based on these results, movement symmetry and goal conceptualisation may not modulate interhemispheric inhibition during dynamic bimanual tasks. These findings contradict prevailing thinking about the roles of CME and interhemispheric inhibition in bimanual coordination.

Acoustic signals are used for communication in underwater sensor networks (UWSNs) because radio signals attenuate heavily when propagating in water, while optical signals have large scattering in water. Data transmission in UWSNs faces great challenges due to the characteristics of underwater acoustic channels. Moreover, high energy consumption and long latency bring about increased challenges for the designs of routing protocols in UWSNs. In this paper, we propose a routing protocol called Layer-based Energy-Efficient Routing (LEER) protocol to address the route failure problem with greedy routing, as well as the long end-to-end delay and high energy consumption problems. In LEER, each node extracts the layer field information from hello packets received and updates its own layer to avoid the problem of routing a packet to a void area. All nodes with the LEER protocol forward packets to a sink node without the need for any location information. Simulation results show that the LEER protocol outperforms the depth-based routing (DBR) protocol in terms of the delivery rate and end-to-end delay.

Marjolin’s ulcer is a rare and often overlooked diagnosis which can be encountered by a variety of specialities. Majority of the literatures describe long latency period of 11 to 75 years. The authors present two unusual cases of rapid progression to Marjolin’s ulcer in patients with previously negative biopsy 8- and 10-month prior. This highlights the importance for clinicians to have a high degree of suspicion when encountered with any non-healing wound, especially one who’s symptomatology and morphological features have undergone an acute change. Even with previous negative biopsy, patients should still be followed-up closely and clinicians should not hesitate to perform re-biopsy if the suspicion arises.

PurposeThis study aimed to investigate usefulness of acoustic change complex (ACC) as an objective measure of difference limen for intensity (DLI) in auditory neuropathy spectrum disorders (ANSD) and cochlear hearing loss (CHL).MethodThe study used a multiple static group comparison research design. Twenty normal-hearing individuals (NH), 19 individuals with ANSD, and 23 individuals with CHL underwent DLI measurement using behavioral (psychoacoustic) techniques and ACC. For eliciting ACC, a 500-ms, 1,000-Hz pure tone was presented at 80 dB SPL. Additionally, six variants of this stimulus with intensity increments of 1, 3, 4, 5, 10, and 20 dB starting 250 ms after stimulus onset were used to elicit the ACC.ResultsThe lowest intensity change that produced replicable and clearly identifiable ACC was referred as objective DLI. In comparison to NH and CHL, the behavioral as well as the objective DLI were significantly larger (poorer) in ANSD (p< .05). Significantly strong positive correlation existed between DLI obtained using behavioral and objective measures (p< .05).ConclusionsACC could be a useful objective tool to measure DLI in the clinical population, provided the individuals of the clinical population fulfill the prerequisite of the presence of Auditory Long Latency Responses.Supplemental Materialhttps://doi.org/10.23641/asha.12560132

Introducción: Un estudio de casos y controles es un estudio en el que se compara individuos que tuvieron un desenlace de interés o outcome (casos) versus individuos que no tuvieron dicho resultado (controles) con respecto a la exposición de interés, potencialmente un "factor de riesgo" o “factor de protección”. El objetivo de un estudio de casos y controles es primariamente determinar si existe asociación entre una exposición (o varias) y un desenlace de interés. Esta asociación debe ser cuantificada y reportada como un odds ratio o razón de momios teniendo en cuenta sus fortalezas y limitaciones. En general, este tipo de estudios ofrece como ventajas su relativo bajo costo y rapidez con la que es posible realizarlos. Sin embargo, no son idóneos si lo que se quiere investigar son desenlaces de interés frecuente o con periodos de latencia largos. En el presente artículo se han revisado las principales consideraciones metodológicas del diseño de los estudios de casos y controles esperando con ello contribuir objeto de promover su correcta utilización e interpretación.

