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Premature birth and disruption of the normal maturation process leave the immature ductus arteriosus unable to respond to postnatal cues for closure. Strategies that advocate conservative management of the patent ductus arteriosus (PDA) in premature infants are dependent on identification of the symptomatic PDA and understanding the risk factors that predispose to PDA. Exposure of premature infants to unintended vasodilatory stimuli may be one of the risk factors for PDA that is under recognized. In this article, we summarize the clinical factors that are associated with PDA and review commonly used neonatal drugs for their vasodilatory properties. Data demonstrating relaxation of the ductus arteriosus by gentamicin and other aminoglycoside antibiotics, by cimetidine and other H2 receptor antagonists, and by heparin are provided as examples of neonatal therapies that have unanticipated effects that may promote PDA. © Elsevier Inc. All rights reserved. [ABSTRACT FROM AUTHOR]

An automated cleft speech evaluator, available globally, has the potential to dramatically improve quality of life for children born with a cleft palate, as well as eliminating bias for outcome collaboration between cleft centers in the developed world. Our automated cleft speech evaluator interprets resonance and articulatory cleft speech errors to distinguish between normal speech, velopharyngeal dysfunction and articulatory speech errors. This article describes a significant update in the efficiency of our evaluator. Speech samples from our Craniofacial Team clinic were recorded and rated independently by two experienced speech pathologists: 60 patients were used to train the evaluator, and the evaluator was tested on the 13 subsequent patients. All sounds from 6 of the CAPS-A-AM sentences were used to train the system. The inter-speech pathologist agreement rate was 79%. Our cleft speech evaluator achieved 85% agreement with the combined speech pathologist rating, compared with 65% agreement using the previous training model. This automated cleft speech evaluator demonstrates good accuracy despite low training numbers. We anticipate that as the training samples increase, the accuracy will match human listeners., (Copyright © 2018. Published by Elsevier Ltd.)

Perceptual evaluation remains the gold-standard evaluation of cleft speech, but with any human interpretation, there can be bias. Eliminating bias, allowing comparison of speech data between units, is labor and time intensive. Globally, there is a shortage of listeners. We have developed a computer learning system to evaluate cleft speech. Our automated cleft speech evaluator interprets resonance and articulatory cleft speech errors. Speech recognition engines typically ignore voice characteristics and speech errors of the speaker, but in cleft speech evaluation, these features are paramount. Our evaluator targets these to distinguish between normal speech, velopharyngeal dysfunction and articulatory speech errors. Speech samples from our Craniofacial Team clinic were recorded and rated independently by two experienced speech pathologists: 60 patients were used to train the evaluator, and the evaluator was tested on the 13 subsequent patients. The inter-speech pathologist agreement rate was 79%. Our cleft speech evaluator achieved 77% on its best sentence and a median of 65% for all sentences. This automated cleft speech evaluator has applications for global cleft speech evaluation when no speech pathologist is available, and for unbiased evaluation, facilitating collaboration between teams. We anticipate that as the training samples increase, the accuracy will match human listeners., (Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Summary: Mastopexy and reduction mammoplasty share techniques of pedicle formation and skin excision patterns, with the main difference being the amount of breast tissue resected. Various types of excision patterns and orientation of pedicles were developed throughout the years, each with flares of popularity at different times. This article reviews the multiple techniques of pedicle orientation and skin excision patterns separately and gives the advantages and disadvantages of each.

The mechanisms that regulate relaxation of the fetal ductus arteriosus (DA) and its postnatal constriction are the subject of ongoing studies. Using pressure myography, a pattern of rhythmic oscillatory contractions termed vasomotion was observed in the isolated DA of preterm (day 15) fetal mice. Vasomotion was enhanced by oxygen-induced DA constriction and other contractile agents, and diminished by vasodilatory stimuli or inhibition of chloride channels. The DA of late preterm (day 17) or term (day 19) gestation fetal mice did not exhibit vasomotion. These studies establish the stage-specific presence of vasomotion in the DA of fetal mice and suggest that complex events contribute to intrinsic mechanisms for control of fetal DA tone.