Significant Threshold Differences Research Articles

Comparación de los umbrales ventilatorios y los parámetros cardiorrespiratorios entre hombres adultos con paraplejia torácica baja e individuos sin lesión medular: Un estudio observacional transversal

Introduction: People with spinal cord injury (SCI) experience sensory, motor, and autonomic alterations that influence cardiovascular and respiratory responses during exercise. In this context, the objective of the present study was to compare the first and second ventilatory thresholds (VT1 and VT2), peak oxygen uptake (VO2 peak), and peak heart rate (HRpeak) between adult men with low thoracic paraplegia and men without SCI. Material or Patients and Methods: A cross-sectional observational comparative study, n = 8 adult males with low thoracic paraplegia (neurological level T6-T12, ASIA A) (PARA group) and n = 19 adult males without SCI (CON group). A maximal incremental test was performed on an upper limb cycle ergometer, using a MetaMax®3B ergos- pirometer and a Polar H7 cardiac transmitter. The data obtained were analyzed with SPSS 17.0, applying the nonparametric Mann-Whitney U test for group comparison. Results: Statistically significant differences were found in VT1 (U = 32, p = 0.019) and VT2 (U = 18.5, p = 0.002) in favor of the CON group. In contrast, no significant differences were observed in VO2peak (PARA = 2.7ml/kg/ min vs. CON=3.0ml/kg/min; p = 0.200) or HRpeak (PARA = 186 bpm vs. CON = 173 bpm; p = 0.099). Conclusion: This study revealed significant differences in ventilatory thresholds between men with and without low thoracic paraplegia, suggesting variations in submaximal exercise efficiency and capacity. Howe­ver, no notable differences were recorded in VO2 peak or HRpeak. These findings reinforce the importance of ventilatory thresholds as a tool for the assessment and prescription of exercise in individuals with SCI.

Association of Occupational Noise Exposure and Extended High-Frequency Hearing Loss in Young Workers With Normal Hearing.

Studies on the relationship between occupational noise exposure and extended high-frequency (EHF) hearing loss are limited. This study investigated the relationship between occupational noise exposure and EHF hearing loss in workers exposed to noise as measured by sound pressure level, exposure duration, and kurtosis to help provide a basis for early detection and prevention of hearing loss in noise-exposed workers. A cross-sectional survey was conducted among 602 participants with 472 noise-exposed workers and 130 non-noise-exposed controls. General demographic characteristics, noise exposure data, and hearing thresholds at conventional frequencies (0.25 to 8 kHz) and EHF (9 to 16 kHz) were collected and analyzed. Linear mixed-effects model analyses between hearing thresholds of EHF and noise exposure indicators including the 8-h equivalent continuous A-weighted sound pressure level (LAeq,8h), cumulative noise exposure (CNE), and kurtosis-adjusted CNE (CNE-K) were conducted. Among the 602 participants included in the analysis, 472 individuals (78.4%) were occupationally exposed to noise exposures ≥75 dBA. Significant differences (p < 0.05) were observed in sex, exposure duration, LAeq,8h, CNE, and CNE-K between the noise-exposed group and the nonexposed group. The mean hearing thresholds for all tested extended high frequencies ranging from 9 to 16 kHz were significantly higher in the noise-exposed group than in the nonexposed group (p < 0.05). The mean hearing thresholds of subjects in different groups of LAeq,8h exposures were generally stable with little variance in the conventional frequencies (0.25 to 8 kHz) but differed in the EHF range. Moreover, EHF hearing loss appeared to be most prominent in the subjects exposed to noise with 80 dBA < LAeq,8h ≤ 85 dBA. After the combination of the sound pressure level, exposure duration, and kurtosis by using the noise exposure indicators CNE and CNE-K, the subjects at the different noise exposures showed significant differences in hearing thresholds at EHF (p < 0.05). Linear mixed-effected model analyses showed that the CNE-K was the best to indicate noise-induced hearing loss among the three noise exposure indicators at EHF. The results indicate that the EHF hearing threshold testing is more sensitive to identifying early occupational noise-induced hearing loss than conventional audiometry. The CNE-K, an indicator combining noise energy, exposure duration, and kurtosis, is a more comprehensive and effective method for assessing the risk of EHF hearing loss due to occupational noise exposure.

