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Quantum key distribution (QKD) is a revolutionary communication technology that promises ultimate security assurance by exploiting the fundamental principles of quantum mechanics. In this work, we report design and development of a fully automated inter-building QKD framework for generation and distribution of cryptographic keys, securely and seamlessly, by executing weak coherent pulse based BB84 protocol. This framework is experimentally validated by establishing a quantum communication link between two buildings separated by ~300m of free-space atmospheric channel. A novel synchronization technique enabled with indigenous NavIC (IRNSS) constellation is developed and implemented. This QKD system demonstrates generation of secure key rate as high as 300 Kbps with QBER< 3% for mean photon no. per pulse (${\mu}$) of 0.15. The intercept-resend eavesdropping attack has been emulated within the system and evaluated during experiment. A novel quantum secured end-to-end encrypted video calling app (QuViC) is also developed and integrated with QKD framework to demonstrate unconditionally secure two-way communication over Ethernet, functioning alongside with quantum communication.

ObjectiveIdentify contemporary noise exposures and hearing protection use among adults.Study designCross-sectional analysis of national health survey.MethodsAdult respondents in the 2014 National Health Interview Series hearing survey module were analyzed. Potentially harmful exposures to occupational and recreational noises in the past 12 months were extracted and quantified. Patterns of hearing protection use also were analyzed.ResultsAmong 239.7 million adults, "loud" and "very loud" occupational noise exposures were reported by 5.3% and 21.7%, respectively. Of those exposed to "loud" or "very loud" sounds at work, only 18.7% and 43.6%, respectively, always used hearing protection. A total of 38.2% (1.9 million) of those with "very loud" occupational exposures never used hearing protection. Frequent (> 10/year) "loud" and "very loud" recreational noise exposures were reported by 13.9% and 21.1%, respectively, most commonly to lawn mowers (72.6% and 55.2%, respectively). When exposed to recreational "loud/very loud" noise, only 11.4% always used hearing protection, whereas 62.3% (6.3 million) never used any protection. Lifetime exposure to firearm noise was reported by 36.6% of adults, 11.5% of whom had used firearms in the prior 12 months. Of those, only 58.5% always used hearing protection, whereas 21.4% (7.4 million) never used hearing protection.ConclusionSubstantial noise exposures with potentially serious long-term hearing health consequences frequently are occurring in occupational and recreational settings, and with the use of firearms. Only a minority of those exposed consistently are using hearing protection. Healthcare providers should actively identify and encourage the use of hearing protection with those patients at risk.Level of evidence4. Laryngoscope, 127:E340-E346, 2017.

Objectives/hypothesisQuantify the relationships between tinnitus, and anxiety and depression among adults.Study designCross-sectional analysis of a national health survey.MethodsAdult respondents in the 2007 Integrated Health Interview Series tinnitus module were analyzed. Data for tinnitus symptoms and severity and reported anxiety and depression symptoms were extracted. Associations between tinnitus problems and anxiety, depression, lost workdays, days of alcohol consumption, and mean hours of sleep were assessed.ResultsAmong 21.4 ± 0.69 million adult tinnitus sufferers, 26.1% reported problems with anxiety in the preceding 12 months, whereas only 9.2% of those without tinnitus reported an anxiety problem (P < .001). Similarly, 25.6% of respondents with tinnitus reported problems with depression, whereas only 9.1% of those without tinnitus reported depression symptoms (P < .001). Those reporting tinnitus symptoms as a "big" or "very big" problem were more likely to concurrently report anxiety (odds ratio [OR]: 5.7; 95% CI: 4.0-8.1; P < .001) and depression (OR: 4.8; 95% CI: 3.5-6.7; P < .001) symptoms. Tinnitus sufferers reported significantly fewer mean hours of sleep per night (7.00 vs. 7.21; P < .001) and greater mean days of work missed (6.94 vs. 3.79, P < .001) compared to those who did not report tinnitus. Mean days of alcohol consumption between the two groups were not significantly different.ConclusionsTinnitus symptoms are closely associated with anxiety, depression, shorter sleep duration, and greater workdays missed. These comorbidities and sequelae should be recognized and addressed to optimally manage patients with chronic and bothersome tinnitus.Level of evidence4 Laryngoscope, 2016 127:466-469, 2017.

ObjectiveIdentify contemporary noise exposures and hearing protection use among adults.Study designCross-sectional analysis of national health survey.MethodsAdult respondents in the 2014 National Health Interview Series hearing survey module were analyzed. Potentially harmful exposures to occupational and recreational noises in the past 12 months were extracted and quantified. Patterns of hearing protection use also were analyzed.ResultsAmong 239.7 million adults, "loud" and "very loud" occupational noise exposures were reported by 5.3% and 21.7%, respectively. Of those exposed to "loud" or "very loud" sounds at work, only 18.7% and 43.6%, respectively, always used hearing protection. A total of 38.2% (1.9 million) of those with "very loud" occupational exposures never used hearing protection. Frequent (> 10/year) "loud" and "very loud" recreational noise exposures were reported by 13.9% and 21.1%, respectively, most commonly to lawn mowers (72.6% and 55.2%, respectively). When exposed to recreational "loud/very loud" noise, only 11.4% always used hearing protection, whereas 62.3% (6.3 million) never used any protection. Lifetime exposure to firearm noise was reported by 36.6% of adults, 11.5% of whom had used firearms in the prior 12 months. Of those, only 58.5% always used hearing protection, whereas 21.4% (7.4 million) never used hearing protection.ConclusionSubstantial noise exposures with potentially serious long-term hearing health consequences frequently are occurring in occupational and recreational settings, and with the use of firearms. Only a minority of those exposed consistently are using hearing protection. Healthcare providers should actively identify and encourage the use of hearing protection with those patients at risk.Level of evidence4. Laryngoscope, 127:E340-E346, 2017.

