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Medical/Scientific Illustration And Production Of Otological Health Awareness Materials

Over the past year, I have worked for my mentor, Beth Cooper, on a large variety of projects. Beth is the Manager of the Acoustical Testing Laboratory, which tests the acoustical emissions of payloads destined for the International Space Station. She is also responsible for educating, and developing new methods of educating, people of all occupational and educational backgrounds in hearing conservation. Beth spends much of her time developing new materials and strategies with which to train people and teach other people to train people in hearing conservation and noise emissions control. I have been helping Beth develop and market these materials by way of graphic design and scientific illustration. Last summer, I spent much of my time creating educational illustrations that visually explained particular concepts in Beth's presentations. Sometimes these illustrations were small "comics" while, at other times, they were an instructional series of illustrations. Since then, Beth and her lab have been developing and updating some materials which will be distributed free to hearing conservation and noise control professionals and others in related fields. I have helped with these projects by designing their packaging. In each instance, it was my responsibility to develop an aesthetically appealing package that would also, through its imagery, describe or summarize the contents of the product. I did this for 3 CD's (Auditory Demonstrations 11, MACSUG, and JeopEARdy) and saw them through their actual production and distribution. In addition to working with Beth, I work with the Imaging Technology Center on various imaging projects. Some of my activities include photo retouching and manipulation for videos and print. This summer, I also had the opportunity to develop a screen saver that would show of some of the photography contained on the soon-to-be-released "Highlights of the GRC Image Archives, vol. 2". I was also able to utilize my medical training to help several of ITC s videographers identify the best histological examples of cancerous cells for incorporation in one of their videos. Over the last part of this summer and then throughout the school year, I will be working with Beth to develop a "pre-packaged" lecture series about the physics of acoustics in the context of hearing conservation. These lectures will be used to teach people of all backgrounds the fundamental concepts involved in acoustical physics so they might be better aware of their own and others auditory health in and out of the work place, and, in the case of payload developers, to design and build more quiet science experiments for the ISS. Even though it may not seem as such, this project is precisely what I am learning to do as a student of the Cleveland Institute of Art's Medical Illustration Department. From my perspective, this project is about taking technical information and translating it into terms that anyone, regardless of background, can understand.

Hawes, Nicholas E.↗

Perimatrix of middle ear cholesteatoma: A granulation tissue with a specific transcriptomic signature

Objectives/Hypothesis: To establish comprehensive transcriptomic profiles of cholesteatoma perimatrix tissue and granulation tissue from chronic otitis media (COM) that did not develop cholesteatoma, which can indicate molecular pathways involved in the cholesteatoma perimatrix pathology and invasiveness. Study Design: Retrospective Case Series. Methods: Transcriptome data were obtained from cholesteatoma perimatrix tissue and COM granulation tissue by an Illumina iScan microarray. Differentially expressed genes (DEGs) were subsequently analyzed using both bioinformatical functional annotation and network analysis. Expression of candidate genes (MMP9 and LCN2) was validated by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) on a larger group of samples. Results: Analysis of the transcriptome led to the identification of 169 differentially expressed genes between investigated tissues. Bioinformatic analysis suggested that most significant biological processes involving DEGs were previously described in cholesteatoma pathology. Network analysis identified ERBB2, TFAP2A, and TP63 as major hubs of the DEGs molecular network. Furthermore, it was observed that the cellular component most significantly enriched in DEGs was extracellular space containing 47 DEGs. Using qRT-PCR, it was confirmed that mRNA levels of the major extracellular hub (MMP9) are increased, whereas its interacting molecule (LCN2) mRNA levels were decreased in cholesteatoma perimatrix tissue compared to COM granulation tissue. Conclusions: The current study approach offers an overall look at molecular mechanisms that describe the cholesteatoma entity by focusing exclusively on the perimatrix processes in comparison to COM granulation tissue. The observed differences in gene expression between cholesteatoma perimatrix and COM granulation tissue could suggest novel markers potentially influenced by the perimatrix–matrix molecular interplay, which is not present in COM without cholesteatoma. Level of Evidence: NA. Laryngoscope, 130:E220–E227, 2020. © 2019 The American Laryngological, Rhinological and Otological Society, Inc.

