The experiences of participating in winter among youths with a physical disability compared with their typically developing peers

BACKGROUND

Having a physical disability and using a wheelchair can create difficulties in navigating the physical and built environment, especially during winter when snow and ice become problematic. Little is known about the experiences of winter among youth who use an assistive mobility device. This study aimed to understand how youth with a physical disability experience winter, compared with typically developing peers.

METHODS

A purposive sample of 25 youths (13 with a physical disability; 12 typically developing) completed a 2-week weather journal and photographs in two Canadian cities during winter. These data were used to guide semi-structured interviews with participants.

RESULTS

Youths with disabilities experienced many similar challenges in winter, such as health and safety concerns and accessibility issues, compared with typically developing youth - but to a greater extent. Youths with disabilities reported more challenges going outdoors during winter and negative psychosocial impacts, including loneliness and increased dependence, compared with peers without a disability. They also, however, described developing several adaptive strategies to cope with these challenges.

CONCLUSIONS

There is a strong need to remove physical and environmental barriers to facilitate the participation and inclusion of youth with disabilities in winter.

Characteristics and analysis of scientific articles submitted to the European Annals of Otorhinolaryngology, Head and Neck Diseases

OBJECTIVES

To evaluate characteristics, suggested modifications and reasons for rejection in scientific articles submitted for publication in the European Annals of Otorhinolaryngology, Head and Neck Diseases.

MATERIALS AND METHODS

A prospective study analyzed the flaws noted by reviewers in 52 scientific articles submitted to the European Annals of Otorhinolaryngology, Head and Neck Diseases between August 31, 2014 and February 28, 2015.

RESULTS

Fifteen flaws concerning content and 7 concerning form were identified. In more than 25% of submissions, major flaws were noted: purely descriptive paper; lack of contribution to existing state of knowledge; failure to define a clear study objective and/or analyze the impact of major variables; poorly structured Materials and methods section, lacking description of study population, objective and/or variables; lack of or inappropriate statistical analysis; Introduction verbose and/or misrepresenting the literature; excessively heterogeneous and/or poorly described study population; imprecise discussion, straying from the point, overstating the significance of results and/or introducing new results not mentioned in the Results section; description of the study population placed in the Results section instead of under Materials and methods; serious mistakes of syntax, spelling and/or tense; and failure to follow the Instructions to Authors. After review, 21.1% of articles were published, 65.3% rejected and 13.4% non-resubmitted within 3 months of review. On univariate analysis, the only variable increasing the percentage of articles accepted was the topic not being devoted to head and neck surgery (P=0.03).

CONCLUSION

These results document the excessive flaw rate still to be found in manuscripts and demonstrate the continuing need for authors to master and implement the rules of scientific medical writing.

Management of multiple tumors in neurofibromatosis type 2 patients

INTRODUCTION

Neurofibromatosis type 2 is characterized by the presence of bilateral vestibular schwannomas. However, other nervous system tumors may also occur. Therefore, the management of NF2 patients is complex and requires a multidisciplinary discussion in a specialized center.

MATERIALS AND METHODS

All recent articles concerning tumors other than vestibular schwannoma in NF2 disease were reviewed, using PubMed databases.

RESULTS

Intracranial meningiomas occur in 50% of NF2 patients, and are often multiple. Surgery remains the main treatment and should be performed in cases of growing tumors. The role of antiangiogenic therapy is currently under evaluation and the role of radiosurgery still remains to be defined in NF2 disease. Spinal tumors occur in about half of NF2 patients. Surgery should be discussed when radiological tumor progression is demonstrated, even if spinal tumors are asymptomatic, in order to preserve neurological function and good quality of life. As regards lower cranial nerve schwannomas, radiosurgery appears to be a more appropriate treatment for growing tumor with a small volume in order to avoid post-operative complications, especially swallowing disorders. Facial nerve schwannomas may appear, on MRI, like vestibular schwannomas. The diagnosis should be suspected when the facial palsy is an early symptom during cerebello-pontine tumor progression. Trigeminal schwannomas are frequent in NF2 disease and fortunately they are often asymptomatic. Among major neurofibromatosis types, peripheral nerve sheath schwannomas are only present in patients with NF2 disease and schwannomatosis. Surgical resection is required when the cutaneous schwannomas is painful or when tumor progression is observed and causes symptoms.

