Italian Fast Speech Reception Threshold Test: A New Method to Investigate Adult Auditory Impairment in Noise.

INTRODUCTION: Purpose of our study was to compare two competing methods of performing bisyllabic word speech audiometry for the detection of the 50% speech reception threshold in noise (SRT50). METHODS: Classic method is performed submitting multiple word lists at a fixed signal-to-noise ratio. A newer Fast method - Italian Fast Speech Reception Threshold 50 (IFastSRT50) - is performed by means of program software with a single list of bisyllabic words and noise intensity shifting. RESULTS: Means comparison between SRT50 Classic and IFastSRT50 shows a slight significant correlation (r = 0.263; p = 0.044) and a wide significant difference: SRT50 Classic = -2.763 dB (SD = 4.1) and IFastSRT50 = -7.803 dB (SD = 2.1) (p < 0.0001). There is a high difference between the test execution time means (SRT50 Classic = 11 min, IFastSRT50 = 2 min; p < 0.0001). The correlation between test results and execution times was higher for SRT50 Classic than IFastSRT50. CONCLUSION: IFastSRT50 test is a reliable method to quickly investigate signal-to-noise ratio needed to obtain 50% of recognition scores with bisyllabic words; it allows less execution time than SRT50 Classic method and can avoid patient fatigue and other limitations of different speech discrimination tests in noise as sentences based ones.

Magnetic resonance imaging accuracy before surgery in children with retropharyngeal abscesses.

AIMS: Retropharyngeal abscess (RPA) is a deep neck infection occurring in childhood. The gold standard technique for diagnosis is computerised tomography (CT) with a contrast medium. The aim of this study is to answer the question of whether magnetic resonance imaging (MRI) can be an alternative in diagnosing RPA and predicting pus drainage at surgery. METHODS: This is a retrospective study conducted at the paediatric emergency department of a tertiary level children hospital. The medical records of 31 children admitted to the Otorhinolaryngology and Paediatric ward, with a suspected diagnosis of RPA, were reviewed. The primary study outcome was the diagnostic accuracy of CT and MRI in predicting the amount of pus during surgery. RESULTS: Twenty-two patients (71%) underwent surgery. Among them, 18 had imaging before surgery. Eleven patients evaluated with CT scan underwent surgery: four had non-significant purulent drainage, three of them were reported to have a significant fluid collection (negative predictive value 66% and positive predictive value of 55%). Nine patients evaluated with MRI underwent surgery: four cases had non-significant purulent drainage, three of them showed a significant fluid collection at MRI (negative predictive value of 60%; positive predictive value of 56%). CONCLUSION: MRI and CT scans showed similar accuracy in predicting successful pus drainage during surgery; therefore, it could be a valid alternative in the diagnosis of RPA in children.

Endoscopic-assisted pediatric transcutaneous bone-anchored hearing implant: how I do it.

BACKGROUND: Conventional technique for transcutaneous bone-anchored hearing implants surgery requires the elevation of a large retroauricular skin flap to expose the site of implantation, that may cause a large scar and the interruption of retroauricular vasculature. METHODS: A less invasive, endoscopic-assisted modification of the surgical technique is described, which provides access to the implant site through two small skin incisions and the creation of a pocket in the retroauricular area. CONCLUSION: Endoscopic-assisted bone-anchored hearing implant surgery could be a viable option for transcutaneous bone-anchored hearing implant surgery, especially for pediatric patients.

Short report on the effects of SARS-CoV-2 face protective equipment on verbal communication.

OBJECTIVE: To predict the impact of face personal protective equipment on verbal communication during the SARS-CoV-2 pandemic. DESIGN: We assessed the effect of common types and combinations of face personal protective equipment on speech intelligibility in quiet and in a simulated noisy environment. RESULTS: Wearing face personal protective equipment impairs transmission of middle-to-high voice frequencies and affects speech intelligibility. Surgical masks are responsible for up to 23.3% loss of speech intelligibility in noisy environments. The effects are larger in the condition of advanced face personal protective equipment, accounting for up to 69.0% reduction of speech intelligibility. CONCLUSION: The use of face personal protective equipment causes significant verbal communication issues. Healthcare workers, school-aged children, and people affected by voice and hearing disorders may represent specific at-risk groups for impaired speech intelligibility.

Influence of Harvest Date on Bull's Eye Rot of 'Cripps Pink' Apple and Control Chemical Strategies.

