Search Results (74)

Background/Objectives: Cochlear implantation (CI) is a transformative intervention for individuals with sensorineural hearing loss, providing auditory and speech perception improvements. Traditional CI activation occurs 4–6 weeks post-surgery; however, recent advancements allow for early activation within 1–2 days. The integration of data logging in modern CI systems offers objective insights into processor usage and auditory exposure, which are crucial for optimizing rehabilitation outcomes. Methods: A retrospective study was conducted on 63 patients with bilateral simultaneous CIs using MED-EL SONNET2/RONDO3 devices. Patients were classified into early activation (n = 30, activation within 1–2 days) and classical activation groups (n = 33, activation after day 2). Data logging metrics, patient demographics, and implant details were analyzed using the Wilcoxon rank-sum test and Poisson regression. Results: Daily processor usage did not significantly differ between groups (9.5 ± 3.0 h/day for classical vs. 9.4 ± 3.7 h/day for early activation, p = 0.927). Subgroup analysis showed a significant 18% increase in processor usage with each additional year of patient age (IRR = 1.18, p < 0.001) and a 15% decrease in usage with each year delay in implantation age (IRR = 0.85, p < 0.001) among early activation users. Switch-on frequencies were comparable between groups, with no significant differences observed (p = 1.0). Conclusions: Early activation is feasible and associated with consistent CI usage, providing potential benefits in auditory rehabilitation. Future research should explore its impact on long-term speech and language outcomes to inform evidence-based practices. Full article

Background: The reported data on African universal neonatal hearing screening (UNHS) practices tend to be quite scarce, despite the developments in hearing screening the last two decades. The objective of this systematic review was (a) to identify the most recent (in a 20-year span) literature information about NHS/UNHS programs in Africa and (b) to provide data on the procedures used to assess the population, the intervention policies, and on the estimated prevalence of congenital hearing loss with an emphasis on bilateral hearing loss cases. Methods: Queries were conducted via the PubMed, Scopus, and Google Scholar databases for the time window of 2004–2024. The mesh terms used were “OAE”, “universal neonatal hearing screening”, “congenital hearing loss”, “well babies”, and “Africa”. Only research articles and review papers were considered as good candidates. The standard English language filter was not used, to identify information from non-English-speaking scientific communities and groups. Results: Data from 15 papers were considered, reflecting the neonatal hearing practices of nine African states. No country-wide NHS programs were reported. The various screening realities are implemented within big urban centers, leaving the residents of rural areas unassisted. For the latter, proposals based on tele-medicine protocols have been suggested. The data on HL prevalence are also incomplete, but the available data refer to rates from 3 to 360 subjects per 1000. These data cannot be taken at face value but within the small sample size context in which they were acquired. Regarding the causes of HL, very few data have been reported; consanguinity is the most attributed factor, at least in the Sub-Saharan African states. For the majority of the programs, no data were reported on hearing loss prevalence/incidence or on any strategies to restore hearing. Conclusions: The information on the African neonatal hearing screening are quite scarce, and it is an urgent need to convince audiologists from the African localized programs to publish their hearing screening data. Full article

Background/Objectives: Hearing loss in childhood is associated with significant challenges in linguistic and cognitive development, particularly affecting language skills such as syntax, semantics, and pragmatics, which are essential for effective communication and social integration. This study aimed to analyze how different types and degrees of hearing loss impact linguistic development in children, and to identify clinical factors—such as age at diagnosis and years of language intervention—that may predict language performance. Methods: This study included a sample of 140 children aged 6 to 12, categorized into seven groups based on their hearing condition: unilateral and bilateral conductive, unilateral and bilateral sensorineural, unilateral and bilateral mixed hearing loss, and a control group with no hearing loss. Linguistic development was assessed using the Clinical Evaluation of Language Fundamentals-5 (CELF-5), a validated tool for diagnosing language disorders. Statistical analyses, including MANOVA and multiple regression, were conducted to evaluate differences in linguistic skills across groups and to determine the predictive value of clinical variables on total language performance. Results: The analysis revealed statistically significant differences across groups in all assessed linguistic domains (p < 0.001), with children with severe or bilateral hearing loss exhibiting notably lower scores compared to normohearing peers. The multiple regression analysis indicated that type of hearing loss was the strongest predictor of total linguistic performance (β = −0.674), followed by age at diagnosis (β = −0.285) and age of hearing device adaptation (β = −0.220). Years of language intervention also contributed significantly (β = 0.198) but to a lesser extent. Conclusions: This study highlights the critical impact of early and comprehensive auditory and language intervention on linguistic outcomes for children with hearing impairments. Early diagnosis and timely adaptation of hearing aids or cochlear implants are essential in mitigating language deficits, particularly in areas like syntax and pragmatic skills. These findings support the need for specialized, long-term interventions tailored to the severity and type of hearing loss to improve language development in this population. Full article