CONCLUSION

Tumors other than vestibular schwannoma are also associated with a poor prognosis in NF2 patients. Surgery remains the main treatment in most cases. Each treatment decision in NF2 disease requires a complete evaluation of all cranial and spinal locations of the disease in order to establish surgical priorities and strategies.

Identification and evaluation of cochlear implant candidates with asymmetrical hearing loss

OBJECTIVE

Recommendation for cochlear implant (CI) treatment for individuals with severe to profound single-sided deafness (SSD) and asymmetrical hearing loss (AHL) is on the rise. This raises the need for greater consistency in the definition of CI candidacy for these cases and in the assessment methods of patient-related benefits to permit effective comparison and interpretation of the outcomes with both conventional and implantable options across studies.

METHOD

During a dedicated seminar on implant treatment in AHL patients, the panellists of the closing round table reviewed the clinical experience presented with the aim to define clear audiometric characteristics for both AHL and SSD cases, as well as a common data set enabling consistent evaluation of hearing benefits in this population.

CONCLUSIONS

The panellists agreed on a clear differentiation between AHL and SSD CI candidates, defining average pure-tone thresholds up to 4 kHz for better and poorer ears. Agreement was reached on a minimum set of assessment procedures, and included the necessity of trials with conventional CROS/BICROS hearing aids and bone conduction devices before considering CI treatment. Objective assessment of sound localisation abilities was identified as the most relevant criterion to quantify performance before and after treatment. In parallel, subjective assessment of overall hearing ability was recommended via the Speech, Spatial and Qualities of hearing questionnaire. Longitudinal follow-up of these parameters and the hours of daily use were considered essential to reflect the potential treatment benefits for this population. The consistency in the data collection and its report will further support health authorities in their decision on acceptable gains from available hearing loss treatment options.

Chitin-Prussian blue sponges for Cs(I) recovery: from synthesis to application in the treatment of accidental dumping of metal-bearing solutions

Prussian blue (i.e., iron[III] hexacyanoferrate[II], PB) has been synthesized by reaction of iron(III) chloride with potassium hexacyanoferrate and further immobilized in chitosan sponge (cellulose fibers were added in some samples to evaluate their impact on mechanical resistance). The composite was finally re-acetylated to produce a chitin-PB sponge. Experimental conditions such as the freezing temperature, the content of PB, the concentration of the biopolymer and the presence of cellulose fibers have been varied in order to evaluate their effect on the porous structure of the sponge, its water absorption properties and finally its use for cesium(I) recovery. The concept developed with this system consists in the absorption of contaminated water by the composite sponge, the in situ binding of target metal on Prussian blue load and the centrifugation of the material to remove treated water from soaked sponge. This material is supposed to be useful for the fast treatment of accidental dumping of Cs-contaminated water.

[Pendred syndrome and nonsyndromic related deafness: a same entity?]

Pendred syndrome is an autosomal recessive familial disorder, defined as a sensorineural deafness coinciding with a goiter related to an iodine organification defect. It constitutes 4 to 10 % of all causes of familial congenital hearing loss. It is now well established that this condition was caused by mutations in the SLC26A4 gene which codes for pendrin, a protein involved in the transport of anions (I-, Cl, HCO3-), particularly in apical iodine efflux in thyroid cells and chloride (Cl-|HCO3-) at the cochlear level. A current issue is to determine factors that distinguish Pendred syndrome from other varieties of isolated deafness also including enlargement of the vestibular aqueduct, but without evidence of thyroid expression. A prospective investigation of these 2 situations, conducted in Lille, leads us to redefine diagnostic criteria and assessment methods, and to discuss genetic or environmental factors contributing to the phenotypes.

