Role of prior intratympanic gentamicin and corticosteroids therapy on speech understanding in patients with Menière's disease after cochlear implantation.

AIM: Intratympanic injection of corticosteroids (ITC) and gentamicin therapy (ITG) are widely used treatments for vertigo in Meniere's disease (MD). Even though studies show good results after cochlea implantation (CI) in MD patients when compared to non-MD groups, there is no indication on the effect of ITC and ITG prior to CI on hearing after CI. This study compares the post-operative hearing of CI patients with and without MD and patients who have received ITG or ITC prior to CI. METHODS: In a retrospective case control study, adult patients with MD who received CI from 2002 till 2021 were compared to a matched control group of CI patients without MD. Patients with prior ITC/ITG were extracted from MD group. Pre-operative audiological results were measured and trends across post-operative monosyllabic word recognition score at 65 decibels (WRS65CI) at switch-on, 3-6 months, 1 year and last yearly value were analyzed across all groups. RESULTS: 28 MD ears were compared with 33 control ears. From MD ears 9 had received ITG and 6 ITC prior to CI. WRS65CI increased significantly with time within MD and control groups, but no difference in WRS65CI was found between these 2 groups. ITG ears showed fluctuating WRS65CI after CI with no change across time, while ITC ears showed significant increase in trend of WRS65CI values across time. CONCLUSION: MD and non-MD patients showed comparable hearing results after CI. Prior ITC might positively influence hearing preservation after CI in MD patients whereas ITG group showed fluctuating hearing.

Role of cochlear reserve in adults with cochlear implants following post-lingual hearing loss.

INTRODUCTION: Pre-operative assessments before cochlear implantation (CI) includes the examination of both tone hearing, and the level of the cochlear reserve indicated by speech understanding. The goal of this study was to explore the predictive influence of tone hearing and cochlear reserve in CI. METHODS: We did a retrospective cohort study, which included adult patients who had undergone CI between January 2012 and December 2019 in a tertiary care center. The pre-operative tone hearing, unaided maximum monosyllabic word recognition score (WRSmax), aided hearing gain, aided monosyllabic word recognition score at 65 dB (WRS65(HA)), and speech perception gap (SPG) were measured. The duration of unaided hearing loss (UHL) was also assessed. These variables were compared with post-operative monosyllabic word recognition score after CI at 65 dB (WRS65(CI)). RESULTS: 103 patients and 128 ears were included in this study. Regardless of tone hearing, patients with better pre-operative WRSmax and WRS65(HA) performed better post-operatively. WRSmax was found to be the most important factor that was statistically significantly associated with WRS65(CI). SPG was statistically significantly associated with WRSmax and SPG ≥ 20% group performed better post-operatively. Any duration of unaided hearing loss was statistically significantly inversely associated with WRSmax above 0%. CONCLUSION: Cochlear reserve represented by WRSmax may play the most important role as a predictive factor in outcomes after CI. SPG should be considered for indicating CI in patients, when WRS65(HA) does not reach WRSmax. Early rehabilitation with hearing aids and duration of hearing aid usage might play an important role in preserving cochlear reserve in adults.

Analysis of Genomic DNA from Medieval Plague Victims Suggests Long-Term Effect of Yersinia pestis on Human Immunity Genes.

Pathogens and associated outbreaks of infectious disease exert selective pressure on human populations, and any changes in allele frequencies that result may be especially evident for genes involved in immunity. In this regard, the 1346-1353 Yersinia pestis-caused Black Death pandemic, with continued plague outbreaks spanning several hundred years, is one of the most devastating recorded in human history. To investigate the potential impact of Y. pestis on human immunity genes, we extracted DNA from 36 plague victims buried in a mass grave in Ellwangen, Germany in the 16th century. We targeted 488 immune-related genes, including HLA, using a novel in-solution hybridization capture approach. In comparison with 50 modern native inhabitants of Ellwangen, we find differences in allele frequencies for variants of the innate immunity proteins Ficolin-2 and NLRP14 at sites involved in determining specificity. We also observed that HLA-DRB1*13 is more than twice as frequent in the modern population, whereas HLA-B alleles encoding an isoleucine at position 80 (I-80+), HLA C*06:02 and HLA-DPB1 alleles encoding histidine at position 9 are half as frequent in the modern population. Simulations show that natural selection has likely driven these allele frequency changes. Thus, our data suggest that allele frequencies of HLA genes involved in innate and adaptive immunity responsible for extracellular and intracellular responses to pathogenic bacteria, such as Y. pestis, could have been affected by the historical epidemics that occurred in Europe.

Interferometric Constraints on Spacelike Coherent Rotational Fluctuations.

