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Active bone-conducting hearing devices (aBCHD; e.g., MEDEL Bonebridge® (BB)) and active middle ear implants (aMEI; e.g., MEDEL Vibrant Soundbridge® (VSB)) use radio frequency transmission to send information from an external microphone and sound processor to an internally implanted transducer. These devices potentially have an advantage over devices with percutaneous links because the skin is closed over the implantable components, which should reduce the risk of skin problems and infection. On the other hand, surgical procedures are more complex, with a greater risk of damage due to surgery. The objectives of this research were to quantify the reliability and long-term survival of MEDEL VSB and BB devices, determine the adverse and serious adverse device-related complications, and consider associated causes. A multi-center observational retrospective and prospective study was conducted at eleven auditory implant centers in the United Kingdom. Data was collected using a surgical questionnaire and audiological reports. Data were obtained from patient notes or from prospective cases that had a minimum follow-up of one year post-implant. Consecutive patient records were reviewed. Datasets from 109 BB and 163 VSB were reviewed. Of these, 205 were retrospective case note reviews, and 67 were prospective cases. The mean follow-up was 4 and 6 years, respectively, for BB and VSB. Kaplan–Meier Survival analyses indicated that the BB survival was 97% and 93.3% at 1 and 5 years, respectively, and the VSB was 92.1% and 87% at the same time points. This is a large cohort study for the field and has indicated that BB and VSB are safe interventions. Care should be taken to monitor magnet strength in the first few months. For the majority of device-related effects, there was no apparent association with etiology. However, an interesting pattern emerged for individuals who exhibited an inflammatory response, e.g., adhesions or device extrusion, and those with a history of chronic suppurative otitis media. This should be considered in future work and is not surprising given that many VSB recipients have a complicated hearing history, often associated with otitis media. [ABSTRACT FROM AUTHOR]

The multifunctional Ca2+/calmodulin-dependent protein kinase II (CaMKII) is a serine/threonine kinase important in transducing intracellular Ca2+ signals. While in vitro data regarding the role of CaMKII in the regulation of endothelial nitric oxide synthase (eNOS) are contradictory, its role in endothelial function in vivo remains unknown. Using two novel transgenic models to express CaMKII inhibitor peptides selectively in endothelium, we examined the effect of CaMKII on eNOS activation, NO production, vasomotor tone and blood pressure. Under baseline conditions, CaMKII activation was low in the aortic wall. Consistently, systolic and diastolic blood pressure, heart rate and plasma NO levels were unaltered by endothelial CaMKII inhibition. Moreover, endothelial CaMKII inhibition had no significant effect on NO-dependent vasodilation. These results were confirmed in studies of aortic rings transduced with adenovirus expressing a CaMKII inhibitor peptide. In cultured endothelial cells, bradykinin treatment produced the anticipated rapid influx of Ca2+ and transient CaMKII and eNOS activation, whereas CaMKII inhibition blocked eNOS phosphorylation on Ser-1179 and dephosphorylation at Thr-497. Ca2+/CaM binding to eNOS and resultant NO production in vitro were decreased under CaMKII inhibition. Our results demonstrate that CaMKII plays an important role in transient bradykinin-driven eNOS activation in vitro, but does not regulate NO production, vasorelaxation or blood pressure in vivo under baseline conditions.

Typically, the number of student visits to a school clinic is interesting only to the health services department as a metric for setting levels for clinic staffing and medical supply stocking. However, the number of visits and the reasons for those visits can gauge a school's indoor environmental quality (IEQ) and can motivate the facility services department to perform an environmental health assessment and implement any necessary corrective actions. To ascertain the IEQ of a classroom, facility services staff members usually perform a visual inspection or use an inexpensive indoor air quality meter. In some cases, they may use a surveyor questionnaire; but such methods are subjective and can result in false negatives since most air pollutants are invisible to the unaided eye. One way to assess a school's IEQ is to monitor clinic visit data. Analyzing clinic visit data can help inform programs to improve environmental quality. (Contains 4 figures.)

