Improved Binaural Hearing Effects and Sound Source Localization in Listeners with Simulated Unilateral Conductive Hearing Loss: Effect of a Bone Conduction Device.

Objectives: It has been proven that patients with unilateral conductive hearing loss (UCHL) may encounter typical problems associated with asymmetric hearing, especially in challenging listening environments. In this study, we aimed to determine how UCHL affects speech recognition under multisource competing environments and the ability of sound source localization, as well as whether assistance with a bone conduction device (BCD) can confer hearing benefits in such listening tasks. Design: Acquired UCHL was simulated using an earplug combined with an earmuff in 10 listeners (mean age: 29.9 ± 4.77 years) with bilateral normal hearing (NH), and a within-subject repeated-measures design was used to compare hearing results among three listening conditions: NH (both ears open, C1), unilateral plug (UP) (simulated UCHL, C2), and UP + BCD (simulated UCHL aided with a BCD, C3). The speech reception threshold (SRT) of summation, squelch, and head shadow (HS) effects and the mean absolute error of sound source localization were used as markers for binaural hearing abilities. Results: BCD assistance (C3) improved the summation and HS effects in all listeners with simulated UCHL, resulting in a lower (i.e., better) SRT than that observed in C2; however, no significant differences in squelch effects were observed between C2 and C3. Notably, most listeners exhibited more accurate sound source localization in C3 than in C2. Further, BCD assistance mainly improved localization accuracy when the noise stimuli were presented at low intensities and on the hearing-impaired (plugged) side, suggesting that the benefits of BCD for sound localization are not based on the reacquisition of binaural processing. Conclusions: The current results have clinical implications for the promotion of BCDs in patients with UCHL, especially those with acquired UCHL who are unable to undergo surgery.

Factors impacting outcomes of cochlear implantation in children at two University centres in China: Multi-year analysis from the Paediatric Implanted Recipient Observational Study (P-IROS).

OBJECTIVES: To identify factors affecting functional hearing performance and quality of life (QoL) outcomes in paediatric cochlear implantation (CI) recipients at two University centres in mainland China. METHODS: Two university centres in mainland China, part of the prospective longitudinal Paediatric Implanted Recipient Observational Study (P-IROS), contributed participant data. Participants were aged under 10 years at time of CI. Functional hearing performance and QoL measures were collected prior to device activation, and at 6-monthly intervals for 2 years post-implantation. Functional hearing endpoints including Categories of Auditory Performance-II (CAP-II) and QoL were evaluated and analysed using ordinal mixed-effects regression models. RESULTS: Data were from 288 children with a mean age at implant of 2.74 years. Overall follow-up at 1 year was 59% and 51% at 2 years. Younger age at implantation (p<0.001) and hearing aid use preimplantation (p=0.026) were associated with significant benefit. Bilateral device users (both CI and bimodal) achieved significantly better functional hearing performance on the CAP-II than unilateral CI users (p<0.001). Slower functional hearing improvements were observed in those with lower parental expectations compared to higher expectations (p<0.001). QoL improved over time but followed a different initial trajectory between centres. CONCLUSION: All participants demonstrated significant improvements in auditory performance and QoL over time. Younger age at CI, and bilateral/bimodal device fitting contributed to earlier improvements. Other potential factors that could help inform families, professionals, and health authorities about choice of hearing device and educational supports required included aetiology of hearing loss and level of maternal education.

Confirming the TMEM232 gene associated with atopic dermatitis through targeted capture sequencing.

Atopic dermatitis (AD) is a common and complex skin disorder, and the 5q22.1 region had been reported to be associated with AD. To confirm the susceptibility gene for AD in the 5q22.1 region by haplotype and targeted capture sequencing. The haplotypes were reconstructed with the genotyping data of four SNPs and six deletions from 3624 Chinese Hans AD patients and 5076 controls. The targeted capture sequencing spanning 5q22.1 region was performed in the selected samples. The gene level enrichment analysis was done using loss of function variants. A total of 62 haplotypes were found, and the H15 haplotype had the strongest association with AD (P = 3.92 × 10-10, OR 0.17, 95% CI 0.09-0.32). However, no co-segregation mutation sites were found in the sequencing analysis within the 16 selected samples, while the enrichment analysis indicated that TMEM232 was significantly associated with AD (P = 7.33 × 10-5, OR 0.33, 95% CI 0.19-0.58). This study confirms previous findings that the TMEM232 gene is associated with AD by haplotype analysis and targeted capture sequencing.

Influence of family environment on the development of speech and language in pre-lingually deaf children after cochlear implantation.

