Search Results (4,483)

Aim: This study compared spectral profile analysis thresholds, speech-in-noise perception, and cerebral asymmetry among Carnatic musicians, Bharatanatyam dancers, and non-trained individuals and examined the influence of training duration on these measures. Method: A total of 105 right-handed adults (18–30 years) with normal hearing were divided into Carnatic musicians (n = 35), Bharatanatyam dancers (n = 35), and non-trained controls (n = 35). Spectral stream segregation was measured using the spectral profile analysis task, and speech-in-noise perception was evaluated using the Kannada QuickSIN under right, left, and binaural conditions. Cerebral asymmetry was derived from the Laterality Index. As data were non-normally distributed, non-parametric tests were used. Results: Significant group differences emerged for spectral profile thresholds, with dancers outperforming musicians and controls. Both trained groups showed superior speech-in-noise performance compared to non-trained individuals across all listening conditions, though no differences were observed between musicians and dancers. Non-trained listeners displayed a clear right-ear advantage, whereas trained groups showed minimal or no hemispheric asymmetry. Training duration negatively correlated with selected spectral profile thresholds in both trained groups and with binaural SNR-50 in dancers, indicating training-related auditory enhancement. Conclusions: Musicians and dancers demonstrate better spectral discrimination, improved speech-in-noise perception, and reduced cerebral asymmetry compared to non-trained peers. These findings underscore training-induced auditory neuroplasticity and suggest that long-term engagement in music or dance promotes efficient auditory processing and greater bilateral hemispheric involvement. Full article

Background/Objectives: This study evaluated the immunomodulatory effects of multiple A. bisporus strains, applying both in vitro and in vivo murine models and aiming to identify specific strains with immune modulatory properties. Methods: Sixteen A. bisporus strains were screened in a dendritic cell (DC)–CD4⁺ T cell co-culture system, using cells from female C57BL/6 mice, for their capacity to induce Th1- and Th17-associated cytokine production. Based on these cytokine profiles, three potent strains (MES01856, MES01706, MES01637), one non-responder strain (MES01515), and the commercially available A15 strain were selected for investigation in a murine model, an ovalbumin (OVA)-induced allergic food allergy. In these sensitized female C3H/HeOuJ mice, ear swelling, anaphylactic shock scores, OVA-specific IgE, and serum mouse mast cell protease-1 (mMCP-1) were measured following an allergen challenge. Additionally, IL-6, IL-10, and TNF-α secretion from bone marrow-derived dendritic cells (BMDCs) was measured after stimulation with these A. bisporus fresh ground extracts (FGEs). Results: In vitro, increases in cytokine production were obtained, with MES01856, MES01706, and MES01637 identified as the most potent inducers. In vivo, OVA sensitization elicited significant ear swelling and elevated shock scores in the mice. Dietary supplementation with MES01706 or MES01515 significantly reduced ear swelling, while the other strains resulted in non-significant changes. No significant changes were observed in shock scores, OVA-specific IgE, or mMCP-1. Conclusions: Multiple different A. bisporus strains elicit specific immunomodulating effects both in vitro and in in vivo murine models, identifying the MES01706 strain as one with the highest potential to beneficially affect immune function. Full article

Plants are a rich source of active metabolites that have been used to treat inflammation troubles. The current study aimed to identify the analgesic and anti-inflammatory compounds in Farsetia aegyptia and Zilla spinosa extracts. The anti-inflammatory activity was evaluated using the xylene-induced ear edema model in mice and the carrageenan-induced paw edema model in Wistar rats. Additionally, both central and peripheral analgesic effects were assessed in mice. The anti-lipoxygenase activity was examined through an in vitro enzyme inhibition assay. The phytochemical composition of the bioactive extracts was characterized using High-Resolution Liquid Chromatography–Mass Spectrometry (HR-LCMS). The aqueous extracts of both species exhibited the strongest anti-inflammatory activity. The F. aegyptia extract showed inhibition percentages of 51.82% at 6.25 mg/kg and 51.14% at 0.78 mg/kg, while the Z. spinosa extract yielded 65.05% inhibition at 12.5 mg/kg and 56.14% at 1.56 mg/kg in the paw and ear edema models, respectively. These extracts also demonstrated significant analgesic activity and inhibited lipoxygenase, with IC₅₀ values of 0.063 mg/mL for F. aegyptia and 0.072 mg/mL for Z. spinosa. HR-LCMS analysis revealed that the main constituent in Fa was malic acid (18.83%), while retronecine (19.03%) was the primary compound in Z. spinosa. Quercetin 3-[rhamnosyl-(1->2)-rhamnosyl-(1->6)-glucoside] was detected in both extracts with important proportions 7.87% in F. aegyptia and 8.29% in Z. spinosa and displayed the best docking score of −9.2 kcal/mol against the 5-lipoxygenase receptor (PDB: 3V99) in molecular docking studies. Overall, these findings indicate that F. aegyptia and Z. spinosa have significant potential as sources of novel anti-inflammatory agents. Full article