Pediatric surgery for middle ear cholesteatoma: analysis of 47 cases

The clinical data of 47 children (52 ears) with middle ear cholesteatoma at Eye & ENT Hospital, Fudan University from January 2021 to February 2024 were prospectively collected. There were 30 males and 17 females, with a mean age of (8.5±2.8) years. Surgical procedures included endoscopic tympanoplasty (29 ears), combined endoscopic/microscopic tympanoplasty (8 ears) and microscopic tympanoplasty (15 ears). After endoscopic surgeries, the mean air conduction hearing threshold, mean bone conduction hearing threshold and air bone gap were (28.4±10.4) dB HL, (12.4±5.9) dB HL and (16.0±6.3) dB HL, respectively, which were significantly improved compared with preoperative indicators [(40.2±14.0) dB HL, (16.3±6.8) dB HL and (23.9±9.8) dB HL, respectively] (all P<0.05). There were statistically significant differences in the postoperative mean air conduction hearing threshold and air bone gap among three surgical groups, and the value of endoscope group was lower than those of microscope group and endoscope combined with microscope group (all P<0.05). After a follow-up of 5.6 (1.2, 11.5) months, no statistically significant differences were observed in the rate of successful tympanic membrane healing between endoscope group and microscope group (P=0.747). One ear in the endoscope group experienced recurrence three years after surgery, and no intracranial and extracranial complications occurred. The current study indicates that endoscopic surgery for pediatric cholesteatoma improves hearing with good results.

Convergence of type 1 spiral ganglion neuron subtypes onto principal neurons of the anteroventral cochlear nucleus.

The mammalian auditory system encodes sounds with subtypes of spiral ganglion neurons (SGNs) that differ in sound level sensitivity, permitting discrimination across a wide range of levels. Recent work suggests the physiologically-defined SGN subtypes correspond to at least three molecular subtypes. It is not known how information from the different subtypes converges within the cochlear nucleus. We examined this issue using transgenic mice of both sexes that express Cre recombinase in SGNs that are positive for markers of two of these subtypes: CALB2 (calretinin) in type 1a SGNs, and LYPD1 in type 1c SGNs, which correspond to high- and low-sensitivity subtypes, respectively. We crossed these with mice expressing floxxed channelrhodopsin, which allowed specific activation of axons from type 1a or 1c SGNs using optogenetics. We made voltage-clamp recordings from bushy cells in the anteroventral cochlear nucleus (AVCN) and found that the synapses formed by CALB2- and LYPD1-positive SGNs had similar EPSC amplitudes and short-term plasticity. Immunohistochemistry revealed that individual bushy cells receive a mix of 1a, 1b, and 1c synapses with VGluT1-positive puncta of similar sizes. We used optogenetic stimulation during in vivo recordings to classify chopper and primary-like units as receiving vs. not-receiving 1a- or 1c-type inputs. These groups showed no significant difference in threshold or spontaneous rate, suggesting the subtypes do not segregate into distinct processing streams in the AVCN. Our results indicate that principal cells in the AVCN integrate information from all SGN subtypes with extensive convergence, which could optimize sound encoding across a large dynamic range.Significance statement Sound information is carried to the brain by auditory afferents that differ in their sensitivity to sound. Auditory afferents fall into three subtypes differing in their spontaneous and sound-evoked activity. These subtypes can be distinguished by anatomical, physiological, and molecular features. However, it is not well understood how the three subtypes relay information to the brain. We addressed this question using optogenetic stimulation to study the properties of two afferent subtypes in the anteroventral part of the cochlear nucleus. We found that the properties of synapses are indistinguishable between subtypes, and they show extensive convergence, suggesting that combining inputs with different sound level sensitivity is important for processing sound.

Normative Data of Extended High Frequency Audiometry in Normal Hearing Subjects with Different Aged Groups.