Precision measurements are reported of the cross-spectrum of rotationally induced differential position displacements in a pair of colocated 39 m long, high-power Michelson interferometers. One arm of each interferometer is bent 90° near its midpoint to obtain sensitivity to rotations about an axis normal to the plane of the instrument. The instrument achieves quantum-limited sensing of spatially correlated signals in a broad frequency band extending beyond the 3.9-MHz inverse light travel time of the apparatus. For stationary signals with bandwidth Δf>10 kHz, the sensitivity to rotation-induced strain h of classical or exotic origin surpasses CSD_{δh}

Hearing rehabilitation after subtotal cochleoectomy using a new, perimodiolar malleable cochlear implant electrode array: a preliminary report.

PURPOSE: We here report about the first surgical experience and audiological outcome using a new, perimodiolar malleable cochlear implant electrode array for hearing rehabilitation after subtotal cochleoectomy for intralabyrinthine schwannoma (ILS). METHOD: Based on a cochlear implant with MRI compatibility of the magnet in the receiver coil up to 3 T, a cochlear implant electrode array was developed that is malleable and can be placed perimodiolar after tumor removal from the cochlea via subtotal cochleoectomy. Malleability was reached by incorporating a nitinol wire into the silicone of the electrode array lateral to the electrode contacts. The custom-made device was implanted in four patients with intracochlear, intravestibulocochlear or transmodiolar schwannomas. Outcome was assessed by evaluating the feasibility of the surgical procedure and by measuring sound field thresholds and word recognition scores. RESULTS: After complete or partial tumor removal via subtotal cochleoectomy with or without labyrinthectomy, the new, perimodiolar malleable electrode array could successfully be implanted in all four patients. Six months after surgery, the averaged sound field thresholds to pulsed narrowband noise in the four patients were 36, 28, 41, and 35 dB HL, and the word recognitions scores for monosyllables at 65 dB SPL were 65, 80, 70, and 25% (one patient non-German speaking). CONCLUSION: The surgical evaluation demonstrated the feasibility of cochlear implantation with the new, perimodiolar malleable electrode array after subtotal cochleoectomy. The audiological results were comparable to those achieved with another commercially available type of perimodiolar electrode array from a different manufacturer applied in patients with ILS.

First Measurements of High Frequency Cross-Spectra from a Pair of Large Michelson Interferometers.

Measurements are reported of the cross-correlation of spectra of differential position signals from the Fermilab Holometer, a pair of colocated 39 m long, high power Michelson interferometers with flat broadband frequency response in the MHz range. The instrument obtains sensitivity to high frequency correlated signals far exceeding any previous measurement in a broad frequency band extending beyond the 3.8 MHz inverse light-crossing time of the apparatus. The dominant but uncorrelated shot noise is averaged down over 2×10^{8} independent spectral measurements with 381 Hz frequency resolution to obtain 2.1×10^{-20}m/sqrt[Hz] sensitivity to stationary signals. For signal bandwidths Δf>11 kHz, the sensitivity to strain h or shear power spectral density of classical or exotic origin surpasses a milestone PSD_{δh}

Photon emission spectrum of ion pumps.

As the sensitivity of gravitational-wave detectors increases, new sources of noise appear. A potential source of noise may arise from charge accumulating on the mirrors of the experiment, the origin of which can be related to UV photons from the surroundings. In order to test one hypothesis, we measured the photon emission spectrum from a type of ion pump that is used in the experiment, an Agilent VacIon Plus 2500 l/s. We found that there is significant emission of UV photons above 5 eV, capable of knocking electrons off mirrors or surrounding surfaces and charging them. Photon emission measurements were taken as a function of gas pressure, ion-pump voltage setting, and type of pumped gas. The overall emission and shape of the measured photon spectrum are consistent with bremsstrahlung as the mechanism for the production of the photons.

Epidemiological insights from a large-scale investigation of intestinal helminths in Medieval Europe.

Helminth infections are among the World Health Organization's top neglected diseases with significant impact in many Less Economically Developed Countries. Despite no longer being endemic in Europe, the widespread presence of helminth eggs in archaeological deposits indicates that helminths represented a considerable burden in past European populations. Prevalence of infection is a key epidemiological feature that would influence the elimination of endemic intestinal helminths, for example, low prevalence rates may have made it easier to eliminate these infections in Europe without the use of modern anthelminthic drugs. To determine historical prevalence rates we analysed 589 grave samples from 7 European sites dated between 680 and 1700 CE, identifying two soil transmitted nematodes (Ascaris spp. and Trichuris trichiura) at all locations, and two food derived cestodes (Diphyllobothrium latum and Taenia spp.) at 4 sites. The rates of nematode infection in the medieval populations (1.5 to 25.6% for T. trichiura; 9.3-42.9% for Ascaris spp.) were comparable to those reported within modern endemically infected populations. There was some evidence of higher levels of nematode infection in younger individuals but not at all sites. The genetic diversity of T. trichiura ITS-1 in single graves was variable but much lower than with communal medieval latrine deposits. The prevalence of food derived cestodes was much lower (1.0-9.9%) than the prevalence of nematodes. Interestingly, sites that contained Taenia spp. eggs also contained D. latum which may reflect local culinary practices. These data demonstrate the importance of helminth infections in Medieval Europe and provide a baseline for studies on the epidemiology of infection in historical and modern contexts. Since the prevalence of medieval STH infections mirror those in modern endemic countries the factors affecting STH decline in Europe may also inform modern intervention campaigns.