Background: The reported data on European universal neonatal hearing screening (UNHS) practices tend to be scarce, despite the fact that the European Union project, EUScreen, collected unofficial data from 38 collaborating European institutions. The objectives of this systematic review were as follows: (a) to identify the most recent (in a 20-year span) literature information about UNHS programs in Europe and (b) to provide data on the procedures used to assess the population, the intervention policies, and on the estimated prevalence of congenital hearing loss with emphasis on the bilateral hearing loss cases. Methods: Queries were conducted via the Pubmed, Scopus and Google Scholar databases for the time period of 2004–2024. The Mesh terms used were “OAE”, “Universal Neonatal Hearing Screening”, “congenital hearing loss” and “well babies”. Only research articles and review papers of European origin were considered good candidates. The standard English language filter was not used, in order to identify information from non-English-speaking scientific communities and groups. Results: Very few data and reports were identified in the literature search. Eleven manuscripts were identified corresponding to eight UNHS programs. Except in Poland, most of the data refer to regional and not national programs. The screening coverage estimates of all programs exceed 90%; infants were mostly assessed by a three-stage protocol (TEOAE + TEOAE + AABR), followed by a clinical ABR test. The average prevalence (i.e., from well babies AND NICU infants) of bilateral hearing loss ranged from 0.5 to 20.94 per 1000 (Zurich sample). Infants presenting unilateral or bilateral hearing losses were first rehabilitated by hearing aids and consequently (>15 mo) by cochlear implants. Conclusions: Even though UNHS programs are well-established clinical practices in the European States, the amount of information in the literature about these programs is surprising low. The existing data in the timespan 2004–2024 corroborate the international UNHS data in terms of coverage and bilateral hearing loss prevalence, but there is a strong need to supplement the existing information with the latest developments, especially in the area of hearing loss rehabilitation. Full article

Studies about the effects of SARS-CoV-2 on pregnant women and children born to positive women are controversial with regard to possible inner ear-related damage but most of them do not detect the involvement of this virus in auditory function. However, only a few studies on long-term effects on language development are currently available because of the recent onset of the pandemic. The aim of this study was to investigate the impact of SARS-CoV-2 infection on perceptual and expressive abilities and the emerging development of communication in young children. To this purpose, the MacArthur–Bates Communicative Development Inventory—Words and Gestures form (CDI-WG), was administered to parents. In total, 115 children whose mother was infected by SARS-CoV-2 during pregnancy were enrolled in the study and evaluated at the Audiology Service of the Modena University Hospital. All children underwent Otoacoustic Emissions (OAE) at birth: 114/115 had a “pass” result bilaterally, while 1 case had a unilateral “refer” result. Overall, 110/115 newborns (95.65%) underwent audiological evaluation between 10–18 months of age. In 5/110 patients (3.6%), the Pure Tone Average (PTA) result was equal to 35 dB; one case had a hearing threshold of around 50 dB due to a bilateral effusive otitis media. A notable finding was the percentage of children with tubal dysfunction in both evaluations, within 2 months of age and around 12 months of age. Most children revealed normal hearing. The CDI-WG was completed by 56/115 families. The rate of children below the fifth percentile was 8.9% for sentences understood, 12.5% for words understood, and 5.4% for words produced. Concerning CDI-Gestures, only 2 children (3.6%) were below the fifth percentile. A structured audiological follow-up in association with the evaluation of communication skills of children appears fundamental, particularly in the years of maximum neuroplasticity. Long-term studies are still necessary to evaluate the possible consequences of the pandemic. Full article