Background/Objectives: Conventional audiometry assesses hearing in the frequency range of 250-8000 Hz, while humans can detect sounds from 20 to 20,000 Hz. Hearing sensitivity above 8000 Hz can be assessed through "Extended high-frequency audiometry (EHFA)", which is useful for early detection and monitoring of hearing loss and counseling for tinnitus patients. Despite its usefulness, age significantly affects hearing sensitivity. Currently, there are no standard hearing thresholds in the EHF range categorized by age groups in Thailand. In this study, the aim was to determine normative EHFA data across different age groups in a healthy Thai population. Methods: This study included 134 participants aged 18-70 years, categorized into five age groups. All participants had normal hearing thresholds and type A tympanograms bilaterally. Following this, EHFA measurement was performed. Results: Across all age groups, there was an observed increase in median hearing thresholds as age increased. In comparison, no significant difference in median hearing thresholds was found between individuals aged 18-30 and >30-40 years. However, those over 40 years had significantly higher median thresholds across all frequencies compared to those under 40 years (p < 0.05). Based on these findings, we propose two new subgroups of 18-40 years and >40-70 years. Median hearing thresholds for those aged 18-40 was ≤20 dB HL across most frequencies, except at 16,000 Hz (30 dB HL). In the >40-70 age group, thresholds ranged from 20 dB HL at 9000 Hz to 70 dB HL at 14,000 and 16,000 Hz. However, no significant differences were found in hearing thresholds between sexes and ear sides. Conclusions: In this study, normative EHFA data were established for healthy Thai adults, appropriately divided into two groups (18-40 and >40-70 years) for clinical use. Further studies with more participants per age group are also needed to validate the results.

Trends in Olfactory Threshold Test Results and Limits of Olfactory Testing in Patients with Parosmia

Introduction: Parosmia poses a clinical challenge due to a lack of established testing methods, leading to underestimated self-reported symptoms. This study investigated olfactory threshold trends, aiming to highlight parosmia prevalence, analyze threshold patterns, and assess diagnostic potential in current olfactory testing. Methods: A total of 407 patients who visited our olfactory clinic from April 2009 to September 2015 were categorized into parosmia and non-parosmia groups based on initial visit questionnaires. The Jet Stream T&T Olfactometer measured olfactory thresholds, including mean detection and recognition thresholds, and the left-right detection threshold difference. Patient characteristics such as gender, age, time from symptom onset to hospital visit, and smoking status were compared. The study also aimed to diagnose parosmia with olfactory identification ability tests such as Open Essence and the gap between T&T detection and recognition thresholds. Results: Parosmia prevalence was 18%, with a significant gender difference and a shorter onset-to-visit duration in the parosmia group. Post-traumatic and post-infectious olfactory dysfunctions exhibited higher parosmia prevalence. Olfactory threshold testing revealed significantly lower average detection (p = 0.014) and recognition (p = 0.005) thresholds in the parosmia group, with a left-right difference in detection thresholds (p = 0.012). No significant differences were found in identification ability tests. Results suggest that preserved sense of smell is crucial for perceiving parosmia symptoms. Conclusion: Parosmia was observed in 18% of patients, more commonly among females and often following trauma or infection. It presents diagnostic challenges as patients tend to maintain olfactory thresholds, making subjective assessments essential for diagnosis. The significant left-right differences in detection thresholds suggest that olfactory lateralization may play a role in the manifestation of parosmia symptoms. Our findings suggest that a unilateral occlusion test, which identifies which nostril is more likely to cause parosmia, could allow for more targeted treatment.

Immediate Effects of Distinct Intensities of Transcutaneous Spinal Direct Current Stimulation on Chronic Pain: A Randomized Controlled Trial.

This study aimed to assess the immediate effects of transcutaneous spinal direct current stimulation (tsDCS) on pain outcomes, measured using the visual analog scale (VAS) and pressure pain thresholds in a cohort of 55 participants experiencing chronic pain using a controlled, randomized trial with 55 participants allocated into 2 groups: 2 mA and 0.5 mA of tsDCS for 20 min. Anodal stimulation was applied on the 12th thoracic vertebra, with the cathode positioned on the 7th cervical vertebra. Pain outcomes were assessed before and post intervention using the VAS and pressure algometry. Between- and within-group differences, along with chi-square tests, were used to determine the differences and responsiveness. Significance was established at p < 0.05. Findings showed significant temporal effects for both VAS (p < 0.001) and pressure algometry (p = 0.04). However, no between-group differences were noted for the time × group factor for VAS (p = 0.46) and pressure algometry (p = 0.78). No significant between-group differences were observed for the responsiveness analysis. The results indicate that a single 20-min session of 2 and 0.5 mA tsDCS improves pain scores for both intensities equally. However, there were no statistically significant between-group differences in pain perception or pressure pain threshold.

