Extreme weather conditions influence the frequency of epistaxis-related emergency room visits.

BACKGROUND: Climate change has been associated with an increase in extreme weather conditions. The aim of this study was to identify environmental factors and the effect of extreme weather events (95th percentile) on the risk for epistaxis-related emergency room visits (EV). METHODS: A total of 2179 epistaxis-related EVs were identified between 2015 and 2018. A distributed lag non-linear model was fitted to investigate the relationship between extreme weather conditions and the total number of epistaxis-related EVs per day. Cumulative relative risk (cRR) is defined as the cumulated daily risk of EV for epistaxis within a stated period after an extreme weather condition compared to the risk of EV at the median value of that weather condition. RESULTS: At a mean daily temperature of 27°C (P95), cRR for epistaxis-related EV was 2.00. At a relative humidity of 39% (P5), cRR was highest on day 3 at 1.59, while extremely high humidity (92%, P99) led to a decreased cRR of 0.7 on day 1. Intense precipitation of 24mm (P99) reduced the cRR on day 3 to 0.38. For prolonged extreme conditions over three days, extremely low wind speed, as well as both high and low atmospheric pressure events, diminished cRR. CONCLUSIONS: Extreme temperatures, relative humidity, and precipitation, as well as extended periods of extreme wind speeds and atmospheric pressure, significantly impact cRR for epistaxis-related EVs.

Plasma VEGF - a candidate biomarker for response to treatment with bevacizumab in HHT patients.

BACKGROUND: Recurrent epistaxis is the principal symptom of hereditary hemorrhagic telangiectasia (HHT). Currently, there is no standard therapy for this condition. Bevacizumab (anti-VEGF) treatment has been under intense investigation but treatment effects vary greatly between individuals. There are currently no markers to predict anti-VEGF therapeutic response in HHT patients. METHODS: We evaluated plasma VEGF levels in 13 HHT patients and correlated values with i) degree of epistaxis, measured by visual analog scale (VAS), epistaxis severity score (ESS), and patient bleeding diaries ii) the prevalence of extranasal manifestations, iii) the HHT subtype and iv) the treatment response to intranasal submucosal bevacizumab. RESULTS: Plasma VEGF was elevated in all 13 HHT patients compared to reference levels and showed a moderate correlation with VAS and duration of moderate bleeding events. In patients treated with intranasal submucosal bevacizumab plasma VEGF levels showed a strong correlation with the degree of reduction of mild bleeding events and VAS. CONCLUSIONS: The role of plasma VEGF as a potential predictive biomarker for therapeutic response to bevacizumab treatment warrants further investigation in larger prospective studies.

Formant frequency discrimination with a fine structure sound coding strategy for cochlear implants.

Recent sound coding strategies for cochlear implants (CI) have focused on the transmission of temporal fine structure to the CI recipient. To date, knowledge about the effects of fine structure coding in electrical hearing is poorly charactarized. The aim of this study was to examine whether the presence of temporal fine structure coding affects how the CI recipient perceives sound. This was done by comparing two sound coding strategies with different temporal fine structure coverage in a longitudinal cross-over setting. The more recent FS4 coding strategy provides fine structure coding on typically four apical stimulation channels compared to FSP with usually one or two fine structure channels. 34 adult CI patients with a minimum CI experience of one year were included. All subjects were fitted according to clinical routine and used both coding strategies for three months in a randomized sequence. Formant frequency discrimination thresholds (FFDT) were measured to assess the ability to resolve timbre information. Further outcome measures included a monosyllables test in quiet and the speech reception threshold of an adaptive matrix sentence test in noise (Oldenburger sentence test). In addition, the subjective sound quality was assessed using visual analogue scales and a sound quality questionnaire after each three months period. The extended fine structure range of FS4 yields FFDT similar to FSP for formants occurring in the frequency range only covered by FS4. There is a significant interaction (p = 0.048) between the extent of fine structure coverage in FSP and the improvement in FFDT in favour of FS4 for these stimuli. FS4 Speech perception in noise and quiet was similar with both coding strategies. Sound quality was rated heterogeneously showing that both strategies represent valuable options for CI fitting to allow for best possible individual optimization.

The recent rise to the alpha-rank in a population of free-living chimpanzees.

The recent rise of a high-ranking adult male chimpanzee to the alpha male position of the Gombe National Park's Kasakela chimpanzee community is reported. The male Figan is the fourth individual to assume this status in the wild chimpanzees' social hierarchy during Goodall's 16 year study in Tanzania. The paper describes the overthrow of the previous top-ranking male, and the manner in which Figan has maintained his new position after the take-over. Emphasis is placed upon his relationship with his elder male sibling, Faben, and the second highest-ranking male in the community, Evered.

Sleeping behavior and associations in a group of captive chimpanzees.

The present study investigated the sleeping behavior and preferences of a group of six adolescent chimpanzees at the Delta Regional Primate Research Center in Louisiana, USA. The study sought to relate sleeping partner preferences to other aspects of social relationships. Comparative observations between those chimpanzee behaviors seen in the wild and in this group are noted.

Fifty-day observation of a free-ranging adult male chimpanzee.

An adult male chimpanzee living in Gombe National Park, Tanzania, was observed for 50 consecutive days during the 1974 dry season, for a total of 563 h. This individual, Figan, was the alpha male of a community of 42 chimpanzees. The composition and size of temporary associations within the community was influenced largely by the presence of one estrus female and by characteristics of the food resources. Figan's daily time budget varied little for travel and grooming, but there were major changes in time spent feeding tha inactive over the 50 days. Predatory behavior occurred periodically and meat was eaten on five occasions. Agonistic and sexual behaviors are discussed relative to Figan's high social status. A cooperative relationship was maintained between Figan and his older brother.