Background/Objectives: Functional MRI (fMRI) is widely used to assess language lateralization, but its application in patients with brain tumors can be hindered by cognitive impairments, compensatory neuroplasticity, and artifacts due to patient movement or severe aphasia. Gray matter volume (GMV) analysis via voxel-based morphometry (VBM) in language-related brain regions may offer a stable complementary approach. This study investigates the relationship between GMV and fMRI-derived language lateralization in healthy individuals and patients with left-hemisphere brain tumors, aiming to enhance accuracy in complex cases. Methods: The MRI data from 22 healthy participants and 28 individuals with left-hemisphere brain tumors were analyzed. Structural T1-weighted and functional images were obtained during three language tasks. Language lateralization was assessed based on activation in predefined regions of interest (ROIs), categorized as typical (left) or atypical (right or bilateral). The GMV in these ROIs was measured using VBM. Linear regressions explored GMV-lateralization associations, and logistic regressions predicted the lateralization based on the GMV. Results: In the healthy participants, typical left-hemispheric language dominance correlated with higher GMV in the left pars opercularis of the inferior frontal gyrus. The brain tumor participants with atypical lateralization showed increased GMV in six right-hemisphere ROIs. The GMV in the language ROIs predicted the fMRI language lateralization, with AUCs from 80.1% to 94.2% in the healthy participants and 78.3% to 92.6% in the tumor patients. Conclusions: GMV analysis in language-related ROIs effectively complements fMRI for assessing language dominance, particularly when fMRI is challenging. It correlates with language lateralization in both healthy individuals and brain tumor patients, highlighting its potential in preoperative language mapping. Further research with larger samples is needed to refine its clinical utility. Full article

Dental implant placement is crucial in oral rehabilitation, requiring precision for successful outcomes. Digital technologies, including surgical guides, enhance predictability and efficiency in implant procedures. However, their impact on implant positioning accuracy is still under investigation. This systematic review aimed to evaluate the literature on implant accuracy using digital prosthetically-derived surgical guides. Registered in PROSPERO (CRD 42023483194), the review employed a PICO strategy and searched PubMed for English-language, in vivo studies from 2013 to 2023 on restrictive digital prosthetically-derived surgical guides. Two reviewers independently assessed records, with a third verifying the decisions. PRISMA guidelines were followed, yielding 24 results after excluding nine duplicates. Ten studies met the criteria after title, abstract, and keyword review, with three included after verification. These studies showed coronal deviations of 0.44 mm to 0.56 mm, apical deviations of 0.64 mm to 1.03 mm, angular deviations of 2.03° to 2.42°, and vertical deviations of 0.19 mm to 0.45 mm. Superior accuracy was noted with static guided techniques, while bilateral guides offered stability and printed guides were cost-effective. A surgical guide that comes from a planning with a primary wax-up of the prosthesis leads to the placement of a dental implant that can be functionally and esthetically rehabilitated. Further research is needed to standardize outcomes and improve implant protocols and patient outcomes. Full article

The distinct clinical and radiological characteristics of right temporal variant FTD have only been recently recognized. Methods: Eight patients with right temporal variant FTD were prospectively recruited and underwent a standardised neuropsychological assessment, clinical MRI, and quantitative neuroimaging. Results: Our voxelwise grey analyses captured bilateral anterior and mesial temporal grey matter atrophy with a clear right-sided predominance. Bilateral hippocampal involvement was also observed, as well as disease burden in the right insular and opercula regions. White matter integrity alterations were also bilateral in anterior temporal and sub-insular regions with a clear right-hemispheric predominance. Extra-temporal white matter alterations have also been observed in orbitofrontal and parietal regions. Significant bilateral but right-predominant thalamus, putamen, hippocampus, and amygdala atrophy was identified based on subcortical segmentation. The clinical profile of our patients was dominated by progressive indifference, decline in motivation, loss of interest in previously cherished activities, incremental social withdrawal, difficulty recognising people, progressive language deficits, increasingly rigid routines, and repetitive behaviours. Conclusions: Right temporal variant FTD has an insidious onset and may be mistaken for depression at symptom onset. It manifests in a combination of apathy, language, and behavioural features. Quantitative MR imaging captures a characteristic bilateral but right-predominant temporal imaging signature with extra-temporal frontal and parietal involvement. Full article

When it comes to relations between Thailand (Siam) and Sri Lanka (Ceylon), the Buddhist connections between the two countries are often discussed and are highly valued. Communications between Thai and Sinhalese monks can be traced back to the 13th century: the Sukhothai era. These communications were then continuously maintained in the Ayutthaya era and have been up until the present day. Despite being situated far from each other and being separated by the sea, the people in these countries have been interacting through maritime routes and cooperating with each other regarding religious, cultural, financial, diplomatic, and political matters for centuries. The continuous interactions between the two came to a halt in the 18th century due to political instability in both countries. Only in the middle of the 19th century did Buddhists from the two countries resume their travels and interactions, rebuilding their bilateral relations and cooperation. There are very few studies that provide information regarding the religious cooperation between Siam and Ceylon in the 19th century. Religious cooperation between the two countries in the 19th Century has never been thoroughly studied and presented in detail. The purpose of the research paper is to investigate how Buddhists in these two countries cooperated with each other to achieve continuity and solidarity in Theravada Buddhism in both countries. We will address this question by analyzing the available data, which can mainly be found in the form of letters written in the Pāli language exchanged between Buddhists in the two countries. These letters have been published in Pālisandesāvalī in Sri Lanka and in Samaṇasāsana in Thailand. Full article