Digit-in-Noise Test as a Hearing Screening Test for Individuals With Intellectual Disability.

Diagnosis of intellectual disability (ID) may overshadow, or co-occur with, hearing impairment, but screening is frequently inaccessible due to various factors that prevent successful test execution. There is a pressing need for easily, locally administered hearing tests. This study aimed to assess the efficacy of the digit-in-noise (DIN) test, as well as three variations of it, as a hearing screening for individuals with mild to moderate ID. Additionally, we explored correlations between participant characteristics and cognitive-linguistic abilities, with DIN test performance. Forty participants with ID aged 21-40 were recruited from two supported employment centres, 31 of whom met full inclusion criteria. Controls were 20 typically developed (TD) participants, aged 21-40. The original DIN test (DIN(3)) was administered, and those unable to recall the three digits were administered a version with two digits (DIN(2)). Participants unable to successfully complete DIN(3) or DIN(2) were administered versions with added visual and verbal performance feedback. A significant difference in speech receptive threshold in noise (SRTn) between DIN(2) and DIN(3) was only present for the ID group. A moderate negative relationship between DIN(2) SRTn and vocabulary and a positive relationship with age was found for the ID group; no correlation was found with digit span or matrices. The DIN(2) SRTn was correlated with the average hearing level of pure tones measured by audiometry. Our findings highlight the DIN(2) as the most effective version, as its signal-to-noise ratio (SRTn) threshold was closest to the typically developed (TD) control group. This study is the first step towards developing a hearing screening test for individuals with ID who are at elevated risk of impairment and who have insufficient evaluation access. Our findings suggest that adults with mild to moderate ID can sufficiently perform the adapted DIN(2) as a hearing screening test.

Clinical Phenotypic Characterization of the SLC26A4 Mutation in Pendred Syndrome/Nonsyndromic Enlarged Vestibular Aqueduct.

To summarize the Solute Carrier Family 26 Member 4 (SLC26A4) mutations and clinical phenotypic characteristics of patients with Pendred syndrome/nonsyndromic enlarged vestibular aqueduct (PS/NSEVA). A retrospective cohort study for the Chinese population was performed to analyze the hearing test results of 406 patients with PS/NSEVA who had a SLC26A4 mutation and the relationship between inner ear imaging and audiology. There was a significant difference in the mean hearing threshold in patients with biallelic mutations (M2), monoallelic mutations (M1), and nonallelic mutations (M0) and between patients with isolated vestibular aqueduct enlargement (IEVA) and patients with IEVA combined with Mondini malformation. There was no significant difference between patients with different gene mutation types or different sexes, or between the width of the vestibular aqueduct (VA) and the mean hearing threshold. The degree of hearing loss was linearly correlated with age. We propose that the presence and absence of SLC26A4 mutation, whether combined with Mondini malformation and patient age, are essential factors affecting the degree of hearing loss in the Chinese population. However, the number and type of mutations, degree of VA expansion, and sex of the patients did not affect the clinical audiological phenotype. 3 Laryngoscope, 2024.

Asymmetric Glaucoma and Corresponding Hearing Impairment.

