Female leadership representation within otolaryngology specialty societies.

OBJECTIVES: Determine if women have continued parity in leadership in otolaryngology specialty societies as compared to a paper by Choi and Miller in 2012. Additionally, we wanted insight into obstacles female leaders faced by surveying them directly to better understand their experiences with gender bias. METHODS: Chi-squared test evaluation was done using the American Academy of Otolaryngology Head and Neck Surgery (AAOHNS) 2020 membership data and directly from various otolaryngology specialty societies. An anonymous survey to assess different experiences of leaders in various Otolaryngology specialty societies was sent to current and past leaders of specialty societies via email. Survey data was assessed using descriptive statistics and multivariate logistical analyses. STUDY DESIGN: Cross-sectional study and survey study. RESULTS: Female members comprised 19.3 % of practicing AAOHNS otolaryngologists. All societies had proportionate female leadership representation except for AAOA, which had greater representation. Compared to data from 10 years ago, female representation in all the societies' leadership has not changed significantly. Survey results demonstrated 64.9 % of respondents felt gender bias exists in Otolaryngology. 45.6 % of respondents personally experienced gender bias during their careers. Survey results showed males are less likely to experience gender bias. CONCLUSION: There is stability in the proportion of women in otolaryngology leadership positions compared to a decade ago largely due to efforts of leaders in the field. However, women leaders note experiencing gender bias and time away from clinical duties are prospective areas where support can be given.

Multiring basin formation constrains Europa's ice shell thickness.

Jupiter's moon Europa hosts a subsurface ocean under an ice shell of uncertain thickness. Europa has two multiring basins that exhibit several concentric rings. The formation of these multiring basins is thought to be sensitive to the thickness and thermal structure of the ice shell. Here, we simulate multiring basin forming impacts on Europa finding that a total ice shell greater than 20 kilometers thick is required to reproduce observed ring structures. Thin ice shells (<15 kilometers thick) result in compressional tectonics inconsistent with observed ring structures. Our simulations are also sensitive to the thermal structure of the ice shell and indicate that Europa's at least 20-kilometer ice shell is composed of a 6- to 8-kilometer-thick conductive lid overlying warm convecting ice. The constraints on Europa's ice shell structure resulting from this work are directly relevant to our understanding of the potential habitability of Europa.

Analysis of the Clinical Course of Children With Initial Negative Polysomnography.

OBJECTIVES: To determine the clinical course of children with initial negative polysomnography (PSG) tests. METHODS: A retrospective chart review was performed on pediatric patients seen by an otolaryngologist who underwent a PSG between October 2012 and March 2019 for obstructive sleep apnea at a single, academic, tertiary-care center. Data including demographics, follow-up PSG tests, and surgeries were collected. RESULTS: A total of 2018 pediatric patients underwent PSG during the timeframe. About 535/2018 (26.5%) patients were negative for obstructive sleep apnea by PSG and had no prior adenotonsillectomy. About 408/535 (76.3%) did not obtain follow-up testing or surgeries; 69/535 (12.9%) underwent subsequent adenotonsillectomy for worsening symptoms without repeat PSG; and 58/535 (10.8%) obtained 1 or multiple follow-up PSG tests. Of the 58 who obtained repeat PSG, 25 (43.1%) were subsequently positive, with 17 of those 25 (29.3% of 58) undergoing adenotonsillectomy. Taken together, 94/535 (17.6%) of patients with initial negative PSG had worsening sleep disordered breathing. CONCLUSION: A significant minority of children who initially tested negative for pediatric obstructive sleep apnea met criteria for diagnosis on follow up PSG. Additionally, other children with initial negative PSG underwent adenotonsillectomy for worsening symptoms in lieu of repeat testing. Patients should be educated that snoring in children could persist or worsen over time, even in the setting of a initial negative PSG.

A commentary on broader use of preoperative polysomnography in pediatric patients with obstructive sleep apnea.

Obstructive sleep apnea (OSA), characterized by repeated episodes of prolonged airway obstruction during sleep, is a common condition in pediatric patients ages 2 to 6. Polysomnography (PSG) testing can be used to assess the severity of OSA or obstructive sleep-disordered breathing prior to adenotonsillectomy. The article "Characteristics and Frequency of Children With Severe Obstructive Sleep Apnea Undergoing Elective Polysomnography" by Bains et al. notes the variability in guidelines regarding indication for PSG amongst professional societies, making it difficult for physicians to determine which patients require PSG. The purpose of this commentary is to emphasize and elaborate on the potential benefit for preoperative PSG in all patients considering adenotonsillectomy as presented by the aforementioned article. With broader use of preoperative PSG, providers would have a more accurate assessment of OSA severity and to aid in surgical decision-making and postoperative planning.