Objectives: Nasal obstruction is a common presenting symptom in otolaryngology practice. Frequent etiologies include allergic and non-allergic rhinitis, inferior turbinate hypertrophy (HIT), and nasal septal deviation (DNS). This study aimed to evaluate the relationship between major causes of nasal obstruction and their effect on patient-reported quality of life (QoL). Methods: We conducted a retrospective analysis of patients presenting with nasal obstruction who completed the 22-item Sino-Nasal Outcome Test (SNOT-22), the Nasal Obstruction Symptom Evaluation (NOSE) scale, and a visual analog scale (VAS). Patients were categorized into three groups based on etiology: rhinitis, anatomical obstruction, or combined pathology. Results: The study included 170 patients (62% male), with a mean age of 38.4 years. Mean SNOT-22, NOSE, and VAS scores were 38, 61, and 6.5, respectively, with no statistically significant differences observed among the three etiologic groups. QoL outcomes were also comparable across anatomical subgroups, including isolated DNS, HIT, or combined findings. Among SNOT-22 domains, rhinologic symptoms demonstrated the highest burden. Patients with rhinitis exhibited significantly higher rhinologic and ear/facial symptom scores compared with patients with isolated anatomical obstruction (p = 0.04 and p = 0.005, respectively). Strong correlations were observed between SNOT-22, NOSE, and VAS scores across the entire cohort. Conclusions: Nasal obstruction is associated with substantial impairment in multiple domains of quality of life, independent of the underlying etiology. These findings highlight the broad impact of nasal obstruction on patient well-being. Larger prospective studies are warranted to further assess changes in quality of life following medical and surgical interventions. Full article

Background/Objective: Self-perceived hearing handicap (SPHH) reflects functional consequences of hearing loss beyond audiometric measures. Clarifying its relationship with audiometric severity and demographic factors is important for understanding age-related hearing loss (ARHL). This study examined associations between SPHH, audiometric measures, age, and sex in individuals with ARHL. Methods: A total of 145 adults (50 men, 95 women) aged 60–89 years (mean 71.65 ± 7.19 years) participated. Hearing status was defined using better-ear pure-tone average thresholds at 0.5, 1, 2, and 4 kHz (BE PTA-4), with ≥20 dB HL as the cutoff and World Health Organization (WHO)-defined severity categories. SPHH was assessed using the Croatian Hearing Handicap Inventory for the Elderly–Screening version (HHIE-S-CRO). HHIE-S-CRO total and subscale scores were examined across BE PTA-4 values and hearing loss categories. Associations were analyzed using correlation and linear regression adjusted for age and sex; group differences were tested using the Kruskal–Wallis test, and ordinal logistic regression assessed monotonic trends across ordered severity categories. Results: HHIE-S-CRO total and subscale scores increased with worsening BE PTA-4 and across hearing loss categories, with substantial overlap. Strong correlations were observed between HHIE-S-CRO scores and audiometric measures. In linear regression, BE PTA-4 was independently associated with HHIE-S-CRO total, emotional, and social/situational scores, whereas age and sex were not. Kruskal–Wallis tests showed significant differences across hearing loss categories. Ordinal logistic regression anchored to WHO severity categories demonstrated graded associations for HHIE-S-CRO total and emotional scores, while the social/situational subscale showed greater dispersion and overlap despite a statistically significant association. Conclusions: SPHH in ARHL shows a strong association with audiometric severity, with particularly robust correspondence for overall and emotional domains, underscoring the complementary role of patient-reported outcome measures alongside audiometric assessment. Full article

