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This population-based study aimed to study the association between tinnitus and cervical spondylosis. A case–control study. We retrieved data from the Taiwan Longitudinal Health Insurance Database. We identified 2465 patients with tinnitus (cases) and 7395 comparison patients by propensity score matching. Multivariable logistic regressions were conducted to estimate the odds (OR) of a diagnosis of cervical spondylosis preceding the tinnitus diagnosis relative to controls. We found that 1596 (16.19%) of 9860 sample patients had received a diagnosis of cervical spondylosis before the index date, significantly different between the tinnitus group and control group (17.20% vs. 15.85%, p < 0.001). Logistic regression analysis showed an adjusted OR for prior cervical spondylosis of 1.235 for cases vs. controls (95% confidence interval [CI]: 1.088–1.402). Further, the adjusted ORs were 1.246 (95% CI: 1.041–1.491) and 1.356 (95% CI: 1.016–1.811), respectively, among patients aged 45 ∼ 64 and >64 groups. No difference in cervical spondylosis likelihood between cases and controls was found among patients aged 18 ∼ 44 groups. In conclusion, the study shows a positive association between cervical spondylosis and tinnitus. The findings call for greater awareness among physicians about a possible somatosensory component of cervical spine function which may contribute to tinnitus. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the association between pioglitazone use and the occurrence of head and neck cancer. Methods: Data for this case‐control study were retrieved from the Taiwan National Health Insurance Research Database. A total of 21 464 diabetic patients newly diagnosed with head and neck cancers were identified. We used propensity score matching to select 64 392 comparison patients (3:1 ratio). Multiple logistic regression modeling was used to examine the association of head and neck cancer with pioglitazone use in the 5 years preceding the cancer diagnosis. Results: Bivariate analysis showed a significant difference in the prevalence of prior using pioglitazone between cases and controls (19.3% vs 18.5%, P <.001) was observed. Multiple regression analysis showed adjusted odds of pioglitazone use of 1.06 (95% CI: 1.02‐1.10) among cases relative to controls. Conclusions: Prior pioglitazone use was associated with oral cavity cancer. [ABSTRACT FROM AUTHOR]

More than 80% of all cases of deafness are related to the death or degeneration of cochlear hair cells and the associated spiral ganglion neurons, and a lack of regeneration of these cells leads to permanent hearing loss. Therefore, the regeneration of lost hair cells is an important goal for the treatment of deafness. Atoh1 is a basic helix-loop-helix (bHLH) transcription factor that is critical in both the development and regeneration of cochlear hair cells. Atoh1 is transcriptionally regulated by several signaling pathways, including Notch and Wnt signalings. At the post-translational level, it is regulated through the ubiquitin-proteasome pathway. In vitro and in vivo studies have revealed that manipulation of these signaling pathways not only controls development, but also leads to the regeneration of cochlear hair cells after damage. Recent progress toward understanding the signaling networks involved in hair cell development and regeneration has led to the development of new strategies to replace lost hair cells. This review focuses on our current understanding of the signaling pathways that regulate Atoh1 in the cochlea. [ABSTRACT FROM AUTHOR]

Hereditary hearing impairment (HHI) is a common but heterogeneous clinical entity caused by mutations in a plethora of deafness genes. Research over the past few decades has shown that the genetic epidemiology of HHI varies significantly across populations. In this study, we used different genetic examination strategies to address the genetic causes of HHI in a large Taiwanese cohort composed of >5000 hearing-impaired families. We also analyzed the clinical features associated with specific genetic mutations. Our results demonstrated that next-generation sequencing-based examination strategies could achieve genetic diagnosis in approximately half of the families. Common deafness-associated genes in the Taiwanese patients assessed, in the order of prevalence, included GJB2, SLC26A4, OTOF, MYO15A, and MTRNR1, which were similar to those found in other populations. However, the Taiwanese patients had some unique mutations in these genes. These findings may have important clinical implications for refining molecular diagnostics, facilitating genetic counseling, and enabling precision medicine for the management of HHI. [ABSTRACT FROM AUTHOR]