Adenoic cystic carcinoma (SACC, ACC) in the head and neck area, occurring in small and large salivary glands are relatively rare tumors, usually undergoing slow progression. ACC is characterized by a different clinical course compared to other cancers, with a long latency period, a tendency to form late, initially asymptomatic metastases and a small percentage of responses to systemic treatment. This article presents current recommendations for diagnostic procedures and treatment possibilities.

Pursuant to a Congressional act in 2008, the Department of Health and Human Services established the Interagency Breast Cancer and Environmental Research Coordinating Committee to address the burden of breast cancer in the United States. Subsequently, the Committee recommended researchers study the timing of exposure to breast cancer risk factors. Given the high breast cancer mortality rate on Staten Island, this paper presents a case-control study investigating breast cancer risk associated with puberty while living on Staten Island. The dataset combined New York City Department of Health and Mental Hygiene female death certificate information between 1985 and 2006, with life history information from newspaper obituaries. Data analyzed included: age, length of residence on Staten Island, birth on Staten Island, and residence on Staten Island during puberty. Cases were individuals who died of breast cancer and controls were individuals who died of non-malignant causes. Analysis included multivariate logistic regression on the full dataset and multiple replicates of randomized one case to two controls simulations. Results indicated that living on Staten Island during puberty (ages 9–19) was associated with an elevated risk of dying from breast cancer (odds ratio 1.35, p < 0.001, 95% CI = 1.18, 1.55). This paper suggests the importance of studying puberty as a window of susceptibility for breast cancer risk.

Introduction: Tinnitus is sound perception in the absence of a sound source. Changes in parameters of latency and amplitude on the auditory event related potentials or long latency potentials waves have been cited in tinnitus patients when compared to a control group. Objective: To perform an assessment of scientific evidence that verifies the possibility of alterations in latency or amplitude of the waves of event related potentials in individuals with tinnitus. Methods: By using SciELO, Lilacs, ISI Web and PubMed, scientific databases, a review was performed. Articles published in English, Portuguese, French and Spanish that correlated tinnitus with changes in event related potentials were included in this review. Results: Twelve articles were located, however only eight fulfilled the criteria for inclusion. Conclusion: The sample of selected studies demonstrate that the long latency auditory evoked potentials related to events between the control and tinnitus patients showed some changes in latency and or amplitude in tinnitus patients. There are changes in event-related potentials when comparing patients with tinnitus and the control group. These changes take place considering the severity of tinnitus, tinnitus site of lesion, and capacity for changes after interventions. The event related potentials can help to determine the neurotransmitter involved in tinnitus generation and evaluate tinnitus treatments. Resumo: Introdução: O zumbido é a percepção de um som na ausência de uma fonte sonora. Mudanças nos parâmetros de latência e amplitude nas ondas dos potenciais evocados auditivos relacionados a eventos ou potenciais de longa latência foram citadas em pacientes com zumbido quando comparados a um grupo controle. Objetivo: Realizar uma avaliação de evidências científicas que verifiquem a possibilidade de alterações na latência ou amplitude das ondas de potenciais evocados auditivos relacionados a eventos em indivíduos com zumbido. Método: Foi feita uma revisão a partir dos bancos de dados científicos SciELO, Lilacs, ISI Web e PubMed. Artigos publicados em inglês, português, francês e espanhol que correlacionavam zumbido com alterações nos potenciais evocados auditivos relacionados a eventos foram incluídos. Resultados: Foram localizados 12 artigos, porém apenas oito preencheram os critérios de inclusão. Conclusão: A amostra de estudos selecionados demonstra que os potenciais evocados auditivos de longa latência relacionados a eventos entre os pacientes-controle e com zumbido apresentaram algumas alterações na latência e/ou amplitude nos pacientes com zumbido. Há mudanças nos potenciais relacionados a eventos ao comparar pacientes com zumbido e o grupo controle. Essas alterações consideram a gravidade do zumbido, o local da lesão do zumbido e a capacidade de alterações após as intervenções. Os potenciais evocados auditivos relacionados a eventos podem ajudar a determinar o neurotransmissor envolvido na geração do zumbido e avaliar os tratamentos para o zumbido. Keywords: Tinnitus, Event Related Potentials (ERP’s), P300, Long latency potentials, Auditory evoked potentials, Palavras-chave: Zumbido, Potenciais relacionados a eventos, P300, Potenciais de longa latência, Potenciais evocados auditivos

