Mean Threshold Research Articles

Clinical Feasibility of a Saliva-Based Antigen Qualitative Test for Severe Acute Respiratory Syndrome Coronavirus 2.

Nasopharyngeal swabs (NPS) are generally used as specimen samples for antigen qualitative tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The principle of the reaction to the antigen protein is the same when saliva is used, and saliva samples were reported to be as accurate as NPS for real-time reverse transcription quantitative polymerase chain reaction (RT-qPCR) testing to identify SARS-CoV-2. Unlike NPS collection, self-collected saliva does not expose healthcare workers to the risk of infection. In this study, we evaluated the feasibility of using saliva samples for a SARS-CoV-2 antigen qualitative test (TA2107SA) under development. Saliva samples were collected from patients with confirmed or suspected COVID-19 infection and analyzed. The sensitivity, specificity, and concordance index of the antigen qualitative test were calculated using an RT-qPCR test as reference. Saliva samples were collected from 105 patients. The mean interval from onset to specimen collection was 5.7 days. The mean cycle threshold (Ct) value of RT-qPCR was 31.3. The sensitivity, specificity, and concordance index were 70.7%, 100%, and 0.85, respectively. In 33 patients with Ct values <30, the results of both the RT-qPCR and antigen tests were positive. The sensitivity of the saliva-based TA2107SA SARS-CoV-2 antigen qualitative test was slightly lower than that of the conventional antigen qualitative test using NPS samples from the same patient. Saliva-based antigen qualitative tests for SARS-CoV-2 are an alternative option during a pandemic.

"Reasonable threshold" of spinopelvic parameters after fixation on distal stenosis in patients with degenerative thoracolumbar kyphosis: A STROBE-compliant article.

The short-segment instrument for precision treatment of lumbar stenosis syndrome (LSS) combined with degenerative thoracolumbar kyphosis (DTLK) receives more attention and the reasonable range of sagittal parameters is debatable in these elderly patients. This study aimed to include LSS patients combined with DTLK performed short-segmental fixation on LSS, to evaluate the efficacy of this procedure, and to determine the reasonable threshold of sagittal parameters. Overall 138 patients (female, 62.3%) were eligible (mean age of 68.8 ± 7.7 years) with a follow-up time of 24.6 ± 11.1 months. Spinopelvic sagittal parameters containing TLK, lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), and sagittal vertical axis were obtained at baseline and final visit, where |PI-LL|, PT, and sagittal vertical axis were seen as the main parameters. Quality of life was evaluated by the Oswestry Disability Index (ODI), which were divided into 4 quarters orderly. The reasonable threshold of parameters corresponding to ODI was determined by both linear regression and logistic regression. For all participants, TLK decreased by a mean of 8.3° and cases got TLK correction occupied 40.4%. ODI got improvement by the change of 29.9 ± 9.9. At baseline, ODI was correlated to |PI-LL|, while at final, ODI was correlated to |PI-LL| and PT. The independent factor affecting preoperative ODI was |PI-LL|, with ODI = 0.19 × |PI-LL| + 36.9 and the mean threshold of preoperative |PI-LL| was 10.7°. At final, PT was the influencing factor with ODI = 0.21 × PT + 3.16 and PT = 0.60 × |PI-LL| + 12.22. The mean threshold of postoperative |PI-LL| was 16.0° and PT was 23.1° by both linear regression and logistic regression. With short-segment fixation on LSS, >40% of patients with DTLK acquired TLK correction. |PI-LL| = 16.0° and PT = 23.1° was the “reasonable threshold” of sagittal parameters with the procedure for this population.

Analysis of the interprovincial embodied carbon flow network of China's exports.

