Can information from citizen science data be used to predict biodiversity in stormwater ponds?

Citizen science data (CSD) have the potential to be a powerful scientific approach to assess, monitor and predict biodiversity. Here, we ask whether CSD could be used to predict biodiversity of recently constructed man-made habitats. Biodiversity data on adult dragonfly abundance from all kinds of aquatic habitats collected by citizen scientists (volunteers) were retrieved from the Swedish Species Observation System and were compared with dragonfly abundance in man-made stormwater ponds. The abundance data of dragonflies in the stormwater ponds were collected with a scientific, standardized design. Our results showed that the citizen science datasets differed significantly from datasets collected scientifically in stormwater ponds. Hence, we could not predict biodiversity in stormwater ponds from the data collected by citizen scientists. Using CSD from past versus recent years or from small versus large areas surrounding the stormwater ponds did not change the outcome of our tests. However, we found that biodiversity patterns obtained with CSD were similar to those from stormwater ponds when we restricted our analyses to rare species. We also found a higher beta diversity for the CSD compared to the stormwater dataset. Our results suggest that if CSD are to be used for estimating or predicting biodiversity, we need to develop methods that take into account or correct for the under-reporting of common species in CSD.

Oxidative Stress in the Blood Labyrinthine Barrier in the Macula Utricle of Meniere's Disease Patients.

The blood labyrinthine barrier (BLB) is critical in the maintenance of inner ear ionic and fluid homeostasis. Recent studies using imaging and histopathology demonstrate loss of integrity of the BLB in the affected inner ear of Meniere's disease (MD) patients. We hypothesized that oxidative stress is involved in the pathogenesis of BLB degeneration, and to date there are no studies of oxidative stress proteins in the human BLB. We investigated the ultrastructural and immunohistochemical changes of the BLB in the vestibular endorgan, the macula utricle, from patients with MD (n = 10), acoustic neuroma (AN) (n = 6) and normative autopsy specimens (n = 3) with no inner ear disease. Each subject had a well-documented clinical history and audiovestibular testing. Utricular maculae were studied using light and transmission electron microscopy and double labeling immunofluorescence. Vascular endothelial cells (VECs) were identified using isolectin B4 (IB4) and glucose-transporter-1 (GLUT-1). Pericytes were identified using alpha smooth muscle actin (αSMA) and phalloidin. IB4 staining of VECS was consistently seen in both AN and normative. In contrast, IB4 was nearly undetectable in all MD specimens, consistent with the significant VEC damage confirmed on transmission electron microscopy. GLUT-1 was present in MD, AN, and normative. αSMA and phalloidin were expressed consistently in the BLB pericytes in normative, AN specimen, and Meniere's specimens. Endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS), and nitrotyrosine were used as markers of oxidative stress. The VECs of the BLB in Meniere's had significantly higher levels of expression of iNOS and nitrotyrosine compared with normative and AN specimen. eNOS-IF staining showed similar patterns in normative and Meniere's specimens. Microarray-based gene expression profiling confirmed upregulation of iNOS mRNA from the macula utricle of Meniere's patients compared with AN. Nitrotyrosine, a marker recognized as a hallmark of inflammation, especially when seen in association with an upregulation of iNOS, was detected in the epithelial and stromal cells in addition to VECs in MD. Immunohistochemical and ultrastructural degenerative changes of the VEC suggest that these cells are the primary targets of oxidative stress, and pericyte pathology including degeneration and migration, likely also plays a role in the loss of integrity of the BLB and triggering of inflammatory pathways in MD. These studies advance our scientific understanding of oxidative stress in the human inner ear BLB and otopathology.

Sudden hearing loss after cialis (tadalafil) use: A unique case of cochlear hydrops.