Intrahepatic cholangiocarcinoma (iCCA) is a lethal malignant neoplasm with limited therapeutic options. Previous studies have found that Notch1 overexpression alone suffices to induce iCCA in the mouse, albeit after long latency. The current study found that activation of the Yes-associated protein (Yap) proto-oncogene occurs during Notch1-driven iCCA progression. After co-expressing activated Notch1 intracellular domain (Nicd) and Yap (YapS127A) in the mouse liver, rapid iCCA formation and progression occurred in Nicd/Yap mice. Mechanistically, an increased expression of amino acid transporters and activation of the mammalian target of rapamycin complex 1 (mTORC1) signaling pathway was detected in Nicd/Yap mouse liver tumors. Significantly, the genetic deletion of Raptor, the major mTORC1 component, completely suppressed iCCA development in Nicd/Yap mice. Elevated expression of Notch1, YAP, amino acid transporters, and members of the mTORC1 pathway was also detected ubiquitously in a collection of human iCCA specimens. Their levels were associated with a poor patient outcome. This study demonstrates that Notch and YAP concomitant activation is frequent in human cholangiocarcinogenesis. Notch and YAP synergize to promote iCCA formation by activating the mTORC1 pathway.

Research has shown that people who are instructed to volitionally respond to pitch-shifted feedback either produce responses that follow the shift direction with a short latency of 100–200 ms or oppose the shift direction with longer latencies of 300–400 ms. This difference in response latencies prompted a comparison of three groups of vocalists with differing abilities, non-trained English-speaking subjects, non-trained Mandarin-speaking subjects, and trained English-speaking singers. All subjects produced short latency following responses and long latency opposing responses, and in most cases the opposing responses were preceded by a shorter latency following response. Across groups, the magnitudes of the opposing and following responses were largest for the Mandarin speakers. Singers produced the smallest opposing response magnitudes, suggesting differences in the pitch goals of the two groups. Opposing response latencies were longest for the English and Mandarin speaking subjects and shortest for the trained singers, demonstrating that musical training increases the speed of producing the opposing responses. The presence of similar latencies of small following responses preceding larger opposing responses in all groups suggests that the tendency to mimic changes in sounds to which a person is attending are not influenced by vocal training or experience.Research has shown that people who are instructed to volitionally respond to pitch-shifted feedback either produce responses that follow the shift direction with a short latency of 100–200 ms or oppose the shift direction with longer latencies of 300–400 ms. This difference in response latencies prompted a comparison of three groups of vocalists with differing abilities, non-trained English-speaking subjects, non-trained Mandarin-speaking subjects, and trained English-speaking singers. All subjects produced short latency following responses and long latency opposing responses, and in most cases the opposing responses were preceded by a shorter latency following response. Across groups, the magnitudes of the opposing and following responses were largest for the Mandarin speakers. Singers produced the smallest opposing response magnitudes, suggesting differences in the pitch goals of the two groups. Opposing response latencies were longest for the English and Mandarin speaking subjects and shortest for the ...

Graphics processing units (GPUs) have become one of the best platforms for exploiting the plentiful thread-level parallelism of applications. However, GPUs continue to underutilize their hardware resources for optimizing the performance of numerous general-purpose applications. One primary reason for this is the inefficiency of existing warp schedulers in hiding long-latency operations such as global loads and stores. This study proposes a long-latency operation-based warp scheduler to improve GPU performance. In the proposed warp scheduler, warps are partitioned into different pools based on the characteristics of instructions that are subsequently executed. Specifically, this warp scheduler uses warps that are likely waiting for long-latency operations for a guiding role. Meanwhile, other warps perform filling roles (i.e., to overlap the latencies caused by the guiding warps). Our experimental results demonstrate that the proposed warp scheduler improves GPU performance by 24.4% on average as compared to the conventional warp scheduler.