Background/Objectives: Postoperative sensory loss is a frequent morbidity following parotidectomy, yet the necessity of preserving the greater auricular nerve (GAN) during parotidectomy remains debated. While some surgeons prioritize nerve sacrifice for better oncological exposure, others advocate for preservation to maintain quality of life (QoL). This narrative review provides a comprehensive synthesis of current evidence regarding the impact of GAN sacrifice on objective sensory modalities, subjective disturbances, and long-term QoL. Methods: A literature search was performed (January 2000–August 2025). Twenty studies, including RCTs and cohorts, were reviewed to synthesize evidence on objective sensory modalities and patient-reported outcomes. Sensory assessments (Semmes–Weinstein monofilaments, VAS, and two-point discrimination) and the POI-8 QoL questionnaire were analyzed. Results: GAN preservation, particularly of the lobular branch, is associated with better early sensory recovery (1–6 months). In the long term (>12 months), although the sensory gap narrows between groups, the sacrifice group exhibits significantly higher rates of persistent anesthesia in localized regions, notably the earlobe. Regarding QoL, while global scores often show no significant long-term differences, 35% of patients with GAN sacrifice continue to experience functional limitations in specific activities, such as telephone use or wearing earrings. Conclusions: Although patients demonstrate adaptation to sensory loss, GAN preservation offers potential benefits in daily function and comfort; thus, it is advised when oncologically feasible. To overcome the high heterogeneity in current evidence, future multicenter trials utilizing unified objective measurements on predefined regions of interest are necessary to further clarify the functional benefits of nerve preservation and establish definitive surgical guidelines. Full article

Background/Objectives: Congenital cytomegalovirus (cCMV) is a leading non-genetic cause of childhood sensorineural hearing loss (SNHL), characterized by heterogeneous and dynamic hearing outcomes. Hearing impairment may be present at birth or emerge later in childhood. This study aimed to characterize hearing trajectories and laterality patterns in children with cCMV, with emphasis on congenital versus delayed-onset SNHL. Methods: We conducted a retrospective study of children with confirmed cCMV who underwent longitudinal audiologic follow-up. Hearing loss was classified as congenital SNHL or delayed-onset SNHL. Better- and poorer-ear thresholds, bilateral involvement, longitudinal changes, and follow-up duration were analyzed. Results: Of 195 included children, 59 (30%) developed SNHL. Congenital SNHL was present in 34 children (17%), while delayed-onset SNHL developed in 25 of 161 children (16%) who were born with normal hearing. Of these delayed-onset cases, 20 (80%) were asymptomatic at birth, while 5 (20%) presented with non-audiological neonatal symptoms. Longitudinal observation of the delayed-onset subgroup revealed that 36 ears developed SNHL during follow-up, spanning infancy through later childhood, including one case identified in early adulthood. Better-ear thresholds were significantly better preserved in delayed-onset SNHL, while poorer-ear thresholds were comparable across groups. Children with SNHL had substantially longer follow-up duration (60 ± 44.5 months) compared with those with normal hearing (37 ± 24.4 months). Conclusions: Children with cCMV-related SNHL exhibit dynamic and asymmetric hearing trajectories with clinically relevant differences between congenital and delayed-onset SNHL. These findings underscore the necessity of a risk-stratified, long-term surveillance framework that ensures individualized long-term monitoring and promotes sustained adherence to follow-up. Full article