The influence of four different harvest times on the bull's eye rot of 'Cripps Pink' apple caused by Neofabraea spp. was investigated in two orchards harvested at four different times. In addition, a control strategy based on chemical treatments performed in preharvest or postharvest was evaluated. Regression analysis between harvest time and disease incidence revealed high r2 values (>0.75). All preharvest fungicide treatments significantly (P < 0.0085) reduced the bull's eye rot incidence; however, thiophanate-methyl (achieving >87% control) was more effective than a mixture of pyraclostrobin and boscalid (<80.7%) or fludioxonil (<57.6%), in all trials. Compared with nontreated control fruit, a postharvest treatment with the ethylene inhibitor 1-methylcyclopropene (1-MCP) halved the incidence of infection in three of four experiments. However, a combination of two preharvest treatments with a mixture of pyraclostrobin plus boscalid and one postharvest 1-MPC treatment suppressed bull's eye rot to a significantly (P < 0.00001) greater degree (achieving >87.5% control) than the single treatments with pyraclostrobin and boscalid (<65%) and 1-MCP (<80%) tested alone.

Influence of berry ripeness on accumulation, composition and extractability of skin and seed flavonoids in cv. Sangiovese (Vitis vinifera L.).

BACKGROUND: The anthocyanin and tannin concentration and composition of Vitis vinifera L. cv. Sangiovese berries were investigated from post-veraison to harvest. Exhaustive extraction with methanol and acetone was performed to determine the total flavonoid concentration, while a model hydroalcoholic solution was used to prepare extracts representing the winemaking process. The aim of this study was to improve the knowledge of the phenolic maturity of Sangiovese grape. RESULTS: The total anthocyanin concentration increased during ripening, but the quantity of extractable anthocyanins increased more rapidly than the total. The total skin tannin concentration declined from post-veraison to harvest, whereas the extractable portion increased, with little difference in the composition of the fractions. Both the total and extractable seed tannin concentration diminished rapidly just after veraison, and only small fluctuations were detected until harvest. CONCLUSION: These results indicate that the extractability of anthocyanins and skin tannins increases during ripening, whereas there is no clear trend for seed tannins during the same period. This is the first survey to study the behavior of phenolic compounds during different steps of ripening of Sangiovese grape. © 2016 Society of Chemical Industry.

Use of an automatic fruit-zone cooling system to cope with multiple summer stresses in Sangiovese and Montepulciano grapes.

Grapevines are frequently subjected to heatwaves and limited water availability during ripening. These conditions can have consequences for the physiological health of the vines. Moreover, the situation is often exacerbated by intense solar radiation, resulting in reduced yield due to sunburn and a decline in quality. In light of these challenges, our study aimed to develop a fruit-zone cooling system designed to mitigate grape sunburn damage and improve the microclimate conditions within the vineyard. The system comprises a network of proximal sensors that collect microclimate data from the vineyard and an actuator that activates nebulizers when the temperature exceeds the threshold of 35°C. The research was conducted over two years (2022 and 2023) in Bologna (Italy) using potted Sangiovese and Montepulciano vines. These two vintages were characterized by high temperatures, with varying amounts of rainfall during the test period, significantly impacting the evaporative demand, which was notably higher in 2023. Starting from the veraison stage we compared three treatments: Irrigated control vines (WW); Control vines subjected to 50% water restriction during the month of August (WS); WS vines treated with nebulized water in the bunch area during the stress period (WS+FOG). The application of nebulized water effectively reduced the temperature of both the air around the clusters and the clusters themselves. As we expected, Montepulciano showed better single leaf assimilation rate and stomatal conductance under non-limiting water conditions than Sangiovese while their behavior was unaffected under water-scarce conditions. Importantly, for the first time, we demonstrated that nebulized water positively affected gas exchange in both grape varieties. In addition to this, the vines treated with the misting system exhibited higher productivity compared to WS vines without affecting technological maturity. In the 2023 vintage, the activation of the system prevented the ripening blockage that occurred in Montepulciano under water stress. Regarding the concentration of total anthocyanins, a significant increase in color was observed in WS+FOG treatment, suggesting a predominant role of microclimate on anthocyanin biosynthesis and reduction of oxidative phenomena. In conclusion, the fruit-zone cooling system proved to be an invaluable tool for mitigating the adverse effects of multiple summer stresses.

Botanical memory: five centuries of floristic changes revealed by a Renaissance herbarium (Ulisse Aldrovandi, 1551-1586).