Conjunctival melanoma is a rare malignant condition of the ocular surface. It is potentially lethal, with regional lymph node spread often preceding distant solid-organ metastasis. Due to its rarity and the long latency between treatment and local recurrence or the development of metastases, it is difficult to study. The literature is composed entirely of case series of varying quality, and there is significant variability in the management of this condition. This commentary attempts to distil the evidence base to provide practical management tips for the clinician.

The treatment of depressive episodes remains complicated by the long latency of antidepressant efficacy, insufficient response, and high risk of suicide. Ketamine and esketamine have been proposed as fast-acting substances able to overcome these impediments.Since the first randomized controlled trial in the year 2000, numerous studies have explored the antidepressant efficacy of ketamine and esketamine. Clear evidence has emerged that a single infusion exerts a significant antidepressant and antisuicidal effect in both unipolar and bipolar depression. A few studies suggest that antidepressant response can be improved and maintained by repeated administration. Although intravenous application has been most common, subcutaneous, intramuscular, and intranasal application has also been successful. There is some evidence that ketamine may accelerate the response to electroconvulsive therapy without improving the overall response rate.The precise position of ketamine and esketamine within treatment algorithms have yet to be defined, and issues surrounding potential toxicity need to be resolved.

The clinical audiologist gained a strong ally in the diagnostic process of central auditory alterations from the association between electrophysiological and behavioral methods.

Background: The establishment of regional development poles in the State of Pernambuco, Brazil was characterized by industrial expansion and consequent concerns about the increase in the occurrence of diseases, specifically those having long latency periods, as is the case of Chronic Myeloid Leukemia. Methods: The study included 367 patients diagnosed with Chronic Myeloid Leukemia over a ten-year period at a reference treatment center. Records of patient charts and the TerraView software were used, respectively, for data collection and geographic mapping of the cases from the twelve established State development regions. Results: A total incidence of 3.4 cases per 100,000 inhabitants was found, with a predominance of the disease among males, a median age of 47 years, a mestizo ethnicity, with elementary schooling and residence in urban area. Microregional incidence varied, but there was no significant variation in numbers over the years, and no relevant socio-environmental determinants were identified. Conclusion: The present study determined the incidence and characterized the spatial distribution of Chronic Myeloid Leukemia cases over a decade in a northeastern Brazilian state. The variation in the incidence rate by region of development is compatible with a homogeneous distribution of the cases. The work is a baseline study to be used for present and future analyses of the impact of the state economic development poles and the occurrence of this chronic malignant disease. Keywords: Chronic Myeloid Leukemia, Epidemiology, Incidence, Geographic mapping

OBJECTIVE: Urgency–rash action during strong emotion–is a robust correlate of nonsuicidal self-injury (NSSI). This study tested whether urgency is associated with time between NSSI urges and NSSI, and sought to replicate the finding that urgency is associated with NSSI history. METHODS: Participants attending a partial hospitalization program (N = 669) completed self-report measures of urgency, NSSI history and latency, and psychiatric symptoms. RESULTS: Consistent with previous research in clinical samples, rates of lifetime engagement in NSSI were high. Using logistic regression to predict short vs. long latency between urges and NSSI, no significant relationship emerged between negative urgency and latency to self-injure. Negative urgency more than doubled the likelihood of NSSI history (p < .001, OR = 2.39). In addition, exploratory analyses revealed several links between NSSI latency and negative urgency. CONCLUSION: Results confirm that urgency is robustly related to NSSI, yet also suggest that more research is needed to understand how urgency relates to the parameters of NSSI within those who self-injure. Use of retrospective self-report measures may limit the ability to test links between urgency and latency of NSSI.

Data prefetching, i.e., the act of predicting an application’s future memory accesses and fetching those that are not in the on-chip caches, is a well-known and widely used approach to hide the long latency of memory accesses. The fruitfulness of data prefetching is evident to both industry and academy: Nowadays, almost every high-performance processor incorporates a few data prefetchers for capturing various access patterns of applications; besides, there is a myriad of proposals for data prefetching in the research literature, where each proposal enhances the efficiency of prefetching in a specific way. In this survey, we evaluate the effectiveness of data prefetching in the context of server applications and shed light on its design trade-offs. To do so, we choose a target architecture based on a contemporary server processor and stack various state-of-the-art data prefetchers on top of it. We analyze the prefetchers in terms of their ability to predict memory accesses and enhance overall system performance, as well as their imposed overheads. Finally, by comparing the state-of-the-art prefetchers with impractical ideal prefetchers, we motivate further work on improving data prefetching techniques.