We discuss a unique case of sudden sensorineural hearing loss after Cialis (tadalafil) use, a phosphodiesterase 5 (PDE5) inhibitor, and the implication of ipsilateral cochlear hydrops seen on magnetic resonance imaging (MRI). We report a case of a 53-year-old male with unilateral low-frequency sudden sensorineural hearing loss (SSNHL) after ingestion of tadalafil. The SSNHL occurred 1 day after ingestion and was associated with aural fullness and tinnitus. There were no symptoms of vertigo. He received oral prednisone immediately after the onset of hearing loss without improvement. Delayed intravenous contrast-enhanced three-dimensional Fluid-attenuated inversion recovery MRI revealed ipsilateral dilation of the cochlear duct without any hydronic change in the vestibular system. Acetazolamide therapy was initiated, and his symptoms improved. A posttreatment audiogram revealed an increase in threshold of 15 dB. To the best of our knowledge, this is the first case of cochlear hydrops visualized on imaging after a PDE5 inhibitor induced SSNHL. Tadalafil and other PDE5 inhibitors have a known association with SSNHL. Despite several proposed mechanisms, there is inconclusive evidence of a causal relationship. Our presented case suggests that cochlear hydrops may be one possible mechanism of PDE5 inhibitor-associated SSNHL. MRI should be considered in the evaluation of such patients who do not respond to oral steroids as initial treatment. Laryngoscope, 2615-2618, 2018.

Intraosseous mucoepidermoid carcinoma: Outcome review.

OBJECTIVE: Identify the effect of patient characteristics, disease traits, and treatment modality on patient outcomes in the rare disease process of intraosseous mucoepidermoid carcinoma. STUDY DESIGN: Retrospective review of institutional case records and literature. METHODS: This study includes one case report, a literature review of the MEDLINE database from 1950 through June 2017 using keywords "intraosseous" and "mucoepidermoid," and a query of the University of California, Los Angeles, Department of Pathology database for all documented cases of intraosseous mucoepidermoid carcinoma of the head and neck. RESULTS: Indicators of poorer prognosis were male gender (P = 0.0071) and higher histological grade (P = 0.0095). Lesion site, size, association with odontogenic cyst, and treatment type did not have a statistically significant correlation with patient outcomes. There also was no statistically significant correlation observed between treatment modality and recurrent or progressive disease when stratified by histological grade of the cancer. CONCLUSION: This study identified male gender and high histological tumor grade as poor prognostic indicators; however, it did not reveal a statistically significant relationship between treatment modality and patient outcomes. Data regarding patient outcomes following treatment was limited due to loss to follow-up, suggesting that further investigation is required. Based on this review, decisions regarding treatment should be clinically guided and individually tailored to the patient's baseline health, disease severity, and the patient's treatment goals. A multi-disciplinary conference, as was utilized in the presented case report, may be the best approach to treatment planning for these patients at this time. LEVEL OF EVIDENCE: 4. Laryngoscope, 128:1083-1092, 2018.

Recurrent Vestibular Migraine Vertigo Attacks Associated With the Development of Profound Bilateral Vestibulopathy: A Case Series.

BACKGROUND: Bilateral vestibulopathy (BVP) is a debilitating condition characterized by gait ataxia, oscillopsia, and imbalance. OBJECTIVE: Case series of patients with migraine-linked vertigo spells and profound BVP. PATIENT 1:: A 69-year-old man presented with a history of recurrent severe vertigo spells lasting up to 3 days in duration associated with prostrating migraine headaches starting at age 60. His symptoms were misdiagnosed as an anxiety syndrome. At age 68, electronystagmography (ENG) revealed bilaterally absent caloric responses and complete BVP. His hearing was normal. PATIENT 2:: A 51-year-old man presented with a history of "earthquake-like" vertigo, sharp head pain, and phonophobia. These episodes occurred a handful of times over a 7-year period. Previous ENG testing at age 43 was normal. However, his ENG at age 48 revealed complete BVP. He was started on acetazolamide and noted improved balance, although subsequent ENG was unchanged. PATIENT 3:: A 49-year-old woman presented with a history of recurrent migraines with visual aura associated with vertigo lasting 1 hour. ENG at age 50 revealed complete BVP. Subjectively, she noted improved balance with acetazolamide and subsequent ENG demonstrated mild improvement. PATIENT 4:: A 43-year-old man presented with a 5-year history of optical migraines and recurrent vertigo spells, lasting 30 seconds, which was misdiagnosed as positional vertigo. He additionally had a 10-year history of oscillopsia. ENG at age 61 revealed complete BVP. CONCLUSION: In these cases, vestibular migraine was linked to recurrent vertigo spells that eventually led to complete bilateral vestibulopathy.

