Changes in audiovestibular handicap following treatment of vestibular schwannomas.

OBJECTIVE: This study aimed to assess degree of audiovestibular handicap in patients with vestibular schwannoma. METHODS: Audiovestibular handicap was assessed using the Hearing Handicap Inventory, Tinnitus Handicap Inventory and Dizziness Handicap Inventory. Patients completed questionnaires at presentation and at least one year following treatment with microsurgery, stereotactic radiosurgery or observation. Changes in audiovestibular handicap and factors affecting audiovestibular handicap were assessed. RESULTS: All handicap scores increased at follow up, but not significantly. The Tinnitus Handicap Inventory and Dizziness Handicap Inventory scores predicted tinnitus and dizziness respectively. The Hearing Handicap Inventory was not predictive of hearing loss. Age predicted Tinnitus Handicap Inventory score and microsurgery was associated with a deterioration in Dizziness Handicap Inventory score. CONCLUSION: Audiovestibular handicap is common in patients with vestibular schwannoma, with 75 per cent having some degree of handicap in at least one inventory. The overall burden of handicap was, however, low. The increased audiovestibular handicap over time was not statistically significant, irrespective of treatment modality.

COVID-19 nightmare response and stress: A new Mexico sample based survey.

Studies conducted during the COVID-19 Pandemic have reported increased rates of mental illnesses including depression, anxiety, and post-traumatic stress disorder (PTSD) [1]. A common symptom of mental illness is change in Rapid Eye Movement (REM) sleep, the phase of sleep associated with dreaming and nightmares. The COVID-19 pandemic offers a unique opportunity to evaluate the effects of systemic stress on nightmares. In this study, we investigate whether the COVID-19 pandemic affects nightmare frequency and content using a web-based survey within the state of New Mexico. The survey returned 197 responses showing an increase in the quantity of both bad dreams and nightmares. Furthermore, significant changes in nightmare themes were reported compared to relative rates prior to the pandemic (RR 1,42, p < 0.01; RR 5, p < 0.001). This novel data supports that increased stress from the COVID-19 pandemic has altered dream and nightmare content and frequency.

Testing Emphasis Message Frames and Metaphors on Social Media to Engage Boaters to Learn about Preventing the Spread of Zebra Mussels.

Message frames are often used to communicate about invasive species due to the additional meaning they provide. They appear in calls to action like "join the battle against invasive species," "unwelcome exotics," or "Stop Aquatic Hitchhikers." However, little is known about how stakeholders respond to these message frames. This research tested five common message emphasis frames used in invasive species communication. These message frames were placed in social media advertisements about zebra mussels to determine the impact each message frame had on user online behavior. For cost-per-click (CPC), ANOVA showed effects for framing and gender. Model coefficients revealed that Hitchhiker and Protective had significantly higher CPC than Science, and that women had a higher CPC. For comments, ANOVA showed effects for framing and gender. Model coefficients revealed that no frame had a significantly different effect on comments than Science, and that women commented on posts less. For shares, ANOVA showed effects for framing. Model coefficients revealed that Hitchhiker was shared more than Science. It is important to note that neither Militaristic nor Nativist outperformed Science on any measured outcome. Coupled with ethical considerations, our results suggest the use of Nativist and Militaristic frames are not necessary to influence online behavior. Message frames without ethical issues can be used to achieve the outcomes we tested without compromising message effectiveness. Within this article, we provide background on commonly used invasive species message frames, explain our methods for testing how they impact user behavior, and suggest limitations and applications of this work.

Unusually sited lower third molar.

We present the case of a 60-year-old woman who presented to our unit with left-sided facial swelling, pain and trismus. Initially managed as a parotitis by a different specialty, an ultrasound subsequently showed a collection deep to the parotid associated with an ectopic wisdom tooth within the mandibular posterior ramus/condyle and the patient was referred to our department. After treating the acute infection, the wisdom tooth was surgically removed. Our case highlights the importance of the clinician maintaining an open mind to differential diagnoses and details a technique for surgical removal of a tooth with difficult access.