Purpose of Review People with isolated REM (rapid eye movement) sleep behavior disorder (iRBD) have a high lifetime risk of developing a neurodegenerative disease, including dementia, but disclosure of this risk remains controversial. Herein, we summarize this controversy and provide guidance on disclosure. Recent Findings Neurodegeneration risk disclosure in iRBD is controversial because of a long latency to disease onset and a lack of preventative strategies. Balancing the relevant ethical principles of beneficence, nonmaleficence, and autonomy is challenging. Although there are few data on disclosure in iRBD, evidence from discussing risk in other diseases with dementia provides some guidance. Summary We provide an approach to risk disclosure for patients with iRBD. Patients should be asked if they want to know about future risks. If so, disclosure should be patient centered, focusing on what might happen. Discussion should occur early to give patients time to prepare for the future and consider participating in research.

Asbestos and zeolites are silicate-based minerals, linked inextricably via paradoxical similarities and differences which have emanated from different geological epochs. Both have been employed in the service of humanity through millennia: asbestos, for its "inextinguishable" quality of being an insulator against heat and fire; zeolite, a "boiling stone" with its volcanic and marine sedimentary rock origins, for its propensity to adsorb water and remove metals and toxins. Serious adverse health effects observed in asbestos miners as long ago as the 1st Century AD did not halt the rising popularity of asbestos. As the miracle material of the 1900s, asbestos production and consumption exploded, culminating in its ubiquity in ships, vehicles, homes, commercial buildings, and over 3000 different industrial and household products. Through the 1940s and 1950s, epidemiological studies concluded that asbestos was a likely cause of asbestosis, lung cancer, and malignant mesothelioma, and it is now banned in many but far from all countries. The long latency between exposure to asbestos and the occurrence of cancer has obscured the deadly consequences of asbestos exposure for centuries. Even today, a considerable part of the world population is insufficiently aware of the dangers of asbestos, and millions of tons of this carcinogen continue to be mined and used worldwide. Zeolites, both natural and synthetic, are microporous aluminosilicate minerals commonly used in a myriad of processes, in the petrochemical industry, in domestic appliances and cleaning agents, as commercial adsorbents and exchangers for toxins and pollutants, and as catalysts. Zeolites are found in agriculture, veterinary science, and human health. More recently, new materials such as carbon nanotubes are being employed in materials requiring durability and thermal and electrical conductivity, yet nanotubes are now joining the ranks of more established particulates such as asbestos and silica, in causing human disease. In this review, we compare and contrast the similarities and differences of these two groups of silicate minerals and their waxing and waning use in the employ of humanity.

The centeral nervous system uses feedback processes that occur at multiple time scales to control interactions with the environment. Insight on the neuromechanical mechanisms subserving the faster feedback processes can be gained by applying rapid mechanical perturbations to the limb, and observing the ensuing muscle responses using electromyography (EMG). The long-latency response (LLR) is the fastest process that directly involve cortical areas, with a motorneuron response measurable 50 ms following an imposed limb displacement. Several behavioral factors concerning perturbation mechanics and the active role of muscles prior or during the perturbation can modulate the long-latency response amplitude (LLRa) in the upper limbs, but the interaction between many of these factors had not been systematically studied before.We conducted a behavioral study on thirteen healthy individuals to determine the effect and interaction of four behavioral factors -- background muscle torque, perturbation direction, perturbation velocity, and task instruction -- on the LLRa evoked from the flexor carpi radialis (FCR) and extensor carpi ulnaris (ECU) muscles following the application of wrist displacements. The effects of the four factors listed above were quantified using both a 0D statistical analysis on the average perturbation-evoked EMG signal in the period corresponding to an LLR, and using a timeseries analysis of EMG signals.All factors significantly modulated LLRa, and that their combination nonlinearly contributed to modulating the LLRa. Specifically, all the three-way interaction terms that could be computed without including the interaction between instruction and velocity significantly modulated the LLR. Analysis of the three-way interaction terms of the 0D model indicated that for the ECU muscle, the LLRa evoked when subjects are asked to maintain their muscle activation in response to the perturbations (DNI) was greater than the one observed when subjects yielded (Y) to the perturbations (ΔLLRa — DNI vs. Y: 1.76±0.16 nu, p

