Tag: nevin manimala

Ear Hear. 2021 Jan 11. doi: 10.1097/AUD.0000000000000976. Online ahead of print.

ABSTRACT

OBJECTIVES: Otoacoustic emissions, a byproduct of active cochlear mechanisms, exhibit a higher magnitude in females than in males. The relatively higher levels of androgen exposure in the male fetus are thought to cause this difference. Postnatally, the onset of puberty is also associated with the androgen surge in males. In this study, we investigated sexual dimorphism in age-related changes in stimulus-frequency otoacoustic emissions for children.

DESIGN: In a retrospective design, stimulus-frequency otoacoustic emissions were analyzed from a cross-sectional sample of 170 normal-hearing children (4 to 12 years) and 67 young adults. Wideband acoustic immittance and efferent inhibition measures were analyzed to determine the extent to which middle ear transmission and efferent inhibition can account for potential sex differences in stimulus-frequency otoacoustic emissions.

RESULTS: Male children showed a significant reduction in otoacoustic emission magnitudes with age, whereas female children did not show any such changes. Females showed higher stimulus-frequency otoacoustic emission magnitudes compared with males. However, the effect size of sex differences in young adults was larger compared with children. Unlike the otoacoustic emission magnitude, the noise floor did not show sexual dimorphism; however, it decreased with age. Neither the wideband absorbance nor efferent inhibition could account for the sex differences in stimulus-frequency otoacoustic emissions.

CONCLUSIONS: The cochlear-amplifier function remains robust in female children but diminishes in male children between 4 and 12 years of age. We carefully eliminated lifestyle, middle ear, and efferent factors to conclude that the androgen surge associated with puberty likely caused the observed masculinization of stimulus-frequency otoacoustic emissions in male children. These findings have significant theoretical consequences. The cochlea is considered mature at birth; however, the present findings highlight that functional cochlear maturation, as revealed by otoacoustic emissions, can be postnatally influenced by endogenous hormonal factors, at least in male children. Overall, work reported here demonstrates sexual dimorphism in the functional cochlear maturational processes during childhood.

PMID:33974790 | DOI:10.1097/AUD.0000000000000976

Ear Hear. 2020 Dec 16. doi: 10.1097/AUD.0000000000000974. Online ahead of print.

ABSTRACT

OBJECTIVES: Military Service members and Veterans commonly report hearing loss and tinnitus, both of which can result in significant disability. During military service, Service members are exposed to many different types of loud noise, which is strongly associated with hearing loss and tinnitus. Other military-related exposures, such as chemicals and traumatic brain injury (TBI), are also linked with auditory problems. The purpose of the “Noise Outcomes in Servicemembers Epidemiology” (NOISE) study is to gather information from Active-Duty Service members and recently separated Veterans about their military and nonmilitary noise exposures, other relevant military and nonmilitary exposures, and potential outcomes of these exposures including tinnitus, hearing loss, and other hearing-related health concerns.

DESIGN: The NOISE study assesses lifetime noise exposures, chemical and blast exposures, TBI, physical and psychiatric comorbidities, and other military and nonmilitary exposures and outcomes that can affect auditory function. Participants undergo comprehensive in-person audiologic examinations; those who experience tinnitus undergo a complete tinnitus assessment. Exposures and select outcomes are reassessed annually by mail, and the comprehensive in-person assessment is completed every 5 years. This report presents descriptive, baseline data obtained from the first 690 participants enrolled between 2014 and 2018.

RESULTS: Some notable findings from this analysis include: (1) the prevalence of hearing loss in the sample was 8% for low frequencies (0.25 to 2 kHz), 20% for high frequencies (3 to 8 kHz), and 39% for extended high frequencies (9 to 16 kHz); (2) the prevalence of tinnitus was 53%; (3) the prevalence of both hearing loss and tinnitus was higher among those with higher age, more years of military service, greater degree of noise exposure, and exposures to blasts and/or TBI in the military; and (4) tinnitus was most prevalent among participants who serve/served in the Army relative to the other military branches.