Objectives: Vestibular disorders can impact cognitive domains, including spatial orientation and memory, which are also affected in Alzheimer's disease. This study aimed to examine the association between Alzheimer's disease and a prior diagnosis of peripheral vestibular disorders in the elderly Taiwanese population., Methods: The case-control study sample was retrieved from Taiwan's Longitudinal Health Insurance Database 2010. We included 3138 cases with Alzheimer's disease and 9414 propensity-matched controls. We conducted multivariable logistic regression modeling to investigate the association between Alzheimer's disease and a prior diagnosis of peripheral vestibular disorders after accounting for sociodemographic characteristics and medical comorbidities including diabetes, coronary heart disease, hypertension, hyperlipidemia, and hearing loss., Results: The results revealed a statistically significant difference in the prevalence of prior peripheral vestibular disorders between patients with Alzheimer's disease and controls; 20.6% among patients with Alzheimer's disease and 11.4% among controls (p < 0.001). Multivariable logistic regression analysis found that patients with Alzheimer's disease were twice as likely as controls to have had a prior diagnosis of peripheral vestibular disorders, adjusted odds ratio 2.040 (95% confidence interval: 1.829-2.274)., Conclusions: The findings suggest the possibility of shared or related pathophysiological pathways in Alzheimer's disease and vestibular dysfunction disorders., Level of Evidence: 3 Laryngoscope, 134:4730-4735, 2024., (© 2024 The American Laryngological, Rhinological and Otological Society, Inc.)

Background: Emerging concerns link periodontitis to an array of cancers, notably thyroid cancer, though investigations into these associations are still in the nascent stages. This population-based study aimed to investigate the association of thyroid cancer with chronic periodontitis using Taiwan's Longitudinal Health Insurance Database 2010 (LHID2010)., Methods: This case-control study utilized LHID2010, selecting 2,775 patients diagnosed with thyroid cancer, matched with 8,325 controls based on age, sex, income, and the presence of diabetes, hypertension, hyperlipidemia, human papillomavirus infection, and tobacco use disorder using propensity-score matching. Multivariate logistic regression models were used to evaluate the association of thyroid cancer with chronic periodontitis., Results: A chi-squared analysis demonstrated a significant disparity in the prevalence of chronic periodontitis between those diagnosed with thyroid cancer and the controls, with prevalence rates of 38.5% and 24.1% respectively, and a p-value less than 0.001. The odds ratio (OR) for having prior chronic periodontitis among patients with thyroid cancer compared to controls was 1.991, with a 95% confidence interval (CI) of 1.816-2.184 and a p-value less than 0.001. The association was similar between sexes, yielding adjusted ORs of 1.991 (95% CI = 1.816∼2.184) for men and 1.962 (95% CI = 1.765-2.182) for women, indicating a statistically significant higher prevalence of chronic periodontitis in both male and female patients diagnosed with thyroid cancer compared to their control counterparts., Conclusion: The findings highlight chronic periodontitis as a potential risk factor for thyroid cancer, underscoring the importance of integrated health surveillance and preventive strategies that encompass oral health., Plain Language Summary: This study aimed to explore the link between thyroid cancer and chronic periodontitis. Using Taiwan's Longitudinal Health Insurance Database 2010 (LHID2010), we selected 2,775 patients with thyroid cancer and matched them with 8,325 individuals without the disease based on age, sex, income, and other health conditions such as diabetes, hypertension, high cholesterol, HPV infection, and smoking habits. The study used statistical models to examine the relationship between thyroid cancer and chronic periodontitis. The findings showed that 38.5% of thyroid cancer patients had chronic periodontitis, compared to 24.1% of the control group. The odds of having chronic periodontitis were nearly twice as high in thyroid cancer patients. This pattern was consistent for both men and women. The study underscores the strong connection between chronic periodontitis and thyroid cancer, emphasizing the importance of raising public awareness about the potential risks of periodontitis., (© 2024 American Academy of Periodontology.)