Moebius syndrome is a collection of orofacial anomalies with highly variable features affecting many different systems but characterised by bilateral facial palsy and absent eye abduction. We largely regard Moebius syndrome as a diagnosis of exclusion. Lack of awareness and knowledge means that children often fall between services, leading to treatment delays and difficulty interfacing with social care and schools, with long-term impact on physical health and psychosocial development. We developed a multidisciplinary team comprising core clinicians (lead physician, geneticist, speech and language therapist, psychologist and specialist nurse) and an expanded group to encompass the other affected systems. The interactions between our specialties lead to the development of a treatment protocol, which we present. The protocol harnesses the aspects of care of children with a range of other rare diseases at a specialised paediatric centre and synthesises them into a holistic approach for MBS and related conditions. Management is sequenced on an “ABC-style” basis, with airway, feeding, vision and speech taking priority in the early years. We define management priorities as airway stabilisation with swallow assessment, ocular surface protection and maintenance of nutritional support. Management principles for issues such as speech, reflux, drooling and sleep issues are outlined. In later years, psychological support has a prominent role geared towards monitoring and interventions for low mood, self-esteem and bullying. Full article

Background: Total hysterectomy with bilateral salpingo-oophorectomy via minimally invasive surgery (MIS) has emerged as the standard of care for early-stage endometrial cancer (EC). Prior systematic reviews and meta-analyses have focused on outcomes reported solely from randomised controlled trials (RCTs), overlooking valuable data from non-randomised studies. This inaugural systematic review and network meta-analysis comprehensively compares clinical and oncological outcomes between MIS and open surgery for early-stage EC, incorporating evidence from randomised and non-randomised studies. Methods: This study was prospectively registered on PROSPERO (CRD42020186959). All original research of any experimental design reporting clinical and oncological outcomes of surgical treatment for endometrial cancer was included. Study selection was restricted to English-language peer-reviewed journal articles published 1 January 1995–31 December 2021. A Bayesian network meta-analysis was conducted. Results: A total of 99 studies were included in the network meta-analysis, comprising 181,716 women and 14 outcomes. Compared with open surgery, laparoscopic and robotic-assisted surgery demonstrated reduced blood loss and length of hospital stay but increased operating time. Compared with laparoscopic surgery, robotic-assisted surgery was associated with a significant reduction in ileus (OR = 0.40, 95% CrI: 0.17–0.87) and total intra-operative complications (OR = 0.38, 95% CrI: 0.17–0.75) as well as a higher disease-free survival (OR = 2.45, 95% CrI: 1.04–6.34). Conclusions: For treating early endometrial cancer, minimal-access surgery via robotic-assisted or laparoscopic techniques appears safer and more efficacious than open surgery. Robotic-assisted surgery is associated with fewer complications and favourable oncological outcomes. Full article

The recent studies on magnetically coupled resonant bidirectional wireless power transfer (MCR-BWPT) systems disregard the challenges posed by nonlinearity, discrete switching action, and hybrid properties within the system. This research focuses on the D-LCL resonant compensation topology MCR-BWPT system. The switch tube’s switching state dictates the division of various working modes and the determination of the switching conditions between them. The coupling relationship between the continuous dynamic characteristics of the system and discrete events and the constrained conditions of the system are derived. The Hybrid System Description Language (HYSDEL) is used to build the Mixed Logic Dynamic (MLD) model of the system. The MLD model is employed as the prediction model, and the hybrid model predictive controller of the MCR-BWPT system is constructed according to the quadratic performance index. Finally, to verify the accuracy of the MLD model and the feasibility of the control strategy, the simulation model of the MLD model is established in MATLAB/Simulink. The study’s findings show that, in terms of response time at system startup and power fluctuation suppression, the approach put forward in this research performs better than both the conventional bilateral dual-phase-shift control strategy and the PQ-based bilateral power control strategy. The MCR-BWPT system can operate more steadily now that PQ’s bidirectional power control technique is in place. The system’s forward and reverse transmission efficiency is increased by 0.29% and 0.32% compared to the conventional bilateral dual-phase-shift control approach; the increases are 0.28% and 0.09%, each compared to the bilateral power control strategy based on PQ. Full article