60 APPLIED LIFE SCIENCES↗

Evaluation of Saccadic Component Measure on Smooth Pursuit Tests

ABSTRACT Introduction Despite the advancement of eye-tracking technology for smooth pursuit (SP) eye movement evaluation, qualitative observation offers much information that is not captured by computers; hence, both objective and qualitative information should be utilized to evaluate SP. This study examined the consistency among our clinicians when evaluating SP using normal (N), grossly normal (GN), mildly abnormal (MA), and abnormal (AB) as classifications. We then evaluated the effect of combining GN and MA into a single subclinical (SUBC) category. We also evaluated the computerized percent saccade (PS) metric by determining its sensitivity and specificity in classifying SP. Materials and Methods Retrospective horizontal and vertical SP test videos and numerical data for 70 participants were obtained from the Neuro Kinetics Neuro-Otologic Test Center and de-identified. From this, eye-tracking videos, time plots of eye-tracking positional data, and tables of SP eye-tracking performance data were generated for 0.1, 0.3, and 0.5 Hz in both horizontal and vertical planes, totaling 6 tests per subject. Three clinicians rated each subject’s SP performance as N, GN, MA, or AB for a total of 6 ratings (3 frequencies, horizontal and vertical). This process was repeated using N, SUBC, and AB as rating categories. Clinicians also provided an overall SP rating for each plane as follows: AB if the results were abnormal for 2 or more frequencies tested. Alternatively, if fewer than 2 frequencies presented with a rating of AB, then an overall rating of MA, GN, or N was determined at the respective clinician’s discretion. Results When the 3 clinicians were tasked with classifying SP videos using 4 clinical categories, fair overall agreement was demonstrated. However, when MA and GN categories were combined into an SUBC category, the overall agreement for the 3 clinicians improved slightly for both horizontal SP (HSP) and vertical SP (VSP). This pattern of agreement did not differ considerably when comparing HSP versus VSP, and good consistency and reliability was observed across clinicians. Again, inter-rater consistency was smaller for VSP versus HSP despite the reduction in clinical categories. Cut-off values were generated for the PS metric and demonstrated good specificity and sensitivity when they were exceeded for 2 or more frequencies in a particular plane when evaluating a subject’s SP test. Conclusions

General & Internal Medicine↗

Presbycusis, sociocusis, and nosocusis

The establishment of a baseline of normal hearing is investigated through the examination of pure tone hearing level surveys and variables such as age, sociocusis, sex, race, and otological disorders. Mathematical formulae used to predict hearing levels in industrial and nonindustrial surveys is included.

Source record↗

A vestibular phenotype for Waardenburg syndrome?

OBJECTIVE: To investigate vestibular abnormalities in subjects with Waardenburg syndrome. STUDY DESIGN: Retrospective record review. SETTING: Tertiary referral neurotology clinic. SUBJECTS: Twenty-two adult white subjects with clinical diagnosis of Waardenburg syndrome (10 type I and 12 type II). INTERVENTIONS: Evaluation for Waardenburg phenotype, history of vestibular and auditory symptoms, tests of vestibular and auditory function. MAIN OUTCOME MEASURES: Results of phenotyping, results of vestibular and auditory symptom review (history), results of vestibular and auditory function testing. RESULTS: Seventeen subjects were women, and 5 were men. Their ages ranged from 21 to 58 years (mean, 38 years). Sixteen of the 22 subjects sought treatment for vertigo, dizziness, or imbalance. For subjects with vestibular symptoms, the results of vestibuloocular tests (calorics, vestibular autorotation, and/or pseudorandom rotation) were abnormal in 77%, and the results of vestibulospinal function tests (computerized dynamic posturography, EquiTest) were abnormal in 57%, but there were no specific patterns of abnormality. Six had objective sensorineural hearing loss. Thirteen had an elevated summating/action potential (>0.40) on electrocochleography. All subjects except those with severe hearing loss (n = 3) had normal auditory brainstem response results. CONCLUSION: Patients with Waardenburg syndrome may experience primarily vestibular symptoms without hearing loss. Electrocochleography and vestibular function tests appear to be the most sensitive measures of otologic abnormalities in such patients.

NASA Discipline Neuroscience↗