Tinnitus revival during COVID‑19 lockdown: how to deal with it?

To the Editor, The novel Coronavirus Disease, officially designated as COVID-19 by the WHO, is a serious issue for public health. To contain the COVID-19, the Italian Government stated on March 9th 2020 the prohibition of any movement throughout the national area unless for work/health reasons and the obligation to remain as much as possible inside one’s own home. With the start of the so-called “Phase Two” on May 4th 2020, circulation within the same region was allowed again, due to the progressive slowdown of the outbreak. Therefore, since lockdown measures were relaxed and access to the emergency room or ENT clinic became less worrying for patients, specialists of Otolaryngology Units in Bari (Italy) observed an increase in the amount of subjects complaining of the revival of intense tinnitus. We attempt in this letter to focus on patients affected by chronic subjective tinnitus, that already had a diagnosis and self-stabilized without a massive treatment. Research studies have reported tinnitus wide impact on quality of life of subjects experiencing it, involving their emotional state, concentration and sleep quality; at this regard, Tinnitus Handicap Inventory (THI) is a self-reported tool regularly used to quantify the grade of perceived handicap as slight (0–16), mild (18–36), moderate (38–56), severe (58–76) or catastrophic (78–100) on the basis of 25 questions [1]. During the past 2 weeks, we have collected data from 16 patients among our population of chronic sufferers: THI observed was moderate in 62.5% and severe in 18.75% of cases, catastrophic in 12.5% and mild in 6.25% of subjects. Interestingly, the grade of handicap resulted increased by one-level in 12 out of 16 patients (75%); in particular, THI shifted from mild to moderate in 9 patients and from moderate to severe in 3 patients. As shown in the literature, tinnitus generation, maintenance and recrudescence are still debated. A cortical reorganization secondary to sensory deprivation has been proposed as one on the most frequent cause of tinnitus [2]. The avoidance of silence and acoustic masking have been proposed as effective measures to overcome sensory deprivation and increase masking of the symptom [3]. It is reasonable to think that, during the lockdown, the absence of environmental masking sounds from everyday life may have enhanced the tinnitus perception. Furthermore, proneness to worry and incoming stress during pandemic could be included as further potential risk factors for tinnitus worsening. As proficiently reviewed in a recent work [4], some internet/smartphone-based applications provide in tinnitus patients adequate counseling and interactive information together with sound therapy. As brain networks implicated in adaptive responses to sound stimuli and to worry are shared in many cases, an early decrease of anxiety status may release neural resources crucial for tinnitus habituation/distress perception [5]. In general, interactive platforms have been widely implemented during lockdown period due to the forced lack of real personal and working relationships; since smart-working seems to be successful for future plans, the development of smart applications and mobile services in the health care field may be promising in terms of cost-effectiveness, tolerability and simplicity of use

International Convergence of Accounting Standards-Perspectives from the FASB on Challenges and Opportunities

Convergence of international accounting standards is not a new initiative at the Financial Accounting Standards Board (FASB or Board); in fact, the FASB has pursued international convergence for almost half of its more than thirty year existence.\u27 The FASB\u27s international activities initially fell under the heading of harmonization, or internationalization, of accounting standards. Today those activities are referred to as convergence.Whatever the term, the Board has long held the view that a single set of high-quality international accounting standards is desirable because its use will improve international comparability of financial information; reduce costs to financial statement users, preparers, auditors, and others; and, ultimately, help promote the efficiency of the world\u27s capital markets. To that end, the FASB has and continues to invest considerable time and resources in convergence efforts

Seasonality in the Surface Energy Balance of Tundra in the Lower Mackenzie River Basin

This study details seasonal characteristics in the annual surface energy balance of upland and lowland tundra during the 1998–99 water year (Y2). It contrasts the results with the 1997–98 water year (Y1) and relates the findings to the climatic normals for the lower Mackenzie River basin region. Both years were much warmer than the long-term average, with Y1 being both warmer and wetter than Y2. Six seasons are defined as early winter, midwinter, late winter, spring, summer, and fall. The most rapid changes in the surface energy balance occur in spring, fall, and late winter. Of these, spring is the most dynamic, and there is distinct asymmetry between rates of change in spring and those in fall. Rates of change of potential insolation (extraterrestrial solar radiation) in late winter, spring, and fall are within 10% of one another, being highest in late winter and smallest in spring. Rates of change in air temperature and ground temperature are twice as large in spring as in fall and late winter, when they are about the same. Rates of change in components of the energy balance in spring are twice and 4 times as large as in fall and late winter, respectively. The timing of snowpack ripening and snowmelt is the major agent determining the magnitude of asymmetry between fall and spring. This timing is a result of interaction between the solar cycle, air temperature, and snowpack longevity. Based on evidence from this study, potential surface responses to a 18C increase in air temperature are small to moderate in most seasons, but are large in spring when increases range from 7% to 10% of average surface energy fluxes

Use and Perceptions of a Campus Food Pantry Among Food Insecure College Students: An Exploratory Study from Appalachia