We calculate the embodied carbon emissions of China’s through the multiregional input–output (MRIO) method, then we construct the interprovincial embodied carbon flow networks of China’s exports based on the mean threshold, and the application of complex network analysis to conduct a detailed examination of the overall characteristics, key nodes and edges, and community structure of China’s interprovincial embodied carbon flow network. We extended the embodied carbon flow network analysis at the provincial level. The results demonstrated the following: (1) The interprovincial embodied carbon flow network of China’s exports has small-world and scale-free characteristics. The node degree probability distribution curves for the networks obviously conformed to a decreasing power law distribution, indicating that a few industrial sectors carry a large amount of embodied carbon and suggesting that reducing the embodied carbon of China’s exports could yield twice the results with half the effort as long as attention is paid to a few sectors. (2) The key nodes and edges in the networks show that industrial sectors and production chains such as the power and heat production and supply industry, the petroleum processing, coking, and nuclear fuel processing industry, and the metal smelting and calendering industry play the role of key “bridges” in the entire network, among which Guangdong, Hebei, Jiangsu, Inner Mongolia, and Shanxi are important node provinces and the main flow paths for the generation of embodied carbon in national exports. These industrial sectors and production chains should bolster their policies to encourage the innovation of carbon emission reduction technologies and decrease carbon emissions, so as to reduce the embodied carbon of national exports on a large scale. (3) The number of communities firstly increased then decreased from 2007 to 2017, while the aggregation coefficient of the node and correlation density within first community displayed firstly downward then upward trends, reflecting firstly decentralization then centralization of the interprovincial embodied carbon flow.

Central Asia daily extreme precipitation in observations and gridded datasets: A threshold criteria perspective

The extreme precipitation threshold is fundamental to extreme precipitation research, directly affecting the cognition of extreme characteristics. Based on the daily precipitation data of 62 meteorological stations from 1985 to 2005, this study uses parametric and non-parametric approaches to determine the extreme precipitation threshold in Central Asia, analyzes the statistics and spatial distribution of different threshold criteria, and discusses the trend of extreme precipitation. The capability of the grid dataset of APHRODITE and GPCC in the extreme precipitation analysis in Central Asia is evaluated from the threshold perspective. The results are as follows: 1) Contrary to the parametric approach, the threshold determined by the percentile indices in the warm season is slightly higher than in the cold season. The mean threshold of the warm (cold) season in Central Asia is defined by the 95th percentile index and the 10-year return period, which are 14.0 mm (13.5 mm) and 24.2 mm (25.7 mm), respectively. 2) The spatial distribution of extreme precipitation threshold in Central Asia is higher in the southeast and lower in the north during the cold season; In the warm season, it is high in the north and southwest and low in the center. 3) Although both APHRODITE and GPCC datasets can basically reproduce the spatial distribution of extreme precipitation threshold, they underestimate the magnitude of the threshold, especially APHRODITE. 4) There is no obvious extreme precipitation trend in Central Asia during the study period. Furthermore, the trend in characteristics of extreme precipitation based on different thresholds shows a consistent trend in time but not spatially. We suggest that the threshold selection should adjust the balance between sufficient samples and extreme values according to actual conditions. The results of this study can provide a reference for extreme precipitation threshold criteria under specific application conditions in Central Asia.

Spectrotemporal Modulation Discrimination in Infants With Normal Hearing.

Spectral resolution correlates with speech understanding in post-lingually deafened adults with cochlear implants (CIs) and is proposed as a non-linguistic measure of device efficacy in implanted infants. However, spectral resolution develops gradually through adolescence regardless of hearing status. Spectral resolution relies on two different factors that mature at markedly different rates: Resolution of ripple peaks (frequency resolution) matures during infancy whereas sensitivity to across-spectrum intensity modulation (spectral modulation sensitivity) matures by age 12. Investigation of spectral resolution as a clinical measure for implanted infants requires understanding how each factor develops and constrains speech understanding with a CI. This study addresses the limitations of the present literature. First, the paucity of relevant data requires replication and generalization across measures of spectral resolution. Second, criticism that previously used measures of spectral resolution may reflect non-spectral cues needs to be addressed. Third, rigorous behavioral measurement of spectral resolution in individual infants is limited by attrition. To address these limitations, we measured discrimination of spectrally modulated, or rippled, sounds at two modulation depths in normal hearing (NH) infants and adults. Non-spectral cues were limited by constructing stimuli with spectral envelopes that change in phase across time. Pilot testing suggested that dynamic spectral envelope stimuli appeared to hold infants' attention and lengthen habituation time relative to previously used static ripple stimuli. A post-hoc condition was added to ensure that the stimulus noise carrier was not obscuring age differences in spectral resolution. The degree of improvement in discrimination at higher ripple depth represents spectral frequency resolution independent of the overall threshold. It was hypothesized that adults would have better thresholds than infants but both groups would show similar effects of modulation depth. Participants were 53 6- to 7-month-old infants and 23 adults with NH with no risk factors for hearing loss who passed bilateral otoacoustic emissions screening. Stimuli were created from complexes with 33- or 100-tones per octave, amplitude-modulated across frequency and time with constant 5 Hz envelope phase-drift and spectral ripple density from 1 to 20 ripples per octave (RPO). An observer-based, single-interval procedure measured the highest RPO (1 to 19) a listener could discriminate from a 20 RPO stimulus. Age-group and stimulus pure-tone complex were between-subjects variables whereas modulation depth (10 or 20 dB) was within-subjects. Linear-mixed model analysis was used to test for the significance of the main effects and interactions. All adults and 94% of infants provided ripple density thresholds at both modulation depths. The upper range of threshold approached 17 RPO with the 100-tones/octave carrier and 20 dB depth condition. As expected, mean threshold was significantly better with the 100-tones/octave compared with the 33-tones/octave complex, better in adults than in infants, and better at 20 dB than 10 dB modulation depth. None of the interactions reached significance, suggesting that the effect of modulation depth on the threshold was not different for infants or adults. Spectral ripple discrimination can be measured in infants with minimal listener attrition using dynamic ripple stimuli. Results are consistent with previous findings that spectral resolution is immature in infancy due to immature spectral modulation sensitivity rather than frequency resolution.