Oral candidiasis is prevalent among older people due to predisposing factors such as impaired immune defenses, medications and denture use. An increasing number of older people live in rest home facilities and it is unclear how this institutionalized living affects the quantity and type of fungi colonizing these people’s oral cavities. Smears and swabs of the palate and tongue and saliva samples were taken from participants residing in rest homes (RH; n = 20) and older people living in their own homes (OH; n = 20). Yeast in samples were quantified and identified by culturing on CHROMagar Candida and sequencing the ITS2 region of rDNA. A higher proportion of RH residents had Candida hyphae present in smears compared to OH participants (35% vs. 30%) although this difference was not statistically significant (p = 0.74). RH residents had, on average, 23 times as many yeast per mL saliva as OH participants (p = 0.01). Seven yeast species were identified in OH samples and only five in RH samples, with Candida albicans and Candida glabrata being the most common species isolated from both participant groups. The results indicate that older people living in aged-care facilities were more likely to have candidiasis and have a higher yeast carriage rate than similarly aged people living at home. This may be due to morbidities which led to the need for residential care and/or related to the rest home environment.

The Strengths and Difficulties Questionnaire (SDQ) is a widely used child mental health questionnaire with five hypothesised subscales. There is theoretical and preliminary empirical support for combining the SDQ's hypothesised emotional and peer subscales into an "internalizing" subscale and the hypothesised behavioral and hyperactivity subscales into an "externalizing" subscale (alongside the fifth prosocial subscale). We examine this using parent, teacher and youth SDQ data from a representative sample of 5-16 year olds in Britain (N = 18,222). Factor analyses generally supported second-order internalizing and externalizing factors, and the internalizing and externalizing subscales showed good convergent and discriminant validity across informants and with respect to clinical disorder. By contrast, discriminant validity was poorer between the emotional and peer subscales and between the behavioral, hyperactivity and prosocial subscales. This applied particularly to children with low scores on those subscales. We conclude that there are advantages to using the broader internalizing and externalizing SDQ subscales for analyses in low-risk samples, while retaining all five subscales when screening for disorder. (Contains 6 tables and 2 figures.)

Objective: Assessing performance validity is imperative in both clinical and research contexts as data interpretation presupposes adequate participation from examinees. Performance validity tests (PVTs) are utilized to identify instances in which results cannot be interpreted at face value. This study explored the hit rates for two frequently used PVTs in a research sample of individuals with and without histories of bipolar disorder (BD). Method: As part of an ongoing longitudinal study of individuals with BD, we examined the performance of 736 individuals with BD and 255 individuals with no history of mental health disorder on the Test of Memory Malingering (TOMM) and the California Verbal Learning Test forced choice trial (CVLT-FC) at three time points. Results: Undiagnosed individuals demonstrated 100% pass rate on PVTs and individuals with BD passed over 98% of the time. A mixed effects model adjusting for relevant demographic variables revealed no significant difference in TOMM scores between the groups, a =.07, SE =.07, p =.31. On the CVLT-FC, no clinically significant differences were observed (ps <.001). Conclusions: Perfect PVT scores were obtained by the majority of individuals, with no differences in failure rates between groups. The tests have approximately >98% specificity in BD and 100% specificity among non-diagnosed individuals. Further, nearly 90% of individuals with BD obtained perfect scores on both measures, a trend observed at each time point. [ABSTRACT FROM AUTHOR]

There is debate in the literature regarding how manipulating the focus of attention (FOA) influences ground reaction forces during the standing long jump (SLJ) and gaps in understanding as to which phases of the SLJ are affected (takeoff, flight, and landing) and whether FOA manipulation benefits remain when tasks are performed in fixed body postures. P urpose: This study compared SLJ performance under external (EXT) and internal (INT) FOA conditions with free and fixed postures. M ethods: Twenty participants performed SLJs under EXT and INT FOA conditions while being allowed to swing arms freely and having to keep hands on their hips. Kinematics and kinetics were recorded using 3D-motion capture and force plates. Jump distances, projection angles, and ground reaction forces and impulses were compared across conditions using a 2 × 3 repeated measures ANOVA. R esults: Jump distances were significantly further with EXT FOA (p <.001). These differences were due to increases in the takeoff distance (p <.001) and landing distances (p <.001), with flight distances not being different between the conditions (p =.061). Peak horizontal ground reaction forces (p <.001) and impulses (p <.001) were both greater, while projection angles were lower (p =.002) in the EXT FOA condition. Co nclusions: Improvements in SLJ distance with an EXT FOA are due to the takeoff and landing phases; manipulating FOA does change forces during the SLJ; and that benefits of an EXT FOA are realized even when movements are performed with constrained body postures. [ABSTRACT FROM AUTHOR]