Introduction: Food insecurity has emerged as a public health problem among college students in Appalachia, jeopardizing their physical, mental, and emotional health and academic success. Campus food pantries have been established in this region, but no data are available concerning student use or perception of services. Purpose: This study measured use and perceptions of a campus food pantry by students at a mid-sized university in rural North Carolina. Methods: An online questionnaire collected behavioral and perceptual data, and follow-up interviews explored these variables. Descriptive statistics with significance at p\u3c0.05 and thematic analytical procedures were used. Results: Questionnaires were submitted by 896 of 6000 recruited students (14.9%), and four students granted interviews. Food insecurity affected 437 (48.8%) of participants, of whom 76 (17.4%) were pantry shoppers. Shoppers (n = 94) were 27.7% males, 65.1% females, and 7.2% non-cisgender, 63.8% non-Hispanic white, 84.5% undergraduate, and 14.3% graduate students. Reasons for non-pantry use by food insecure students included: others need it more (30.1%) and feel embarrassed (20.7%). Benefits of pantry use were: spent more on necessities (56.4%) and job performance improved (18.1%). Shoppers perceived the pantry’s physical environment most favorably and food offerings less favorably. Implications: The low use of the campus food pantry by food insecure students suggests that these students may be jeopardizing their physical and mental health and academic success. Greater efforts by faculty, academic advisers, and student leaders are needed to promote pantry use and decrease the associated stigma

Characterization of Magnetic Steels for the FCC-ee Magnet Prototypes

At the European Organization for the Nuclear Research (CERN), several efforts were combined for a preliminary design of a new accelerator, the Future Circular Collider (FCC), a 100-TeV double-ring hadron collider to be installed in a 100-km tunnel. As potential intermediate step, a high-luminosity lepton collider called FCC-ee is foreseen with more than 9,000 magnets. This paper provides an insight into the magnetic properties of the steels, potentially considered for the new dipole magnets, with nominal field of only 56 mT. The influence of the properties of these steels on the magnet transfer function has been assessed analytically using an equivalent reluctance network to model the first 1-m long dipole prototypes. The analytical results were validated experimentally. The proposed approach can be a useful tool for traceability and quality control during the series production

Passive noise control oriented design of aircraft headrests

Two Passive Noise Control (PNC) concepts were numerically evaluated in terms of their impact on the Sound Pressure Level (SPL) perceived by passengers of an aircraft flight. A concept was based on the shape optimization of the headrests, whereas the second one was based on the adoption of a high absorbing material, i.e. a nanofiber textile, to improve the acoustic performances of the headrests. To this aim, an aircraft seat was modelled with the Boundary Element Method (BEM) and loaded with a spherical distribution of monopole sources surrounding the seat. Different configurations of headrest shape and covering textiles were then compared in terms of the SPL calculated at passengers’ ears. The work shows how an acoustic-oriented design of the aircraft headrests could achieve an average SPL reduction for passengers up to 3 dBA

Predicting Elective Orthopaedic Sports Medicine Surgical Cancellations Based on Patient Demographics.

Purpose:To evaluate whether patient demographics are associated with cancellation of elective orthopaedic sports medicine surgical procedures. Methods:We retrospectively reviewed the electronic medical records of 761 patients who were scheduled to undergo an elective sports medicine orthopaedic operation from January 1, 2015, to December 31, 2017. The patients were divided into 2 groups: those who underwent the scheduled procedure (group A) and those in whom the operation was canceled for any reason prior to the surgical date and not rescheduled (group B). Univariate analysis assessed patient factors consisting of age, sex, race, language, marital status, occupation status, type of insurance (Medicaid or Medicare vs private), smoking history, employment status, and history of surgery to determine which demographic factors led to an increased risk of elective case cancellation. Results:Patients who canceled were significantly older (46.5 years vs 41.5 years, t = 2.432, P = .015) than those who do not. In addition, current smokers (22.5% vs 10.9%, χ2 = 10.85, P = .001), patients with Medicare or Medicaid versus private insurance (16.7% vs 10.0%, χ2 = 5.35, P = .021), non-English-speaking patients (29.5% vs 11.6%, χ2 = 11.43, P = .001), and patients without a history of surgery requiring anesthesia (18.8% vs 9.6%, χ2 = 9.96, P = .002) were all more likely to cancel. When all studied variables were examined in a logistic regression analysis, of the above demographic variables, only insurance status was no longer significant, given its correlation with age and language. Conclusions:Increased age (≥46.5 years), non-English speaking, smoking, lack of a history of surgery requiring anesthesia, and Medicaid or Medicare insurance were found to contribute to an increased risk of elective orthopaedic surgery cancellation. Level of Evidence:Level III, case-control study

A cnidarian homologue of an insect gustatory receptor functions in developmental body patterning.

Insect gustatory and odorant receptors (GRs and ORs) form a superfamily of novel transmembrane proteins, which are expressed in chemosensory neurons that detect environmental stimuli. Here we identify homologues of GRs (Gustatory receptor-like (Grl) genes) in genomes across Protostomia, Deuterostomia and non-Bilateria. Surprisingly, two Grls in the cnidarian Nematostella vectensis, NvecGrl1 and NvecGrl2, are expressed early in development, in the blastula and gastrula, but not at later stages when a putative chemosensory organ forms. NvecGrl1 transcripts are detected around the aboral pole, considered the equivalent to the head-forming region of Bilateria. Morpholino-mediated knockdown of NvecGrl1 causes developmental patterning defects of this region, leading to animals lacking the apical sensory organ. A deuterostome Grl from the sea urchin Strongylocentrotus purpuratus displays similar patterns of developmental expression. These results reveal an early evolutionary origin of the insect chemosensory receptor family and raise the possibility that their ancestral role was in embryonic development