We analysed the spatially explicit floristic information available in the herbarium of Ulisse Aldrovandi (1551-1586) to track floristic changes in the surroundings of Bologna across five centuries. Aldrovandi's data were compared with the Flora della Provincia di Bologna by Girolamo Cocconi (1883) and the Floristic Database of Emilia-Romagna (1965-2021). We explored potential variations in native range and life forms composition, and habitat affinity of the species in the three floras, also contrasting between native and alien species. Native species, mainly in terms of variations of hydro-hygrophytes, chamaephytes and therophytes, provide clear signals of human disturbance and habitat loss. Signals of climate change are provided by the high-mountain species, that were comparably rare between Aldrovandi and current flora and more represented in Cocconi, probably reflecting the effect of the Little Ice Age. Our findings also indicate the increasing importance of alien species from the Renaissance onwards. In this perspective, Aldrovandi's herbarium preserves the memory of the first signs of a radical transformation of the European flora and habitats. Finally, the study warns about the risk of dismissing herbaria and herbarium specimens collection, which would cause irreparable lacunas in our botanical memory, hindering our ability to predict biodiversity trajectories.

Primary tumors and tumor-like lesions of the eustachian tube: a systematic review of an emerging entity.

Eustachian tube (ET) primary tumors and tumor-like lesions are rare diseases presenting with common ear, nose and throat symptoms. Pathology can range from developmental anomalies to high malignant neoplasms. Hence this review aimed at suggesting a classification and outline relevant aspects of ET primary tumors and tumor-like lesions, describing clinical findings, diagnostic management and therapeutic approaches. MEDLINE, CINAHL, OVIDSP, HIGHWIRE, and GOOGLE databases were searched from inception to July 2011 for relevant studies. Further papers were identified by examining the reference lists of all included. Sixty-five papers met the inclusion criteria, enclosing 78 cases. Case reports are increasing in the past few years. Benign lesions and tumor-like lesions of ET have been reported. Moreover, melanomas, carcinomas, and sarcomas can affect the ET as a primary site.

Deep neck infections: a study of 365 cases highlighting recommendations for management and treatment.

The aims of this investigation were to review the clinical behavior of deep neck infections (DNIs) treated in our institution in order to identify the predisposing factors of life-threatening complications and propose valuable recommendations for management and treatment. A total of 365 adult patients with DNIs were retrospectively identified. One-hundred and thirty-nine patients (38.1%) underwent surgical drainage. Overall, 226 patients (61.9%) responded effectively to intravenous antimicrobial therapy only. There were 67 patients (18.4%) developing life-threatening complications. Diabetes mellitus (odd ratio 5.43; P < 0.001) and multiple deep neck spaces involvement (odd ratio 4.92; P < 0.001) were the strongest independent predictors of complications. The mortality rate was 0.3%. Airway obstruction and descending mediastinitis are the most troublesome complications of DNIs. In selected patients, a trial of intravenous antibiotic therapy associated with an intensive computed tomography-based wait-and-watch policy may avoid an unnecessary surgical procedure. However, about one-fourth of patients present significant comorbidities, which may negatively affect the course of the infection. In these cases and in patients with large or multiple spaces infections, a more aggressive surgical strategy is mandatory.

Temporal bone high-resolution computed tomography in non-syndromic unilateral hearing loss in children.

OBJECTIVE: The aim of this study was to disclose possible inner ear abnormalities/pathologies by means of high-resolution computed tomography (HRCT) of the temporal bone (TBHRCT) in children with unilateral hearing loss (UHL). METHODS: Retrospective review of audiological evaluation and TBHRCT in 22 children with UHL. RESULTS: Two thirds of the children showed profound hearing loss. Review of HRCT scans identified inner ear malformations/pathologies in 9 (41%) cases and a high jugular bulb (HJB), always dehiscent with the vestibular aqueduct, in another 5 (22%). Inner ear malformations included enlarged vestibular aqueduct, common cavity and cochleovestibular hypoplasia, while labyrinthine ossification was the detected pathology. In 1 child, the common cavity of the right ear was associated with congenital melanocytic naevus of the left eyelid and lipomeningocele. To the best of our knowledge, this condition has never been described. CONCLUSIONS: The aetiology of UHL may be revealed in more than half of patients by means of TBHRCT. Besides common inner ear abnormalities, TBHRCT should be evaluated carefully to rule out HJB, dehiscences, diverticulum or erosion of inner ear structures.

Spontaneous head movements support accurate horizontal auditory localization in a virtual visual environment.

