The Core Rehabilitation Outcome Set for Single-Sided Deafness (CROSSSD) study: International consensus on outcome measures for trials of interventions for adults with single-sided deafness

Abstract Background Single-sided deafness (SSD) has functional, psychological, and social consequences. Interventions for adults with SSD include hearing aids and auditory implants. Benefits and harms (outcome domains) of these interventions are until now reported inconsistently in clinical trials. Inconsistency in reporting outcome measures prevents meaningful comparisons or syntheses of trial results. The Core Rehabilitation Outcome Set for Single-Sided Deafness (CROSSSD) international initiative used structured communication techniques to achieve consensus among healthcare users and professionals working in the field of SSD. The novel contribution is a set of core outcome domains that experts agree are critically important to assess in all clinical trials of SSD interventions. Methods A long list of candidate outcome domains compiled from a systematic review and published qualitative data, informed the content of a two-round online Delphi survey. Overall, 308 participants from 29 countries were enrolled. Of those, 233 participants completed both rounds of the survey and scored each outcome domain on a 9-point scale. The set of core outcome domains was finalised via a web-based consensus meeting with 12 participants. Votes involved all stakeholder groups, with an approximate 2:1 ratio of professionals to healthcare users participating in the Delphi survey, and a 1:1 ratio participating in the consensus meeting. Results The first round of the survey listed 44 potential outcome domains, organised thematically. A further five outcome domains were included in Round 2 based on participant feedback. The structured voting at round 2 identified 17 candidate outcome domains which were voted on at the consensus meeting. Consensus was reached for a core outcome domain set including three outcome domains: spatial orientation, group conversations in noisy social situations, and impact on social situations. Seventy-seven percent of the remaining Delphi participants agreed with this core outcome domain set. Conclusions Adoption of the internationally agreed core outcome domain set would promote consistent assessment and reporting of outcomes that are meaningful and important to all relevant stakeholders. This consistency will in turn enable comparison of outcomes reported across clinical trials comparing SSD interventions in adults and reduce research waste. Further research will determine how those outcome domains should best be measured

N-ethylmaleimide-modified heavy meromyosin : a probe for actomyosin interactions

Treatment of rabbit skeletal muscle heavy meromyosin (HMM) with the sulfhydryl reagent N-ethylmaleimide (NEM) produces a species of HMM which remains tightly bound to actin in the presence ofMgATP. NEM-HMM forms characteristic "arrowhead " complexes with actin which persist despite rinses with MgATP. NEM-HMM inhibits the actin activation of native HMM-ATPase activity, the superprecipitation of actomyosin, the contraction of glycerinated muscle myofibrils, and the contraction of cytoplasmic strands of the soil amoeba Chaos carolinensis. However, NEM-HMM does not interfere with in vitro microtubule polymerization or beating of demembranated cilia. KEY WORDS actomyosin N-ethylmaleimide- cell motility- heavy meromyosin Microfilament systems are ubiquitous components of eukaryotic cells, serving as cytoskeletal element

Empirical correlations for the compression index of Irish soft soils

Numerous correlations have been developed in the literature relating the compression index Cc of soft soils to simple index properties that serve as a useful reality check on oedometer test results. However, many of these empirical correlations are specific to soils of a certain geographic region and/or geological origin and therefore may not be applicable in other contexts. Compression index data and corresponding index properties, specific to a good geographic spread of Irish soft soil sites, have been compiled in this paper. Of all the forms of correlation considered, the relationship between compression ratio Cc and the natural water content is the most fruitful in terms of allowing preliminary predictions of compression index to be made

Core Rehabilitation Outcome Set for Single Sided Deafness (CROSSSD) study:Protocol for an international consensus on outcome measures for single sided deafness interventions using a modified Delphi survey

BackgroundSingle-sided deafness (SSD) describes the presence of a unilateral severe to profound sensorineural hearing loss. SSD disrupts spatial hearing and understanding speech in background noise. It has functional, psychological and social consequences. Potential options for rehabilitation include hearing aids and auditory implants. Benefits and harms of these interventions are documented inconsistently in the literature, using a variety of outcomes ranging from tests of speech perception to quality of life questionnaires. It is therefore difficult to compare interventions when rehabilitating SSD. The Core Rehabilitation Outcome Set for Single Sided Deafness (CROSSSD) study is an international initiative that aims to develop a minimum set of core outcomes for use in future trials of SSD interventions.Methods/designThe CROSSSD study adopts an international two-round online modified Delphi survey followed by a stakeholder consensus meeting to identify a patient-centred core outcome domain set for SSD based on what is considered critical and important for assessing whether an intervention for SSD has worked.DiscussionThe resulting core outcome domain set will act as a minimum standard for reporting in future clinical trials and could have further applications in guiding the use of outcome measures in clinical practice. Standardisation will facilitate comparison of research findings

