The Impact of the COVID-19 Pandemic on Real-world Functioning in Adult Cochlear-implant Users.

Hypothesis: As a result of COVID-19 lockdowns and the associated effects on the auditory-social environments of cochlear-implant (CI) users, we expected that adult CI users would report a decrease in real-world communication abilities, a decrease in social isolation, and a decrease in quality of life (QOL) from pre- to post-pandemic. Background: The COVID-19 pandemic brought many changes to the environments in which adults with CIs interact and communicate. However, the impact of these changes on CI users' real-world functioning is not well understood. This study investigated the impact of the COVID-19 pandemic on real-world communication abilities, social isolation, and CI-related QOL in adult CI users. Methods: Fourteen adult CI users completed self-report questionnaires assessing communication abilities, social isolation, and CI-related QOL at time points before and after the onset of the COVID-19 pandemic. Responses at the 2 time points were compared to evaluate changes in CI users' real-world functioning. Results: Adult CI users showed a significant decrease in self-reported communication ability and a nonsignificant decline in CI-related QOL from before to during COVID-19. However, a nonsignificant trend of a decline in social isolation was also observed in adult CI users. Conclusion: Findings showed a decrease in self-reported communication abilities and, to a lesser extent, CI-related QOL, suggesting that changes to the auditory-social environment brought on by the COVID-19 pandemic may have negatively impacted communication abilities in real-world, challenging environments. Yet, the potential decrease in social isolation suggests that these changes may have had an overall positive effect on social interaction, potentially with close family and friends in well-controlled environments. Assessing changes in real-world functioning in the same CI users from both before and during the COVID-19 pandemic provided a unique glimpse into how changes in the auditory-social environment may impact outcomes in adult CI users.

Smoking and Carcinoma Trends in Recurrent Respiratory Papillomatosis Patients.

INTRODUCTION: Recurrent respiratory papillomatosis (RRP) is a chronic disease of the upper respiratory tract caused by human papillomavirus types 6 and 11. The disease course is characteristically unpredictable, ranging from spontaneous remission to aggressive, recurrent disease. Thus, management is often challenging and requires unique approaches tailored to each individual patient. While recent literature has described risk factors for more aggressive disease, few sources have investigated the impact of smoking on RRP disease course and risk for malignant transformation. METHODS: A retrospective chart review was conducted for adult RRP patients evaluated at an academic tertiary care center between 2005 and 2020. A total of 188 patients were identified. Demographic and clinical data were collected, including smoking and alcohol history, HPV subtype, history of dysplasia and/or carcinoma, voice handicap index scores, Derkay scores, debulkings (in office and operating room), and days to papilloma recurrence. RESULTS: Malignant degeneration in RRP occurred in 16.3% of smokers and 3.6% of nonsmokers. Smokers who developed carcinoma had less debulkings per years of evaluation than those not developing carcinoma (0.21 vs 0.92, P = .004). Additionally, patients that either presented with or developed carcinoma during their course had a higher pack-year smoking history (18.0 vs 12.21, P = .0002). No difference in days to recurrence or inter-surgical interval was demonstrated between smokers and nonsmokers. CONCLUSIONS: The report demonstrates that smoking can increase the risk of malignant transformation in RRP patients.

CD117/c-kit in Cancer Stem Cell-Mediated Progression and Therapeutic Resistance.

Metastasis is the primary cause of cancer patient morbidity and mortality, but due to persisting gaps in our knowledge, it remains untreatable. Metastases often occur as patient tumors progress or recur after initial therapy. Tumor recurrence at the primary site may be driven by a cancer stem-like cell or tumor progenitor cell, while recurrence at a secondary site is driven by metastatic cancer stem cells or metastasis-initiating cells. Ongoing efforts are aimed at identifying and characterizing these stem-like cells driving recurrence and metastasis. One potential marker for the cancer stem-like cell subpopulation is CD117/c-kit, a tyrosine kinase receptor associated with cancer progression and normal stem cell maintenance. Further, activation of CD117 by its ligand stem cell factor (SCF; kit ligand) in the progenitor cell niche stimulates several signaling pathways driving proliferation, survival, and migration. This review examines evidence that the SCF/CD117 signaling axis may contribute to the control of cancer progression through the regulation of stemness and resistance to tyrosine kinase inhibitors.