Clinical atherosclerotic cardiovascular disease (ASCVD) requires years to manifest, providing a window of opportunity for preventive cardiovascular management. Subclinical atherosclerosis imaging leverages this long latency period to estimate and improve future ASCVD risk. Coronary artery calcium (CAC) scoring has the most robust data in the detection of subclinical atherosclerosis. CAC scan significantly enhances cardiovascular risk stratification in addition to traditional risk models. Coronary computed tomography angiography data show similar strengths in subclinical atherosclerosis detection in addition to plaque morphology characterization with inherent limitations. Carotid intima-media thickness and ankle-brachial index are other modalities whose predictive value becomes incremental when added to the aforementioned modalities. When added to traditional risk models, subclinical atherosclerosis imaging modalities personalize future ASCVD risk stratification and assist in the initiation and rate of intensification of preventive therapies. Emerging imaging techniques exist but further research is required for primetime clinical use.

Asking “does an asbestos ban lead to a decrease in malignant mesothelioma?” is not a simple question as it may seem. This is largely because the phrase “asbestos ban” refers to a wide range of national situations and processes. It also reflects that countries have varied widely in their speed of reducing asbestos consumption in relation to, or independent of, adopting a ban. Thus, it is analytically complex to address an asbestos ban in relation to mesothelioma incidence, and few such studies have been conducted. The first study to directly address this question compared national-level data of changes in pleural mesothelioma mortality rates versus changes in asbestos use across a range of countries; the authors found correlations between these changes and suggested that there may be an early effect. The second study, which was a birth cohort analysis conducted in Sweden, showed that a later birth cohort (one active in the workforce after the decrease in asbestos use) had a decreased risk of pleural mesothelioma relative to an earlier birth cohort, regardless of gender. These studies implicated a causal effect, wherein an asbestos ban leads to a decrease in mesothelioma incidence. Given the very long latency period for mesothelioma, it can be expected that a much clearer effect will soon become evident in countries that adopted an early ban on asbestos. Furthermore, given the ongoing use of asbestos by many industrializing countries, it is also pertinent to ask: “Did an increase in mesothelioma incidence lead to an asbestos ban in some countries?”.

Introduction Otitis media (OM) is considered one of the most common reasons patients seek medical care in childhood. The fluctuating nature of hearing loss in cases of OM leads to irregular sound stimulation of the central auditory nervous system. Objectives To analyze the long-latency auditory-evoked potential (LLAEP) by verbal and nonverbal sounds in children with a history of OM in the first six years of life. Methods A total of 106 schoolchildren participated in the study, 55 females and 51 males, aged between 8 and 16 years, who were divided into 3 groups: the control group (CG), the bilateral experimental group (BEG), and the unilateral experimental group (UEG). All children underwent a complete audiological evaluation (audiometry, logoaudiometry and immitance testing) and an electrophysiological evaluation (LLAEP with toneburst stimulus – LLAEP-TB, and LLAEP with speech stimulus – LLAEP-S). Results Both study groups (BEG and UEG) presented a statistically lower performance (p Conclusion Children who had suffered secretory OM in the first six years of life and who had undergone myringotomy for the placement of a ventilation tube, either unilaterally or bilaterally, presented worse performance in their electrophysiological responses to verbal and nonverbal LLAEPs.