CONCLUSIONS: The NOISE study is acquiring comprehensive data on military-related auditory dysfunction. It is the first of its kind to enroll active Service members and recently separated Veterans into a longitudinal study to examine the etiology and outcomes of tinnitus and hearing loss in this population. Although these data do not necessarily represent the entire military and Veteran populations, ongoing enrollment is focused on increasing generalizability and will also provide the statistical power to conduct multivariable analyses. This will allow us to examine longitudinal associations of interest while controlling for potential confounders and other possible sources of error. These data will provide critical knowledge to refine future military hearing conservation efforts and inform efforts to develop future treatments.

PMID:33974792 | DOI:10.1097/AUD.0000000000000974

WMJ. 2021 Apr;120(1):17-22.

ABSTRACT

BACKGROUND: Studies suggest widespread advantages to peer mentoring programs; however, there is minimal data pertaining to medical students mentoring undergraduate students.

OBJECTIVES: To determine the feasibility and perceived effectiveness of a medical student-undergraduate student peer mentorship program.

METHODS: A needs assessment guided the development of Pre-Med Pair Up, a program connecting medical student mentors from the Medical College of Wisconsin and other US medical schools to undergraduates at Marquette University and the University of Wisconsin-Oshkosh to provide peer mentorship, premedical resources, and global health information. After 6 months, surveys were distributed to 43 premedical and 26 medical students to evaluate the program. Descriptive statistics and Pearson correlations (r) were used to assess the relational strength between program components and student confidence and knowledge.

RESULTS: Eleven undergraduate and 26 medical students completed surveys. Most undergraduates expressed increased confidence in abilities as premedical students associated with program involvement (18.2% great, 27.3% moderate, 45.5% minimal, 9.1% no improvement). Increased confidence was strongly correlated with knowledge of volunteer opportunities (r = 0.887, P < 0.001) and feelings of preparedness for the medical school application process (r = 0.854, P = 0.001) and curriculum (r = 0.871, P < 0.001).

CONCLUSION: While self-reported confidence improved and overall positive program outcomes were statistically significant, the number of participants was low and the number who completed mid-year surveys was even lower. Therefore, no conclusions about program effectiveness were made. Instead, a lessons-learned approach was used to discuss the pilot development, implementation, and suggestions for future program installment.

PMID:33974760

WMJ. 2021 Apr;120(1):34-40.

ABSTRACT

PROBLEM CONSIDERED: Obstructive sleep apnea (OSA) is underdiagnosed during pregnancy, but there is strong theoretical and some empiric evidence that treatment may improve obstetric outcomes. Barriers to screening, testing, and treatment are common during pregnancy. The goal of this described intervention was to reduce these barriers and improve detection of OSA in pregnancy.

METHODS: Representatives from sleep medicine and perinatology established a cross-disciplinary, collaborative Sleep Pregnancy Clinic offering a streamlined referral process for multimodal screening, testing, and treatment of OSA during pregnancy. This is a retrospective analysis of data from the clinic’s first 19 months.

RESULTS: Between June 2017 and December 2018, 134 pregnant women were referred for OSA testing. Sixty-three (47.0%) completed objective sleep testing, and 38 (60.3%) of the women who completed testing met diagnostic criteria for OSA. This intervention resulted in a statistically significant increase in the number of diagnostic sleep apnea tests performed (average 22.4 tests per year pre-intervention, 77 per year post-intervention [P = 0.0012]).

DISCUSSION AND CONCLUSIONS: Despite a streamlined referral pipeline, completion rates of OSA testing in pregnant women remained below 50%. However, the overall number of women referred and who completed testing increased significantly during this time period. Of those who completed testing, the majority were diagnosed with OSA. Since starting this clinic, we have created resources to familiarize patients with the equipment and worked to reduce other barriers. Assessment of these interventions and the impact of treatment on obstetric outcomes is ongoing, as is assessment of reasons women do not complete diagnostic testing.

PMID:33974763

WMJ. 2021 Apr;120(1):45-50.

ABSTRACT

OBJECTIVE: The American College of Obstetrics and Gynecology (ACOG) has recommended every hospital disclose their level of maternal care (LOMC) to categorize the capabilities of their birthing center and regionalize perinatal care. Of the 98 birthing centers in Wisconsin, 44% have self-disclosed their LOMC. In many states, disclosing LOMC is mandated but, despite evidence and professional association recommendations, Wisconsin relies on voluntary self-reporting. We surveyed all birthing centers in Wisconsin to better understand the barriers to disclosing their LOMC.

