ABSTRACT
OBJECTIVE: In patients who cannot or will not cooperate in behavioral hearing assessment, electrophysiological examinations are used, but are time-consuming because the subject has to remain immobile. The aim of this study was to assess whether auditory steady-state responses (ASSR) are sufficiently reliable, compared to auditory brainstem responses (ABR) and free-field audiometry, for assessment to begin with ASSR instead of ABR. MATERIAL AND METHODS: A retrospective study was performed between January 2012 and April 2013, including children less than 6 years of age who could not be tested via headphones. ASSR and ABR were measured during natural sleep or under phenobarbital-alimemazine sedation. Subjective pure-tone audiometry was performed, using the visual reinforcement audiometry method, in 69 children who were able and willing to cooperate. RESULTS: A total of 175 children were included. ASSR and ABR thresholds showed good positive correlation (338 ears; Pearson's correlation coefficient, 0.87). Behavioral thresholds correlated significantly with ASSR thresholds (Student t-test for matched series; P<0.05). ASSR thresholds were usually better than behavioral thresholds, with a difference of 8-15dB HL. CONCLUSION: ASSR is reliable in children under 6 years of age, and should be performed before ABR when hearing threshold rather than latency is to be determined.
Subject(s)
Audiometry, Evoked Response , Audiometry, Pure-Tone , Evoked Potentials, Auditory, Brain Stem , Evoked Potentials, Auditory , Hearing Loss/diagnosis , Auditory Threshold , Behavior Rating Scale , Child , Child, Preschool , Humans , Infant , Infant, Newborn , Retrospective StudiesABSTRACT
Alterations in genomic content and changes in gene expression levels are central characteristics of tumors and pivotal to the tumorigenic process. We analyzed 23 non-small cell lung cancer (NSCLC) tumors by array comparative genomic hybridization (array CGH). Aberrant regions identified included well-characterized chromosomal aberrations such as amplifications of 3q and 8q and deletions of 3p21.31. Less frequently identified aberrations such as amplifications of 7q22.3-31.31 and 12p11.23-13.2, and previously unidentified aberrations such as deletion of 11q12.3-13.3 were also detected. To enhance our ability to identify key acting genes residing in these regions, we combined array CGH results with gene expression profiling performed on the same tumor samples. We identified a set of genes with concordant changes in DNA copy number and expression levels, i.e. overexpressed genes located in amplified regions and underexpressed genes located in deleted regions. This set included members of the Wnt/beta-catenin pathway, genes involved in DNA replication, and matrix metalloproteases (MMPs). Functional enrichment analysis of the genes both overexpressed and amplified revealed a significant enrichment for DNA replication and repair, and extracellular matrix component gene ontology annotations. We verified the changes in expressions of MCM2, MCM6, RUVBL1, MMP1, MMP12 by real-time quantitative PCR. Our results provide a high resolution map of copy number changes in non-small cell lung cancer. The joint analysis of array CGH and gene expression analysis highlights genes with concordant changes in expression and copy number that may be critical to lung cancer development and progression.
Subject(s)
Carcinoma, Non-Small-Cell Lung/genetics , Chromosome Aberrations , Gene Expression , Lung Neoplasms/genetics , Gene Expression Profiling , Humans , Nucleic Acid Hybridization , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
Training of Dental Auxiliaries in the United States Air Force is a highly structured process combining training in short formal courses at the School of Health Care Sciences with extended periods of formal on-the-job training and self-study correspondence courses conducted at bases throughout the Air Force. The rigid control imposed by Air Force training directives is a major factor in the success of this dual channel concept. Dental auxiliaries are trained for what they need to know, as outlined in a 'task list' for their specific career field and behavioral objectives devised from the task list. Dental auxiliaries are utilized in the field performing in four basic areas: Dental Laboratory Technology, Chairside Dental Assisting, Preventive Dentistry (dental hygiene), and Expanded Function Dental Assisting. The scope of their duties range all the way from receiving the patient at the reception desk, assisting with dental treatment and dismissing the patient, to long-range planning for resource requirements necessary for the operation of a complete dental service. To paraphrase an old saying: 'The dental auxiliary is the backbone of the Dental Corps of the United States Air Force'.