AUDIOLOGICAL EVALUATION IN HYPERTENSIVE PATIENTS

Every fifth person is affected by impaired hearing. Hearing loss, regardless of commitment, has an impact on people's quality of life, and even when acquired later in life, it develops gradually and impairs spoken communication, affecting sociability, employment, and earning potential. Instead of receiving social sympathy, the person is ridiculed. Among vascular diseases, arterial hypertension is the most common, causing pathological structural changes in the heart and blood vessels. By affecting the vascular system, high blood pressure can produce inner ear bleeding and alter perfusion, resulting in progressive or sudden hearing loss. The present research project is undertaken to serve as a basis for greater awareness of prevention and restoration of hearing loss occurring in association with systemic infirmities like silently progressing arterial hypertension. The purpose of this study is to evaluate the hearing functions of patients of both sexes with hypertension and compare it with normal individuals. To assess the possibility of reversibility of hearing loss with control of hypertension. A prospective comparative study including all patients with hypertension in one group and normal subjects in another who fulfilled the inclusion criteria in Nepalgunj Medical College during the time period of 1st December 2014 to 30th January 2016 was carried out. All the individuals were subjected to a thorough E.N.T. examination. The audiological evaluation was done with Special tests of audiometry. Blood pressure level was estimated at the primary visit and 3 subsequent visits. mild to severe degree of hearing loss was found in 16 subjects (32%) as compared to control cases (statistically significant). There was sensorineural hearing loss in 28 ears (13 Rt. Ears and 15 Lt. Ears) amongst hypertensives (statistically significant). Overall, moderately severe and severe hearing losses were more often associated with stage 1 hypertension than stage 2 as is observed for both ears which are statistically significant. The mean threshold of the hearing was 28.84±16.84 and 24.16±11.31 amongst stage 1 and stage 2 hypertensives respectively. There was no statistically significant alteration of the hearing status of the hypertensives on subsequent follow-up, baring 3 cases that showed some recovery on the last follow-up. Hypertension as compared to control cases has a statistically significant influence on the hearing status of subjects above 31 years of age. Present data show that they have only marginally raised threshold for speech frequencies and it is at 4 kHz and 8 kHz that they are most often affected with hypertension. Keywords: Hearing loss, Hypertension, Pure Tone Audiometry, Sensorineural Hearing Loss.

Perimetric Comparison Between the IMOvifa and Humphrey Field Analyzer.