Scale-up and operation of a pilot-scale ammonia fiber expansion reactor.

Pretreatment and densification of agricultural residues at regional depots can simplify feedstock supply logistics for the production of biofuels in commercial biorefineries. We have previously reported the performance of a laboratory-scale (5 L) packed-bed ammonia fiber expansion (AFEX) reactor system, which showed significant promise for biomass pretreatment at distributed depots. In this paper, we describe the performance of a 90-fold larger pilot-scale packed-bed AFEX-reactor system, used to produce over 1,500 batches (~36 tons) of pretreated crop residues over a 5-year period. Virtually all unreacted ammonia was successfully removed from the biomass, and 76% of the ammonia was recycled and reused. Pretreatment performance at pilot scale was comparable to laboratory-scale, averaging 74% glucose and 75% xylose yield in a standard test compared with 71% and 73%, respectively. Other operating and maintenance aspects are also discussed.

Exposure Assessment of Acetamide in Milk, Beef, and Coffee Using Xanthydrol Derivatization and Gas Chromatography/Mass Spectrometry.

Acetamide has been classified as a possible human carcinogen, but uncertainties exist about its levels in foods. This report presents evidence that thermal decomposition of N-acetylated sugars and amino acids in heated gas chromatograph injectors contributes to artifactual acetamide in milk and beef. An alternative gas chromatography/mass spectrometry protocol based on derivatization of acetamide with 9-xanthydrol was optimized and shown to be free of artifactual acetamide formation. The protocol was validated using a surrogate analyte approach based on d3-acetamide and applied to analyze 23 pasteurized whole milk, 44 raw sirloin beef, and raw milk samples from 14 different cows, and yielded levels about 10-fold lower than those obtained by direct injection without derivatization. The xanthydrol derivatization procedure detected acetamide in every food sample tested at 390 ± 60 ppb in milk, 400 ± 80 ppb in beef, and 39 000 ± 9000 ppb in roasted coffee beans.

Animalism and the varieties of conjoined twinning.

We defend the view that we are not identical to organisms against the objection that it implies that there are two subjects of every conscious state one experiences: oneself and one's organism. We then criticize animalism--the view that each of us is identical to a human organism--by showing that it has unacceptable implications for a range of actual and hypothetical cases of conjoined twinning: dicephalus, craniopagus parasiticus, and cephalopagus.

Emerging disease burdens and the poor in cities of the developing world.

Patterns of future urban growth, combined with advances in the treatment of traditional scourges of communicable diseases, will cause a shift in the burden of disease toward category 2 (noncommunicable) and 3 (injury) conditions over the next 30 years. Communicable diseases, particularly HIV/AIDs, will continue to be the most important killers among the poor. However, new risks will emerge for several reasons. First, the marked sprawl of cities in the developing world will make access to care more difficult. Second, increasing motor vehicles and the likelihood of inadequate infrastructure will make air pollution and accidents in road traffic more common than in the past. Third, impoverished urban populations have already shown a propensity toward undernourishment, and its obverse, obesity, is already emerging as a major risk. Also, the large projected increase in slums suggests that violence and homicide will become a more important burden of health, and very large hazards will be created by fire-prone, insubstantial dwellings that will house nearly two billion people by 2030. In addition, decentralized governance will exacerbate the tensions and discontinuities that have plagued the management of health issues on the urban fringe over the past decade. Accordingly, public health agencies will need to adjust to the regional and country-specific factors to address the changing profile of risk. This analysis suggests that four factors--levels of poverty, speed of city growth, sprawl in cities, and degree of decentralization--will have importance in shaping health strategies. These factors vary in pace and intensity by region, suggesting that health care strategies for Category II and III conditions will need to be differentiated by region of the world. Also, interventions will have to rely increasingly on actors outside the ranks of public health specialists.