STUDY DESIGN: An anonymous survey was sent to all 98 birthing centers in Wisconsin. Survey recipients were hospital administrators, nursing supervisors, or physician directors of obstetric units. The survey sought information on perceived barriers to completing self-assessments and disclosing their hospital’s LOMC. Quantitative descriptive statistics were used for data analysis.

RESULTS: Of 98 birth centers in Wisconsin, 40 (40.8%) responded. Fifteen of the 40 responses were from birthing centers that have not yet disclosed their LOMC. Of these, 93% were unsure how to disclose, 73% found the paperwork confusing, and 80% did not have the time or staff to complete the paperwork. Respondents did not report lack of departmental support, concerns about losing business or reputation, or future physician recruitment as barriers. Of all respondents, 77.5% were aware of ACOG’s LOMC recommendations, but only 35% thought disclosing their LOMC would be beneficial to maternal care.

CONCLUSIONS: Birthing centers in Wisconsin need further guidance on how to complete a self-assessment of their LOMC. In order to increase self-disclosure of LOMC, statewide perinatal organizations will need to continue to emphasize the benefits of releasing this information. Organizations should also provide additional support to level 1 and 2 birthing centers and improve maternal and neonatal care overall.

PMID:33974765

WMJ. 2021 Apr;120(1):8-16.

ABSTRACT

PROBLEM CONSIDERED: Medical schools historically have utilized instructor-centered lectures to teach medical students the basic sciences. Several commercial electronic-based resources are now available to enhance lecture-based content. This study examines perceptions between students and faculty regarding the efficacy of lecture-based teaching and learning strategies used by students overall.

RESEARCH METHODS: The authors distributed surveys to medical students and basic science teaching faculty at the Medical College of Wisconsin. Survey items used categorical and 10-point scales and open-ended text response. Mean scores were compared with independent t tests and Cohen d effect sizes. Pearson (r) and Spearman rho (ρ) correlations were used for relational analysis. IBM SPSS 24.0 was used for statistical analysis, NVivo 11 was used for qualitative analysis.

RESULTS: Faculty’s perception of meeting students’ learning needs was rated significantly higher (mean [SD] = 7.3 [1.3]) than students (5.9 [2.0]) (Cohen d = 1.0/P < .001). There was a significant negative correlation between lectures meeting students’ learning needs and time students spent outside of lecture seeking supplemental learning resources (ρ = -0.4/P < .001). Students highlighted their use of personal learning strategies, desire for equitable access to resources, and preparation for national board examinations. Faculty emphasized their perceptions of learning resources, recognition of learning styles, time restrictions, and desire to utilize diverse teaching methods.

CONCLUSIONS: Student and faculty perceptions regarding student learning needs were significantly different. Students use lectures extensively, but additionally add to the financial burden of medical school by personally funding supplemental resources. This study helps bridge the gap between medical students and faculty regarding what educational tools are best suited to support a student population with increasingly diverse learning needs.

PMID:33974759

J Infect Dis. 2021 May 11:jiab253. doi: 10.1093/infdis/jiab253. Online ahead of print.

ABSTRACT

BACKGROUND: Understanding the genetic interplay between human hosts and infectious pathogens is crucial for how we interpret virulence factors. Here, we tested for associations between HIV and host genetics, and interactive genetic effects on viral load (VL) in HIV+ ART-naive clinical trial participants.

METHODS: HIV genomes were sequenced and the encoded amino acid (AA) variants were associated with VL, human single nucleotide polymorphisms (SNPs) and imputed HLA alleles, using generalized linear models with Bonferroni correction.

RESULTS: Human (388,501 SNPs) and HIV (3,010 variants) genetic data was available for 2,122 persons. Four HIV variants were associated with VL (p-values<1.66×10 -5). Twelve HIV variants were associated with a range of 1-512 human SNPs (p-value<4.28×10 -11). We found 46 associations between HLA alleles and HIV variants (p-values<1.29×10 -7). We found HIV variants and immunotypes when analyzed separately, were associated with lower VL, whereas the opposite was true when analyzed in concert. Epitope binding prediction showed HLA alleles to be weaker binders of associated HIV AA variants relative to alternative variants on the same position.