High magnitude head impacts experienced during youth football practices.

To reduce the risk of concussion in the 3.5 million youth athletes who participate in organized football leagues in the United States each year, practice structure can be modified to decrease impact frequency and magnitude. The objective of this study is to identify activities that result in high magnitude head impacts in youth football players during practice. The HIT System was used to record the head acceleration magnitude, impact location on the helmet, and time of each impact for each game and practice players participated in. These data were used to quantify the head impact exposure associated with players between the ages of 9 and 11 years. Video footage recorded during each practice and game session was used to identify the activity associated with any impact above 45 g. The incidence rate of high magnitude impacts in various activities were compared by normalizing by the amount of time associated with each activity. It was determined that scrimmages accounted for 0.094 impacts greater than 45 g per minute in practices while contact drills contributed to 0.102 impacts greater than 45 g per minute during practices. The results of this study indicate future youth football practice modifications should focus on both scrimmages and contact drills.

Methodology for mapping football head impact exposure to helmet pads for repeated loading testing.

Football helmets have a lifespan of 10 years; however, no work has investigated how helmet padding properties change over time with use. The purpose of this study is to develop a methodology to control repeated pad loading and quantify changes in energy management. Head impact exposure data for 7-8 year old football players were used to find an average impact magnitude. NOCSAE-style drop tests were performed using an instrumented headform fitted with the same style helmet (Helmet A) used to collect population data to determine the compression depth and rate of the helmet padding during an average impact. Drops from the same height were then conducted for two other helmet types (Helmet B and Helmet C). For the average impact of ~15 g, the compression depth and rate of the pads from Helmet A were found to be 9.8 mm and 0.72 m/s respectively. The compression depths and rates for Helmets B and C were found to be 6.1 mm and 0.71 m/s and 10.7 mm and 0.69 m/s respectively. These parameters were utilized by a material testing system program to impact helmet padding. Repeated helmet pad loading can be tested using a material testing system for populations with known head impact exposure. The energy absorbing characteristics of the padding can be used to develop new safety regulations regarding the lifetime of helmets, affording better protection to athletes.

Head impact exposure in youth football: elementary school ages 7-8 years and the effect of returning players.

OBJECTIVE: To provide data describing the head impact exposure of 7- to 8-year-old football players. DESIGN: Head impact data were collected from 19 players over the course of 2 seasons using helmet-mounted accelerometer arrays. SETTING: Data were collected from 2 youth football teams in Blacksburg, VA, spanning 2 seasons. PARTICIPANTS: A total of 19 youth football players aged 7-8 years. INDEPENDENT VARIABLES: Type of session (practice or game) and the player's experience. MAIN OUTCOME MEASURES: Head impact frequency, acceleration magnitude, and impact location for games, practices, and the season as a whole were measured. RESULTS: The average instrumented player sustained 9 ± 6 impacts per practice, 11 ± 11 impacts per game, and 161 ± 111 impacts per season. The average instrumented player had a median impact of 16 ± 2 g and 686 ± 169 rad/s and a 95th percentile impact of 38 ± 13 g and 2052 ± 664 rad/s throughout a season. Impacts of 40 g or greater tended to occur more frequently in practices than in games, and practices had a significantly higher 95th percentile impact magnitude than games (P = 0.023). Returning players had significantly more impacts than first time players (P = 0.007). CONCLUSIONS: These data are a further step toward developing effective strategies to reduce the incidence of concussion in youth football and have applications toward youth-specific football helmet designs.