Agreed-upon procedures report on the City of Delmar, Iowa for the period July 1, 2015 through June 30, 2016

Agreed-upon procedures report on the City of Delmar, Iowa for the period July 1, 2015 through June 30, 2016

Seqüenciamento de peptídeos usando espectrometria de massas: um guia prático

This paper introduces the basics of peptide mass spectra interpretation applied to proteomics and is directed to chemists, biochemists and biologists. The manuscript presents a well detailed protocol aiming to serve as a first choice guide for understanding peptide sequencing. The tutorial was elaborated based on both a thorough bibliographic revision and the author's experience. In order to prove the applicability of the proposed guide, spectra obtained on different instruments have been successfully interpreted by applying the presented rational.

High Penetrance of Pheochromocytoma Associated with the Novel C634Y/Y791F Double Germline Mutation in the RET Protooncogene

Context: Previous studies have shown that double RET mutations may be associated with unusual multiple endocrine neoplasia type 2 (MEN 2) phenotypes. Objective: Our objective was to report the clinical features of patients harboring a previously unreported double mutation of the RET gene and to characterize this mutation in vitro. Patients: Sixteen patients from four unrelated families and harboring the C634Y/Y791F double RET germline mutation were included in the study. Results: Large pheochromocytomas measuring 6.0-14 cm and weighing upto 640 g were identified in the four index cases. Three of the four tumors were bilateral. High penetrance of pheochromocytoma was also seen in the C634Y/Y791F-mutation-positive relatives (seven of nine, 77.7%). Of these, two cases had bilateral tumors, one presented with multifocal tumors, two cases had large tumors (>5 cm), and one case, which was diagnosed with a large (5.5 x 4.5 x 4.0 cm) pheochromocytoma, reported early onset of symptoms of the disease (14 yr old). The overall penetrance of pheochromocytoma was 84.6% (11 of 13). Development of medullary thyroid carcinoma in our patients seemed similar to that observed in patients with codon 634 mutations. Haplotype analysis demonstrated that the mutation did not arise from a common ancestor. In vitro studies showed the double C634Y/Y791F RET receptor was significantly more phosphorylated than either activated wild-type receptor or single C634Y and Y791F RET mutants. Conclusions: Our data suggest that the natural history of the novel C634Y/Y791F double mutation carries a codon 634-like pattern of medullary thyroid carcinoma development, is associated with increased susceptibility to unusually large bilateral pheochromocytomas, and is likely more biologically active than each individual mutation. (J Clin Endocrinol Metab 95: 1318-1327, 2010)

Early-Onset, Progressive, Frequent, Extensive, and Severe Bone Mineral and Renal Complications in Multiple Endocrine Neoplasia Type 1-Associated Primary Hyperparathyroidism

Differences in bone mineral density (BMD) patterns have been recently reported between multiple endocrine neoplasia type 1-related primary hyperparathyroidism (HPT/MEN1) and sporadic primary HPT However studies on the early and later outcomes of bone/renal complications in HPT/MEN1 are lacking In this cross sectional study performed in a tertiary academic hospital 36 patients cases with uncontrolled HPT from 8 unrelated MEN1 families underwent dual energy X ray absorptiometry (DXA) scanning of the proximal one third of the distal radius (1/3DR) femoral neck, total hip, and lumbar spine (LS) The mean age of the patients was 389 +/- 145 years Parathyroid hormone (PTH)/calcium values were mildly elevated despite an overall high percentage of bone demineralization (77 8%) In the younger group (<50 years of age) demineralization in the 1/3DR was more frequent more severe and occurred earlier (40% Z-score 1 81 +/- 0 26) The older group (>50 years of age) had a higher frequency of bone demineralization at all sites (p < 005) and a larger number of affected bone sites (p < 0001), and BMD was more severely compromised in the 1/3DR (p = 007) and LS (p= 002) BMD values were lower in symptomatic (88 9%) than in asymptomatic HPT patients (p < 006) Patients with long standing HPT (>10 years) and gastnnoma/HPT presented significantly lower 1/3DR BMD values Urolithiasis occurred earlier (<30 years) and more frequently (75%) and was associated with related renal comorbidities (50%) and renal insufficiency in the older group (33%) Bone mineral- and urolithiasis-related renal complications in HPT/MEN1 are early onset frequent extensive severe and progressive These data should be considered in the individualized clinical/surgical management of patients with MEN1 associated HPT (C) 2010 American Society for Bone and Mineral Research

Bone mineral density analysis in patients with primary hyperparathyroidism associated with multiple endocrine neoplasia type 1 after total parathyroidectomy