Facial nerve stimulation following cochlear implantation for X-linked stapes gusher syndrome leading to identification of a novel POU3F4 mutation.

We report a case of a nine-year-old male who presented with facial nerve stimulation four years after cochlear implantation. Computed tomography was performed revealing a dilated internal auditory meatus and the cochlear implant electrode was found to be protruding into the fallopian canal at the level of the geniculate ganglion. Subsequent genetic analysis demonstrated X-linked deafness type 2 (DFNX2) caused by a novel c.769C > T nucleotide change in the POU domain, class 3, transcription factor 4 gene (POU3F4). Inactivation of electrodes 1 and 19-21 successfully abated facial nerve stimulation.

Surgical outcomes in the elderly patient after osteocutaneous free flap transfer.

OBJECTIVES/HYPOTHESIS: Morbidity of free tissue transfer in the elderly patient is controversial. Recent studies have shown no significant difference in elderly fasciocutaneous free-flap donor site morbidity. The purpose of this study is to assess surgical outcomes in elderly patients receiving osteocutaneous free-tissue transfer. STUDY DESIGN: Retrospective chart review of patients 70 years and older undergoing osteocutaneous free flaps from 2000 to 2013. METHODS: Fibular, radial forearm, and scapular flaps were reviewed. Younger patients randomly selected from the same time period served as controls. Data collected included donor site morbidity, flap complications, feeding tube and tracheostomy dependence, and hospital stay. RESULTS: Forty-four osteocutaneous free flaps were performed in elderly patients. Overall, there was no significant difference in donor site morbidity between older and younger patients (P = 0.50) (tendon exposure, P = 1.00; split-thickness skin graft loss, P = 0.36; infections, P = 0.52; dehiscence, P = 1.00; and seroma, P = 1.00). There was no significant difference between older and younger patients being decannulated (P = 0.61) or the time to decannulation (P = 0.24). There was no difference in those who returned to baseline diet (P = 0.67). All patients returned to baseline ambulatory and shoulder status. Length of postoperative hospitalization (P = 0.78) and intensive care unit stay (P = 0.94) were also equal. The only significant difference was that more elderly patients were discharged to skilled nursing facilities (SNF) (40.9% vs. 15.9%, P < 0.01). CONCLUSION: Elderly patients undergoing free tissue transfer have similar flap and donor site outcomes, feeding tube and tracheostomy outcomes, ambulatory status, and hospital stays compared to younger patients. They are, however, more likely to require SNF care posthospitalization. LEVEL OF EVIDENCE: 4.

AlloDerm with split-thickness skin graft for coverage of the forearm free flap donor site.