IMO visual function analyzer (IMOvifa), a binocular perimeter, has similar output to the Humphrey Field Analyzer (HFA), but reduced the measurement time. The purpose of this study is to evaluate the performance of IMOvifa, a perimeter that performs binocular visual field (VF) testing, and to compare its results with standard automated perimetry. All patients underwent HFA 24-2 SITA-Fast and IMOvifa 24-2 AIZE-Rapid on the same day. Mean deviation (MD), pattern SD (PSD), foveal threshold, and visual field index (VFI) were compared between the 2 perimeters using Wilcoxon signed-rank tests, Pearson correlation, and Bland-Altman plot. Measurement time for performing VF for both eyes was also collected for each device. In this cross-sectional study, 138 eyes (including 25 healthy, 48 glaucoma suspects, and 65 primary open angle glaucoma) of 69 patients were evaluated. Measurement time was significantly faster for IMOvifa compared with HFA (256 vs. 419s, P <0.001). No significant differences were seen in MD and VFI between HFA and IMOvifa (both P >0.05). Significant differences were seen in mean PSD 3.2 (2.7, 3.6) dB for HFA versus 4.1 (3.5, 4.6) for IMOvifa ( P <0.001), and foveal threshold 33.9 (33.1, 34.6) dB for HFA versus 30.6 (29.3, 31.9) dB for IMOvifa ( P <0.001). Pearson r was strong for MD ( r =0.90, P <0.001), PSD ( r =0.78, P <0.001), and VFI ( r =0.94, P <0.001). The mean difference (95% limits of agreement) was -0.1 (-3.8, 3.5) dB for MD, -0.4 (-3.4, 2.5) dB for PSD, and 0.1 (-8.9, 9.1) dB for VFI, respectively. IMOvifa reduced measurement time by 39%. MD, PSD, and VFI values for IMOvifa showed good agreement with HFA SITA-Fast strategy. This perimeter reduced fatigue for both patient and examiner. Additional studies are needed to determine whether it will be useful for routine VF testing.

Results of permanent lead implantation at the His bundle without the use of an electrophysiological unit

Abstract Background His bundle pacing (HBP) promises physiological cardiac stimulation using the conduction system for a synchronous ventricular excitation, excluding the risk of pacing-induced cardiomyopathy. In daily practice, HBP is rather rarely used in Germany, in part because it has been recommended to use an electrophysiological unit (EPU) for registration of the His bundle potential and the HV interval. We attempted HBP replacing the EPU by a normal pacing system analyzer (PSA) with high resolution of the electrogram (EGM) which is used during daily clinical routine (Figs. 1 &amp; 2). Methods Consecutive patients (pts) with attempted HBP in our department were included in this prospective study. We used a 4,1F and a 7F lead together with specific sheaths to reach the His bundle. Mapping was performed using a conventional PSA (atrial channel, unipolar mode, 20 mm/mV). We recorded the success of the implantation for HBP, selective versus non-selective His bundle capture, parameters of sensing and pacing performance, operation and fluoroscopy times, the number of lead implantation attempts and QRS duration before and after HBP. Results Implantation of a system for HBP was attempted in 265 pts (mean age 78±12 years, 102 female, mean left ventricular ejection fraction 55±8%) and was successful in 244 (92%), selective His bundle capture was achieved in 55%, non-selective in 37%. Implantation success rates increased from 86% (earliest quartile) to 98% (latest quartile). Mean operation time was 95±46 min, mean fluoroscopy time 11±10 min; a mean of 6±7 attempts (median: 3) were necessary. Mean R wave amplitude was 5±4 mV, mean threshold 0,7±0,5 V at 1,0 ms. QRS duration before implantation was 111±29 ms, post implantation 88±20 ms. Conclusions HBP in daily clinical routine can be successful in &amp;gt;90% of cases without an EPU. Mean operation and fluoroscopy times were similar to those needed for biventricular pacing. An extremely narrow paced QRS could be achieved that indicates extremely good synchronization with HBP. Funding Acknowledgement Type of funding sources: None.

Intelligibility and detectability of speech measured diotically and dichotically in groups of listeners with, at most, "slight" hearing loss.

The purpose of this investigation was to determine if a group of listeners having thresholds at 4 kHz exceeding 7.5 dB HL, and no more than "slight" hearing loss, would exhibit degradations in performance when "target" stimuli were masked tokens of speech. Intelligibility thresholds and detection thresholds were measured separately for speech masked by flat-spectrum noise or speech-shaped noise. Both NoSo and NoSπ configurations were employed. Consistent with findings of earlier investigations, when maskers and speech tokens were broadband, NoSo and NoSπ detection thresholds were substantially lower than intelligibility thresholds. More importantly, for the small cohorts tested, mean thresholds obtained from the ≤7.5 dB and &gt;7.5 dB groups were equivalent. When maskers and speech targets were high-pass filtered at 500 Hz and above, the mean intelligibility thresholds obtained from the &gt;7.5 dB group were about 4 dB higher than those obtained from the ≤7.5 dB group, independent of masker type and interaural configuration of the stimuli. In real-world listening situations, such deficits may manifest themselves as substantially reduced speech intelligibility and, perhaps, increased "listening effort" for listeners whose thresholds at 4 kHz exceed 7.5 dB HL and who have no more than "slight" hearing loss.