P>Objective Limited data have been reported on the effect of parathyroidectomy (PTx) on bone mineral density (BMD) in the setting of patients with hyperparathyroidism (HPT) associated with multiple endocrine neoplasia type 1 (MEN1). This study investigates the impact of total PTx on BMD in patients with HPT/MEN1. Design and patients A case series study was performed in a tertiary academic hospital. A total of 16 HPT/MEN1 patients from six families harbouring MEN1 germline mutations were subjected to total PTx followed by parathyroid auto-implant in the forearm. Measurements Bone mineral density values were assessed using dual-energy X-ray absorptiometry. Results Before PTx, reduced BMD (Z-score <-2 center dot 0) was highly prevalent in the proximal one-third of the distal radius (1/3 DR) (50%), lumbar spine (LS) (43 center dot 7%), ultradistal radius (UDR) (43 center dot 7%), femoral neck (FN) (25%) and total femur (TF) (18 center dot 7%) in the patients. Fifteen months after PTx, we observed a BMD improvement in the LS (from 0 center dot 843 to 0 center dot 909 g/cm2; +8 center dot 4%, P = 0 center dot 001), FN (from 0 center dot 745 to 0 center dot 798 g/cm2; +7 center dot 7%, P = 0 center dot 0001) and TF (from 0 center dot 818 to 0 center dot 874 g/cm2; +6 center dot 9%, P < 0 center dot 0001). No significant change was noticed in the 1/3 DR and UDR after PTx. Conclusions This data confirmed BMD recovery in the LS and FN after PTx in HPT/MEN1 patients. We also documented a significant BMD increase in the TF and no change in both the 1/3 DR and UDR BMD after PTx. Our data suggest that LS and proximal femur are the most informative sites to evaluate the short-term BMD outcome after PTx in HPT/MEN1 subjects.

Kinematic analysis of lingual fatigue in myasthenia gravis

This study describes a preliminary examination of the viability and suitability of the physiologic technique electromagnetic articulography (EMA) in investigating lingual fatigue in myasthenia gravis (MG). A 52.9-year-old female diagnosed with MG at the age of 18 years, but who was in remission, participated in the study with a matched control subject. Changes in the duration, speed, and range of tongue-tip and tongue-back movements during repetition of /taka/ over two minutes were investigated. Results revealed that the MG subject did not exhibit significant changes in duration, maximum velocity, maximum acceleration, or the distance travelled by her tongue as measured by EMA over the task. The kinematic results were, in part, expected since the MG subject was in remission. The results, therefore, may not be representative of the majority of individuals with active MG. The examination of the current case did highlight, however, the potential advantages of EMA in providing detailed, objective information regarding lingual kinematics for future investigations of individuals with MG. It also showed that EMA may be sensitive in detecting subclinical kinematic features of fatigue in individuals who are in remission from MG. Finally, EMA led to the identification of possible physiologic factors underlying the CV transform effect, which was evident for the MG subject's syllable productions. In the past, the effect had been assumed to be a purely perceptual-based phenomenon.

What We Don't Know Could Hurt Us: A Single Center Study of Batch-to-Batch Variability of Dietary Fluids and Matched Videofluoroscopy Fluids

This study examines batch-to-batch variability in the production of dietary fluids and videofluoroscopy fluids of a single hospital. The material properties, such as viscosity, yield stress, and density, show significant variations between batches. Also waterbased products (i.e., cordial) provide (a) the most stability from week to week for both dietary and videofluoroscopy fluids and (b) the best dietary and videofluoroscopy fluid matches. The study also highlights the need for further research into how base substances, such as water, juice, and dairy products, react with different thickeners and with barium.

What happens after the swallow? Introducing the glottal release sound

Cervical auscultation presents as a noninvasive screening assessment of swallowing. Until now the focus of acoustic research in swallowing has been the characterization of swallowing sounds,. However, it may be that the technique is also suitable for the detection of respiratory sounds post swallow. A healthy relationship between swallowing and respiration is widely accepted as pivotal to safe swallowing. Previous investigators have shown that the expiratory phase of respiration commonly occurs prior to and after swallowing. That the larynx is valved shut during swallowing is also accepted. Previous research indicates that the larynx releases valved air immediately post swallow in healthy individuals. The current investigation sought to explore acoustic evidence of a release of subglottic air post swallow in nondysphagic individuals using a noninvasive medium. Fifty-nine healthy individuals spanning the ages of 18 to 60+ years swallowed 5 and 10 milliliters (ml) of thin and thick liquid boluses. Objective acoustic analysis was used to verify presence of the sound and to characterize its morphological features. The sound, dubbed the glottal release sound, was found to consistently occur in close proximity following the swallowing sound. The results indicated that the sound has distinct morphological features and that these change depending on the volume and viscosity of the bolus swallowed. Further research will be required to translate this information to a clinical tool.

Voice and speech characteristics and vocal hygiene in novice and professional voice broadcast journalists

Knowledge of differences in voice and speech characteristics between novice and professional broadcasters is essential for effective education of broadcast journalism students. Because newsreaders rely on optimal voice production, information pertaining to vocal hygiene is also important. The first aim of this study was to compare the voice and speech characteristics of professional newsreaders, student newsreaders and control participants. The second aim was to compare the awareness and use of vocal hygiene across these groups. Professional radio newsreaders, broadcast journalism students and two matched control groups were included in the study. Each participant recorded a news bulletin and completed a questionnaire on vocal hygiene. Data analysis of the recording included objective analysis and perceptual ratings by a panel of three judges. Significant student-professional differences were found. Compared to both the students and the control groups, the professional newsreaders had greater variation in speaking fundamental frequency, a faster rate of speech, fewer pronunciation errors and higher perceptual ratings on vocal quality, emphasis, continuity, phrasing and style of newsreading. Female professional newsreaders had a higher speaking fundamental frequency than both their control participants and the student newsreaders. Comparison of vocal hygiene awareness revealed few significant differences between any of the groups.

