Evaluation of the ClearVoice Strategy in Adults Using HiResolution Fidelity 120 Sound Processing

ObjectivesThis study aimed to evaluate the benefits of ClearVoice strategy on speech perception in noise and in everyday listening situations in Cantonese-speaking cochlear implant users.MethodsTwelve experienced adult users of the Harmony implant and HiRes 120 sound processing participated in the study. The study employed a prospective within-subjects design wherein speech recognition in adults using HiRes 120 without ClearVoice turned on (control option) was compared to their performance with HiRes 120 with ClearVoice turned on. Each subject was evaluated with two different ClearVoice gain settings: -12 dB (ClearVoice medium) and -18 dB (ClearVoice high) after one-week of use. The Cantonese hearing in noise test and a questionnaire were used as the outcome measures.ResultsSubjects performed significantly better with ClearVoice medium than with control option in noise. No significant difference in performance was noted among the 3 settings in quiet. Most subjects reported high level of satisfaction with ClearVoice in daily listening situations and preferred to keep ClearVoice on.ConclusionClearVoice can help cochlear implant recipients to hear better in noise

Towards a global partnership model in interprofessional education for cross-sector problem-solving

Objectives A partnership model in interprofessional education (IPE) is important in promoting a sense of global citizenship while preparing students for cross-sector problem-solving. However, the literature remains scant in providing useful guidance for the development of an IPE programme co-implemented by external partners. In this pioneering study, we describe the processes of forging global partnerships in co-implementing IPE and evaluate the programme in light of the preliminary data available. Methods This study is generally quantitative. We collected data from a total of 747 health and social care students from four higher education institutions. We utilized a descriptive narrative format and a quantitative design to present our experiences of running IPE with external partners and performed independent t-tests and analysis of variance to examine pretest and posttest mean differences in students’ data. Results We identified factors in establishing a cross-institutional IPE programme. These factors include complementarity of expertise, mutual benefits, internet connectivity, interactivity of design, and time difference. We found significant pretest–posttest differences in students’ readiness for interprofessional learning (teamwork and collaboration, positive professional identity, roles, and responsibilities). We also found a significant decrease in students’ social interaction anxiety after the IPE simulation. Conclusions The narrative of our experiences described in this manuscript could be considered by higher education institutions seeking to forge meaningful external partnerships in their effort to establish interprofessional global health education

Identification of QTL genes for BMD variation using both linkage and gene-based association approaches

Low bone mineral density (BMD) is a risk factor for osteoporotic fracture with a high heritability. Previous large scale linkage study in Northern Chinese has identified four significant quantitative trait loci (QTL) for BMD variation on chromosome 2q24, 5q21, 7p21 and 13q21. We performed a replication study of these four QTL in 1,459 Southern Chinese from 306 pedigrees. Successful replication was observed on chromosome 5q21 for femoral neck BMD with a LOD score of 1.38 (nominal p value = 0.006). We have previously identified this locus in a genome scan meta-analysis of BMD variation in a white population. Subsequent QTL-wide gene-based association analysis in 800 subjects with extreme BMD identified CAST and ERAP1 as novel BMD candidate genes (empirical p value of 0.032 and 0.014, respectively). The associations were independently replicated in a Northern European population (empirical p value of 0.01 and 0.004 for CAST and ERAP1, respectively). These findings provide further evidence that 5q21 is a BMD QTL, and CAST and ERAP1 may be associated with femoral neck BMD variation

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

The global retinoblastoma outcome study : a prospective, cluster-based analysis of 4064 patients from 149 countries

DATA SHARING : The study data will become available online once all analyses are complete.BACKGROUND : Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. METHODS : We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. FINDINGS : The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). INTERPRETATION : This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes.The Queen Elizabeth Diamond Jubilee Trust and the Wellcome Trust.https://www.thelancet.com/journals/langlo/homeam2023Paediatrics and Child Healt

Test-retest reliability of distortion product otoacoustic emissions inthe high frequency range

abstractpublished_or_final_versiontocSpeech and Hearing SciencesMasterMaster of Science in Audiolog

Human herpesvirus 6 (HHV-6) mRNA in peripheral blood leukocytes differentiates active infection from latency

published_or_final_versionMicrobiologyMasterMaster of Philosoph

Serological diagnosis of influenza B virus infection in pigs : a comparison of the hemagglutination inhibition assay and the cell-based ELISA assay

Background Swine influenza virus (SIV) was first isolated in the United States in 1930 and was thereafter widely reported in many countries. Most SIVs that have been identified are influenza A viruses. There was no report of influenza B viruses isolated in swine. Seroepidemiological study in UK has shown a low seroprevalence of influenza B antibody in pigs. The primary serological test used to detect influenza antibody is the hemagglutination inhibition (HI)test. Enzyme-linked immunosorbent assay (ELISA) are also available commercially for detection of antibodies against influenza A viruses but not for the detection of influenza B antibodies. Objectives 1) To examine the prevalence of influenza B antibodies in pig sera sampled at the abattoir in Hong Kong. 2) To develop the cell-based ELISA assay for the detection of antibodies against influenza A and B viruses. 3) To compare the cell-based ELISA assays with three commercial ELISA kits, namely the IDVet ID Screen influenza A antibody competition ELISA, the IDEXX Influenza A Ab test and the IDEXX AI MultiS-Screen Ab test using swine sera. 4) To test swine sera using the influenza B cell-based ELISA assay to complement data on swine seroprevalence obtained with HI tests. Methods The first part of this study involved HI screening of 4643 pig sera from 2009 to 2012. These sera were tested for the presence of antibodies against B/Brisbane/60/2008 and B/Wisconsin/1/2010whichrepresent the B/Victoria and B/Yamagata lineages respectively. The second part of this study involved the development and performance evaluation of the cell-based ELISA assays. The cell-based ELISA assays were developed using influenza virus infected cells as the capture antigens and fluorescence-labelled anti-IgG antibody as the detection antibody. The viruses that were used to prepare the assays were A/California/04/2009, B/Brisbane/60/2008 and B/Wisconsin/1/2010. All three cell-based ELISA assays were tested with WHO reference sera and swine sera and the results were analyzed using paired t-test and receiver operating characteristic analysis. In addition, the results of the influenza A cell-based ELISA assay were compared with the commercial ELISA assay using Fisher’s exact two-tailed test, Pearson’s correlation analysis and Bland-Altman plot. Results A low prevalence (0.28%; 95%CI: 0.16%-0.47%) of influenza B antibody was observed inthe swine sera samples. The seroprevalence for B/Victoria was higher than that of B/Yamagatain 2010to2012. Co-existence of B/Victoria and B/Yamagata antibodies were found in the swine population during 2010 and 2011. The influenza A cell-based ELISA was found to have low sensitivity (64.1%;95%CI: 52.4%-74.4%) and high specificity (94.7%; 95%CI:80.9%-99.1%) when compared with the commercial ELISA assays. In contrast, using HI as the reference test influenza B cell-based ELISA prepared using B/Wisconsin/1/2010 infected cells were shown to have high sensitivity (92.31%; 95%CI:64.0%-99.8%) but low specificity (63.16%;95%CI:38.4%-83.7%) in detection of influenza B antibodies in swine sera. Conclusion Sporadic transmission of influenza B virus may occur in swine but there is no evidence for efficient and sustained transmission of the virus between them. Cell-based ELISA assay prepared with B/Wisconsin/1/2010 may be considered as an alternative screening testprior to HI subtyping.published_or_final_versionPublic HealthMasterMaster of Public Healt