Quality control in cochlear implant therapy: clinical practice guidelines and registries in European countries.

PURPOSE: The treatment with a cochlear implant (CI) is the gold standard in therapy of patients with profound hearing loss or deafness. Successful hearing rehabilitation with a CI is a complex, multi-stage process. In medicine, "Clinical Practice Guidelines" (CPG) are widely accepted for the standardization of such processes. These are supplemented by medical registries in which data regarding the treatment can be collected and evaluated. The aim of this paper is to identify currently existing CI-related CPGs and registries in Europe. METHODS: Between 01/2021 and 06/2021, 42 countries on the European continent, including the United Kingdom, Russia and Turkey, were screened using an internet search (search engine: Google) and a key word search in the Pubmed database. Search terms were the respective country name combined with the following terms: "Cochlear Implant", "CI", "Cochlear implant clinical practice guideline", "CI Guideline", "Cochlear Implant Registry", "CI Registry", "Ear nose throat society". The internet search was conducted in English as well as in the corresponding national language. The objective was to identify a CI-related CPG or registry. RESULTS: A CPG was found in 16 of 42 (38%) countries. In terms of population, this accounts for 645 million out of 838 million people (77%). A registry existed in 4 of the 42 (10%) countries assessed. This corresponds to 102 million out of 838 million (12%) people. In total, 4 out of 42 countries (10%) had both a CPG and a registry. CONCLUSION: Our work shows numerous efforts in Europe to standardize CI care at the national level. While most people in Europe already live in countries with a CPG, this is not the case for CI registries. European-wide consensus on CPGs or registries does not yet exist. The present study thus provides a first assessment of the distribution of CI-related CPGs and registries.

The use of a new passive sampler for ozone and nitrogen oxides monitoring in ecological effects research.

A simple, cost-effective diffusive sampler is described that is suitable for measuring parts per billion (ppb) levels of ozone and nitrogen oxides. The diffusive sampler makes use of nitrite for ozone determination whereas for nitrogen oxides and nitrogen dioxide an active carbon tissue impregnated with sodium carbonate is used. Nitrate and nitrite, the formation of which is proportional to the pollutant concentration and sampling duration, are the two species analysed, respectively. Diffusion tubes have the advantage of being a low- cost, convenient way of mapping spatial distributions and investigating long-term trends of ozone and nitrogen oxides. The method is extremely useful for assessing long-term concentrations such as the annual mean for nitrogen oxides, as required by the Daughter Directive 1999/30/EC. Field tests to validate the method have been carried out at an urban background location with co-located passive samplers and continuous measurements of O3 and NOx. An application in ecological effects monitoring for ozone is also presented.

[Chronic pelvic pain in women and prevalent orthostatic work. Preliminary results of a study on health staff of the surgical field]. / Dolore pelvico cronico nella donna e lavoro ortostatico prevalente. Risultati preliminari di uno studio condotto sul personale sanitario dell'area chirurgica.

BACKGROUND: The purpose of this research is to estimate the causal and/or pre-existing causal influence of some working factors, such as the standing (position) in pelvic pain syndrome, in relation to the reduction in working performance. METHODS: The research was carried out by means of an inclusive questionnaire, the purpose being to analyse anamnestic and working information. The questionnaire was proposed to a group of female sanitary staff selected in relation to their working activity. RESULTS: Examination of the questionnaire shows prominently the association between pelvic pain and orthostatic working activity, kept not below 4-6 hours each duty. In fact, 70% of the people selected have reported this mutual relationship. CONCLUSIONS: Working activities in the orthostatic position can produce pelvic pain, whose origin and intensity seem to be related to extended orthostatic working activity. The mechanism by which the upright position can produce an outbreak of pelvic pain in women seems to be linked to the compression on abdominal vessels, with slowing-down and reduction of the hematic uterine discharge.

Monitoring of atmospheric pollutants by passive sampling for the protection of historic buildings and monuments.

When considering the various possibilities to assess the effects of SO2 and NO2 on historic buildings and monuments, a distinction can be made according to the completeness of the scope of the assessment itself. A first approach can be limited to gathering data as they become available through the official bodies established under air quality legislation. This approach is based on a single point measurement where a "general purpose" monitoring station is located, often quite far from the monument to protect and often without investigating local and temporal variations. A more comprehensive assessment should include a generalisation that covers the territory. This can be made on the basis of the knowledge of the spatial distribution of concentrations and the knowledge of the causes of air pollution. Passive samplers allow the measurement of air quality in numerous sites and to assess the pollutant spatial distribution over a large area with a high resolution. As an application of the method, the spatial distribution of SO2 and NO2 in the city of Siracusa, Sicily, Italy, has been studied to identify areas of high deposition fluxes in relation to the protection of buildings and monuments of the historic centre.