OBJECTIVE: Major causes of donor site morbidity after free flap harvest are lack of split-thickness skin graft (STSG) take and tendon exposure. Long-term cosmesis remains poor. AlloDerm has shown cosmetically better donor site healing, albeit prolonged healing. We sought to evaluate the use of STSG with AlloDerm compared with STSG alone. STUDY DESIGN: Case series with chart review. SETTING: Academic tertiary care medical center. METHODS AND SUBJECTS: Institutional review board-approved study. Microvascular database queried from 2002 to 2012. Subjects with forearm free flaps and either AlloDerm + STSG or STSG alone for donor site reconstruction were included. Morbidity outcomes were compared. RESULTS: Eighty patients (50 male, 30 female) received AlloDerm + STSG at the donor site. Major and minor donor site complications were 15.0% and 18.8% in the AlloDerm + STSG group compared with 10.2% and 16.9% in the STSG-only group (P = .30 and P = .72), respectively. Complete STSG loss (5.0% vs 3.0%, P = .48), tendon exposure (5.0% vs 5.4%, P = 1.0), functional impairment (2.5% vs 1.8%, P = .66), infection (8.8% vs 9.6%, P = 1.0), hematoma/seroma (5.0% vs 3.6%, P = .73), and paresthesia (1.3% vs 3.6%, P = .43) were not significant. No patients required a second STSG after loss in the AlloDerm + STSG group compared with 60% (P = .17). Cosmetic results were superior in the AlloDerm + STSG group as rated by the surgeon (3.5 vs 2.6, P = .03) and patients (3.7 vs 2.9, P = .05) on a scale of 1 to 5. CONCLUSION: Our results suggest that the use of AlloDerm with STSG can provide thicker coverage of the forearm defect, with minimal donor site morbidity and superior cosmetic results compared with STSG alone.

Efficacy of free flap reconstruction of the head and neck in patients 90 years and older.

OBJECTIVE: To determine the efficacy of free flap reconstruction in patients 90 years and older. DESIGN: Retrospective medical chart review. SETTING: Academic medical center. PATIENTS: Patients 90 years and older who underwent a free flap reconstruction from 2002 through 2011 were identified. MAIN OUTCOME MEASURES: Clinical, demographic, and procedural data were recorded. Complications of surgery were either medical or flap related. Long-term follow-up was recorded to determine late flap complications, donor site morbidity, and functional outcomes. RESULTS: Of 847 free flaps, 10 (1.2%) were performed in patients 90 years and older, with a median follow-up time of 8.5 months. Four medical complications (40%) occurred (1 case of pneumonia and 3 cases of arrhythmia). There were no mortalities. Two recipient site complications (20%) occurred (1 infection and 1 fistula). The flap failure rate was 0%. One late complication developed 7 months postoperatively involving infection and nonunion of the mandibular reconstruction. There was donor site morbidity in 1 patient. Functional status returned to baseline in 8 patients (80%) at the last follow-up visit. CONCLUSIONS: Medical and flap-related complications in patients 90 years and older are consistent with rates previously reported in elderly patients. Furthermore, patients 90 years and older can tolerate free flap reconstruction with favorable long-term outcomes.

Airway reconstruction in Wegener's granulomatosis-associated laryngotracheal stenosis.

OBJECTIVES/HYPOTHESIS: Open airway reconstruction is considered definitive treatment of laryngotracheal stenosis (LTS). Although most cases of LTS are not autoimmune, there are few data reported in patients with Wegener's granulomatosis. In this study, we aimed to assess outcomes of airway reconstruction in LTS patients with Wegener's compared to nonautoimmune patients. STUDY DESIGN: Retrospective chart review of LTS cases managed with open airway reconstruction at an academic medical center. METHODS: Patients who underwent open airway reconstruction for LTS due to Wegener's or nonautoimmune causes were identified from 1995 to 2010. Clinical, demographic, and procedural data were recorded. Fisher exact test, Mann-Whitney U test, and McNemar's test were used to test for significance. RESULTS: A total of 53 patients were identified; eight Wegener's, 45 nonautoimmune, with median follow-up time of 8.3 and 1.8 years, respectively. Before reconstruction, there was no statistical difference between Wegener's and nonautoimmune patients with previous dilations (88% vs. 68%, P = .41) and tracheostomy dependence (50% vs. 42%, P = .72). Following reconstruction, 75% Wegener's and 36% nonautoimmune patients required further dilations (P = .05), with a decannulation rate of 75% and 58% (P = 1.0), respectively. CONCLUSIONS: Wegener's patients have an increased need for dilations after open airway reconstruction for LTS. However, these patients can be decannulated after surgery at a rate similar to patients with nonautoimmune LTS.