Comparison of Hearing Abnormalities in Non-Diabetic and Diabetic End-Stage Renal Disease Patients Undergoing Hemodialysis

Background and Aim: Hearing loss is a highly prevalent symptom in patients with chronic kidney diseases (CKD). Comorbidities such as Diabetes Mellitus is known as the most common cause of CKD and a significant risk factor for sensorineural hearing loss (SNHL). The aim of this study was to compare SNHL among diabetic with non-diabetic hemodialysis patients.&#x0D; Methods: In this study, 33 diabetic patients on hemodialysis were selected from Hami center, Arak, Iran. Non-diabetic subjects were 31 hemodialysis patients without diabetes were matched for age, duration of CKD and hemodialysis. Data were obtained via questionnaire, patients’ files, physical examination, otoscopy and tympanometry. Hearing was analyzed using pure-tone audiometry for both groups.&#x0D; Results: In the study, 66.2% of diabetic patients and 52.1% of non-diabetic subjects had SNHL. Results showed that diabetic patient has 1.3 times more likely to have hearing impairment. This difference was not statistically significant. Bilateral mild SNHL was the most prevalent in both groups. No significant difference was reported in SNHL prevalence, mean thresholds of hearing and ear laterality between the groups. Gender and age had a significant effect on hearing loss after adjusting covariables. No significant association was found between diabetes and hearing loss.&#x0D; Conclusion: SNHL was more common in hemodialysis patients with diabetes. Patients with diabetes had poorer hearing thresholds compared to non-diabetic group, with no significant difference between groups. The periodical assessment of hearing and extending audiological care in this high-risk population is recommended due to long-term irreversible symptoms of the disease.&#x0D; Keywords: Diabetes mellitus; hearing loss; end-stage renal disease

Diagnostic accuracy of a novel SARS CoV-2 rapid antigen test and usefulness of specimens collected from the anterior nasal cavity

ObjectivesWe aimed to validate a newly developed antigen-detecting rapid diagnostic test (Ag-RDT) for SARS-CoV-2 using anterior nasal specimens. MethodsBetween February 12 and September 30, 2021, 16 patients (age range, <1 month-76 years) were enrolled, and samples were collected simultaneously from anterior nasal and nasopharyngeal sites continuously during hospitalization. The primary end points were the diagnostic accuracy of the Ag-RDT and utility of anterior nasal specimens. ResultsIn total, 226 sets of paired samples were obtained. In 88.2% of specimens, the viral load was high at the nasopharyngeal site. The mean cycle threshold values for the anterior nasal and nasopharyngeal sites were 32.4 and 29.9, respectively. Using the real-time polymerase chain reaction results as a reference, the Ag-RDT showed a 100% sensitivity up to day 6 of the illness, using specimens with moderate or high viral load (cycle threshold <30) from either site. From day 7, the sensitivity was 70.4-90.6% and 83.9-84.6% for the anterior nasal and nasopharyngeal sites, respectively. The specificity remained at 100%. ConclusionOur novel Ag-RDT meets the World Health Organization criteria and provides stable sensitivity and specificity and accurate results with anterior nasal specimens.

Sex differences in number of X chromosomes and X-chromosome inactivation in females promote greater variability in hearing among males

BackgroundFor more than 150 years, research studies have documented greater variability across males than across females (“greater male variability”—GMV) over a broad range of behavioral and morphological measures. In placental mammals, an ancient difference between males and females that may make an important contribution to GMV is the different pattern of activation of X chromosomes across cells in females (mosaic inactivation of one the two X chromosomes across cells) vs males (consistent activation of a single X chromosome in all cells). In the current study, variability in hearing thresholds was examined for human listeners with thresholds within the normal range. Initial analyses compared variability in thresholds across males vs. across females. If greater across-male than across-female variability was present, and if these differences in variability related to the different patterns X-chromosome activation in males vs. females, it was expected that correlations between related measures within a given subject (e.g., hearing thresholds at given frequency in the two ears) would be greater in males than females.MethodsHearing thresholds at audiometric test frequencies (500–6000 or 500–8000 Hz) were extracted from two datasets representing more than 8500 listeners with normal hearing (4590 males, 4376 females). Separate data analyses were carried out on each dataset to compare: (1) relative variability in hearing thresholds across males vs. across females at each test frequency; (2) correlations between both across-ear and within-ear hearing thresholds within males vs. within females, and (3) mean thresholds for females vs. males at each frequency.ResultsA consistent pattern of GMV in hearing thresholds was seen across frequencies in both datasets. In addition, both across-ear and within-ear correlations between thresholds were consistently greater in males than females. Previous studies have frequently reported lower mean thresholds for females than males for listeners with normal hearing. One of the datasets replicated this result, showing a clear and consistent pattern of lower mean thresholds for females. The second data set did not show clear evidence of this female advantage.ConclusionsHearing thresholds showed clear evidence of greater variability across males than across females and higher correlations across related threshold measures within males than within females. The results support a link between the observed GMV and the mosaic pattern of X-activation for females that is not present in males.