Objectives/hypothesisQuantify the relationships between tinnitus, and anxiety and depression among adults.Study designCross-sectional analysis of a national health survey.MethodsAdult respondents in the 2007 Integrated Health Interview Series tinnitus module were analyzed. Data for tinnitus symptoms and severity and reported anxiety and depression symptoms were extracted. Associations between tinnitus problems and anxiety, depression, lost workdays, days of alcohol consumption, and mean hours of sleep were assessed.ResultsAmong 21.4 ± 0.69 million adult tinnitus sufferers, 26.1% reported problems with anxiety in the preceding 12 months, whereas only 9.2% of those without tinnitus reported an anxiety problem (P < .001). Similarly, 25.6% of respondents with tinnitus reported problems with depression, whereas only 9.1% of those without tinnitus reported depression symptoms (P < .001). Those reporting tinnitus symptoms as a "big" or "very big" problem were more likely to concurrently report anxiety (odds ratio [OR]: 5.7; 95% CI: 4.0-8.1; P < .001) and depression (OR: 4.8; 95% CI: 3.5-6.7; P < .001) symptoms. Tinnitus sufferers reported significantly fewer mean hours of sleep per night (7.00 vs. 7.21; P < .001) and greater mean days of work missed (6.94 vs. 3.79, P < .001) compared to those who did not report tinnitus. Mean days of alcohol consumption between the two groups were not significantly different.ConclusionsTinnitus symptoms are closely associated with anxiety, depression, shorter sleep duration, and greater workdays missed. These comorbidities and sequelae should be recognized and addressed to optimally manage patients with chronic and bothersome tinnitus.Level of evidence4 Laryngoscope, 2016 127:466-469, 2017.

Advancement of the scientific enterprise relies on individuals conducting research in an ethical and responsible manner. Educating emergent scholars in the principles of ethics/responsible conduct of research (E/RCR) is therefore critical to ensuring such advancement. The recent impetus to include authentic research opportunities as part of the undergraduate curriculum, via course-based undergraduate research experiences (CUREs), has been shown to increase cognitive and noncognitive student outcomes. Because of these important benefits, CUREs are becoming more common and often constitute the first research experience for many students. However, despite the importance of E/RCR in the research process, we know of few efforts to incorporate E/RCR education into CUREs. The Ethics Network for Course-based Opportunities in Undergraduate Research (ENCOUR) was created to address this concern and promote the integration of E/RCR within CUREs in the biological sciences and related disciplines. During the inaugural ENCOUR meeting, a four-pronged approach was used to develop guidelines for the effective integration of E/RCR in CUREs. This approach included: 1) defining appropriate student learning objectives; 2) identifying relevant curriculum; 3) identifying relevant assessments; and 4) defining key aspects of professional development for CURE facilitators. Meeting outcomes, including the aforementioned E/RCR guidelines, are described herein.

Advancement of the scientific enterprise relies on individuals conducting research in an ethical and responsible manner. Educating emergent scholars in the principles of ethics/responsible conduct of research (E/RCR) is therefore critical to ensuring such advancement. The recent impetus to include authentic research opportunities as part of the undergraduate curriculum, via course-based undergraduate research experiences (CUREs), has been shown to increase cognitive and noncognitive student outcomes. Because of these important benefits, CUREs are becoming more common and often constitute the first research experience for many students. However, despite the importance of E/RCR in the research process, we know of few efforts to incorporate E/RCR education into CUREs. The Ethics Network for Course-based Opportunities in Undergraduate Research (ENCOUR) was created to address this concern and promote the integration of E/RCR within CUREs in the biological sciences and related disciplines. During the inaugural ENCOUR meeting, a four-pronged approach was used to develop guidelines for the effective integration of E/RCR in CUREs. This approach included: 1) defining appropriate student learning objectives; 2) identifying relevant curriculum; 3) identifying relevant assessments; and 4) defining key aspects of professional development for CURE facilitators. Meeting outcomes, including the aforementioned E/RCR guidelines, are described herein.

ImportanceTinnitus is a common problem for millions of individuals and can cause substantial negative effects on their quality of life. A large epidemiologic study of tinnitus and its management patterns in the US adult population is lacking.ObjectivesTo quantify the epidemiologic features and effect of tinnitus and to analyze the management of tinnitus in the United States relative to the 2014 American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) clinical practice guidelines.Design, methods, and participantsThis cross-sectional analysis of the representative 2007 National Health Interview Survey (raw data, 75 764 respondents) identified a weighted national sample of adults (age, ≥18 years) who reported tinnitus in the preceding 12 months. Data were collected in November 2014 at the University of California, Irvine, and Harvard Medical School.Main outcomes and measuresIn addition to quantifying prevalence, severity, duration, and regularity of tinnitus, specific data regarding noise exposure and tinnitus management patterns during health care visits were analyzed.ResultsAmong an estimated (SE) 222.1 (3.4) million US adults, 21.4 (3.4) million (9.6% [0.3%]) experienced tinnitus in the past 12 months. Among those who reported tinnitus, 27% had symptoms for longer than 15 years, and 36% had nearly constant symptoms. Higher rates of tinnitus were reported in those with consistent exposure to loud noises at work (odds ratio, 3.3; 95% CI, 2.9-3.7) and during recreational time (odds ratio, 2.6; 95% CI, 2.3-2.9). Years of work-related noise exposure correlated with increasing prevalence of tinnitus (r = 0.13; 95% CI, 0.10-0.16). In terms of subjective severity, 7.2% reported their tinnitus as a big or a very big problem compared with 41.6% who reported it as a small problem. Only 49.4% had discussed their tinnitus with a physician, and medications were the most frequently discussed recommendation (45.4%). Other interventions, such as hearing aids (9