This study investigates the relationship between auditory localization accuracy in the horizontal plane and the spontaneous translation and rotation of the head in response to an acoustic stimulus from an invisible sound source. Although a number of studies have suggested that localization ability improves with head movements, most of them measured the perceived source elevation and front-back disambiguation. We investigated the contribution of head movements to auditory localization in the anterior horizontal field in normal hearing subjects. A virtual reality scenario was used to conceal visual cues during the test through a head mounted display. In this condition, we found that an active search of the sound origin using head movements is not strictly necessary, yet sufficient for achieving greater sound source localization accuracy. This result may have important implications in the clinical assessment and training of adults and children affected by hearing and motor impairments.

Effects of simulated nitrogen deposition on the nutritional and physiological status of beech forests at two climatic contrasting sites in Italy.

Anthropogenic activities have resulted in a significant increase of reactive nitrogen (N) compounds in the atmosphere and a rise in N deposition on forest ecosystems. Increasing N loads impact forest productivity and health, altering tree physiological status and nutrient balance with possible beneficial and detrimental consequences. The impact of N deposition has received considerable attention by scientific research, covering medium and high latitudes, while experimental studies in the Mediterranean area are almost absent. The present study used a manipulative approach, through replicated N additions (background deposition, 30, 60 kg N ha-1yr-1) to simulate the cumulative effects of N deposition in two beech (Fagus sylvaticaL.) forests located in contrasting climatic regions of Italy. Leaf nutrients and photosynthetic pigments were tested as monitoring indicators after four years of N fertilization. Foliar N and pigment concentrations indicated not limiting N conditions at both forest sites, although changes in chlorophylls and carotenoids showed an early response of the canopy to N additions. N-to-phosphorus (P) and sulfur (S) ratios increased under elevated N fertilization, which could be partly related to the relative enhancement of foliar N concentration, and partly associated with the reduction of foliar P and S. The two eutrophic beech forests monitored were not severely affected by chronic N addition, not showing critical nutritional and physiological impairments over the short to medium period. However, the modifications in leaf nutrient and pigment compositions showed an incipient stress response and accentuated the differences induced by climatic and soil characteristics at the two sites. The potential use of nutrients and photosynthetic pigments in monitoring forest N deposition under contrasting climatic conditions and the eventual limits of manipulative experiments are discussed.

Non-sutured fixation of the internal receiver-stimulator in cochlear implantation.

The aim of this study is to describe an alternative technique to secure the receiver-stimulator of the cochlear implant to the skull with a tailored flap of periosteum. Other techniques are also reviewed and discussed. 179 consecutive patients were implanted by the same surgeon in a tertiary care setting. Age ranged from 11 months to 74 years. Patients were retrospectively evaluated for device migration. No cases of migration were observed during follow up, ranged 1-99 months with a median of 48 months. The alternative technique proposed is safe and reliable.

Functional organ preservation after chemoradiotherapy in elderly patients with loco-regionally advanced head and neck squamous cell carcinoma.

The aim of the present investigation is to evaluate the outcome after induction chemotherapy and concurrent multi-drug chemoradiotherapy (IC/CCRT) with or without post-chemoradiation neck dissection in medically fit elderly patients with loco-regionally advanced head and neck squamous cell carcinoma (HNSCC). Retrospective study including 44 elderly patients (median age 71 years; range 66-77 years) with previously untreated, inoperable, histologically proven non-metastatic stage III or IV HNSCC. Following one cycle of IC, two cycles of cis-platinum and 5-fluorouracil CCRT with conventional fractionated radiotherapy up to a dose of 66-70 Gy were administrated. A neck dissection was recommended for patients with node metastasis larger than 3 cm regardless of the response to therapy and for patients who had suspected persistent neck disease 8-12 weeks after completing treatment. Salvage surgery was considered for histologically proven persistent or recurrent tumor in the primary site. Time-to-event data were described using Kaplan-Meier actuarial curves. Overall, 37 patients (84.1%) completed the planned treatment. There were no cases of treatment-related deaths. Twenty-nine patients (65.9%) developed severe toxicities with grade 4 toxicity accounting for 22.7%. The median follow-up time in survivors was 41 months. Three-year overall survival, progression-free survival, and functional progression-free survival estimates were 70.9, 67.0, and 57.3%, respectively. In selected medically fit elderly patients with loco-regionally advanced HNSCC, cis-platinum-based chemoradiotherapy can be successfully applied, with moderate adverse events, in attempt to preserve a functional upper aerodigestive tract.