Differences of radiological artefacts in cochlear implantation in temporal bone and complete head.

OBJECTIVES: Accurate radiological evaluation of cochlear implants is essential for improvement of devices and techniques and also for assessing the position of the electrodes within the cochlea. Radiological study of implants has focused on isolated temporal bones. Previous studies showed relevant sizes of artefacts (dimensions of the radiological image compared with the actual dimensions of the electrode) in visualization of cochlear implants in computed tomography and cone beam computed tomography (CBCT). In this study, we aimed to obtain CBCT images of cochlear electrodes in isolated temporal bones and in whole heads and to assess the differences in image quality between the two. METHODS: Cochlear electrodes were implanted in three complete human heads. Radiological examinations were performed using a single CBCT scanner with varying x-ray tube currents, voltages, and rotation angles. The temporal bones were then removed and the same radiological examinations were repeated, with and without the receiver coils. Artefacts from a basal electrode (electrode 9) and an apical electrode (electrode 2) were calculated. These were compared with each other by measuring the diameter of the image of the electrode (electrode inclusive of imaging artefacts) and with the real electrode diameters from the manufacturer's data. Additionally, the radiological diameters (inclusive of artefact) of the electrodes were compared to the cross-sectional diameters of the basal and apical coils of the cochlea at the locations of these two electrodes. RESULTS: In comparison to the real electrode diameters, radiological artefact proportions of 51-58% for electrode 9 and 56-61% for electrode 2 were calculated. The differences between whole head images (group 1) and temporal bone images with and without the receiver coil (groups 2 and 3) were highly significant for each protocol (P < 0.001). DISCUSSION AND CONCLUSION: These results indicate that it is not possible reliably to determine the exact intracochlear positions of electrodes using CBCT. Imaging of isolated temporal bones produced significantly greater artefacts than imaging of the whole head. Evaluations of image quality based only on results for isolated temporal bones are not transferable to clinical situations, and should be assessed critically.

Visualisation of the Bonebridge by means of CT and CBCT.

BACKGROUND: With the Bonebridge, a new bone-anchored hearing aid has been available since March 2012. The objective of the study was to analyse the visualisation of the implant itself as well as its impact on the representation of the bony structures of the petrosal bone in CT, MRI and cone beam CT (CBCT). METHODS: The Bonebridge was implanted unilaterally in two completely prepared human heads. The radiological imaging by means of CBCT, 64-slice CT, 1.5-T and 3.0-T MRI was conducted both preoperatively and postoperatively. The images were subsequently evaluated from both the ENT medical and nd radiological perspectives. RESULTS: As anticipated, no visualisation of the implant or of the petrosal bones could be realised on MRI because of the interactive technology and the magnet artefact. In contrast, an excellent evaluability of the implant itself as well as of the surrounding neurovascular structures (sinus sigmoideus, skull base, middle ear, inner ear, inner auditory canal) was exhibited in both the CT and in the CBCT. CONCLUSION: The Bonebridge can be excellently imaged with the radiological imaging technologies of CT and CBCT. In the process, CBCT shows discrete advantages in comparison with CT. No relevant restrictions in image quality in the evaluation of the bony structures of the petrosal bones could be seen.

Crystal structure and thermochemical reactivity of an unusual copper complex that contains copper in four different coordination geometries.

According to X-ray single-crystal structure analysis, {[Cu(II)(en)2]2[Cu(I)2(CN)6]}[Cu(II)(en)2]2[Cu(I)(CN)3]2.2H2O contains copper in four different coordination environments: trigonal planar, square planar, square pyramidal and tetrahedral. The different coordination geometries of copper were investigated by quantum chemical calculations of model compounds, thus allowing to tentatively assign the different CN-bands in the IR spectrum. The thermolysis led to sub-microm sized rod-like copper(II) oxide particles.

Solid-state laser intensity stabilization at the 10(-8) level.

A high-power, low-noise photodetector, in conjunction with a current shunt actuator, is used in an ac-coupled servo to stabilize the intensity of a 10-W cw Nd:YAG laser. A relative intensity noise of 1 x 10(-8) Hz(-1/2) at 10 Hz is achieved.