Newborn hearing screening methodology impacts the timing of diagnosis for auditory neuropathy spectrum disorder.

INTRODUCTION: Auditory Neuropathy Spectrum Disorder (ANSD) accounts for 10 % to 15 % of pediatric hearing loss. In most cases, otoacoustic emissions (OAE) are present as the outer hair cell function is normal, and the auditory brainstem response (ABR) is abnormal. Newborn hearing screen (NBHS) is completed using OAE or ABR depending on the institution. Because OAEs are often present in ANSD, NBHS done solely with OAE can miss and delay diagnosis of patients with ANSD. OBJECTIVES: To assess whether NBHS methodology impacts the age of diagnosis of ANSD. METHODS: This is a retrospective study of patients, 0-18 years of age, diagnosed with ANSD at two tertiary pediatric hospitals from 1/01/2010 to 12/31/2018 after referral from NBHS performed in the community. Data recorded included patient demographics, method of NBHS, NICU stay, and age at ANSD diagnosis. RESULTS: 264 patients were diagnosed with ANSD. Of those, 123 (46.6 %) were female, and 141 (53.4 %) were male. Ninety-seven (36.8 %) were admitted to NICU and the mean stay was 6.98 weeks (STD = 10.7; CI = 4.8-9.1). The majority (244, 92.4 %) of patients had NBHS with ABR, and 20 (7.5 %) had NBHS with OAE. Patients screened with ABR were diagnosed with ANSD earlier than those who screened with OAE, with a mean age of 14.1 versus 27.3 weeks (p = 0.0397, CI = 15.2-39.3). Among those screened with ABR, median age at diagnosis was 4 months for NICU infants and 2.5 months for infants with no history of NICU stay over 5 days. In comparison, median diagnosis age was 8 months for non-NICU infants screened with OAEs. CONCLUSION: Patients with ANSD who had NBHS with ABR were diagnosed earlier than those with OAE. Our data suggest that universal screening with ABR may facilitate earlier diagnosis of ANSD and earlier evaluation for aural rehabilitation, especially in high-risk cohorts such as NICU patients. Further research is needed into factors that contribute to earlier diagnosis among patients screened with ABR.

The Quality of Otolaryngology- Head and Neck Surgery Literature over the Last Decade.

OBJECTIVE: To describe the changes in the quality of the Otolaryngology-Head and Neck Surgery (OTOHNS) literature over the last decade, and compare it to other surgical-based fields. METHODS: Based on impact factors, the top eight clinical U.S. OTOHNS journals were selected, and articles were analyzed from 2020 (Oto 2020) and compared to 2010 (Oto 2010). This was done similarly for Neurosurgery, Orthopedic, Ophthalmology, and General Surgery journals in 2020 (non-Oto). To limit bias and account for random variability, the first 10 research articles from each journal in each group were included. Data regarding the study type, level of evidence, use of confidence intervals, and funding source were collected. RESULTS: Based on an a priori power analysis, 160 articles were analyzed for Oto 2010 and Oto 2020. Compared to Oto 2020, Oto 2010 had more level 1 and 2 evidence (12 vs. 4; p = 0.032) and less reporting of confidence intervals (10 vs. 32; p < 0.001). Comparing the top 160 articles from 2020 from Non-Oto and OTOHNS (Oto), Non-Oto had more level 1 and 2 evidence (19 vs. 6; p = 0.0047), more randomized controlled trials (8 vs. 1; p = 0.016), and less reporting of confidence intervals (42 vs. 58; p = 0.009). CONCLUSION: High quality studies remain relatively scarce in the OTOHNS literature. Although reporting of confidence intervals has improved over the last decade, aggregate levels of evidence and extramurally funded studies lag behind other surgical-based fields. Better study design will provide stronger evidence basis, in hopes of improving clinical care. LEVEL OF EVIDENCE: N/A Laryngoscope, 133:1853-1856, 2023.

In-Field Evaluation of Drone-Released Lacewings for Aphid Control in California Organic Lettuce.

Aphids are one of the most economically important pests to California's Central Coast lettuce industry. Aphids vector the lettuce mosaic virus and are crop contaminants in the packaging of the product. Lettuce aphid, Nasonovia ribisnigri (Mosley) (Hemiptera: Aphididae), is one of the predominant aphid species in lettuce, and it poses unique management challenges forming colonies inside the lettuce head. Current management practices rely on repeated foliar insecticide applications to reduce aphid densities per plant. Some organic growers have explored the release of laboratory-reared beneficial insects to manage aphids in their commercial fields. This project sought to document the effects of drone-released lacewing eggs on lettuce aphid densities in organic romaine lettuce fields. Commercially reared lacewing eggs were released at a rate of 74,131 eggs/ha and organic-certified insecticides were sprayed following their respective label recommendations. Our results could be interpreted as preliminary evidence that drone release of lacewings could reduce aphid densities (15.6-150.0 aphids/lettuce head) when compared to the untreated plots (32.1-257.9 aphids/lettuce head). Aphid densities were also decreased after the application of foliar organic-certified insecticides (11.77-143.5). Traditionally, the cost of labor has limited the use of beneficials in the lettuce production system, but the use of drones for these releases may make this strategy more attractive. Based on our calculations, spraying an organic-certified insecticide is less expensive (direct operational costs of U.S. $ 116.36/ha) than releasing beneficial insects by hand ($ 185.40) or by drone ($ 176.00) when mimicking the conditions of this study.