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Jeffrey Wischhusen,1 Uneeb Qureshi,2 Macario Camacho31School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; 2United States Public Health Service, Indian Health Service, Uniformed Services University, Bethesda, MD, USA; 3Department of Otolaryngology, Tripler Army Medical Center, Honolulu, HI, USAObjective: Laser-assisted uvulopalatoplasty (LAUP) has been used as a treatment option for snoring and obstructive sleep apnea for almost three decades. It has been previously reported that some patient’s sleep-disordered breathing worsened following surgery. The aim of this paper is to further elucidate the specific complications of LAUP.Data sources: A systematic search of the electronic databases MEDLINE/PubMed, Google Scholar, and Embase.Review methods: The PRISMA statement was followed. Databases were searched from inception through September 2, 2018. The following search was applied to MEDLINE/PubMed ((laser AND uvul*) OR (LAUP) OR (LAVP) OR (laser AND (apnea OR apnoea OR sleep))).Results: Forty-two studies with a mean follow-up of 16.1 months reported complications on 3,093 total patients who underwent LAUP. The percentages and associated complications of LAUP are as follows: bleeding (2.6%), candidiasis (0.3%), dryness (7.2%), dysgeusia (0.3%), dysosmia (0.2%), globus sensation (8.2%), surgical site infection (1.3%), velopharyngeal (VP) insufficiency (3.9%), and VP stenosis (1.6%). The mean duration of patient-reported pain in studies that reported pain was 11.65 days. Only globus and VP insufficiency had a significant incidence compared with either the general population or the post-oropharyngeal surgery population with relative risks of 1.48 and 2.25, respectively. Overall, there were approximately 26 complications per 100 patients who underwent LAUP.Conclusion: LAUP is associated with a statistically significant rate of VP insufficiency and globus sensation; however, studies lack details of surgical approaches, suggesting that in a population identified as good candidates, a tissue-sparing approach may result in fewer complications.Keywords: LAUP, uvulopalatoplasty, outcomes, complications

In Winter 2016, root and soil samples were collected from the rhizosphere soil at 10 to 15 cm depth of turfgrass, in the yard of a complex of houses in Caxias, a region near Lisbon, Portugal. The grass (dominated by tall fescue) showed yellow patches, stunting, and poor growth. Several specimens of a ring nematode (50-60 nematodes/100 ml soil) were recovered from soil and identified as Mesocriconema xenoplax (peach ring nematode) based on morphological and morphometrical analysis of females. The observed morphological features were with previous descriptions. Species identification was confirmed through sequencing of the fragment spanning D2/D3 domain of the 28S rDNA gene. Phylogenetic analysis revealed that the Portuguese isolate grouped with M. xenoplax isolates (98% similarity), supporting its identification as M. xenoplax. This is the first report of M. xenoplax from turfgrass in Portugal and in Europe contributing with additional information on the distribution of this phytoparasite.

Lauren K Reckley, Camilo Fernandez-Salvador, Macario Camacho Otolaryngology – Head and Neck Surgery, Tripler Army Medical Center, Honolulu, HI, USA Objective: Tonsillectomy with adenoidectomy is a combination surgery that has been used to treat pediatric obstructive sleep apnea (OSA). For adults, tonsillectomy has also been reported as a primary treatment modality when the tissue is hypertrophied. The objective of this study is to provide an overview of published systematic reviews and meta-analyses of tonsillectomy with or without adenoidectomy as used in the treatment of OSA in children and adults.Data sources: Nine databases, including PubMed/MEDLINE. Review methods: Databases were searched from their inception through July 9, 2017. The PRISMA statement was followed.Results: More than 20 recent systematic reviews and meta-analyses were identified regarding tonsillectomy as a treatment modality for OSA. There were four articles that addressed tonsillectomy’s overall success, efficacy, and complications in otherwise healthy pediatric patients. Three studies evaluated tonsillectomy in obese children, and two specifically examined children with Down syndrome. Only one systematic review and meta-analysis discussed tonsillectomy as a treatment for OSA in the adult population.Conclusion: Tonsillectomy as an isolated treatment modality is rarely performed in pediatric patients with OSA; however, tonsillectomy is commonly performed in combination with adenoidectomy and the combination has demonstrated efficacy as the primary treatment option for most children. In the limited adult data, tonsillectomy alone for OSA has a surprising success rate; yet, more research is required to determine long-term improvement and need for further treatment. Keywords: tonsillectomy, sleep apnea syndromes, systematic review, review