[The Bell Labs contributions to (singing) voice enginee­ring]

While in «art» and «traditional» music, the nimbleness of the voice and the mastering of the vocal tone are put into pers­pective, in «popular» music, sound engineering takes the lead, and relegates the vocal virtuosity of the interpreter to second place. We propose to study here three technologies with contri­butions to music. All are developed and patented by the Bell Labs: The artificial larynx (and its derivatives, Sonovox and TalkBox), the vocoder and the speech synthesis. After a presen­tation of the source-filter theory, vital to these innovations, the principle of these three technologies is explained. A brief historical is outlined and is complemented by examples of films and musical selections depicting these processes. In light of these elements, we conclude: Sound engineering, and in parti­cular the modification of voice sonority, has become an indis­pensable component in the process of «pop» artistic musical creation.

Impact of modulating phase duration on electrically evoked auditory brainstem responses obtained during cochlear implantation

Objective To investigate the effect of increasing phase duration (pulse width, T-pulse) using a biphasic pulse composed of an initial anodic active phase followed by a balancing cathodic phase on the electrically evoked auditory brainstem responses (eABRs) recorded at the time of cochlear implantation. Design eABRs recorded during 188 surgeries for cochlear implantation from 1999 to 2006 in a single center were retrospectively reviewed by two independent observers. All patients were fitted with a NEURELEC cochlear implant (CI) device, initially DIGISONIC(®) then DIGISONIC SP(®) (2004-2006). Result Immediately following cochlear implantation, stimulation by the CI resulted in reliable wave III and V eABR waveforms (mean wave III latency 2.23 ± 0.38 ms SD and wave V latency 4.28 ± 0.42 ms SD). Latencies followed an apical to basal gradient (0.32 ms increase in mean eV latency and 0.12 ms for eIII latency). With increasing phase duration, wave III and wave V latencies significantly decreased in association with a shortening of the eIII-eV interwave gap, while amplitudes of both waves increased. Conclusion The impact of increasing phase duration on latency and amplitude of brainstem responses in a large set of patients implanted with NEURELEC CIs was reported.

Analysis of the thyroid phenotype in 42 patients with Pendred syndrome and nonsyndromic enlargement of the vestibular aqueduct

BACKGROUND

Pendred syndrome (PS), a recessive disorder caused by mutations in the SLC26A4 (PDS) gene, is associated with deafness and goiter. SLC26A4 mutations have also been identified in patients exhibiting isolated sensorineural hearing loss without apparent thyroid abnormality (nonsyndromic enlargement of the vestibular aqueduct; nonsyndromic EVA). Our aim was to describe systematically the thyroidal phenotypes and the SLC26A4 genotypes of patients presenting with PS or nonsyndromic EVA.

METHODS

Nineteen patients with PS and 23 patients with nonsyndromic EVA, aged 5-53 years, were included. They underwent thyroid evaluation (physical examination, biological thyroid function tests, measurement of thyroglobulin level, thyroid ultrasonography, and thyroid (123)I scintigraphy with perchlorate discharge test), otological evaluation, and SLC26A4 mutation screening.

RESULTS

In 19 patients with PS, goiter was identified in 15 (79%) and hypothyroidism in 15 (79%); hypothyroidism was subclinical in four patients and congenital in six patients. The perchlorate discharge test (PDT) was positive in 10/16 (63%). Morphological evaluation of the inner ear using MRI and/or CT showed bilateral EVA in 15/15 PS patients. Mutation screening revealed two SLC26A4 mutant alleles in all 19 PS patients that were homozygous in two families and compound heterozygous in 12 families. In the 23 patients with nonsyndromic EVA, systematic thyroid evaluation found no abnormalities except for slightly increased thyroglobulin levels in two patients. SLC26A4 mutations were identified in 9/23 (39%). Mutations were biallelic in two (compound heterozygous) and monoallelic in seven patients.

CONCLUSION

The thyroid phenotype is widely variable in PS. SLC26A4 mutation screening is needed in patients exhibiting PS or nonsyndromic EVA. PS is associated with biallelic SLC26A4 mutations and nonsyndromic EVA with no, monoallelic, or biallelic SLC26A4 mutations. Systematic thyroid evaluation is recommended in patients with nonsyndromic EVA associated with one or two SLC26A4 mutations. We propose using a combination of three parameters to define and diagnose PS: (i) sensorineural deafness with bilateral EVA; (ii) thyroid abnormality comprising goiter and/or hypothyroidism and/or a positive PDT; (iii) biallelic SLC26A4 mutations.