Background/Objectives: This study aims to explore the potential relationship between unilateral or asymmetric glaucoma and ipsilateral hearing impairment. Methods: In this retrospective study, visual and hearing functions were assessed in patients with unilateral or asymmetric glaucoma. Correlations between retinal nerve fiber layer (RNFL) thickness, visual field mean deviation (MD) values, and pure tone audiometry (PTA) measurements across various frequencies were analyzed to explore potential associations between visual and ipsilateral hearing functions. Differences in PTA values between ears ipsilateral to the more affected glaucomatous eyes and the contralateral ears were studied for statistical significance. Results: Twenty-six patients with unilateral or asymmetric glaucoma were included in the study. Significant differences in hearing thresholds between the ears corresponding to the more severely glaucomatous eyes and the contralateral ears were found at 0.7, 1, 1.5, and 3 kHz (p < 0.05). Additionally, a statistically significant difference was observed in the speech frequencies (0.5, 0.7, 1, 1.5, 2, 3, and 4 kHz) between ears corresponding to glaucomatous or more affected glaucomatous eyes and the contralateral ears (p = 0.016). Furthermore, a moderately positive correlation was found between differences in MD and PTA values at 0.125 kHz (r = 0.50; p = 0.01). Conclusions: This study highlights a potential association between unilateral or asymmetric glaucoma and ipsilateral hearing impairment, particularly at speech-relevant frequencies. These findings underscore the importance of integrated sensory assessment in the management of glaucoma patients, suggesting that early detection and intervention for concurrent hearing loss could enhance overall quality of life.

Evaluating the accuracy of a self-administered smartphone hearing test application in a geriatric population.

As the global population ages, hearing loss becomes increasingly prevalent, and is associated with neurocognitive and psychiatric comorbidities, impacting quality of life. Early screening and timely intervention might prevent or delay cognitive decline, a gap in care that can potentially be addressed by self-administered smartphone hearing tests. This study aims to evaluate the accuracy of Mimi™ (Berlin, Germany), a commercially available self-administered smartphone hearing test compared to pure tone audiogram (PTA) in terms of both hearing levels and hearing thresholds in our local geriatric population > 65 years-old. Fifty-two participants above 65 years of age requiring conventional audiograms were recruited from a National Referral University Hospital Otolaryngology clinic from March to June 2022. All participants were administered the conventional PTA tests in a sound-proof booth conducted by audiology technicians followed by Mimi™ Hearing Test in a quiet clinic room. Comparisons between the hearing levels of both tests were analyzed using Spearman's rank correlation coefficient, Bland-Altman plots and Gwet's Kappa which looked at concordance. Hearing thresholds were then analysed using the Wilcoxon signed rank (SR) test. Mimi™ showed strong to very strong correlation with good agreement compared to readings obtained from formal PTA. Concordance in determining hearing loss also showed substantial to almost perfect agreement at each individual frequency, with values of kappa falling between 0.735-0.857. In terms of thresholds, there were no significant differences in thresholds given by both tests except for 2.0 kHz, HFPTA and 4FPTA (p < 0.05). Mimi™ serves as a good screening tool for detection of moderate hearing loss for early pickup and treatment except at higher frequencies. The smartphone hearing test is also less accurate in determining the extent of hearing loss and formal PTA after hearing loss is detected on screening should still be standard of care.

Perception Threshold for Pressure by a Soft Textile Actuator.

Electroactive textile (EAT) has the potential to apply pressure stimuli to the skin, e.g. in the form of a squeeze on the arm. To present a perceivable haptic sensation we need to know the perception threshold for such stimuli. We designed a set-up based on motorized ribbons around the arm with five different widths (range 3 - 49 mm) for psychophysical studies. We investigated the perception threshold of force pressure and ribbon reduction in two studies, using two methods (PSI and 1up/3down staircase), comparing sex, the left and right arm, the lower and upper arm, and stimulated surface area with a total of 57 participants. We found that larger stimulation surfaces require less pressure to reach the perception threshold (0.151 N per cm 2 for 3 mm width, 0.00972 N per cm 2 for 49 mm width on the lower arm). This indicates a spatial summation effect for these pressure stimuli. We did not find significant differences in perception threshold for the left and right arm and, the upper and lower arm. Between male and female participants we found significant differences for two conditions (10 mm and 25 mm) in Experiment 1, but we could not reproduce this in Experiment 2.

