Sub-clinical effects of chronic noise exposure on vestibular system

Aim: to investigate the effect of chronic noise exposure on vestibular function of subjects without clinical evidence of vestibular disorders and with documented cochlear damage from noise. Subjects and methods: 25 patients with chronic noise- induced hearing loss (NIHL) and without vestibular complaints (group A) and 25 matched controls with sensorineural hearing loss without noise exposure (group B), underwent audiological and vestibular test including caloric and cervical vestibular-evoked myogenic potentials tests (cVEMPs). Results: In subjects chronically exposed to noise, similarly to that of the auditory threshold, an increase in the evocation threshold of VEMPs has been documented, statistically significant (p<0,05) and independent of the performance of the auditory threshold. p1-n1 amplitude values showed a significant difference between group A and group B. No significant difference for p1-n1 latencies between the two groups was found. Conclusion: We have documented the possibility of vestibular lesion, along with cochlear damage, related to chronic acoustic trauma

Tinnitus and equilibrium disorders in COVID-19 patients: preliminary results

Purpose: Tinnitus and equilibrium disorders such as dizziness and vertigo have been reported by patients with COVID-19; however, they have been rarely investigated. The aim of this study was to study the prevalence of subjective tinnitus and dizziness in a sample of COVID-19 patients using an online 10-item close-ended questionnaire. Methods: A multicentric study that included 15 Italian hospitals in different regions was conducted using an online 10-item close-ended questionnaire developed to identify the presence of tinnitus and balance disorders in patients with COVID-19 between May 5 and June 10, 2020. The questionnaire was administered to 185 patients in a period of > 30 – < 60 days after diagnosis of COVID-19; responses were recorded in an online Excel spreadsheet. The questionnaire was composed of three sections: (1) demographic information; (2) presence and characteristics of tinnitus and dizziness after COVID-19 diagnosis; (3) possible association with migraine. Results: Thirty-four patients (18.4%) reported equilibrium disorders after COVID-19 diagnosis. Of these, 32 patients reported dizziness (94.1%) and 2 (5.9%) reported acute vertigo attacks. Forty-three patients (23.2%) reported tinnitus; 14 (7.6%) reported both tinnitus and equilibrium disorders. Conclusion: This study suggests that the presence of subjective otoneurological symptoms such as tinnitus and balance disorders can affect COVID-19 patients; further studies are necessary to investigate the prevalence and pathophysiological mechanisms underlying these subjective symptoms in COVID-19 patients

Sudden olfactory loss as an early marker of COVID-19: a nationwide Italian survey

Purpose: The presence of many asymptomatic COVID-19 cases may increase the risks of disease dissemination, mainly for physicians. There are numerous reports on the frequent findings of sudden anosmia or hyposmia, before or at the same time of the typical COVID-19 symptoms onset. The aim of this study was to verify the association of olfactory impairment and COVID-19, providing a basis for subsequent research in the field of COVID-19 clinical heterogeneity. Methods: We developed a 15-item online questionnaire on “Sudden Olfactory Loss (SOL) and COVID-19” that was administered during March 2020 to Italian general practitioners registered to a social media group. Results: One hundred and eighty responses were received. SOL was identified as a significant sign of infection in COVID-19 patients, mainly aged between 30 and 40 years, even in the absence of other symptoms. SOL was present as an initial symptom in 46.7% of subjects, and in 16.7%, it was the only symptom. Among the COVID-19 confirmed cases, SOL occurred as the only symptom in 19.2% of patients. Conclusion: SOL could represent a possible early symptom in otherwise asymptomatic COVID-19 subjects. Subjects affected by SOL should be considered as potential COVID-19 cases. Level of evidence: 4

Fermi LAT Observations of LS I +61 303: First detection of an orbital modulation in GeV Gamma Rays

This Letter presents the first results from the observations of LSI +61 303 using Large Area Telescope data from the Fermi Gamma-Ray Space Telescope between 2008 August and 2009 March. Our results indicate variability that is consistent with the binary period, with the emission being modulated at 26.6 +/- 0.5 days. This constitutes the first detection of orbital periodicity in high-energy gamma rays (20 MeV-100 GeV, HE). The light curve is characterized by a broad peak after periastron, as well as a smaller peak just before apastron. The spectrum is best represented by a power law with an exponential cutoff, yielding an overall flux above 100 MeV of 0.82 +/- 0.03(stat) +/- 0.07(syst) 10^{-6} ph cm^{-2} s^{-1}, with a cutoff at 6.3 +/- 1.1(stat) +/- 0.4(syst) GeV and photon index Gamma = 2.21 +/- 0.04(stat) +/- 0.06(syst). There is no significant spectral change with orbital phase. The phase of maximum emission, close to periastron, hints at inverse Compton scattering as the main radiation mechanism. However, previous very high-energy gamma ray (>100 GeV, VHE) observations by MAGIC and VERITAS show peak emission close to apastron. This and the energy cutoff seen with Fermi suggest the link between HE and VHE gamma rays is nontrivial.Comment: 7 pages, 5 figures, accepted for publication in ApJ Letters 21 July 200