Gaurav Nigam,1 Macario Camacho,2 Edward T Chang,2 Muhammad Riaz3 1Division of Sleep Medicine, Clay County Hospital, Flora, IL, 2Division of Otolaryngology, Sleep Surgery and Sleep Medicine, Tripler Army Medical Center, Honolulu, HI, 3Division of Sleep Medicine, Astria Health Center, Grandview, WA, USA Abstract: Kidney disorders have been associated with a variety of sleep-related disorders. Therefore, researchers are placing greater emphasis on finding the role of chronic kidney disease (CKD) in the development of obstructive sleep apnea and restless legs syndrome. Unfortunately, the presence of other sleep-related disorders with CKDs and non-CKDs has not been investigated with the same clinical rigor. Recent studies have revealed that myriad of sleep disorders are associated with CKDs. Furthermore, there are a few non-CKD-related disorders that are associated with sleep disorders. In this narrative review, we provide a balanced view of the spectrum of sleep disorders (as identified in International Classification of Sleep disorders-3) related to different types of renal disorders prominently including but not exclusively limited to CKD. Keywords: kidney disease, sleep disorders, obstructive sleep apnea, parasomnias, restless legs syndrome, chronic kidney disease, insomnia

BACKGROUND: Unsupervised online cognitive assessments have demonstrated promise as an efficient and scalable approach for evaluating cognition in aging, and Alzheimers disease and related dementias. OBJECTIVES: The aim of this study was to evaluate the feasibility, usability, and construct validity of the Paired Associates Learning task from the Cambridge Neuropsychological Test Automated Battery® in adults enrolled in the Brain Health Registry. DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS: The Paired Associates Learning task was administered to Brain Health Registry participants in a remote, unsupervised, online setting. In this cross-sectional analysis, we 1) evaluated construct validity by analyzing associations between Paired Associates Learning performance and additional participant registry data, including demographics, self- and study partner-reported subjective cognitive change (Everyday Cognition scale), self-reported memory concern, and depressive symptom severity (Patient Health Questionnaire-9) using multivariable linear regression models; 2) determined the predictive value of Paired Associates Learning and other registry variables for identifying participants who self-report Mild Cognitive Impairment by employing multivariable binomial logistic regressions and calculating the area under the receiver operator curve; 3) investigated feasibility by looking at task completion rates and statistically comparing characteristics of task completers and non-completers; and 4) evaluated usability in terms of participant requests for support from BHR related to the assessment. RESULTS: In terms of construct validity, in participants who took the Paired Associates Learning for the first time (N=14,528), worse performance was associated with being older, being male, lower educational attainment, higher levels of self- and study partner-reported decline, more self-reported memory concerns, greater depressive symptom severity, and self-report of Mild Cognitive Impairment. Paired Associates Learning performance and Brain Health Registry variables together identified those with self-reported Mild Cognitive Impairment with moderate accuracy (areas under the curve: 0.66-0.68). In terms of feasibility, in a sub-sample of 29,176 participants who had the opportunity to complete Paired Associates Learning for the first time in the registry, 14,417 started the task. 11,647 (80.9% of those who started) completed the task. Compared to those who did not complete the task at their first opportunity, those who completed were older, had more years of education, more likely to self-identify as White, less likely to self-identify as Latino, less likely to have a subjective memory concern, and more likely to report a family history of Alzheimers disease. In terms of usability, out of 8,395 received requests for support from BHR staff via email, 4.4% (n=374) were related to PAL. Of those, 82% were related to technical difficulties. CONCLUSIONS: Our findings support moderate feasibility, good usability, and construct validity of cross-sectional Paired Associates Learning in an unsupervised online registry, but also highlight the need to make the assessment more inclusive and accessible to individuals from ethnoculturally and socioeconomically diverse communities. A future, improved version could be a scalable, efficient method to assess cognition in many different settings, including clinical trials, observational studies, healthcare, and public health.

The field of fetal, infant, and toddler (FIT) neuroimaging research—including magnetic resonance imaging (MRI), electroencephalography (EEG), magnetoencephalography, and functional near-infrared spectroscopy, among others—offers pioneering insights into early brain development and has grown in popularity over the past 2 decades. In broader neuroimaging research, multisite collaborative projects, data sharing, and open-source code have increasingly become the norm, fostering big data, consensus standards, and rapid knowledge transfer and development. Given the aforementioned benefits, along with recent initiatives from funding agencies to support multisite and multimodal FIT neuroimaging studies, the FIT field now has the opportunity to establish sustainable, collaborative, and open science practices. By combining data and resources, we can tackle the most pressing issues of the FIT field, including small effect sizes, replicability problems, generalizability issues, and the lack of field standards for data collection, processing, and analysis—together. Thus, the goals of this commentary are to highlight some of the potential barriers that have waylaid these efforts and to discuss the emerging solutions that have the potential to revolutionize how we work together to study the developing brain early in life.