Little is known about a possible association of autoimmune inner ear disease among patients diagnosed with polymyositis (PM)/dermatomyositis (DM). This study aimed to explore differences in the prevalence of inner ear symptoms among patients with and without PM/DM using a nationwide population-based dataset. Data for this study were retrieved from the Taiwan National Health Insurance Research Database. The study sample included 1622 patients diagnosed with PM/DM and 8109 propensity-score matched comparison patients without PM/DM. We performed multivariate logistic regressions to calculate odds ratios (ORs) and 95% confidence interval (CI) for tinnitus, hearing loss, sudden deafness, and vertigo among patients with PM/DM versus comparison patients. Chi-square tests showed statistically significant differences between patients with PM/DM and comparison patients in the prevalence of tinnitus (16.1% vs. 12.7%, p < 0.001), non-conductive hearing loss (9.2% vs. 6.8%, p < 0.001), and vertigo (14.4% vs. 11.1%, p < 0.001). The adjusted ORs for tinnitus, non-conductive hearing loss, and vertigo, respectively, were 1.332 (95% CI = 1.147-1.547), 1.399 (95% CI = 1.154-1.696), and 1.374 (95% CI = 1.173-1.611) for patients with PM/DM when compared to comparison patients. Our study finds that patients with PM/DM have higher prevalence rates of tinnitus, non-conductive hearing loss, and vertigo than comparison patients., (© 2024. The Author(s).)

The coronavirus disease 2019 (COVID-19) pandemic has had a major impact on human life. This review highlights the versatile roles of both classical and modern structure-based approaches for COVID-19. X-ray crystallography, nuclear magnetic resonance spectroscopy, and cryogenic electron microscopy are the three cornerstones of classical structural biology. These technologies have helped provide fundamental and detailed knowledge regarding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the related human host proteins as well as enabled the identification of its target sites, facilitating the cessation of its transmission. Further progress into protein structure modeling was made using modern structure-based approaches derived from homology modeling and integrated with artificial intelligence (AI), facilitating advanced computational simulation tools to actively guide the design of new vaccines and the development of anti-SARS-CoV-2 drugs. This review presents the practical contributions and future directions of structure-based approaches for COVID-19., Competing Interests: Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article., (Copyright © 2023, the Chinese Medical Association.)

Objective: The study objective was to evaluate the association between cervical spondylosis (CS) and a subsequent diagnosis of obstructive sleep apnea (OSA) in light of the expected constricting impact of CS-associated cervical spine changes on the pharyngeal airway space, a key contributor to OSA., Methods: Data were retrieved from the Taiwan National Health Insurance Research Dataset. A total of 98,234 patients who newly received a diagnosis of OSA were identified. We identified four propensity score-matched controls per OSA patient (n = 392,936). Chi-square tests were used to compare cases and controls on sociodemographic characteristics, and multivariable logistic regression modelling to examine the association of OSA with prior CS., Results: Of the 98,234 sampled patients, 18,070 (18.4%) patients had a prior CS diagnosis, significantly different among cases compared to controls, being 18.4% and12.1%, respectively, p < 0.001. Logistic regression analysis showed an adjusted odds ratio (OR) of prior CS of 1.778 (95% confident interval (CI): 1.744-1.814) relative to controls. The adjusted odds of prior CS without myelopathy was 1.764 for cases relative to controls (95% CI: 1.727-1.801), and for prior CS with myelopathy (adjusted OR: 1.778, 95% CI: 1.721-1.837). Analysis stratified by age showed that in the 45-64- and >64-year age groups, the adjusted ORs of CS were 1.803 (95% CI: 1.758-1.850) and 1.634 (95% CI: 1.568-1.703), respectively, for cases relative to controls., Conclusions: Our results suggest that OSA is associated with prior CS. The results call for professionals to be alert to the possibility of subsequent development of OSA among patients with CS., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Sensorineural hearing loss is one of the most common sensory disorders worldwide. Recent advances in vector design have paved the way for investigations into the use of adeno-associated vectors (AAVs) for hearing disorder gene therapy. Numerous AAV serotypes have been discovered to be applicable to inner ears, constituting a key advance for gene therapy for sensorineural hearing loss, where transduction efficiency of AAV in inner ear cells is critical for success. One such viral vector, AAV2/Anc80L65, has been shown to yield high expression in the inner ears of mice treated as neonates or adults. Here, to evaluate the feasibility of prenatal gene therapy for deafness, we assessed the transduction efficiency of AAV2/Anc80L65-eGFP (enhanced green fluorescent protein) after microinjection into otocysts in utero . This embryonic delivery method achieved high transduction efficiency in both inner and outer hair cells of the cochlea. Additionally, the transduction efficiency was high in the hair cells of the vestibules and semicircular canals and in spiral ganglion neurons. Our results support the potential of Anc80L65 as a gene therapy vehicle for prenatal inner ear disorders., (© 2020 The Author(s).)