ImportanceTinnitus is a common problem for millions of individuals and can cause substantial negative effects on their quality of life. A large epidemiologic study of tinnitus and its management patterns in the US adult population is lacking.ObjectivesTo quantify the epidemiologic features and effect of tinnitus and to analyze the management of tinnitus in the United States relative to the 2014 American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) clinical practice guidelines.Design, methods, and participantsThis cross-sectional analysis of the representative 2007 National Health Interview Survey (raw data, 75 764 respondents) identified a weighted national sample of adults (age, ≥18 years) who reported tinnitus in the preceding 12 months. Data were collected in November 2014 at the University of California, Irvine, and Harvard Medical School.Main outcomes and measuresIn addition to quantifying prevalence, severity, duration, and regularity of tinnitus, specific data regarding noise exposure and tinnitus management patterns during health care visits were analyzed.ResultsAmong an estimated (SE) 222.1 (3.4) million US adults, 21.4 (3.4) million (9.6% [0.3%]) experienced tinnitus in the past 12 months. Among those who reported tinnitus, 27% had symptoms for longer than 15 years, and 36% had nearly constant symptoms. Higher rates of tinnitus were reported in those with consistent exposure to loud noises at work (odds ratio, 3.3; 95% CI, 2.9-3.7) and during recreational time (odds ratio, 2.6; 95% CI, 2.3-2.9). Years of work-related noise exposure correlated with increasing prevalence of tinnitus (r = 0.13; 95% CI, 0.10-0.16). In terms of subjective severity, 7.2% reported their tinnitus as a big or a very big problem compared with 41.6% who reported it as a small problem. Only 49.4% had discussed their tinnitus with a physician, and medications were the most frequently discussed recommendation (45.4%). Other interventions, such as hearing aids (9

Purpose Dry eye is known to impact on clinical outcomes after laser vision correction and the use of a newer ‘all femtosecond laser’ surgical approach may be associated with less impact on the ocular surface post-operatively. The purpose of this study was to evaluate the early clinical outcomes and tear instability after the first small incision lenticule extraction (SMILE) cases undertaken by three surgeons at a single site in the UK. Methods Retrospective audit. Seventy-one eyes of 37 patients underwent SMILE surgery using the Zeiss VisuMax laser system (Carl Zeiss Meditec, Germany). Uncorrected and corrected distance visual acuity, spherical equivalent refraction, fluorescein enhanced tear break up time, simulated keratometry and complications were evaluated pre- and post-operatively where applicable. Results The study population consisted of 21 males and 16 females. The mean ± standard deviation age was 33 ± 8 years. The results showed that 100% of eyes achieved 20/40 or better and 88% achieved 20/20 or better uncorrected distance visual acuity. The spherical equivalent refraction after surgery was within ±0.50D in 82% of eyes at three months. There was no significant difference in tear break up time from pre-operative levels at three months. Complications were infrequent. Conclusions This early data from surgeons’ first SMILE procedures suggest SMILE provides good outcomes in terms of refractive predictability and visual acuity with minimal impact on the tear film. Longitudinal research will further improve our understanding of the longer-term impact of SMILE on clinical outcomes, ocular surface metrics and patient reported outcomes.

Purpose Dry eye is known to impact on clinical outcomes after laser vision correction and the use of a newer ‘all femtosecond laser’ surgical approach may be associated with less impact on the ocular surface post-operatively. The purpose of this study was to evaluate the early clinical outcomes and tear instability after the first small incision lenticule extraction (SMILE) cases undertaken by three surgeons at a single site in the UK. Methods Retrospective audit. Seventy-one eyes of 37 patients underwent SMILE surgery using the Zeiss VisuMax laser system (Carl Zeiss Meditec, Germany). Uncorrected and corrected distance visual acuity, spherical equivalent refraction, fluorescein enhanced tear break up time, simulated keratometry and complications were evaluated pre- and post-operatively where applicable. Results The study population consisted of 21 males and 16 females. The mean ± standard deviation age was 33 ± 8 years. The results showed that 100% of eyes achieved 20/40 or better and 88% achieved 20/20 or better uncorrected distance visual acuity. The spherical equivalent refraction after surgery was within ±0.50D in 82% of eyes at three months. There was no significant difference in tear break up time from pre-operative levels at three months. Complications were infrequent. Conclusions This early data from surgeons’ first SMILE procedures suggest SMILE provides good outcomes in terms of refractive predictability and visual acuity with minimal impact on the tear film. Longitudinal research will further improve our understanding of the longer-term impact of SMILE on clinical outcomes, ocular surface metrics and patient reported outcomes.

