Sequential bilateral cochlear implant: long-term speech perception results in children first implanted at an early age

Purpose: The study aims to assess the benefit of sequential bilateral cochlear implantation in children with congenital bilateral profound hearing loss, submitted to the first implant at an early age. Methods: We enrolled all the bilateral sequential cochlear implanted children who received the first implant within 48 months and the second within 12 years of age at our Institution. The children were submitted to disyllabic word recognition tests and Speech Reception Threshold (SRT) assessment using the OLSA matrix sentence test with the first implanted device (CI1), with the second implanted device (CI2), and with both devices (CIbil). Furthermore, we measured the datalogging of both devices. Then we calculated the binaural SRT gain (b-SRTgain) and checked the correlations between speech perception results and the b-SRTgain with the child’s age at CI1 and CI2, DELTA and the datalogging reports. Results: With the bilateral electric stimulation, we found a significant improvement in disyllabic word recognition scores and in SRT. Moreover, the datalogging showed no significant differences in the time of use of CI1 and CI2. We found significant negative correlations between speech perception abilities with CI2 and age at CI2 and DELTA, and between the SRT with CI1 and the b-SRTgain. Conclusions: From this study we can conclude that in a sequential CI procedure, even if a short inter-implant delay and lower ages at the second surgery can lead to better speech perception with CI2, children can benefit from bilateral stimulation independently of age at the second surgery and the DELTA

The decline of the charismatic Parnassius mnemosyne (L.) (Lepidoptera: Papilionidae) in a central italy national park: A call for urgent actions

Here we report the strong decline of a population of the endangered species Parnassius mnemosyne (Linnaeus, 1758) (Lepidoptera: Papilionidae) in the National Park of Foreste Casentinesi, Monte Falterona and Campigna (Italy). We compared historical presence data (before 1969) with current data from two years of monitoring (2018–2019) and provided evidence of a drastic reduction in the number of sites inhabited by the species. A preliminary assessment suggested that the population of P. mmemosyne occurring in the Park is limited to a few individuals. We argue that the population of this iconic and charismatic butterfly is at the verge of extinction in this National Park, probably because of a combination of habitat loss (i.e. decrease in size and number of areas of open grassland on the mountain belt) and climatic changes. Being one of the few populations of P. mnemosyne in the Northern Apennines, the implementation of protection measures is a high conservation priority. Several other butterfly species on the Italian mountains that are facing the same survival challenges would also benefit from the establishment of conservation actions aimed at improving habitat quality for P. mnemosyne. Present article is meant to call for action researchers, stakeholders, and especially decision-makers in order to increase the efforts to upturn the evident decline in abundance of this population

Testing for the myth of cognitive reserve. Are the static and dynamic cognitive reserve indexes a representation of different reserve warehouses?

Background: Cognitive reserve (CR) explains the individual resilience to neurodegeneration. Years of formal education express the static measure of reserve (sCR). A dynamic aspect of CR (dCR) has been recently proposed. Objective: The aim of the study was to compare sCR and dCR indexes, respectively, to detect brain abnormalities in Alzheimer's disease (AD) patients. Methods: 117 individuals [39 AD, 40 amnestic mild cognitive impairment (aMCI), 38 healthy subjects (HS)] underwent neuropsychological evaluation and a 3T-MRI. T1-weighted volumes were used for manual segmentation of the hippocampus and of the parahippocampal cortices. Years of formal education were used as an index of sCR. Partial Least Square analysis was used to decompose the variance of individual MMSE scores, considered as a dCR index. In aMCI and AD patients, the brain abnormalities have been assessed comparing individuals with high and low levels of sCR and dCR in turn. Moreover, we investigated the effect of the different CR indexes in mediating the relationship between changes in brain volumes and memory performances. Results: sCR and dCR indexes classified differently individuals having high or low levels of CR. Smaller hippocampal and parahippocampal volumes in high dCR patients were found. The sCR and dCR indexes mediated significantly the relationship between brain abnormalities and memory in patients. Conclusions: CR mediated the relationship between brain and memory dysfunctions. We hypothesized that sCR and dCR indexes are a representation of different warehouses of reserve not operating in parallel but forming a complex system, in which crystalized cognitive abilities and actual cognitive efficiency interact with brain atrophy impacting on memory

Biodegradable polymeric micro/Nano-structures with intrinsic antifouling/antimicrobial properties: Relevance in damaged skin and other biomedical applications

Bacterial colonization ofimplanted biomedical devicesis themain cause of healthcare-associated infections, estimated to be 8.8 million per year in Europe. Many infections originate from damaged skin, which lets microorganisms exploit injuries and surgical accesses as passageways to reach the implant site and inner organs. Therefore, an effective treatment of skin damage is highly desirable for the success of many biomaterial-related surgical procedures. Due to gained resistance to antibiotics, new antibacterial treatments are becoming vital to control nosocomial infections arising as surgical and post-surgical complications. Surface coatings can avoid biofouling and bacterial colonization thanks to biomaterial inherent properties (e.g., super hydrophobicity), specifically without using drugs, which may cause bacterial resistance. The focus of this review is to highlight the emerging role of degradable polymeric micro- and nano-structures that show intrinsic antifouling and antimicrobial properties, with a special outlook towards biomedical applications dealing with skin and skin damage. The intrinsic properties owned by the biomaterials encompass three main categories: (1) physical-mechanical, (2) chemical, and (3) electrostatic. Clinical relevance in ear prostheses and breast implants is reported. Collecting and discussing the updated outcomes in this field would help the development of better performing biomaterial-based antimicrobial strategies, which are useful to prevent infections