Comparative Analysis of HPV Detection Efficiency: Evaluating Cobas 8800 Performance in Vaginal Self-Sampling versus Clinician-Collected Samples at a Regional Thai Hospital

Background: This study, conducted at a regional Thai hospital, assesses the comparative efficacy of self-collected versus clinician-collected samples for HPV detection using the Cobas 8800 system among Thai women aged 30–60. Methods: Our methodology involved analyzing 1541 self-collected and 1398 clinician-collected samples. Results: The results show a statistically significant mean difference in cycle threshold (Ct) values favoring clinician-collected samples (1.53; 95% CI: 1.18–1.87, p &lt; 0.0001). This pattern was consistent across various age groups, with the most pronounced differences noted in the oldest cohort (50–59 years), suggesting higher detection efficiency in clinician-collected samples. The study further explored the correlation of Ct values with cytological and histological outcomes, where clinician-collected samples demonstrated superior diagnostic performance, particularly in identifying LSIL and HSIL conditions, evidenced by AUC values of 0.793 and 0.866, respectively. While self-sampling remains a viable method, with sensitivity reaching up to 48.84% for LSIL and 46.15% for HSIL, clinician collection proved more accurate, likely influencing future national screening policies. Conclusions: This work underscores the need for robust sample collection methods and the importance of ongoing enhancements to self-sampling assays and techniques to ensure their efficacy in cervical cancer screening programs.

Pressure algometry in the general adult population: Age and sex differences.

Experimental pain studies have revealed inter-individual variations in pain perception that are influenced by age, sex, and country of origin. This study aimed to explore the age and sex differences in pressure pain thresholds within the Iranian general population. To assess the pressure pain thresholds, a handheld pressure algometer was applied bilaterally to the middle fingers of both hands. The participants also completed the short form of the McGill Pain Questionnaire to provide a clinical pain rating. This cross-sectional study included 1610 adult subjects (54.96% female, mean age 40.13 ± 10.18 years). The findings indicated that females generally exhibited lower pain thresholds than males when assessing pain detection and tolerance parameters (P < .001). Females also demonstrated a significant lower pressure thresholds and clinical pain ratings compared with men (P < .001). Additionally, significant differences were observed between age groups in terms of pain detection and tolerance thresholds (P = .02 and P = .03, respectively). However, the interaction between sex and age was not significant. No significant differences in pain detection thresholds were observed between the right and left hand (P = .11). This study underscores the potential utility of algometry as a valuable tool for objectifying pain in the Iranian population.

The Loop Technique in Cardiac Resynchronization Therapy: A Prospective Cohort Study.

A new approach called the loop technique has been proven safe and effective for repeated intraoperative transvenous left ventricular (LV) lead dislocations during cardiac resynchronization therapy (CRT) in a 3-year follow-up. This study aimed to report on the 5-year safety and effectiveness of the loop technique. This study was a prospective cohort study. Forty-four patients who underwent CRT device implantation at the Cardiology Department of Shaanxi Provincial People's Hospital between January 2013 and June 2019 were included. Data on patient demographics, medical history, laboratory test results, and echocardiography images at admission were collected. The loop technique was performed with repeated intraoperative dislocations of the LV lead. The intraoperative CRT parameters were also recorded. All patients were followed for 5 years. Several auxiliary examinations were performed during follow-up. The 44 patients were divided into the traditional operation group (n=36, 81.8%) and loop technique group (n=8, 18.2%). The baseline patient characteristics were almost balanced. During the 5-year follow-up, 8 (22.2%) patients in the traditional operation group and 2 (25.0%) patients in the loop technique group died. No lead dislocation or other complications related to CRT were observed. There were no significant differences in mortality rate (P=0.87), cardiac function (P=0.56), echocardiographic indices, threshold (P=0.58), or impedance (P=0.22) of the LV lead. There were no significant differences in the threshold and impedance between postoperative, 3-year, and 5-year follow-ups in the loop technique group (P=0.53). The loop technique is an ideal solution for repeated intraoperative LV lead dislocation during CRT implantation.

Differences in self-reported signs related to central sensitization and pressure pain threshold related to knee osteoarthritis and sarcopenia.