Purpose Dry eye is known to impact on clinical outcomes after laser vision correction and the use of a newer ‘all femtosecond laser’ surgical approach may be associated with less impact on the ocular surface post-operatively. The purpose of this study was to evaluate the early clinical outcomes and tear instability after the first small incision lenticule extraction (SMILE) cases undertaken by three surgeons at a single site in the UK. Methods Retrospective audit. Seventy-one eyes of 37 patients underwent SMILE surgery using the Zeiss VisuMax laser system (Carl Zeiss Meditec, Germany). Uncorrected and corrected distance visual acuity, spherical equivalent refraction, fluorescein enhanced tear break up time, simulated keratometry and complications were evaluated pre- and post-operatively where applicable. Results The study population consisted of 21 males and 16 females. The mean ± standard deviation age was 33 ± 8 years. The results showed that 100% of eyes achieved 20/40 or better and 88% achieved 20/20 or better uncorrected distance visual acuity. The spherical equivalent refraction after surgery was within ±0.50D in 82% of eyes at three months. There was no significant difference in tear break up time from pre-operative levels at three months. Complications were infrequent. Conclusions This early data from surgeons’ first SMILE procedures suggest SMILE provides good outcomes in terms of refractive predictability and visual acuity with minimal impact on the tear film. Longitudinal research will further improve our understanding of the longer-term impact of SMILE on clinical outcomes, ocular surface metrics and patient reported outcomes.

Purpose Dry eye is known to impact on clinical outcomes after laser vision correction and the use of a newer ‘all femtosecond laser’ surgical approach may be associated with less impact on the ocular surface post-operatively. The purpose of this study was to evaluate the early clinical outcomes and tear instability after the first small incision lenticule extraction (SMILE) cases undertaken by three surgeons at a single site in the UK. Methods Retrospective audit. Seventy-one eyes of 37 patients underwent SMILE surgery using the Zeiss VisuMax laser system (Carl Zeiss Meditec, Germany). Uncorrected and corrected distance visual acuity, spherical equivalent refraction, fluorescein enhanced tear break up time, simulated keratometry and complications were evaluated pre- and post-operatively where applicable. Results The study population consisted of 21 males and 16 females. The mean ± standard deviation age was 33 ± 8 years. The results showed that 100% of eyes achieved 20/40 or better and 88% achieved 20/20 or better uncorrected distance visual acuity. The spherical equivalent refraction after surgery was within ±0.50D in 82% of eyes at three months. There was no significant difference in tear break up time from pre-operative levels at three months. Complications were infrequent. Conclusions This early data from surgeons’ first SMILE procedures suggest SMILE provides good outcomes in terms of refractive predictability and visual acuity with minimal impact on the tear film. Longitudinal research will further improve our understanding of the longer-term impact of SMILE on clinical outcomes, ocular surface metrics and patient reported outcomes.

Objective To examine the relationship between the prescribed target dose and the dose to healthy neurovascular structures in patients with vestibular schwannomas treated with stereotactic radiosurgery (SRS). Study Design Case series with chart review. Setting SRS center from 2011 to 2013. Subjects Twenty patients with vestibular schwannomas treated at the center from 2011 to 2013. Methods Twenty patients with vestibular schwannomas were included. The average radiation dose delivered to healthy neurovascular structures (eg, carotid artery, basilar artery, facial nerve, trigeminal nerve, and cochlea) was analyzed. Results Twenty patients with vestibular schwannomas who were treated with fused computed tomography/magnetic resonance imaging-guided SRS were included in the study. The prescribed dose ranged from 10.58 to 17.40 Gy over 1 to 3 hypofractions to cover 95% of the target tumor volume. The mean dose to the carotid artery was 5.66 Gy (95% confidence interval [CI], 4.53-6.80 Gy), anterior inferior cerebellar artery was 8.70 Gy (95% CI, 4.54-12.86 Gy), intratemporal facial nerve was 3.76 Gy (95% CI, 3.04-4.08 Gy), trigeminal nerve was 5.21 Gy (95% CI, 3.31-7.11 Gy), and the cochlea was 8.70 Gy (95% CI, 7.81-9.59 Gy). Conclusions SRS for certain vestibular schwannomas can expose the anterior inferior cerebellar artery (AICA) and carotid artery to radiation doses that can potentially initiate atherosclerotic processes. The higher doses to the AICA and carotid artery correlated with increasing tumor volume. The dose delivered to other structures such as the cochlea and intratemporal facial nerve appears to be lower and much less likely to cause immediate complications when shielded.

Objectives/hypothesisPermanent facial nerve injury is a difficult challenge for both patients and physicians given its potential for debilitating functional, cosmetic, and psychological sequelae. Although current surgical interventions have provided considerable advancements in facial nerve rehabilitation, they often fail to fully address all impairments. We aim to introduce an alternative approach to facial nerve rehabilitation.Study designAcute experiments in animals with normal facial function.MethodsThe study included three anesthetized cats. Four facial muscles (levator auris longus, orbicularis oculi, nasalis, and orbicularis oris) were monitored with a standard electromyographic (EMG) facial nerve monitoring system with needle electrodes. The main trunk of the facial nerve was exposed, and a 16-channel penetrating electrode array was placed into the nerve. Electrical current pulses were delivered to each stimulating electrode individually. Elicited EMG voltage outputs were recorded for each muscle.ResultsStimulation through individual channels selectively activated restricted nerve populations, resulting in selective contraction of individual muscles. Increasing stimulation current levels resulted in increasing EMG voltage responses. Typically, selective activation of two or more distinct muscles was successfully achieved via a single placement of the multi-channel electrode array by selection of appropriate stimulation channels.ConclusionWe have established in the animal model the ability of a penetrating electrode array to selectively stimulate restricted fiber populations within the facial nerve and to selectively elicit contractions in specific muscles and regions of the face. These results show promise for the development of a facial nerve implant system.Level of evidenceN/A.Laryngoscope, 2016 127:460-465, 2017.