The decline of the charismatic Parnassius mnemosyne (L.) (Lepidoptera: Papilionidae) in a Central Italy national park: a call for urgent actions

Here we report the strong decline of a population of the endangered species Parnassius mnemosyne (Linnaeus, 1758) (Lepidoptera: Papilionidae) in the National Park of Foreste Casentinesi, Monte Falterona and Campigna (Italy). We compared historical presence data (before 1969) with current data from two years of monitoring (2018–2019) and provided evidence of a drastic reduction in the number of sites inhabited by the species. A preliminary assessment suggested that the population of P. mmemosyne occurring in the Park is limited to a few individuals. We argue that the population of this iconic and charismatic butterfly is at the verge of extinction in this National Park, probably because of a combination of habitat loss (i.e. decrease in size and number of areas of open grassland on the mountain belt) and climatic changes. Being one of the few populations of P. mnemosyne in the Northern Apennines, the implementation of protection measures is a high conservation priority. Several other butterfly species on the Italian mountains that are facing the same survival challenges would also benefit from the establishment of conservation actions aimed at improving habitat quality for P. mnemosyne. Present article is meant to call for action researchers, stakeholders, and especially decision-makers in order to increase the efforts to upturn the evident decline in abundance of this population

Diagnosi eziologica dell’ipoacusia nei bambini identificati attraverso lo screening audiologico neonatale

Parallelamente alla attuazione dei programmi di screening audiologico neonatale e di diagnosi audiologica e trattamento precoci, si è resa evidente la necessità di mettere a punto e attuare un protocollo per la diagnosi eziologica della sordità, che sia sistematizzato e che si coordini, senza interferire, con il percorso diagnostico audiologico. Nell’ambito del progetto del Ministero della Salute CCM 2013 “Programma regionale di identificazione, intervento e presa in carico precoci per la prevenzione dei disturbi comunicativi nei bambini con deficit uditivo” è stata presa in considerazione la problematica relativa alla diagnosi eziologica della ipoacusia infantile nell’ambito dei programmi di screening audiologico neonatale. L’obiettivo specifico è quello di attuare il protocollo diagnostico per ottenere una definizione della causa della ipoacusia in almeno il 70% dei casi con diagnosi audiologica confermata. Nell’ambito di questa parte del progetto, sono state individuate quattro principali raccomandazioni utili nella ricerca di una diagnosi eziologica nei bambini affetti da ipoacusia, che possono costituire, per i centri audiologici di III livello, dei validi suggerimenti per ottimizzare le risorse e produrre cambiamenti positivi

Experimental Assessment of Cuff Pressures on the Walls of a Trachea-Like Model Using Force Sensing Resistors: Insights for Patient Management in Intensive Care Unit Settings

The COVID-19 outbreak has increased the incidence of tracheal lesions in patients who underwent invasive mechanical ventilation. We measured the pressure exerted by the cuff on the walls of a test bench mimicking the laryngotracheal tract. The test bench was designed to acquire the pressure exerted by endotracheal tube cuffs inflated inside an artificial model of a human trachea. The experimental protocol consisted of measuring pressure values before and after applying a maneuver on two types of endotracheal tubes placed in two mock-ups resembling two different sized tracheal tracts. Increasing pressure values were used to inflate the cuff and the pressures were recorded in two different body positions. The recorded pressure increased proportionally to the input pressure. Moreover, the pressure values measured when using the non-armored (NA) tube were usually higher than those recorded when using the armored (A) tube. A periodic check of the cuff pressure upon changing the body position and/or when performing maneuvers on the tube appears to be necessary to prevent a pressure increase on the tracheal wall. In addition, in our model, the cuff of the A tube gave a more stable output pressure on the tracheal wall than that of the NA tube

Systematic review of the literature on the clinical effectiveness of the cochlear implant procedure in adult patients

The aim of this systematic review was to summarize the results of scientific publications on the clinical effectiveness of the cochlear implant (CI) procedure in adults. The members of the Working Group first examined existing research evidence from the national and international literature and main international guidelines. They considered as universally accepted the usefulness/effectiveness of unilateral cochlear implantation in severelyprofoundly adult patients. Accordingly, they focused their attention on the systematic reviews addressing clinical effectiveness and cost/efficacy of CI procedures, with particular regard to the most controversial issues for which international consensus is still lacking. The following aspects were evaluated: monolateral CI in advanced-age adult patients; bilateral (simultaneous/sequential) CI vs. unilateral CI and vs. bimodal stimulation; benefits derived from the monolateral CI procedure in adult patients with prelingual deafness. With regard to CI in elderly patients, the selected studies document an improvement of the quality of life and perceptive abilities after CI, even if the benefits were found to be inferior in patients over 70 years at the time of surgery. Thus, from the results of the studies included in the review, advanced age is not a contraindication for the CI procedure. With respect to unilateral CI, bilateral CI offers advantages in hearing in noise, in sound localization and less during hearing in a silent environment. However, high interindividual variability is reported in terms of benefits from the second implant. With regard to CI in prelingually deaf adults, the selected studies document benefits deriving from the CI procedure in terms of improvement of perceptive abilities and in the quality of life after CI, as well as subjectively perceived benefits. However, there is high interindividual variability and the study sample is limited