Background: Otoplasty is a commonly performed cosmetic ear procedure, yet patient-reported outcome data remain limited. This study analyzes otoplasty reviews on RealSelf, a widely used aesthetic review platform that provides insight into patient experiences and outcomes. Methods: A retrospective review of otoplasty-related posts on RealSelf from January 2009 to March 2025 was performed. Reviews were manually screened and coded independently by reviewers. Extracted variables included demographics, procedure location, surgeon specialty, anesthesia type, postoperative pain, satisfaction rating (“Worth It,” “Not Worth It,” “Not Sure”), cost, motivations for surgery, and reasons for choosing the surgeon. Results: A total of 615 reviews met inclusion criteria, and 90.7% rated the procedure as “Worth It.” Protruding ears were the most common motivation for surgery (55.1%), followed by ear asymmetry (17.0%). Surgeon selection was most influenced by the consultation experience (34.4%), credentials (24.8%), and online reviews (21.6%). Positive surgeon comments emphasized comfort (32.3%), personality (27.9%), and communication (25.1%). Satisfaction was significantly associated with postoperative pain level (p < 0.001) and improved confidence after surgery (p = 0.032), but not with age, gender, procedure location, anesthesia type, or cost. Improved confidence (38.5%), enhanced ear shape (27.8%), and natural-appearing results (17.4%) were the most frequently cited reasons for being satisfied with otoplasty. Conclusion: Patient-reported satisfaction with otoplasty on RealSelf is high and is associated with favorable aesthetic results, improved self-confidence, and positive surgeon–patient interactions. In this cohort, effective communication, realistic expectation setting, and postoperative pain management were central to optimizing the patient experience. Full article

Background/Objectives: Hyperbaric Oxygen Therapy (HBOT) involves breathing oxygen at pressures greater than atmospheric levels and is used to treat diverse clinical conditions. However, little is known about the lived experiences and perceived needs of patients undergoing scheduled treatment in multiplace hyperbaric chambers, where nurses play a key role in support, safety, and communication. This study aimed to explore the perceptions, expectations, and needs of patients receiving scheduled HBOT sessions in a multiplace chamber in a hospital setting. Methods: A qualitative phenomenological design was used. Participants were recruited consecutively among adults who had completed at least 10 HBOT sessions and demonstrated adequate cognitive function. Individual semi-structured interviews were conducted between January and March 2023 in locations chosen by participants. Interviews were audio-recorded, transcribed, and validated by participants. Results: Twelve participants (eight men, four women; aged 25–84 years) were included. Four thematic areas emerged: (1) Biopsychosocial lived experiences, including initial uncertainty, physical discomfort such as ear pressure or mask-related issues, and progressive recognition of therapeutic benefits. (2) Interpersonal relationships, highlighting trust, security, and emotional support provided mainly by nurses. (3) Communication experiences, with participants expressing satisfaction but requesting clearer, earlier information on procedures, risks, and expected sensations. (4) Structural and organizational factors, where transportation logistics and treatment scheduling were significant sources of fatigue and discomfort. Conclusions: Patients valued HBOT and perceived notable health improvements, while identifying specific unmet informational and organizational needs. These findings suggest the importance of nurse-led educational interventions to enhance preparation, reduce anxiety, and optimize patient experience during HBOT. Full article

As intelligent vehicle technologies evolve, reliable driver monitoring systems have become increasingly critical for ensuring the safety of human drivers and operational reliability. This paper proposes a novel visual computing framework for Driver Fatigue Monitoring Systems (DFMSs) based on hierarchical decoupling and scenario element analysis, specifically designed for intelligent transportation environments. By treating the monitoring system as an engineering-level embodied perception–decision system deployed within the vehicle, rather than a purely disembodied vision module, the framework decouples low-level algorithmic perception from application-layer decision logic, enabling a more granular evaluation of visual computing performance in real-world scenarios. We leverage Python 3.9-driven automated test case generation to simulate diverse environmental variables, improving testing efficiency by 50% over traditional manual methods. The system utilizes deep learning-based visual computing to achieve high-fidelity monitoring of eye closure (PERCLOS, EAR), yawning (MAR), and head pose dynamics, enabling real-time assessment of the driver’s state within the embodied system loop. Comparative benchmarking reveals that our framework significantly outperforms existing models in visual understanding accuracy, achieving perfect confidence scores (1.000) for eye closure and smoking behavior detection, while drastically reducing false positives in mobile phone usage detection (misidentification rate: 0.016 vs. 0.805). These results demonstrate that an embodied approach to visual perception enhances the robustness and reliability of driver monitoring systems deployed in real vehicles, providing a scalable pathway for the development of next-generation intelligent transportation safety standards. Full article