Objectives/hypothesisPermanent facial nerve injury is a difficult challenge for both patients and physicians given its potential for debilitating functional, cosmetic, and psychological sequelae. Although current surgical interventions have provided considerable advancements in facial nerve rehabilitation, they often fail to fully address all impairments. We aim to introduce an alternative approach to facial nerve rehabilitation.Study designAcute experiments in animals with normal facial function.MethodsThe study included three anesthetized cats. Four facial muscles (levator auris longus, orbicularis oculi, nasalis, and orbicularis oris) were monitored with a standard electromyographic (EMG) facial nerve monitoring system with needle electrodes. The main trunk of the facial nerve was exposed, and a 16-channel penetrating electrode array was placed into the nerve. Electrical current pulses were delivered to each stimulating electrode individually. Elicited EMG voltage outputs were recorded for each muscle.ResultsStimulation through individual channels selectively activated restricted nerve populations, resulting in selective contraction of individual muscles. Increasing stimulation current levels resulted in increasing EMG voltage responses. Typically, selective activation of two or more distinct muscles was successfully achieved via a single placement of the multi-channel electrode array by selection of appropriate stimulation channels.ConclusionWe have established in the animal model the ability of a penetrating electrode array to selectively stimulate restricted fiber populations within the facial nerve and to selectively elicit contractions in specific muscles and regions of the face. These results show promise for the development of a facial nerve implant system.Level of evidenceN/A.Laryngoscope, 2016 127:460-465, 2017.

Objective To examine the relationship between the prescribed target dose and the dose to healthy neurovascular structures in patients with vestibular schwannomas treated with stereotactic radiosurgery (SRS). Study Design Case series with chart review. Setting SRS center from 2011 to 2013. Subjects Twenty patients with vestibular schwannomas treated at the center from 2011 to 2013. Methods Twenty patients with vestibular schwannomas were included. The average radiation dose delivered to healthy neurovascular structures (eg, carotid artery, basilar artery, facial nerve, trigeminal nerve, and cochlea) was analyzed. Results Twenty patients with vestibular schwannomas who were treated with fused computed tomography/magnetic resonance imaging-guided SRS were included in the study. The prescribed dose ranged from 10.58 to 17.40 Gy over 1 to 3 hypofractions to cover 95% of the target tumor volume. The mean dose to the carotid artery was 5.66 Gy (95% confidence interval [CI], 4.53-6.80 Gy), anterior inferior cerebellar artery was 8.70 Gy (95% CI, 4.54-12.86 Gy), intratemporal facial nerve was 3.76 Gy (95% CI, 3.04-4.08 Gy), trigeminal nerve was 5.21 Gy (95% CI, 3.31-7.11 Gy), and the cochlea was 8.70 Gy (95% CI, 7.81-9.59 Gy). Conclusions SRS for certain vestibular schwannomas can expose the anterior inferior cerebellar artery (AICA) and carotid artery to radiation doses that can potentially initiate atherosclerotic processes. The higher doses to the AICA and carotid artery correlated with increasing tumor volume. The dose delivered to other structures such as the cochlea and intratemporal facial nerve appears to be lower and much less likely to cause immediate complications when shielded.

ObjectiveMal de debarquement syndrome (MdDS) is a balance disorder that typically starts after an extended exposure to passive motion, such as a boat or plane ride. Management is typically supportive (e.g. physical therapy), and symptoms that persist beyond 6 months have been described as unlikely to remit. This study was conducted to evaluate the response of patients with MdDS to management with migraine prophylaxis, including lifestyle changes and medical therapy.Study designProspective review.SettingAmbulatory setting at a tertiary care medical center.MethodsClinical history, detailed questionnaires, and audiograms were used to diagnose patients with MdDS. Those patients with the diagnosis of the MdDS were placed on our institutional vestibular migraine management protocol. Treatment response was assessed with a quality-of-life (QOL) survey and visual analog scale.ResultsFifteen patients were diagnosed with MdDS, with a predominance of females (73%) and a mean age of 50 ± 13 years. Eleven patients (73%) responded well to management with a vestibular migraine protocol, which included lifestyle changes, as well as pharmacotherapy with verapamil, nortriptyline, topiramate, or a combination thereof. In comparison, a retrospective control group of 17 patients demonstrated a lower rate of improvement when treated with vestibular rehabilitation and physical therapy.ConclusionManagement of MdDS as vestibular migraine can improve patients' symptoms and increase the QOL. Nearly all the patients suffering from MdDS had a personal or family history of migraine headaches or had signs or symptoms suggestive of atypical migraine.Level of evidence4 Laryngoscope, 127:1670-1675, 2017.