Electropalatographic assessment of tongue-to-palate contacts exhibited in dysarthria following traumatic brain injury: Spatial characteristics

Consonant imprecision has been reported to be a common feature of the dysarthric speech disturbances exhibited by individuals who have sustained a traumatic brain injury (TBI). Inaccurate tongue placements against the hard palate during consonant articulation may be one factor underlying the imprecision. To investigate this hypothesis, electropalatography (EPG) was used to assess the spatial characteristics of the tongue-to-palate contacts exhibited by three males (aged 23-29 years) with dysarthria following severe TBI. Five nonneurologically impaired adults served as control subjects. Twelve single-syllable words of CV or CVC construction (where initial C = /t, d, S, z, k, g/, V=/i, a/) were read aloud three times by each subject while wearing an EPG palate. Spatial characteristics were analyzed in terms of the location, pattern, and amount of tongue-to-palate contact at the frame of maximum contact during production of each consonant. The results revealed that for the majority of consonants, the patterns and locations of contacts exhibited by the TBI subjects were consistent with the contacts generated by the group of control subjects. One notable exception was one subject's production of the alveolar fricatives in which complete closure across the palate was demonstrated, rather than the characteristic groove configuration. Major discrepancies were also noted in relation to the amount of tongue-to-palate contact exhibited, with two TBI subjects consistently demonstrating increased contacts compared to the control subjects. The implications of these findings for the development of treatment programs for dysarthric speech disorders subsequent to TBI are highlighted.

Conservação de grãos de pólen de mamoneira a baixas temperaturas

A finalidade do armazenamento do grão de pólen é conservar material para futura utilização, proporcionando-lhe condições ótimas, de forma a manter seu poder germinativo, vigor e integridade genética originais. O objetivo deste trabalho foi verificar o poder germinativo dos grãos de pólen de mamoneira (Ricinus communis L.), após armazenamento a baixas temperaturas. Para tanto, grãos de pólen dos cultivares IAC 80 e AL Guarany 2002 foram utilizados e armazenados em quatro temperaturas: -196, -72, -18 e 4 ºC, durante um período de oito semanas. A avaliação da viabilidade deste pólen foi realizada semanalmente, até completar cinco semanas, sendo realizada uma última avaliação após a oitava semana de armazenamento, por meio do teste de germinação in vitro. Meio de cultura, contendo 10 gL-1 de ágar, 100 gL-1 de sacarose, 0,004 gL-1 de ácido bórico e pH 6,0, foi preparado e depositado em placas de lâmina escavada, onde o pólen foi distribuído sobre a superfície do meio. As placas foram incubadas a 20 ºC em BOD. O delineamento experimental foi inteiramente casualizado, em arranjo fatorial 2 x 4 (2 cultivares x 4 temperaturas) para cada tempo de armazenamento, sendo analisados 100 grãos de pólen por repetição, totalizando seis de cada tratamento. Verificou-se diferença significativa entre os tratamentos para a interação cultivar x temperatura na quinta semana de observação (p < 0,05). Demais interações foram altamente significativas em todas as épocas de observação (p < 0,01). Portanto, a utilização de ultrabaixas temperaturas permite a manutenção da viabilidade de grãos de pólen de mamoneira, até a quinta semana de armazenamento.

Expressão de caracteres de tubérculos em função do tamanho de recipiente usado no cultivo de batata na geração de plântulas

No melhoramento genético de batata, para alguns caracteres, é possível eliminar genótipos inferiores já nas gerações iniciais, o que permite reduzir o número de genótipos avaliados a campo, proporcionando redução de custos. O objetivo deste trabalho foi verificar a influência do tamanho de vaso na expressão de caracteres de tubérculo, em famílias de batata, na geração de plântula. Em casa de vegetação, dez famílias de batata foram avaliadas em dois tamanhos de recipientes, vaso grande (1 L) e vaso pequeno (250 ml). Os caracteres de tubérculos avaliados foram: cor, aspereza, profundidade de olho, sobrancelha, formato, uniformidade de formato, apontamento, curvatura, achatamento, aparência geral, massa por planta, massa média e número de tubérculos. O vaso grande proporciona maior expressão da variação genética para os caracteres profundidade de olho, sobrancelha, curvatura, achatamento, aparência geral e todos os componentes de rendimento. As maiores médias de produção de tubérculos em número, tamanho e massa foram obtidas no vaso grande, enquanto o maior coeficiente de variação genético para os caracteres formato, uniformidade de formato e apontamento de tubérculo foi obtido no vaso pequeno.