Identifying Sources of Faecal Contamination in a Small Urban Stream Catchment: A Multiparametric Approach

Small urban streams discharging in the proximity of bathing waters may significantly contribute to the deterioration of water quality, yet their impact may be overlooked. This study focuses on the Elm Park stream in the city of Dublin that is subject to faecal contamination by unidentified sources. The aim of the study was to identify a minimum number of “sentinel” sampling stations in an urban catchment that would provide the maximum amount of information regarding faecal pollution in the catchment. Thus, high-resolution sampling within the catchment was carried out over the course of 1 year at 11 stations. Faecal indicator bacteria were enumerated and microbial source tracking (MST) was employed to evaluate human pollution. In addition, ammonium, total oxidised nitrogen, and phosphorus levels were monitored to determine if these correlated with faecal indicator and the HF183 MST marker. In addition, the effect of severe weather events on water quality was assessed using automated sampling at one of the identified “sentinel” stations during baseflow and high flow conditions over a 24-h period. Our results show that this urban stream is at times highly contaminated by point source faecal pollution and that human faecal pollution is pervasive in the catchment. Correlations between ammonium concentrations and faecal indicator bacteria (FIB) as well as the human MST marker were observed during the study. Cluster analysis identified four “sentinel” stations that provide sufficient information on faecal pollution in the stream, thus reducing the geographical complexity of the catchment. Furthermore, ammonium levels strongly correlated with FIB and the human HF183 MST marker under high flow conditions at key “sentinel” stations. This work demonstrates the effectiveness of pairing MST, faecal indicators, and ammonium monitoring to identify “sentinel” stations that could be more rapidly assessed using real-time ammonium readouts to assess remediation efforts.</p

Perioperative nimodipine and postoperative analgesia

Opioids are the mainstay of treating acute postoperative pain. However, they are associated with a number of adverse events, including nausea and vomiting, respiratory depression, mood alteration, and pruritus. Treatment with adjunctive analgesic drugs can have a morphine-sparing effect, thereby reducing these side effects. This has been demonstrated with nonsteroidal antiinflammatory drugs, such as diclofenac (1), but these drugs are associated with their own adverse event profile, including gastrointestinal hemorrhage and renal impairment. There is growing evidence suggesting that voltage-gated calcium channels have an important role in the transmission of nociceptive impulses. Subtypes of voltage-gated calcium channels include L-, N-, and T- Ca2+ calcium channels. Calcium influx and efflux from sensory neurons appears to facilitate nociceptive neurotransmitter release in the spinal cord (2). Acute opioid exposure decreases intracellular calcium levels and Ca2+ binding to synaptic membranes (3). Conversely, increases in intracellular Ca2+ are associated with development of central sensitization after a noxious insult (4). L-type voltage-gated Ca2+ channels have been shown to have a functional role in morphine antinociception in a diabetic rat model (5). It seems logical to hypothesize, therefore, that inhibition of Ca2+ into sensory neurons using calcium antagonists might reduce pain and requirement for morphine in clinical situations. Nimodipine is a dihydropiridine calcium channel antagonist, which binds to the L-type voltage gated calcium channel. It crosses the blood-brain barrier and is demonstrably effective in the prevention of secondary ischemic neurological damage after subarachnoid hemorrhage (6). There are case reports of its efficacy when administered epidurally in reducing pain and opioid requirement in patients receiving palliative analgesic therapy (7). However, a placebo-controlled cross-over study in cancer patients failed to demonstrate any analgesic benefit of oral nimodipine (8). We tested the hypothesis in a randomized, double-blind, placebo-controlled clinical trial that perioperative nimodipine commenced preoperatively and continued for 48 h postoperatively would reduce pain and morphine requirements.N/

Additional file 4 of The Core Rehabilitation Outcome Set for Single-Sided Deafness (CROSSSD) study: International consensus on outcome measures for trials of interventions for adults with single-sided deafness

Additional file 4. Detailed plan and guidance document for consensus meetin