Paracoccidioidomycosis is a systemic mycosis that is endemic in geographical regions of Central and South America. Cases that occur in nonendemic regions of the world are imported through migration and travel. Due to the limited number of cases in Europe, most physicians are not familiar with paracoccidioidomycosis and its close clinical and histopathological resemblance to other infectious and noninfectious disease. To increase awareness of this insidious mycosis, we conducted a systematic review to summarize the evidence on cases diagnosed and reported in Europe. We searched PubMed and Embase to identify cases of paracoccidioidomycosis diagnosed in European countries. In addition, we used Scopus for citation tracking and manually screened bibliographies of relevant articles. We conducted dual abstract and full-text screening of references yielded by our searches. To identify publications published prior to 1985, we used the previously published review by Ajello et al. Overall, we identified 83 cases of paracoccidioidomycosis diagnosed in 11 European countries, published in 68 articles. Age of patients ranged from 24 to 77 years; the majority were male. Time from leaving the endemic region and first occurrence of symptoms considerably varied. Our review illustrates the challenges of considering systemic mycosis in the differential diagnosis of people returning or immigrating to Europe from endemic areas. Travel history is important for diagnostic-workup, though it might be difficult to obtain due to possible long latency period of the disease.

Background Recent outbreaks of duodenoscope-associated multidrug-resistant organisms (MDROs) have brought attention to the infection risk from procedures performed with duodenoscopes. Prior to these MDRO outbreaks, procedures with duodenoscopes were considered safe and low risk for exogenous infection transmission, provided they were performed in strict accordance with manufacturer instructions for use and multisociety reprocessing guidelines. The attention and efforts of the scientific community, regulatory agencies, and the device industry have deepened our understanding of factors responsible for suboptimal outcomes. These include instrument design, reprocessing practices, and surveillance strategies for detecting patient and instrument colonization. Various investigations have made it clear that current reprocessing methods fail to consistently deliver a pathogen-free instrument. The magnitude of infection transmission has been underreported due to several factors. These include the types of organisms responsible for infection, clinical signs presenting in sites distant from ERCP inoculation, and long latency from the time of acquisition to infection. Healthcare providers remain hampered by the ill-defined infectious risk innate to the current instrument design, contradictory information and guidance, and limited evidence-based interventions or reprocessing modifications that reduce risk. Therefore, the objectives of this narrative review included identifying outbreaks described in the peer-reviewed literature and comparing the findings with infections reported elsewhere. Search strategies included accessing peer-reviewed articles, governmental databases, abstracts for scientific conferences, and media reports describing outbreaks. This review summarizes current knowledge, highlights gaps in traditional sources of evidence, and explores opportunities to improve our understanding of actual risk and evidence-based approaches to mitigate risk.

Recent advances of end-to-end models have outperformed conventional models through employing a two-pass model. The two-pass model provides better speed-quality trade-offs for on-device speech recognition, where a 1st-pass model generates hypotheses in a streaming fashion, and a 2nd-pass model re-scores the hypotheses with full audio sequence context. The 2nd-pass model plays a key role in the quality improvement of the end-to-end model to surpass the conventional model. One main challenge of the two-pass model is the computation latency introduced by the 2nd-pass model. Specifically, the original design of the two-pass model uses LSTMs for the 2nd-pass model, which are subject to long latency as they are constrained by the recurrent nature and have to run inference sequentially. In this work we explore replacing the LSTM layers in the 2nd-pass rescorer with Transformer layers, which can process the entire hypothesis sequences in parallel and can therefore utilize the on-device computation resources more efficiently. Compared with an LSTM-based baseline, our proposed Transformer rescorer achieves more than 50% latency reduction with quality improvement., Comment: Proceedings of Interspeech, 2020

Radiation-associated valvular disease (RAVD) is characterized by late valvular manifestations following radiation exposure to the mediastinum. Review of current guidelines was performed to examine best practices to reduce risk and optimize outcomes in this patient population. Early and consistent screening and comprehensive and careful planning are critical in managing RAVD. Due to long latency periods, serial screening and targeted evaluation of risk factors are essential to early detection. Varying and complex presentations of RAVD require an integrated team of experienced specialists equipped with multimodality imaging-based screening protocols to stratify risk, plan intervention, and evaluate treatment response. Patients with valvular manifestations associated with radiation therapy call for an individualized plan of care involving longitudinal multimodality imaging-based screening and experienced decision-making regarding timing and strategy of intervention to improve patient outcomes.