Inositols: From established knowledge to novel approaches

Myo-inositol (myo-Ins) and D-chiro-inositol (D-chiro-Ins) are natural compounds involved in many biological pathways. Since the discovery of their involvement in endocrine signal transduction, myo-Ins and D-chiro-Ins supplementation has contributed to clinical approaches in ameliorating many gynecological and endocrinological diseases. Currently both myo-Ins and D-chiro-Ins are well-tolerated, effective alternative candidates to the classical insulin sensitizers, and are useful treatments in preventing and treating metabolic and reproductive disorders such as polycystic ovary syndrome (PCOS), gestational diabetes mellitus (GDM), and male fertility disturbances, like sperm abnormalities. Moreover, besides metabolic activity, myo-Ins and D-chiro-Ins deeply influence steroidogenesis, regulating the pools of androgens and estrogens, likely in opposite ways. Given the complexity of inositol-related mechanisms of action, many of their beneficial effects are still under scrutiny. Therefore, continuing research aims to discover new emerging roles and mechanisms that can allow clinicians to tailor inositol therapy and to use it in other medical areas, hitherto unexplored. The present paper outlines the established evidence on inositols and updates on recent research, namely concerning D-chiro-Ins involvement into steroidogenesis. In particular, D-chiro-Ins mediates insulin-induced testosterone biosynthesis from ovarian thecal cells and directly affects synthesis of estrogens by modulating the expression of the aromatase enzyme. Ovaries, as well as other organs and tissues, are characterized by a specific ratio of myo-Ins to D-chiro-Ins, which ensures their healthy state and proper functionality. Altered inositol ratios may account for pathological conditions, causing an imbalance in sex hormones. Such situations usually occur in association with medical conditions, such as PCOS, or as a consequence of some pharmacological treatments. Based on the physiological role of inositols and the pathological implications of altered myo-Ins to D-chiro-Ins ratios, inositol therapy may be designed with two different aims: (1) restoring the inositol physiological ratio; (2) altering the ratio in a controlled way to achieve specific effects

Tear fluid biomarkers in ocular and systemic disease: potential use for predictive, preventive and personalised medicine

In the field of predictive, preventive and personalised medicine, researchers are keen to identify novel and reliable ways to predict and diagnose disease, as well as to monitor patient response to therapeutic agents. In the last decade alone, the sensitivity of profiling technologies has undergone huge improvements in detection sensitivity, thus allowing quantification of minute samples, for example body fluids that were previously difficult to assay. As a consequence, there has been a huge increase in tear fluid investigation, predominantly in the field of ocular surface disease. As tears are a more accessible and less complex body fluid (than serum or plasma) and sampling is much less invasive, research is starting to focus on how disease processes affect the proteomic, lipidomic and metabolomic composition of the tear film. By determining compositional changes to tear profiles, crucial pathways in disease progression may be identified, allowing for more predictive and personalised therapy of the individual. This article will provide an overview of the various putative tear fluid biomarkers that have been identified to date, ranging from ocular surface disease and retinopathies to cancer and multiple sclerosis. Putative tear fluid biomarkers of ocular disorders, as well as the more recent field of systemic disease biomarkers, will be shown

Mechanisms of stretch-mediated skin expansion at single-cell resolution.

The ability of the skin to grow in response to stretching has been exploited in reconstructive surgery1. Although the response of epidermal cells to stretching has been studied in vitro2,3, it remains unclear how mechanical forces affect their behaviour in vivo. Here we develop a mouse model in which the consequences of stretching on skin epidermis can be studied at single-cell resolution. Using a multidisciplinary approach that combines clonal analysis with quantitative modelling and single-cell RNA sequencing, we show that stretching induces skin expansion by creating a transient bias in the renewal activity of epidermal stem cells, while a second subpopulation of basal progenitors remains committed to differentiation. Transcriptional and chromatin profiling identifies how cell states and gene-regulatory networks are modulated by stretching. Using pharmacological inhibitors and mouse mutants, we define the step-by-step mechanisms that control stretch-mediated tissue expansion at single-cell resolution in vivo.Wellcome Trust Royal Societ

Long-term monitoring of the high-energy gamma-ray emission from LS I +61{\deg} 303 and LS 5039

The Fermi Large Area Telescope (LAT) reported the first definitive GeV detections of the binaries LS I +61\degree 303 and LS 5039 in the first year after its launch in June, 2008. These detections were unambiguous as a consequence of the reduced positional uncertainty and the detection of modulated gamma-ray emission on the corresponding orbital periods. An analysis of new data from the LAT, comprising 30 months of observations, identifies a change in the gamma-ray behavior of LS I +61\degree 303. An increase in flux is detected in March 2009 and a steady decline in the orbital flux modulation is observed. Significant emission up to 30GeV is detected by the LAT; prior datasets led to upper limits only. Contemporaneous TeV observations no longer detected the source, or found it -in one orbit- close to periastron, far from the phases at which the source previously appeared at TeV energies. The detailed numerical simulations and models that exist within the literature do not predict or explain many of these features now observed at GeV and TeV energies. New ideas and models are needed to fully explain and understand this behavior. A detailed phase-resolved analysis of the spectral characterization of LS I +61\degree 303 in the GeV regime ascribes a power law with an exponential cutoff spectrum along each analyzed portion of the system's orbit. The on-source exposure of LS 5039 is also substantially increased with respect to our prior publication. In this case, whereas the general gamma-ray properties remain consistent, the increased statistics of the current dataset allows for a deeper investigation of its orbital and spectral evolution.Comment: 12 pages, 13 figures, accepted for publication in Ap