ObjectivesTo evaluate the outcomes and complications of transcanal excision of exostoses using micro-osteotomes, without a postauricular incision or the use of the drill.Study designA retrospective chart review of patients undergoing exostoses excision.SettingTertiary Care Medical Center.Subjects and methodsAll of the patients underwent surgical removal of the exostoses using only a 1 or 2 mm micro-osteotomes. Patients were followed postoperatively and associated complications were evaluated.ResultsOne-hundred thirty-eight ears in 106 patients were treated for obstructive exostosis. The average age of patients was 43 ± 16 years. Of these, 99 were man (93%) and 7 were woman (7%). A majority of the patients (84%, n = 89) had 90 to 100% obstruction of the ear canal. Complete ear canal healing was observed in 80% of patients by 3 weeks. All but one patient had healed by 6 weeks postoperatively. There were 9 (6.5%) slit tympanic membrane perforations that healed with intraoperative gelfoam or fascia myringoplasty. One patient had an anterior canal mobilization which required Xeroform packing for 3 weeks for stabilization. There were no postoperative vertigo, facial paresis, conductive/sensorineural hearing loss, soft tissue stenoses, and no skin grafting required.ConclusionsThis is the first study to report a series of patients performing solely a transcanal approach using micro-osteotomes for removing exostoses. Results indicate that it is a safe procedure with low complication rate and expeditious healing. Patients with 100% obstruction can have this procedure performed with no significant increase in morbidity.

Last year, researchers and librarians at both Drexel University and the University of Maryland initiated similar collaborative projects in their respective institutions to contribute to the development of life-long learning skills among the select participants. One joint finding was the importance of linking advances in knowledge, not just as hypothetical learnin

ObjectiveThis project was conducted to evaluate the loudness and acoustic parameters of toys designed for children. In addition, we investigated whether occluding the toys' speaker with tape would result in a significant loudness reduction; thereby potentially reducing the risk of noise induced hearing loss.MethodsTwenty-six toys were selected after an initial screening at two national retailers. Noise amplitudes at 0.25, 0.5, 1, 2, 4, and 8kHz were measured using a digital sound level meter at a distance of 0 and 30cm. The toys' speakers were then occluded using adhesive tape and the same acoustic parameters were re-measured.ResultsMean maximum noise amplitude of the toys at 0cm and 30cm was 104dBA (range, 97-125dBA) and 76dBA (range, 67-86dBA), respectively. Mean maximum noise amplitude after occlusion at 0cm and 30cm distances was 88dBA (range, 73-110dBA) and 66dBA (range, 55-82dBA), respectively, with a p-value <0.001.ConclusionsProper use of the loudest toys at a distant of 30cm between the speaker and the child's ear will likely not pose a risk of noise-induced hearing loss. However, since most toys are used at closer distances, use of adhesive tape is recommended as an effective modification to decrease the risk of hearing loss.

ObjectiveThis project was conducted to evaluate the loudness and acoustic parameters of toys designed for children. In addition, we investigated whether occluding the toys' speaker with tape would result in a significant loudness reduction; thereby potentially reducing the risk of noise induced hearing loss.MethodsTwenty-six toys were selected after an initial screening at two national retailers. Noise amplitudes at 0.25, 0.5, 1, 2, 4, and 8kHz were measured using a digital sound level meter at a distance of 0 and 30cm. The toys' speakers were then occluded using adhesive tape and the same acoustic parameters were re-measured.ResultsMean maximum noise amplitude of the toys at 0cm and 30cm was 104dBA (range, 97-125dBA) and 76dBA (range, 67-86dBA), respectively. Mean maximum noise amplitude after occlusion at 0cm and 30cm distances was 88dBA (range, 73-110dBA) and 66dBA (range, 55-82dBA), respectively, with a p-value <0.001.ConclusionsProper use of the loudest toys at a distant of 30cm between the speaker and the child's ear will likely not pose a risk of noise-induced hearing loss. However, since most toys are used at closer distances, use of adhesive tape is recommended as an effective modification to decrease the risk of hearing loss.

The engineering library plays a critical role in initiating and maintaining the conduit between vendors of engineering information and the users of that information—faculty, students, and researchers. Likewise, vendors play a key role in supporting library and faculty efforts to promote engineering information resources, beyond just supplying content and interface. Engineering libraries and vendors can effectively work together to get the most from electronic engineering resources for both large and small institutions. The case studies here show how Knovel Corporation, a sci-tech e-book vendor, has worked with engineering librarians at large and small institutions and with faculty members to promote awareness and usage of Knovel’s interactive library of electronic books for engineering education.

The engineering library plays a critical role in initiating and maintaining the conduit between vendors of engineering information and the users of that information—faculty, students, and researchers. Likewise, vendors play a key role in supporting library and faculty efforts to promote engineering information resources, beyond just supplying content and interface. Engineering libraries and vendors can effectively work together to get the most from electronic engineering resources for both large and small institutions. The case studies here show how Knovel Corporation, a sci-tech e-book vendor, has worked with engineering librarians at large and small institutions and with faculty members to promote awareness and usage of Knovel’s interactive library of electronic books for engineering education.