Introduction: Hearing loss in childhood compromises a child’s auditory, linguistic, and social skill development. Stimulation and early intervention through therapy and the use of personal sound amplification devices (PSAPs) are important for improving communication. Purpose: To verify the effectiveness of speech therapy intervention on the auditory and linguistic skills of Brazilian children aged between 6 and 8 years using PSAPs. Methods: Experimental study analyzing the intervention process in children aged between 6 and 8 years with mild to severe bilateral hearing loss and prelingual deafness who are PSAP users. Diagnostic information was analyzed, and assessments and interventions were carried out using the Glendonald Auditory Screening Procedure (GASP), a phoneme discrimination test with figures (TFDF), an expressive language category classification test, and an Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) questionnaire. Results: Sixteen children participated in the study; they were divided into a control group (CG) of six children and an intervention group (IG) of ten children. All research subjects underwent two protocol application sessions, and the IG underwent six speech therapy intervention sessions. In the IT-MAIS, the CG had a 9% increase in score, and the IG had an increase of 3% after intervention. The TFDF obtained a 5% increase in the IG in terms of phonemic discrimination ability. The expressive language category classification tests and GASP were considered not sensitive enough to modify the parameters of auditory and linguistic skills. Conclusions: The study found a significant improvement amongst the IG in the TFDF protocol and an increase in IT-MAIS scores in both groups. Full article

Aim: As a medical condition, pregnancy mandates the simultaneous treatment of both the mother and the fetus, making it a distinctive aspect of clinical medicine. Material and Method: We analyze the physiological changes occurring in the eyes and brain during pregnancy, as well as the neuro-ophthalmological manifestations that can occur during pregnancy. Studies published in both English and other languages, case reports, and reviews from 2011 to 2023 onwards were included. All surveys were acquired by exploring the databases. Results: We found a total of 2135 articles that showcase neuro-ophthalmic changes related to pregnancy: review and research articles (Science Direct 804, Web of Science 923, Scopus 345, and 63 Pub Med). In total, 86 studies were examined after applying the inclusion and exclusion criteria. Bilateral papilledema can be a warning sign for intracranial hypertension or cerebral venous sinus thrombosis. Additionally, when unilateral, it is important to differentially diagnose anterior ischemic optic neuropathy secondary to a hypercoagulant, compressive or inflammatory optic neuropathy, optic neuritis, or even orbital pseudotumor state. Severe eclampsia and preeclampsia can manifest as choroidal infarction, serous retinal detachment, and even cortical blindness. There can also be implications at the level of cranial nerves or transient Horner syndrome. Conclusions: Evaluating and treating a pregnant woman with neuro-ophthalmological manifestations is challenging. The obstetrician closely follows and has a medical relationship with the pregnant woman; hence he/she might be the first to be informed about the general condition of the pregnant woman or might request an ophthalmologic examination tailored to each specific case. Full article

(1) Background: The wider adoption of a preoperative ultrasound and calcitonin screening complemented by an intraoperative frozen section has increased the number of patients with occult sporadic medullary thyroid cancer (MTC). These advances offer new opportunities to reduce the extent of the initial operations, minimizing operative morbidity and the risk of postoperative thyroxin supplementation without compromising the cure. (2) Methods: This systematic review of the international literature published in the English language provides a comprehensive update on the latest progress made in the risk-adapted surgery for sporadic and hereditary MTC guided by an intraoperative frozen section. (3) Results: The current evidence confirms the viability of a hemithyroidectomy for desmoplasia-negative sporadic MTC. To add an extra safety margin, the hemithyroidectomy may be complemented by a diagnostic ipsilateral central node dissection. Despite the limited extent of the surgery, all the patients with desmoplasia-negative sporadic tumors achieved a biochemical cure with excellent clinical outcomes. A hemithyroidectomy decreases the need for postoperative thyroxine substitution, but a total thyroidectomy may be required for bilateral nodular thyroid disease. Hereditary MTC is a different issue. Because each residual thyroid C cell carries its own risk of malignant progression, a total thyroidectomy remains mandatory for hereditary MTC. (4) Conclusion: In experienced hands, a hemithyroidectomy, which minimizes morbidity without compromising the cure, is an adequate therapy for desmoplasia-negative sporadic MTC. Full article