Neuroinflammation, which occurs in knee osteoarthritis and sarcopenia, has attracted attention as a mechanism of central sensitization, but the relationship between central sensitization and these conditions has not been widely studied. This study investigates differences in self-reported signs of central sensitization and pressure pain threshold in individuals with knee osteoarthritis and sarcopenia. We examined 340 patients (mean age ± standard deviation: 76 ± 5.9, women were 86.9%) with knee osteoarthritis scheduled to undergo total knee arthroplasty. For comparison, 129 community-dwelling older people (mean age ± standard deviation: 76 ± 5.5, women were 68.9%) individuals without a history of knee osteoarthritis or any other diagnosed illnesses were matched for age and sex. We assessed central sensitization inventory-9, pressure pain threshold, pain-related factors, skeletal muscle mass index, and hand grip strength. ANCOVA using 2 (patients with knee osteoarthritis and community older people without knee osteoarthritis) × 2 (sarcopenia and robust) was performed to assess outcome measurements. The prevalence of sarcopenia among patients with knee osteoarthritis was 50.3%. ANCOVA revealed an interaction effect for the central sensitization inventory-9. For the main effect of knee osteoarthritis, there was a significant difference in central sensitization inventory-9, and for the main effect of sarcopenia, there was a significant difference in pressure pain threshold. Discrepancies in the evaluation of central sensitization were identified between knee osteoarthritis and sarcopenia. Individuals with knee osteoarthritis had elevated score of self-reported indications of central sensitization, whereas sarcopenic patients had reduced pressure pain thresholds.

To determine the value of iMAX, a new electrodiagnostic method, and its application in the evaluation of peripheral motor nerve excitability

Objective: To test the new method of iMAX (the minimum stimulus current that elicits the maximum compound muscle action potential amplitude) electrodiagnosis, verify the feasibility of this method in evaluating the excitability of peripheral motor axons, and preliminarily explore the clinical application value. Methods: This study was a cross-sectional study. A total of 50 healthy subjects were recruited from the outpatient department of Peking University Third Hospital from June 2022 to March 2023, including 25 males and 25 females, aged 25-68 (48±8) years. Eleven patients with Charcot-Marie-Pain-1A (CMT1A), 7 males and 4 females, aged 19-55 (41±13) years and 21 patients with diabetic peripheral neuropathy (DPN), 10 males and 11 females, aged 28-79 (53±16) years were enrolled in this study. iMAX of bilateral median nerves, ulnar nerves and peroneal nerves were detected in all patients. Repeatable motor responses with minimum motor threshold and amplitude of at least 0.1 mV and the minimum stimulus current intensity, at which the maximum compound muscle action potential amplitude is elicited, were measured respectively [1 mA increment is called (iUP) and, 0.1 mA adjustment is called (iMAX)].Comparison of the parameters: the parameters of threshold, iUP and iMAX were compared among different age groups, genders and sides, body mass index(BMI) values and detection time , as well as between CMT1A patients, DPN patients and healthy subjects. Results: In healthy subjects, the threshold, iUP value and iMAX value were (1.8±0.7) mA, (4.4±1.2) mA, and (4.2±1.3) mA respectively; ulnar nerve (3.1±1.6) mA, (6.8±3.2) mA, (6.4±3.2) mA; peroneal nerve (3.7±2.0) mA, (7.8±2.8) mA, (7.4±2.9) mA. There were statistically significant differences in threshold, iUP value and iMAX value among different age groups (all P<0.001).With the increase of age, there was a trend of increasing threshold, iUP, and iMAX values in different nerves, and the differences are statistically significant (all P<0.001). There were no significant differences in gender, side and detection time threshold, iUP value and iMAX value (all P>0.05). The parameters of healthy subjects with high BMI value were higher than those of healthy subjects with low BMI value(all P<0.05). Compared with the healthy subjects, the parameters of 11 CMT1A patients were significantly increased (all P<0.05), and the parameters of 21 DPN patients were slightly increased (P<0.05). Conclusion: The new iMAX method reflects the excitability of motor axons and early axonal dysfunction, which is an important supplement to the traditional nerve conduction, and can be used to monitor motor axon excitability disorders.