Exposure assessment is an important factor in all epidemiological research seeking to identify, evaluate, and control health risks. In the military and veteran context, population health research to explore exposure-response links is complicated by the wide variety of environments and hazards encountered during active service, long latency periods, and a lack of information on exposures in potentially vulnerable subgroups. This paper summarizes some key considerations for exposure assessment in long-term health studies of military populations, including the identification of hazards related to military service, characterization of potentially exposed groups, exposure data collection, and assignment of exposures to estimate health risks. Opportunities and future directions for exposure assessment in this field are also discussed.

Previous conflicting findings on multisensory integration in schizophrenia might be related to differences in top-down attention demands across the different studies. We tested this with a visuo-tactile stimulation paradigm and high-density event-related potentials (ERPs) to examine the interplay between multisensory integration and top-down intersensory attention in healthy controls (N=27) and in people with schizophrenia (N=27). Unisensory visual, unisensory tactile or bisensory stimuli while participants attended to either visual or tactile inputs. D-prime values, ERPs, clinical symptomatology, and cognitive performance were examined, comparing the interplay of intersensory attention and multisensory integration between groups. The former was impaired in the schizophrenia group at the behavioral level, but only for unisensory and not for multisensory stimuli. ERPs showed earlier intersensory attention responses ( 230ms) over frontal and occipital brain areas. In contrast, multiple phases of multisensory integration, starting around 240ms, were preserved in the schizophrenia group. There was no correlation between ERP response and positive or negative symptoms. Our study provides evidence for long latency intersensory attention deficits in schizophrenia, presumably reflecting aberrant top-down processing. These findings indicate that uncompromised integrative multisensory processes, which elevate and capture attention, may serve as a compensatory mechanism for aberrant top-down processing in schizophrenia. Differences in attentional demands may have contributed to previous conflicting findings.

© 2020 American Physiological Society. All rights reserved. Time course of changes in the longlatency feedback response parallels the fast process of short-term motor adaptation Adapting to novel dynamics involves modifying both feedforward and feedback control. We investigated whether the motor system alters feedback responses during adaptation to a novel force field in a manner similar to adjustments in feedforward control. We simultaneously tracked the time course of both feedforward and feedback systems via independent probes during a force field adaptation task. Participants (n 35) grasped the handle of a robotic manipulandum and performed reaches to a visual target while the hand and arm were occluded. We introduced an abrupt counterclockwise velocity-dependent force field during a block of reaching trials. We measured movement kinematics and shoulder and elbow muscle activity with surface EMG electrodes. We tracked the feedback stretch response throughout the task. Using force channel trials, we measured overall learning, which was later decomposed into a fast and slow process. We found that the longlatency feedback response (LLFR) was upregulated in the early stages of learning and was correlated with the fast component of feedforward adaptation. The change in feedback response was specific to the long-latency epoch (50-100 ms after muscle stretch) and was observed only in the triceps muscle, which was the muscle required to counter the force field during adaptation. The similarity in time course for the LLFR and the estimated time course of the fast process suggests both are supported by common neural circuits. While some propose that the fast process reflects an explicit strategy, we argue instead that it may be a proxy for the feedback controller. NEW & NOTEWORTHY We investigated whether changes in the feedback stretch response were related to the proposed fast and slow processes of motor adaptation. We found that the long-latency component of the feedback stretch response was upregulated in the early stages of learning and the time course was correlated with the fast process. While some propose that the fast process reflects an explicit strategy, we argue instead that it may be a proxy for the feedback controller.

Cervical cancer screening was revolutionized in the early 1980s with the discovery of human papillomaviruses (HPVs) as the single causative agent of the disease. Viral infections contribute to ~12% of cancers worldwide, and two DNA viruses, Epstein-Barr virus and HPV, are associated with 38% of all virus-associated cancers. Most viral-associated cancers develop after a long latency period (15-40 yr).