BackgroundAlthough Black/African American older adults bear significant inequities in prevalence, incidence, and outcomes of Alzheimer's disease and related dementias, they are profoundly under-included in Alzheimer's Disease research. Community-Engaged Research (e.g., equitable community/science partnerships) is an evidence-based approach for improving engagement of underrepresented populations into Alzheimer's Disease research, but has lacked scalability to the national level. As internet use among older adults from underrepresented populations continues to grow, internet-based research shows promise as a feasible, valid approach to engagement and longitudinal assessment. The Community Engaged Digital Alzheimer's Research (CEDAR) study utilizes a community-engaged research approach to increase the engagement and research participation of Black/African American adults in the Brain Health Registry (BHR) and Alzheimer Disease clinical research.ObjectivesTo describe the methods and evaluate the feasibility of the CEDAR culturally-informed digital platform within BHR.DesignAll Black/African American participants in BHR were invited to enroll in CEDAR and to consider serving on a newly convened Community-Scientific Partnership Board to guide the study. The community board guided the development a culturally-informed cadre of engagement materials and strategies to increase research participation. Engagement strategies included incentives for study task completion, culturally-informed communications (e.g., landing page, emails and social media), resources about brain health, and video and written testimonials by CEDAR participants.SettingBHR, an Internet-based registry and cohort.ParticipantsBHR participants self-identifying as Black/African American were invited to enroll. All participants who signed an online informed consent document were enrolled.MeasurementsWe report the number of participants invited, enrolled, completed tasks, and volunteered to join the community board. We compared the demographics, cognitive profile, and baseline BHR task completion rates between CEDAR participants and all those invited to join the study.ResultsOf 3738 invited, 349 (9.34%) enrolled in CEDAR. 134 (37% of CEDAR participants) volunteered to join the community board, of which 19 were selected for the community board. Compared to those invited, the CEDAR cohort had a higher percentage of female participants (84.5%) and a lower percentage of participants who identify as belonging to more than one ethnocultural group (21.8%). Compared to those did not enroll in CEDAR, those enrolled in CEDAR had a higher percentage of participants completing all BHR tasks (22%) and a higher percentage of participants completing at least one cognitive test (76%). Those enrolled in CEDAR also had a higher percentage of participants having an enrolled study partner (18%).ConclusionsA culturally-informed Community-Engaged Research approach, including a remotely-convened community board, to engagement of Black/African American participants in an online research registry is feasible. This approach can be adapted for use in various clinical studies and other settings. Future studies will evaluate the effectiveness of the engagement strategies.

The taxonomic status of the Neotropical bat genus Trachops is reevaluated through an integrated study that incorporates morphological, morphometric, and molecular data across its extensive geographic range. Our research, which included previously unexamined geographical regions, revealed substantial insights into the diversity within Trachops. Genetic and morphological results support elevation of T. cirrhosus ehrhardti , distributed within the Atlantic Forest of Brazil, to species status due to differences in southeastern Brazil specimens. Conversely, our analysis found insufficient evidence to maintain the subspecific distinction of T. c. coffini , which lacks diagnosable morphological characters and is not genetically distinct from T. c. cirrhosus across its distribution range. Additionally, our findings challenge a prior notion of latitudinal differentiation in body size in T. cirrhosus , because specimens from western South America and northeastern South America exhibit similar sizes to those from Central America. These results underscore the importance of revising the taxonomic framework for this bat genus—contributing to a more precise understanding of its evolutionary relationships—and further enhancing conservation efforts considering potential threats to the newly recognized species in the imperiled Atlantic Forest of Brazil. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to assess the effectiveness of active teaching methodologies, namely, problem-oriented learning and the case method, to develop sustainability competencies. It also analyses the advantages and challenges for teachers when implementing the sustainable development goals (SDGs) in eight undergraduate and postgraduate degrees within the framework of a cross-departmental collaboration. Design/methodology/approach: A mixed research methodology was used: a quantitative study to assess the levels of acquisition of sustainability and research competencies and the potential correlation between them, as well as a mixed study of the advantages and challenges for the teachers participating in the cross-departmental initiative. Curriculum content linked to the SDGs was worked on. Active teaching methodologies and a competency assessment rubric were used as curriculum implementation strategies in the eight courses involved. Findings: Active teaching methodologies are suitable to implement the SDGs in university teaching and to develop both sustainability and research competencies. A synergic effect is observed between them. Coordinated work between teachers of different subjects in several degrees contributes to developing a culture of sustainability at the university. Research limitations/implications: Although the collaboration between teachers from different disciplines was successful, this study did not promote interdisciplinary projects among students from different degrees. This promises to be highly valuable for future research. Practical implications: Students can become present and future leaders in achieving the SDGs. This approach can be replicated in other educational institutions. Social implications: This study bridges the gap between theoretical recommendations and the practical implementation of the SDGs in undergraduate and postgraduate degrees. Originality/value: Coordinated work between teachers of different subjects in different degrees contributes to the development of a culture of sustainability at the university. [ABSTRACT FROM AUTHOR]