Background: Acquired cholesteatoma is a chronic inflammatory middle ear disease characterized by keratinizing squamous epithelium overgrowth and bone erosion. While the upregulation of pattern-recognition receptor (PRR) signaling has been consistently observed, it remains unclear whether this reflects a secondary response to microbial infection or a primary dysfunction driven by genetic predisposition. Methods: Using the UK Biobank, we analyzed 678 individuals with cholesteatoma (ICD-10: H71) among 502,164 participants. Candidate genes implicated in cholesteatoma-related inflammatory pathways (n = 17) were selected, and 147 polymorphisms were studied. Gene-specific genetic risk scores (GRSs) were calculated for cholesteatoma patients (GRSchol) and the general UK Biobank population (GRSpop). The difference (ΔGRSchol-GRSpop) was used to assess the relative contribution of each gene. Results: Genes with the highest ΔGRS were IL6, TREM1, IL1R1, IL1A, HIF1A, ID1, RAGE, and TNFA. These genes represent key downstream mediators and amplifiers of PRR signaling rather than the receptors themselves. Variants in cytokine genes (IL6, IL1R1, IL1A, and TNFA) may enhance inflammatory signaling and bone resorption; Trem1 amplifies TLR responses; RAGE sustains sterile DAMP-driven inflammation, while HIF1A and ID1 implicate hypoxia, tissue remodeling, and keratinocyte proliferation in disease persistence. Conclusions: Our findings suggest that cholesteatoma pathogenesis may not be driven solely by microbial activation of PRRs but rather by genetic variants that amplify and sustain downstream inflammatory responses. This supports a model of cholesteatoma as a disease of self-perpetuating inflammation triggered by diverse stressors, including microbial and non-microbial insults. These insights may inform preventive strategies targeting environmental stressors, as well as therapeutic approaches using biologics to interrupt chronic inflammatory amplification in cholesteatoma. Full article

Pseudomonas aeruginosa is a clinically important opportunistic pathogen in dogs and cats, frequently associated with chronic infections and increasing antimicrobial resistance. In 2024, 111 P. aeruginosa isolates from 77 dogs and 34 cats were analyzed. Isolates originated from the external ear canal of animals with chronic otitis externa (66/111, 59.5%) and the nasal cavity of animals with chronic rhinitis (29/111, 26.1%), wounds (7/111, 6.3%), the conjunctival sac (5/111, 4.5%), and the skin (4/111, 3.6%). MICs for ciprofloxacin, meropenem, ceftazidime, aztreonam, piperacillin, piperacillin/tazobactam, and colistin were determined using a commercial microdilution panel and interpreted with CLSI M100 breakpoints for P. aeruginosa. Susceptibility was highest to piperacillin and piperacillin/tazobactam (both 90.1% susceptible and 7.2% resistant). Resistance was more frequent to ciprofloxacin (26.1%), meropenem (17.1%), and ceftazidime (16.2%). Colistin resistance (MIC ≥ 4 µg/mL) was detected in 6.3% of isolates. MDR (Magiorakos definition; non-susceptibility to ≥1 agent in ≥3 antimicrobial categories) was identified in 17/111 (15.3%) isolates. Meropenem non-susceptibility was strongly associated with ceftazidime non-susceptibility (25/111, 22.5%; OR 11.21; 95% CI 4.29–29.30; phi 0.51; p = 2.4 × 10⁻⁷). These findings provide baseline phenotypic surveillance data for P. aeruginosa from companion animals in Poland and highlight clinically relevant co-non-susceptibility patterns involving meropenem and ceftazidime. Full article