Short-term plasticity of neuro-auditory processing induced by musical active listening training.

Although there is strong evidence for the positive effects of musical training on auditory perception, processing, and training-induced neuroplasticity, there is still little knowledge on the auditory and neurophysiological short-term plasticity through listening training. In a sample of 37 adolescents (20 musicians and 17 nonmusicians) that was compared to a control group matched for age, gender, and musical experience, we conducted a 2-week active listening training (AULOS: Active IndividUalized Listening OptimizationS). Using magnetoencephalography and psychoacoustic tests, the short-term plasticity of auditory evoked fields and auditory skills were examined in a pre-post design, adapted to the individual neuro-auditory profiles. We found bilateral, but more pronounced plastic changes in the right auditory cortex. Moreover, we observed synchronization of the auditory evoked P1, N1, and P2 responses and threefold larger amplitudes of the late P2 response, similar to the reported effects of musical long-term training. Auditory skills and thresholds benefited largely from the AULOS training. Remarkably, after training, the mean thresholds improved by 12dB for bone conduction and by 3-4dB for air conduction. Thus, our findings indicate a strong positive influence of active listening training on neural auditory processing and perception in adolescence, when the auditory system is still developing.

The effect of time regime in noise exposure on the auditory system and behavioural stress in the zebrafish

Anthropogenic noise of variable temporal patterns is increasing in aquatic environments, causing physiological stress and sensory impairment. However, scarce information exists on exposure effects to continuous versus intermittent disturbances, which is critical for noise sustainable management. We tested the effects of different noise regimes on the auditory system and behaviour in the zebrafish (Danio rerio). Adult zebrafish were exposed for 24 h to either white noise (150 ± 10 dB re 1 μPa) or silent control. Acoustic playbacks varied in temporal patterns—continuous, fast and slow regular intermittent, and irregular intermittent. Auditory sensitivity was assessed with Auditory Evoked Potential recordings, revealing hearing loss and increased response latency in all noise-treated groups. The highest mean threshold shifts (c. 13 dB) were registered in continuous and fast intermittent treatments, and no differences were found between regular and irregular regimes. Inner ear saccule did not reveal significant hair cell loss but showed a decrease in presynaptic Ribeye b protein especially after continuous exposure. Behavioural assessment using the standardized Novel Tank Diving assay showed that all noise-treated fish spent > 98% time in the bottom within the first minute compared to 82% in control, indicating noise-induced anxiety/stress. We provide first data on how different noise time regimes impact a reference fish model, suggesting that overall acoustic energy is more important than regularity when predicting noise effects.

Micra pacemaker in adult congenital heart disease patients: A case series.

Implantation of transvenous endocardial or epicardial pacemakers presents specific challenges in adult congenital heart disease (ACHD) patients. Micra leadless permanent pacemakers (Micra PPM) may overcome some of these difficulties. FifteenACHD patients who underwent Micra PPM insertion were retrospectively evaluated. Males 53.3%. Mean age at study: 37.5 ± 10.7 years. Mean age at Micra PPM insertion: 35.5 ± 11.0 years. Mean follow-up so far: 2.0 ± 0.3 years. Concerning the ACHD patients, 6.7% had a simple defect, 66.6% had a moderately complex defect, 26.7% were complex. Four patients (26.7%) had a previous PPM implantation. Three patients (20%) had a systemic right ventricle. Two patients (13.3%) had a single ventricle physiology. Five (33.3%) had Trisomy 21. The most commonly used Micra PPM modality was single chamber ventricular pacemaker (73.3%). Mean threshold post implantation was 0.48 V [range: 0.25-1.13 V], while mean threshold at 6 months control was 0.60 V [range: 0.38-1.13 V] (p = ns). Mean R wave postimplantation was 10.3 V [range: 3.25-19.4 V], whilst mean R wave at 6 months follow-up was 10.1 V [range: 3.5-19.0 V] (p = ns). No major peri and postprocedural complications were encountered. since ACHD patients are living longer and surviving into adulthood, the incidence of conduction disorders continues to increase, as part of the natural history of some lesions or as early or late complication of surgery. The Micra leadless PPM can be successfully implanted in ACHD patients and have significant theoretical advantages. They should be considered when transvenous and epicardial pacing are either contraindicated or represent an otherwise suboptimal approach.