Last year, researchers and librarians at both Drexel University and the University of Maryland initiated similar collaborative projects in their respective institutions to contribute to the development of life-long learning skills among the select participants. One joint finding was the importance of linking advances in knowledge, not just as hypothetical learning that benefits an elite few, but rather for the advancement of our society as a whole. Drexel University has two NSF-supported programs, Research Experience for Teachers (RET) and the Research Experience for Undergraduates Site (REU) DREAM (Drexel Research Experience in Advanced Materials). RET’s primary goal is to provide experiential engineering education to K-12 teachers in the Delaware Valley. DREAM hosts undergraduates from around the country to work closely with faculty and graduate students in cutting-edge research areas, such as biomaterials, nanomaterials, and the design and processing of advanced materials. In both these programs, the participants learned different skills. For example, in the RET program, participating teachers developed skills that would help them to find, apply for, and secure funding for their schools to improve their classrooms and laboratories. RET participants also worked with their faculty mentors on research projects in emerging technologies, such as nanotechnology, biotechnology, and information technology. The library staff played a key role in helping participants in both programs develop crucial information seeking skills to obtain, evaluate, and use needed research material through a variety of information sources. The RET program helps teachers create opportunities to enhance the delivery of science and math education at their schools by helping their students and colleagues learn about science and technology careers and academic opportunities. It is projected that such awareness will motivate more high school students to pursue careers in science, technology, engine

A management issue of increasing importance is the need to provide distance learners the same library services as students who take courses on-site. Remote access to library-provided electronic resources has gone a long way to equalizing access for these students and for others who, because of work or family commitments, find coming to the library difficult. However, we have found that just making the resources available is insufficient; we must also teach the students how to use them effectively. The Drexel Libraries have assumed responsibility for information literacy instruction and have an extensive on-campus instruction program. The logical way too extend the critical component of library service off-campus is through online tutorials. Drexel’s Engineering Librarian is currently working with Elsevier Engineering Information and Elsevier Advanced Technology Group, University Faculty and Students to develop an online interactive tutorial to support engineering information retrieval needs of Drexel community. We have collected a sample of research questions that students had over a period of two years. Analysis of these questions and the results from several pilot studies to develop better understanding of their information needs, will be used to create FAQ based online interactive modules. We expect to use other professionals such as instructional designer, graphic designer, programmer, and others develop the content for the Web in ways that are attractive, functional, pedagogically sound, and appropriate to the audience. Once developed, it will be tested and reviewed by selected universities with engineering programs for their feedback and further refinement. We also expect that the tutorial can be effectively integrated into learning management systems such as WebCT and Blackboard. Library’s visionary management perspectives coupled with dynamic collaboration with the Faculty, Students, Engineering Librarians, and Elsevier Engineering Information and Elsevier A

A management issue of increasing importance is the need to provide distance learners the same library services as students who take courses on-site. Remote access to library-provided electronic resources has gone a long way to equalizing access for these students and for others who, because of work or family commitments, find coming to the library difficult. However, we have found that just making the resources available is insufficient; we must also teach the students how to use them effectively. The Drexel Libraries have assumed responsibility for information literacy instruction and have an extensive on-campus instruction program. The logical way too extend the critical component of library service off-campus is through online tutorials. Drexel’s Engineering Librarian is currently working with Elsevier Engineering Information and Elsevier Advanced Technology Group, University Faculty and Students to develop an online interactive tutorial to support engineering information retrieval needs of Drexel community. We have collected a sample of research questions that students had over a period of two years. Analysis of these questions and the results from several pilot studies to develop better understanding of their information needs, will be used to create FAQ based online interactive modules. We expect to use other professionals such as instructional designer, graphic designer, programmer, and others develop the content for the Web in ways that are attractive, functional, pedagogically sound, and appropriate to the audience. Once developed, it will be tested and reviewed by selected universities with engineering programs for their feedback and further refinement. We also expect that the tutorial can be effectively integrated into learning management systems such as WebCT and Blackboard. Library’s visionary management perspectives coupled with dynamic collaboration with the Faculty, Students, Engineering Librarians, and Elsevier Engineering Information and Elsevier A

Last year, researchers and librarians at both Drexel University and the University of Maryland initiated similar collaborative projects in their respective institutions to contribute to the development of life-long learning skills among the select participants. One joint finding was the importance of linking advances in knowledge, not just as hypothetical learning that benefits an elite few, but rather for the advancement of our society as a whole. Drexel University has two NSF-supported programs, Research Experience for Teachers (RET) and the Research Experience for Undergraduates Site (REU) DREAM (Drexel Research Experience in Advanced Materials). RET’s primary goal is to provide experiential engineering education to K-12 teachers in the Delaware Valley. DREAM hosts undergraduates from around the country to work closely with faculty and graduate students in cutting-edge research areas, such as biomaterials, nanomaterials, and the design and processing of advanced materials. In both these programs, the participants learned different skills. For example, in the RET program, participating teachers developed skills that would help them to find, apply for, and secure funding for their schools to improve their classrooms and laboratories. RET participants also worked with their faculty mentors on research projects in emerging technologies, such as nanotechnology, biotechnology, and information technology. The library staff played a key role in helping participants in both programs develop crucial information seeking skills to obtain, evaluate, and use needed research material through a variety of information sources. The RET program helps teachers create opportunities to enhance the delivery of science and math education at their schools by helping their students and colleagues learn about science and technology careers and academic opportunities. It is projected that such awareness will motivate more high school students to pursue careers in science, technology, engine