EVALUATION OF THE POSTOPERATIVE ANALGESIC EFFECTS OF TUNING ELEMENT RELIEF PATCHES IN DOGS UNDERGOING OVARIOHYSTERECTOMY

Ovariohysterectomy (OHE) is a common surgical procedure in small animals that causes significant postoperative pain. Tuning Element Relief Patches (TERPs) are silicone patches containing titanium salts, believed to relieve pain by resonating pain-related ion channels. In this experiment, 12 dogs undergoing OHE surgery received subcutaneous robenacoxib (group R, [Formula: see text]) injection or two sheets of TERPs (group T, [Formula: see text]) as postoperative analgesia to assess the analgesic effect of TERPs. The results demonstrated no significant differences in physiological parameters, pain scores and mechanical nociceptive thresholds (MNTs) between groups postoperatively, indicating that the TERPs provide comparable results to robenacoxib in managing postoperative pain in dogs undergoing OHE. While this study provides evidence of the pain-relieving effects of TERPs, further studies are required to evaluate their long-term safety and efficacy in various clinical conditions.

The pursuit of gender equality: a substudy of the PACE-CONDUCT trial on gender differences in His bundle pacing implantation

Abstract Background His bundle pacing (HBP) is an effective alternative to traditional right ventricular pacing, providing physiological pacing. The impact of gender on the success of HBP implantation has not been extensively explored. We conducted a substudy of the PACE-CONDUCT registry to investigate gender differences in HBP implantation success. Methods We analyzed successful HBP implantations performed from 2021 to 2023. A total of 61 patients were included, comprising 22 females (36%) and 39 males (64%) . The mean age of the entire cohort was 73 years, with ages ranging from 51 to 86 years. His bundle thresholds were assessed at implantation, the day following implantation, and four weeks post-implantation. All data were analyzed using IBM SPSS Statistics 29.0, and thresholds were converted into volts × milliseconds for statistical analysis. Results The minimal HBP threshold across all measurements was 0.10 volts × milliseconds, equivalent to a standard threshold of 0.25 volts by 0.4 milliseconds, while the maximal threshold was 7.13 volts × milliseconds, corresponding to a standard threshold of 4.75 volts by 1.5 milliseconds. Gender differences were examined, dividing the patient cohort into male and female groups, and an independent-samples t-test was conducted. The results did not reveal any statistically significant differences in HBP threshold between the two groups at the time of implantation, one day post-implantation, or one month post-implantation. Chi square tests were conducted to determine if there could be any gender differences analyzing the complication rates, also finding negative results. Conclusion This substudy of the PACE-CONDUCT trial found no significant gender-based differences in the success of His bundle pacing implantations, taking the threshold at implantation, one day after and four weeks after implantation as a surrogate of goodness of the HBP implantation itself. Although the cohort size was limited, our findings provide initial insights, suggesting that gender is not a decisive factor in HBP threshold outcomes or in complication rates. Further investigations with larger sample sizes are warranted to explore this topic in greater depth.statistics output

Contrast Discrimination and Global Form Perception in Primary Open-Angle Glaucoma and Primary Angle-Closure Glaucoma.

This study explored early (contrast discrimination) and intermediate (global form perception) visual processing in primary subtypes of glaucoma: primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). We aimed to understand early and intermediate visual processing in POAG and PACG, matched for similar visual field defect severity. Early visual processing was measured using a contrast discrimination task described by Porkorny and Smith (1997), and intermediate processing using a global form perception task using glass pattern coherence thresholds. Thresholds were determined centrally and at a single midperipheral location (12.5°) in a quadrant without visual field defects. Controls were tested in corresponding quadrants to individuals with glaucoma. Sixty participants (20 POAG, 20 PACG, and 20 age-matched controls), aged 50 to 77years, were included. Visual field defects were matched between POAG and PACG, with mean deviation values of -6.53 ± 4.46 (range: -1.5 to -16.85) dB and -6.2 ± 4.24 (range: -1.37 to -16.42) dB, respectively. Two-Way ANOVA revealed significant differences in thresholds between the glaucoma groups and the control group for both contrast discrimination and global form perception tasks, with higher thresholds in the glaucoma groups. Post hoc analyses showed no significant contrast discrimination difference between POAG and PACG, but POAG had significantly higher thresholds than PACG for form perception. In form perception, POAG showed slightly worse performance than PACG, suggesting that individuals with POAG may experience more severe functional damage than PACG of similar visual field severity.