OBJECTIVE: To investigate the influence of family environment on the development of speech and language in pre-school children after cochlear implantation. METHODS: A total of 88 pre-lingually deaf children, aged 2-5 years, who received cochlear implantation, were included in this study. All families completed a self-report family environment questionnaire (FES). The deaf children's linguistic progress was assessed by Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) at 0, 3, 6 and 12 months after implantation. RESULTS: The family environment was the significant factor associated with CAP and SIR at 6 months post-implantation. The children in families with higher levels of Cohesion, Intellectual-Cultural Orientation and the ability to express emotion effectively had better auditory and speech abilities, while children in families with low intimacy and high incompatibility exhibited a delay in the development of auditory speech (P < .05). CONCLUSIONS: The development of speech and language in pre-lingually deaf children after cochlear implantation can be influenced by family environment and parents' roles.

GWAS Follow-up Study Discovers a Novel Genetic Signal on 10q21.2 for Atopic Dermatitis in Chinese Han Population.

Atopic dermatitis (AD) is a common inflammatory skin disease with high heritability. Two susceptibility loci have been confirmed in our previous AD genome-wide association study (GWAS). To look for additional genetic factors in Chinese Han ethnicity, we performed a large-scale GWAS follow-up study. Forty-nine top single nucleotide polymorphisms (SNPs) that had never been reported previously were genotyped using Sequenom Massarray system in an independent cohort, which consist of northern Chinese (1634 cases and 1263 controls) and southern Chinese (2985 cases and 9526 controls). Association analyses were performed using PLINK 2 software. Three SNPs in northern and ten SNPs in southern were found exhibiting association evidence with AD (P < 0.05). Finally, SNP rs224108 on 10q21.2 showed high significance for AD in joint analysis of GWAS and replication study (P meta = 4.55 × 10-9, OR = 1.21), and was confirmed as an independent genetic marker by Linkage disequilibrium calculation and conditional logistic regression analysis. Bioinformatics analysis strongly suggested that rs224108 may have the potential to alter the target gene expression through non-coding epigenetic regulation effects. Meanwhile, SNP rs11150780 on 17q25.3 was also found suggestive association with AD (P meta = 7.64 × 10-7, OR = 1.18). Our findings confirmed a novel susceptibility signal on 10q21.2 for AD in Chinese Han population and advanced the understanding of the genetic contribution to AD.

A variant on chromosome 2p13.3 is associated with atopic dermatitis in Chinese Han population.

BACKGROUND: Multi-ancestry genome-wide association study (GWAS) has recently identified 11 new susceptibility loci for Atopic dermatitis (AD). The replication of these new susceptibility loci in different populations should not be ignored. OBJECTIVE: To examine whether these 11 new identified susceptibility loci are also associated with AD in the Chinese Han population. METHODS: These 11 variants were imputed using our genome-wide array dataset. The selected SNPs with suggestive signals were genotyped in a large-scale replication study with a total of 4619 cases and 10,789 controls using the Sequenom Massarray system. Association analyses were performed using PLINK 1.07 software. Results were combined across our previous AD-GWAS stage and the replication stage by meta-analysis. Bioinformatic analysis was done to predict the possible causal gene. RESULTS: Of the 11 SNPs investigated, four SNPs showed suggestive association (P<0.05) in our previously published GWAS datasets. Association evidence for an intergenic variant rs112111458 at 2p13.3 with AD was replicated in Chinese Han population (P=7.37×10-7, OR=0.86), showing significance in Meta analysis of GWAS and replication study (Pmeta=8.18×10-08, OR=0.69). Further functional annotation by HaploReg indicated that transcriptional regulation activity exists at this locus for the CD207 gene in skin tissue. CONCLUSIONS: Our study confirmed a previously reported susceptibility loci in the Chinese Han population, which implicates CD207 might be a new susceptibility gene for AD and highlights the crucial role of immune responses in AD.

Association analyses identify two susceptibility loci 5q31 and 5q22.1 for atopic dermatitis in Chinese Han population.