Last year, researchers and librarians at both Drexel University and the University of Maryland initiated similar collaborative projects in their respective institutions to contribute to the development of life-long learning skills among the select participants. One joint finding was the importance of linking advances in knowledge, not just as hypothetical learning that benefits an elite few, but rather for the advancement of our society as a whole. Drexel University has two NSF-supported programs, Research Experience for Teachers (RET) and the Research Experience for Undergraduates Site (REU) DREAM (Drexel Research Experience in Advanced Materials). RET’s primary goal is to provide experiential engineering education to K-12 teachers in the Delaware Valley. DREAM hosts undergraduates from around the country to work closely with faculty and graduate students in cutting-edge research areas, such as biomaterials, nanomaterials, and the design and processing of advanced materials. In both these programs, the participants learned different skills. For example, in the RET program, participating teachers developed skills that would help them to find, apply for, and secure funding for their schools to improve their classrooms and laboratories. RET participants also worked with their faculty mentors on research projects in emerging technologies, such as nanotechnology, biotechnology, and information technology. The library staff played a key role in helping participants in both programs develop crucial information seeking skills to obtain, evaluate, and use needed research material through a variety of information sources. The RET program helps teachers create opportunities to enhance the delivery of science and math education at their schools by helping their students and colleagues learn about science and technology careers and academic opportunities. It is projected that such awareness will motivate more high school students to pursue careers in science, technology, engine

A management issue of increasing importance is the need to provide distance learners the same library services as students who take courses on-site. Remote access to library-provided electronic resources has gone a long way to equalizing access for these students and for others who, because of work or family commitments, find coming to the library difficult. However, we have found that just making the resources available is insufficient; we must also teach the students how to use them effectively. The Drexel Libraries have assumed responsibility for information literacy instruction and have an extensive on-campus instruction program. The logical way too extend the critical component of library service off-campus is through online tutorials. Drexel’s Engineering Librarian is currently working with Elsevier Engineering Information and Elsevier Advanced Technology Group, University Faculty and Students to develop an online interactive tutorial to support engineering information retrieval needs of Drexel community. We have collected a sample of research questions that students had over a period of two years. Analysis of these questions and the results from several pilot studies to develop better understanding of their information needs, will be used to create FAQ based online interactive modules. We expect to use other professionals such as instructional designer, graphic designer, programmer, and others develop the content for the Web in ways that are attractive, functional, pedagogically sound, and appropriate to the audience. Once developed, it will be tested and reviewed by selected universities with engineering programs for their feedback and further refinement. We also expect that the tutorial can be effectively integrated into learning management systems such as WebCT and Blackboard. Library’s visionary management perspectives coupled with dynamic collaboration with the Faculty, Students, Engineering Librarians, and Elsevier Engineering Information and Elsevier A

Last year, researchers and librarians at both Drexel University and the University of Maryland initiated similar collaborative projects in their respective institutions to contribute to the development of life-long learning skills among the select participants. One joint finding was the importance of linking advances in knowledge, not just as hypothetical learning that benefits an elite few, but rather for the advancement of our society as a whole. Drexel University has two NSF-supported programs, Research Experience for Teachers (RET) and the Research Experience for Undergraduates Site (REU) DREAM (Drexel Research Experience in Advanced Materials). RET’s primary goal is to provide experiential engineering education to K-12 teachers in the Delaware Valley. DREAM hosts undergraduates from around the country to work closely with faculty and graduate students in cutting-edge research areas, such as biomaterials, nanomaterials, and the design and processing of advanced materials. In both these programs, the participants learned different skills. For example, in the RET program, participating teachers developed skills that would help them to find, apply for, and secure funding for their schools to improve their classrooms and laboratories. RET participants also worked with their faculty mentors on research projects in emerging technologies, such as nanotechnology, biotechnology, and information technology. The library staff played a key role in helping participants in both programs develop crucial information seeking skills to obtain, evaluate, and use needed research material through a variety of information sources. The RET program helps teachers create opportunities to enhance the delivery of science and math education at their schools by helping their students and colleagues learn about science and technology careers and academic opportunities. It is projected that such awareness will motivate more high school students to pursue careers in science, technology, engine

A management issue of increasing importance is the need to provide distance learners the same library services as students who take courses on-site. Remote access to library-provided electronic resources has gone a long way to equalizing access for these students and for others who, because of work or family commitments, find coming to the library difficult. However, we have found that just making the resources available is insufficient; we must also teach the students how to use them effectively. The Drexel Libraries have assumed responsibility for information literacy instruction and have an extensive on-campus instruction program. The logical way too extend the critical component of library service off-campus is through online tutorials. Drexel’s Engineering Librarian is currently working with Elsevier Engineering Information and Elsevier Advanced Technology Group, University Faculty and Students to develop an online interactive tutorial to support engineering information retrieval needs of Drexel community. We have collected a sample of research questions that students had over a period of two years. Analysis of these questions and the results from several pilot studies to develop better understanding of their information needs, will be used to create FAQ based online interactive modules. We expect to use other professionals such as instructional designer, graphic designer, programmer, and others develop the content for the Web in ways that are attractive, functional, pedagogically sound, and appropriate to the audience. Once developed, it will be tested and reviewed by selected universities with engineering programs for their feedback and further refinement. We also expect that the tutorial can be effectively integrated into learning management systems such as WebCT and Blackboard. Library’s visionary management perspectives coupled with dynamic collaboration with the Faculty, Students, Engineering Librarians, and Elsevier Engineering Information and Elsevier A