CONCLUSIONS: Our results show the importance of immunotype specificity on viral antigenic determinants, and the identified genetic interplay puts emphasis that viral and human genetics should be studied in the context of each other.

PMID:33974707 | DOI:10.1093/infdis/jiab253

Catheter Cardiovasc Interv. 2021 May 1;97(6):1139-1140. doi: 10.1002/ccd.29726.

NO ABSTRACT

PMID:33974740 | DOI:10.1002/ccd.29726

PLoS One. 2021 May 11;16(5):e0251075. doi: 10.1371/journal.pone.0251075. eCollection 2021.

ABSTRACT

Chlamydia trachomatis, the leading cause of bacterial sexually transmitted diseases in developed countries, with around 127 million new cases per year, is mainly responsible for urethritis and cervicitis in women, and urethritis and epididymitis in men. Most C. trachomatis infections remain asymptomatic (>50%) and, hence, untreated, leading to severe reproductive complications in both women and men, like infertility. Therefore, the detection of C. trachomatis as well as the antimicrobial susceptibility testing becomes a priority, and, along the years, several methods have been recommended, like cell culture and direct immunofluorescence (DFA) on cell cultures. Herein, we described the application of In-Cell Western assay (ICW) via Odyssey CLx as a fast, more accessible, and high-throughput platform for the quantification of C. trachomatis and the screening of anti-chlamydial drugs. As a first step, we set up a standard curve by infecting cell monolayers with 2-fold serial dilutions of C. trachomatis Elementary Body (EB) suspension. Then, different unknown C. trachomatis EB suspensions were quantified and the chlamydial susceptibility testing to erythromycin was performed, using the DFA as comparison. Our results showed a very high concordance between these two assays, as evidenced by the enumeration of chlamydial IFUs as well as the determination of erythromycin Minimum Inhibitory Concentration (MIC). In conclusion, the ICW assay may be a promising candidate as an accurate and accessible methodology for C. trachomatis antimicrobial susceptibility testing.

PMID:33974662 | DOI:10.1371/journal.pone.0251075

PLoS One. 2021 May 11;16(5):e0251436. doi: 10.1371/journal.pone.0251436. eCollection 2021.

ABSTRACT

BACKGROUND: In recent years, the price of pork in China continues to fluctuate at a high level. The forecast of pork price becomes more important. Single prediction models are often used for this work, but they are not accurate enough. This paper proposes a new method based on Census X12-GM(1,1) combination model.

METHODS: Monthly pork price data from January 2014 to December 2020 were obtained from the State Statistics Bureau(Mainland China). Census X12 model was adopted to get the long-term trend factor, business cycle change factor and seasonal factor of pork price data before September 2020. GM (1,1) model was used to fit and predict the long-term trend factor and business cycle change factor. The fitting and forecasting values of GM(1,1) were multiplied by the seasonal factor and empirical seasonal factor individually to obtain the fitting and forecasting values of the original monthly pork price series.

RESULTS: The expression of GM(1,1) model for fitting and forecasting long-term trend factor and and business cycle change factor was X(1)(k) = -1704.80e-0.022(k-1) + 1742.36. Empirical seasonal factor of predicted values was 1.002 Using Census X12-GM(1,1) method, the final forecast values of pork price from July 2020 to December 2020 were 34.75, 33.98, 33.23, 32.50, 31.78 and 31.08 respectively. Compared with ARIMA, GM(1,1) and Holt-Winters models, Root mean square error (RMSE), mean absolute percentage error (MAPE) and mean absolute error (MAE) of Census X12-GM(1,1) method was the lowest on forecasting part.

CONCLUSIONS: Compared with other single model, Census X12-GM(1,1) method has better prediction accuracy for monthly pork price series. The monthly pork price predicted by Census X12-GM(1,1) method can be used as an important reference for stakeholders.

PMID:33974663 | DOI:10.1371/journal.pone.0251436