Validating a smart nutrient solution replenishment strategy to save water and nutrients in hydroponic crops

Sustainable use of water and nutrients is fundamental in modern Mediterranean greenhouses and the use of modern decision support systems (DSS) can contribute to this direction. This work focuses on implementing new elements in water and nutrient recycling in cropping systems under saline conditions. Thus, two nutrient solution (NS) control strategies were applied to tomato crops grown in a recirculated NS under low- and high-salinity (NaCl) conditions. According to the first strategy, (i.e., Standard-STD) NS was replenished with water and nutrients based on predetermined “uptake concentrations” (UCs), i.e., nutrient to water uptake ratios, following standard commercial practices. According to the second strategy, NS was replenished by applying recalculated UCs of all nutrients after chemical analysis of a drainage solution sample using the software NUTRISENSE (NTS). Compared with the STD strategy, tomato plants treated with NTS retained drainage nutrient concentrations closer to the optimal values irrespectively of the salinity treatment. This eventually accounted for a smaller deviation from the mean threshold salinity value in the root zone at higher salinity levels, thus plants retained water consumption and crop yield potential at higher stomatal conductance minimizing physiological impacts of salinity on plants. Nutritional control strategies did not impose substantial difference in the UCs for most of the nutrients; however, this was not the case under salinity. Nutrient UCs determined and NTS strategy can be successfully used in DSS to optimize nutrient supply and prolong recirculation, thereby saving precious water and nutrients, in Mediterranean hydroponic crops with particular emphasis on saline environments.

Characterization of influenza seasonality in China, 2010-2018: Implications for seasonal influenza vaccination timing.

Optimizing the timing of influenza vaccination based on regional temporal seasonal influenza illness patterns may make seasonal influenza vaccination more effective in China. We obtained provincial weekly influenza surveillance data for 30 of 31 provinces in mainland China from the Chinese Center for Disease Control and Prevention for the years 2010-2018. Influenza epidemiological regions were constructed by clustering analysis. For each region, we calculated onset date, end date, and duration of seasonal influenza epidemics by the modified mean threshold method. To help identify initial vaccination target populations, we acquired weekly influenza surveillance data for four age groups (0-4, 5-18, 19-59, and ≥60 years) in each region and in 171 cities of wide-ranging size. We used linear regression analyses to explore the association of epidemic onset dates by age group, city, and epidemiological region and provide evidence for initial target populations for seasonal influenza vaccination. We determined that northern, mid, southwestern, southeast regions of mainland China have distinct seasonal influenza epidemic patterns. We found significant regional, temporal, and spatial heterogeneity of seasonal influenza epidemics. There were significant differences by age group and city size in the interval between epidemic onset in the city or age group and regional spread (epidemic lead time), with longer epidemic lead times for 5- to 18-year-old children and larger cities. Knowledge of influenza epidemic characteristics may help optimize local influenza vaccination timing and identify initial target groups for seasonal influenza vaccination in mainland China. Similar analyses may help inform seasonal influenza vaccination strategies in other regions and countries.

Otitis Media with Persistent Inflammation is a Common Cause of Sensorineural Hearing Loss