Background/Objectives: The variable accuracy of middle ear disease diagnosis based on oto-endoscopy underscores the need for improved decision support. Although convolutional Neural Networks (CNNs) are currently a mainstay of computer-aided diagnosis (CAD), their constraints in global feature integration persist. We therefore systematically benchmarked state-of-the-art CNNs and Transformers to establish a performance baseline. Beyond this benchmark, our primary contribution is the development of a probability-guided Top-K clinical decision framework that balances high accuracy with complete case coverage for practical deployment. Methods: Using a multicenter dataset of 6361 images (five categories), we implemented a two-stage validation strategy (fixed-split followed by 5-fold cross-validation). A comprehensive comparison was performed among leading CNNs and Transformer variants assessed by accuracy and Macro-F1 score. Results: The Swin Transformer model demonstrated superior performance, achieving an accuracy of 95.53% and a Macro-F1 score of 93.37%. It exhibited exceptional stability (95.61% ± 0.38% in cross-validation) and inherent robustness to class imbalance. A probability-guided Top-2 decision framework was developed, achieving 93.25% accuracy with 100% case coverage. Conclusions: This rigorous benchmark established Swin Transformer as the most effective architecture. Consequently, this study delivers not only a performance benchmark but also a clinically actionable decision-support framework, thereby facilitating the deployment of AI-assisted diagnosis for chronic middle ear conditions in specialist otology. Full article

Background/Objectives: Perioperative neurocognitive disorders (PNDs), including delirium and postoperative cognitive dysfunction, affect 10–50% of elderly surgical patients and are associated with increased morbidity and mortality, as well as substantial healthcare costs. Despite their clinical significance, the underlying mechanisms remain incompletely understood and effective interventions are limited. This narrative review synthesizes current evidence on the pathophysiology, risk factors, and management strategies for PNDs. Methods: We conducted a comprehensive literature review of peer-reviewed publications addressing PND epidemiology, mechanisms, assessment, and interventions. Key databases were searched for studies published through 2025, with emphasis on systematic reviews, meta-analyses, and landmark clinical trials. Results: PND represents a spectrum of cognitive impairments with multifactorial etiology involving neuroinflammation, neurotransmitter imbalances, and blood–brain barrier dysfunction. Advanced age, pre-existing cognitive impairment, and surgical factors constitute major risk domains. Validated assessment tools including the Confusion Assessment Method (CAM) and 4AT enable systematic detection. Multicomponent non-pharmacological interventions demonstrate 30–40% delirium reduction, while pharmacological prevention shows limited efficacy. Emerging evidence links perioperative delirium to accelerated long-term cognitive decline and increased dementia risk. Conclusions: PND represents a significant public health challenge requiring systematic attention in aging surgical populations. Evidence-based multicomponent interventions should be integrated into routine perioperative care pathways. Future research must elucidate mechanistic pathways linking acute delirium to chronic cognitive impairment and develop targeted therapies to preserve cognitive health in surgical populations. Full article

Objectives: To investigate the differences in inner ear anatomical variations between patients with acute low-tone sensorineural hearing loss (ALHL) and those with unilateral stage I/II Ménière’s disease (MD) based on magnetic resonance imaging (MRI). Methods: A total of 30 patients with unilateral ALHL, 41 patients with unilateral stage I/II MD, and 59 healthy controls were enrolled retrospectively. 3.0T MRI was used to evaluate the distance between the vertical part of the posterior semicircular canal and the posterior fossa (PPD) and vestibular aqueduct (VA) visibility. Inter-group and intra-group comparisons and correlation analyses were performed to clarify the characteristics of anatomical variations. Results: (1) There were no significant differences in PPD and VA visibility between ALHL patients and healthy controls; the PPD of unaffected ears in MD patients was significantly shorter than that in healthy controls, while no significant difference was observed in the PPD of affected ears between MD patients and healthy controls. (2) The VA visibility of affected ears in ALHL patients was significantly higher than that in MD patients. (3) No significant intra-group differences in PPD and VA visibility between affected and unaffected ears were noted in ALHL or MD patients. (4) A significant negative correlation was found between the PPD of affected ears and pure tone average of affected ears in MD patients, while no correlations were observed between anatomical indices and clinical characteristics in ALHL patients. Conclusions: Although both ALHL and MD are categorized as hydropic ear diseases, radiological evidences demonstrate that MD patients exhibit inner ear anatomical variations, whereas no significant anatomical variations are observed in ALHL patients. This suggests that anatomical variations in the endolymphatic drainage system may be a predisposing factor for the pathogenesis of unilateral MD rather than for unilateral ALHL. Full article