Monitoring the air quality around an oil refinery through the use of diffusive sampling.

Diffusive sampling has been used to study the spatial distribution of SO(2), NO(2), NO(x), NH(3) and BTX (benzene, toluene and xylenes) near an oil refinery located in Falconara, Italy, over the period from March to October 2001. Three different categories of sampling sites (roadside, residential and background) were studied. In total, 56 sites were monitored. The results were evaluated on the basis of the limit values found in the European Directives. The results of the defined study indicate that the measured concentrations were substantially lower than the ambient air quality standard with the maximum concentrations being generally found much closer to emission sources. The monitoring method described here can be used to assess integrated concentration levels over long periods of time and to identify pollution "hotspots" where concentrations are likely to be consistently high. Identification of these hotspots may help to assess air quality and to implement proper action plans, especially in locations where industrial and urban pollution coexist.

Changes in leaf hexokinase activity and metabolite levels in response to drying in the desiccation-tolerant species Sporobolus stapfianus and Xerophyta viscosa.

The phosphorylation of glucose and fructose is an important step in regulating the supply of hexose sugars for biosynthesis and metabolism. Changes in leaf hexokinase (EC 2.7.1.1) activity and in vivo metabolite levels were examined during drying in desiccation-tolerant Sporobolus stapfianus and Xerophyta viscosa. Leaf hexokinase activity was significantly induced from 85% to 29% relative water content (RWC) in S. stapfianus and from 89% to 55% RWC in X. viscosa. The increase in hexokinase corresponded to the region of sucrose accumulation in both species, with the highest activity levels coinciding with region of net glucose and fructose removal. The decline of hexose sugars and accumulation of sucrose in both plant species was not associated with a decline in acid and neutral invertase. The increase in hexokinase activity may be important to ensure that the phosphorylation and incorporation of glucose and fructose into metabolism exceeded production from potential hydrolytic activity. Total cellular glucose-6-phosphate (Glc-6-P) and fructose-6-phosphate (Fru-6-P) levels were held constant throughout dehydration. In contrast to hexokinase, fructokinase activity was unchanged during dehydration. Hexokinase activity was not fully induced in leaves of S. stapfianus dried detached from the plant, suggesting that the increase in hexokinase may be associated with the acquisition of desiccation-tolerance.

Laboratory development and field evaluation of a new diffusive sampler to collect nitrogen oxides in the ambient air.

Diffusive samplers for the determination of NO(x) and NO2 based on collection on a coated carbon paper filter have been developed. NO is first oxidized to NO2 and then collected on the reactive surface. When NO2 and NOx samplers are exposed simultaneously, NO can be calculated by difference. The sampler has been derived from a Palmes design as recently modified by Bertoni et al. for the determination of BTX (benzene, toluene, xylenes). Laboratory tests were conducted in controlled atmosphere to evaluate linearity, uptake rate, face velocity effects, sample stability, influence of relative humidity, precision and accuracy. The samplers are capable of reliable measurements of the two species at common levels of a polluted atmosphere in urban settings yielding average concentration levels over 1 month and beyond. The uptake rate of NO2 was found to be 11.7 mL/min in a very good agreement (within 5%) with the value calculated from theory. The measured uptake rate for NO(x) was determined in experiments involving sampling at different concentration levels in comparison to chemiluminescence (CL) measurements. The precision of the measurements for co-located passive samplers was better than 5%. The accuracy of the data collected is within +/-20% of the actual value measured by CL. The laboratory and field results show that the NO(x) and NO2 samplers meet the data quality goal requested by the first EU Directive 1999/30/EU for these pollutants.

Protein dynamics in thylakoids of the desiccation-tolerant plant Boea hygroscopica during dehydration and rehydration.

Plants of Boea hygroscopica F. Muell were dehydrated to 9% relative water content (RWC) by withholding water for 26 d, and afterward the plants were rehydrated. Leaves were taken from control plants after 7, 12, and 26 d from the beginning of dehydration, and after 6 and 48 h from rehydration. The RWC decreased by 80% during dehydration, but the leaves regained RWC with rehydration. Dehydrated plants showed lesser amounts of proteins, lipids, and chlorophyll, all of which increased following rewatering. The lipid-to-protein ratio, which decreased during dehydration, returned to control level after 48 h of rehydration. Thylakoid lipids were more unsaturated when RWC reached the value of 9%. EPR measurements of spin-labeled proteins showed the presence of three different groups of proteins with different mobility in thylakoid membranes. The rotational correlation time of groups 1 and 2 increased with dehydration and decreased upon rehydration, whereas group 3 showed little changes. Desiccation did not cause thylakoid swelling or breakage, but the membrane system assemblage showed changes in thylakoid stacking. After 48 h of rehydration the membrane system recovered completely the organization of the fully hydrated state, showing several well-defined and regularly distributed grana.