Objective: The purpose of the research was to determine the rate of sensorineural hearing loss that is associated with chronic otitis media. Study Design: A Descriptive Cross-sectional study Place and Duration: Frontier Medical College, Abbottabad, from June, 2021 to November, 2021. Methods: Total 87 patients of both genders had age 15-55 years were presented. All the included patients had chronic suppurative otitis media clinical symptoms. Patients were enrolled after getting informed written consent from the patients. Through the use of a pure tone audiogram, we were able to determine the mean threshold of voice frequencies for sick as well as normal contralateral ears. In sick ears, a mean of more than 25 dB was considered to represent a positive case of SNHL. SPSS 24.0 was used to analyze all data. Results: We found that 49 (56.9%) patients were males and 38 (43.1%) patients were females. 17 (19.5%) cases had age 15-25 years, 35 (40.2%) patients had age 26-35 years, 25 (28.7%) patients had age 36-45 years and 10 (11.5%) patients were aged between 46-55 years. Majority of the cases 51 (58.6%) were from urban areas. There were 50 (57.5%) cases had chronic otitis media duration &lt;10 months and remaining had disease duration &gt;10 months. Frequency of sensorineural hearing loss was found in 47 (54.02%) cases. Among 47 cases SNHL, 32 cases were aged between 31-55 years. Conclusion: We concluded in this study that patients with chronic otitis media had significantly higher number of sensorineural hearing loss, Among SBHL cases, patients were mostly aged between 31-55 years and disease duration was &gt;10months. Keywords: Otitis Media, Sensorineural Hearing Loss,

The Effect of Pluronic-Coated Gold Nanoparticles in Hearing Preservation Following Cochlear Implantation-Pilot Study.

Introduction: During cochlear implantation, electrode insertion can cause cochlear damage, inflammation, and apoptosis, which can affect the residual hearing. Nanoparticles are increasingly studied as a way to increase the availability of inner ear protective factors. We studied the effect on rats of Pluronic-coated gold nanoparticles (Plu-AuNPs) containing dexamethasone, which were applied locally in the rat’s middle ear following the implant procedure. Methods: Seven rats were used in the study. The right ear served as a model for the Dex-Plu-AuNP group. Following the intracochlear dummy electrode insertion through the round window, Dex-Plu-AuNPs were placed in the round window niche. In the right ear, following the same insertion procedure, free dexamethasone (Dex) was placed in the same manner. Auditory brainstem response thresholds (click stimulus, pure tones at 8 kHz, 16 kHz, 24 kHz, and 32 kHz) were measured before and one week after the procedure. A two-tailed T-test was used for the variables. Statistical significance was set as p < 0.05. Results: In the Dex-Plu-AuNP group, the threshold shift was less than that in the free dexamethasone group, but no statistical significance was noted between the groups. When compared individually, only the 8 kHz frequency showed statistically significant, better results after one week, in favor of the Dex-Plu-AuNP group. The mean postoperative 8 kHz threshold in the Dex-Plu-AuNPs was significantly lower than that of the control group (p = 0.048, t-test). For the other frequencies, statistical analysis showed no significant differences between the mean threshold shifts of the two cohorts. Conclusions: The local application of Plu-AuNPs containing dexamethasone following cochlear implantation may better protect the residual hearing than dexamethasone alone, but a larger sample size is needed to reach a possible statistical significance. Dex-Plu-AuNPs do not seem to cause ototoxicity and may be used as a carrier for other agents. In a clinical setting, Dex-Plu-AuNPs may have the effect of protecting lower frequencies in patients with partial deafness who are candidates for electric acoustic stimulation (EAS). If we consider this tendency, Dex-Plu-AuNPs may also be beneficial for patients with Ménière’s disease.

Discrimination thresholds for interaural-time differences and interaural-level differences in naïve listeners: Sex differences and learning

The two primary cues to sound-source location on the horizontal plane are interaural time differences (ITDs) and interaural level differences (ILDs). Here we asked whether the ability to discriminate small changes in each of these interaural cues differs between the sexes. We tested one group of males (n = 43) and females (n = 94) on ITD discrimination at 0.5 kHz and a separate group of males (n = 80) and females (n = 166) on ILD discrimination at 4 kHz. None of the participants had any prior experience with psychoacoustic tasks. Testing of each participant was completed in a single testing session of 4–5 blocks of 60 trials. For ILD discrimination, the overall mean threshold, as well as the mean threshold for each block, was statistically significantly lower for males than for females. Despite that, males and females learned at an equal rate over the course of testing. For ITD discrimination, in contrast, thresholds did not differ significantly between the sexes for the overall mean or for any block. There also was no statistically significant learning across blocks for either sex. For both tasks and both sexes, the individual thresholds spanned a wide range. The presence of a statistically significant sex difference and learning for ILD but not for ITD discrimination, along with a larger effect size for ILD than for ITD discrimination, suggests that the factors responsible for these outcomes acted upon an ILD-specific neural pathway, and not upon an ITD-specific pathway, nor any pathway common to the two cues. Because the ILD and ITD specific pathways are most separable initially, the factors associated with sex and learning may have acted upon the ILD-specific pathway at an early stage.