BACKGROUND: Atopic dermatitis (AD) and other atopic diseases often share some common genetic and pathogenic bases. Recent genome-wide association studies (GWAS) have identified several loci associated with atopic diseases, allergic sensitization and asthma in different populations. The aim of this study was to investigate whether these susceptibility loci were related to AD in Chinese Han population. METHODS: Eight single nucleotide polymorphisms (SNPs) from recent atopic diseases and allergic sensitization GWAS were genotyped in 3,013 AD patients and 5,483 healthy controls in Chinese Han population using Sequenom MassArray system. Data was analyzed with PLINK 1.07 software. RESULTS: We identified that the susceptibility loci at 5q31 (RAD50/IL13, rs2158177, P = 1.08×10-3, OR = 1.15) and 5q22.1 (TSLP, rs1837253, P = 2.66×10-3, OR = 0.91) were significantly associated with AD. Genotype-based association testing revealed that the dominant model provided the best fit for both rs2158177 (P = 3.75×10-3) and rs1837253 (P = 5.30×10-3). Pathway analysis conformed that both loci were associated with the JAK-STAT signaling pathway. CONCLUSIONS: We identified two susceptibility loci 5q31 and 5q22.1 for AD that might bear candidate genes conferring susceptibility to AD.

Cost-Effectiveness of Pediatric Cochlear Implantation in Rural China.

OBJECTIVES: To evaluate the cost utility of cochlear implantation (CI) for severe to profound sensorineural hearing loss (SNHL) among children from rural settings in P.R. China (China). RESEARCH DESIGN: A cost-utility analysis (CUA) was undertaken using data generated from a single-center substudy of the Cochlear Pediatric Implanted Recipient Observational Study (Cochlear P-IROS). The data were projected over a 20-year time horizon using a decision tree model. SETTING: The Chinese healthcare payer and patient perspectives were adopted. INTERVENTION: Unilateral CI of children with a severe-to-profound SNHL compared with their preimplantation state of no treatment or amplification with hearing aids ("no CI" status). MAIN OUTCOME MEASURE/S: Incremental costs per quality adjusted life year (QALY) gained. RESULTS: The mean total discounted cost of unilateral CI was CNY 252,506 (37,876 USD), compared with CNY 29,005 (4,351 USD) for the no CI status from the healthcare payer plus patient perspective. A total discounted benefit of 8.9 QALYs was estimated for CI recipients compared with 6.7 QALYs for the no CI status. From the healthcare payer plus patient perspective, incremental cost-effectiveness ratio (ICER) for unilateral CI compared with no CI was CNY 100,561 (15,084 USD) per QALY. The healthcare payer perspective yielded an ICER of CNY 40,929 (6,139 USD) per QALY. Both ICERs fell within one to three times China's gross domestic product per capita (GDP, 2011-2015), considered "cost-effective" by World Health Organization (WHO) standards. CONCLUSIONS: Treatment with unilateral CI is a cost-effective hearing solution for children with severe to profound SNHL in rural China. Increased access to mainstream education and greater opportunities for employment, are potential downstream benefits of CI that may yield further societal and economic benefits. CI may be considered favorably for broader inclusion in medical insurance schemes across China.

[Selective neck dissection for node-positive necks (N1, N2) in patients with head and neck squamous cell carcinoma].

OBJECTIVE: To evaluate therapeutic effect in a consecutive series of patients with node-positive of N1 and N2 head and neck squamous cell carcinoma (HNSCC) who underwent selective neck dissection as part of their treatment in a single institution. METHODS: Retrospectively analyzed 36 patients with node positive head and neck squamous cell carcinoma, which had undergone 40 selective neck dissection (SND) and 16 radical neck dissections (RND) and the therapeutic effects of the SND in HNSCC patients with node positive. Kaplan-Meier method was used to estimate the survival analysis among the different levels, and log-rank method for comparison of the different distribution of the several influential factors of the survival; the fisher's exact test was used to test the difference of the neck recurrence between the groups that with or without lymph node extracapsular spread. Cox proportional hazard model was applied to screen the potentially significant prognostic factors. RESULTS: The 3 and 5 years survival rate of this group were 76.8% and 54.3% retrospectively. The 3 and 5 years' survival rate were both 100% in the N1 + N2a group, while 59.4% and 32.0% in the N2b + N2c group correspondingly. With log-rank test between the two groups above, significant statistical difference was revealed (P = 0.003) in the 5 years' survival rates. To the groups that with or without extracapsular spread (ECS), the recurrence rate were 36.4% and 3.4% respectively and significant statistical difference existed (P = 0.015). In the groups that with or without ECS, the 3 years' survival rate were 45.5% and 81.8% , and 5 years' survival rate were 39.7% and 65.5% respectively, also the significant statistical difference (P = 0.0148 and P = 0.0423 respectively) had presented. CONCLUSIONS: SND is appropriate for treatment of N1 neck of the patient with HNSCC; However, SND should be taken very cautious to the N2 neck and node-positive neck with extracapsular spread, MRND or RND might be a better choice to prevent the recurrence in the neck.