Loss of the Atrial Fibrillation-Related Gene, Zfhx3, Results in Atrial Dilation and Arrhythmias.

BACKGROUND: ZFHX3 (zinc finger homeobox 3), a gene that encodes a large transcription factor, is at the second-most significantly associated locus with atrial fibrillation (AF), but its function in the heart is unknown. This study aims to identify causative genetic variation related to AF at the ZFHX3 locus and examine the impact of Zfhx3 loss on cardiac function in mice. METHODS: CRISPR-Cas9 genome editing, chromatin immunoprecipitation, and luciferase assays in pluripotent stem cell-derived cardiomyocytes were used to identify causative genetic variation related to AF at the ZFHX3 locus. Cardiac function was assessed by echocardiography, magnetic resonance imaging, electrophysiology studies, calcium imaging, and RNA sequencing in mice with heterozygous and homozygous cardiomyocyte-restricted Zfhx3 loss (Zfhx3 Het and knockout, respectively). Human cardiac single-nucleus ATAC (assay for transposase-accessible chromatin)-sequencing data was analyzed to determine which genes in atrial cardiomyocytes are directly regulated by ZFHX3. RESULTS: We found single-nucleotide polymorphism (SNP) rs12931021 modulates an enhancer regulating ZFHX3 expression, and the AF risk allele is associated with decreased ZFHX3 transcription. We observed a gene-dose response in AF susceptibility with Zfhx3 knockout mice having higher incidence, frequency, and burden of AF than Zfhx3 Het and wild-type mice, with alterations in conduction velocity, atrial action potential duration, calcium handling and the development of atrial enlargement and thrombus, and dilated cardiomyopathy. Zfhx3 loss results in atrial-specific differential effects on genes and signaling pathways involved in cardiac pathophysiology and AF. CONCLUSIONS: Our findings implicate ZFHX3 as the causative gene at the 16q22 locus for AF, and cardiac abnormalities caused by loss of cardiac Zfhx3 are due to atrial-specific dysregulation of pathways involved in AF susceptibility. Together, these data reveal a novel and important role for Zfhx3 in the control of cardiac genes and signaling pathways essential for normal atrial function.

Infrasound direction of arrival determination using a balloon-borne aeroseismometer.

Free-floating balloons are an emerging platform for infrasound recording, but they cannot host arrays sufficiently wide for multi-sensor acoustic direction finding techniques. Because infrasound waves are longitudinal, the balloon motion in response to acoustic loading can be used to determine the signal azimuth. This technique, called "aeroseismometry," permits sparse balloon-borne networks to geolocate acoustic sources. This is demonstrated by using an aeroseismometer on a stratospheric balloon to measure the direction of arrival of acoustic waves from successive ground chemical explosions. A geolocation algorithm adapted from hydroacoustics is then used to calculate the location of the explosions.

A Late Paleocene age for Greenland's Hiawatha impact structure.

The ~31-km-wide Hiawatha structure, located beneath Hiawatha Glacier in northwestern Greenland, has been proposed as an impact structure that may have formed after the Pleistocene inception of the Greenland Ice Sheet. To date the structure, we conducted 40Ar/39Ar analyses on glaciofluvial sand and U-Pb analyses on zircon separated from glaciofluvial pebbles of impact melt rock, all sampled immediately downstream of Hiawatha Glacier. Unshocked zircon in the impact melt rocks dates to ~1915 million years (Ma), consistent with felsic intrusions found in local bedrock. The 40Ar/39Ar data indicate Late Paleocene resetting and shocked zircon dates to 57.99 ± 0.54 Ma, which we interpret as the impact age. Consequently, the Hiawatha impact structure far predates Pleistocene glaciation and is unrelated to either the Paleocene-Eocene Thermal Maximum or flood basalt volcanism in east Greenland. However, it was contemporaneous with the Paleocene Carbon Isotope Maximum, although the impact's exact paleoenvironmental and climatic significance awaits further investigation.