Background: Pure-tone screening (PTS) is considered as the gold standard for hearing screening programs in school-age children. Mobile devices, such as mobile phones, have the potential for audiometric testing., Objective: This study aimed to demonstrate a new approach to rapidly screen hearing status and provide stratified test values, using a smartphone-based hearing screening app, for each screened ear of school-age children., Method: This was a prospective cohort study design. The proposed smartphone-based screening method and a standard sound-treated booth with PTS were used to assess 85 school-age children (170 ears). Sound-treated PTS involved applying 4 test tones to each tested ear: 500 Hz at 25 dB and 1000 Hz, 2000 Hz, and 4000 Hz at 20 dB. The results were classified as pass (normal hearing in the ear) or fail (possible hearing impairment). The proposed smartphone-based screening employs 20 stratified hearing scales. Thresholds were compared with those of pure-tone average (PTA)., Results: A total of 85 subjects (170 ears), including 38 males and 47 females, aged between 11 and 12 years with a mean (SD) of 11 (0.5) years, participated in the trial. Both screening methods produced comparable pass and fail results (pass in 168 ears and fail in 2 ears). The smartphone-based screening detected moderate or worse hearing loss (average PTA>25 dB) accurately. Both the sensitivity and specificity of the smartphone-based screening method were calculated at 100%., Conclusions: The results of the proposed smartphone-based self-hearing test demonstrated high concordance with conventional PTS in a sound-treated booth. Our results suggested the potential use of the proposed smartphone-based hearing screening in a school-age population., (©Yuan-Chia Chu, Yen-Fu Cheng, Ying-Hui Lai, Yu Tsao, Tzong-Yang Tu, Shuenn Tsong Young, Tzer-Shyong Chen, Yu-Fang Chung, Feipei Lai, Wen-Huei Liao. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 01.04.2019.)

Atoh1, a basic helix-loop-helix transcription factor, plays a critical role in the differentiation of several epithelial and neural cell types. We found that beta-catenin, the key mediator of the canonical Wnt pathway, increased expression of Atoh1 in mouse neuroblastoma cells and neural progenitor cells, and baseline Atoh1 expression was decreased by siRNA directed at beta-catenin. The up-regulation of Atoh1 was caused by an interaction of beta-catenin with the Atoh1 enhancer that could be demonstrated by chromatin immunoprecipitation. We found that two putative Tcf-Lef sites in the 3' enhancer of the Atoh1 gene displayed an affinity for beta-catenin and were critical for the activation of Atoh1 transcription because mutation of either site decreased expression of a reporter gene downstream of the enhancer. Tcf-Lef co-activators were found in the complex that bound to these sites in the DNA together with beta-catenin. Inhibition of Notch signaling, which has previously been shown to induce bHLH transcription factor expression, increased beta-catenin expression in progenitor cells of the nervous system. Because this could be a mechanism for up-regulation of Atoh1 after inhibition of Notch, we tested whether siRNA to beta-catenin prevented the increase in Atoh1 and found that beta-catenin expression was required for increased expression of Atoh1 after Notch inhibition.

Objective: To determine the effect of carbon dioxide laser microsurgery in the treatment of intractable chronic myringitis (CM)., Design: Retrospective 10-year case note review., Setting: Tertiary referral hospital., Patients: We reviewed retrospective case notes for 30 treated ears in 29 consecutive patients with CM (ie, loss of the tympanic membrane for longer than 1 month, refractory to conservative medical treatment) who underwent carbon dioxide laser microsurgery between 1995 and 2004, excluding patients who had undergone previous otologic surgery such as tympanoplasty., Interventions: Carbon dioxide laser microsurgery for resurfacing the nonepithelialized tympanic membrane was performed using local anesthesia., Main Outcome Measures: Resolution of disease in the affected tympanic membrane., Results: Of 30 affected ears, 22 demonstrated total resolution of CM, 7 demonstrated partial resolution, and the status of 1 ear remained unchanged at the end of follow-up (mean,19.7 months). Revision laser therapy was performed in 3 ears, resulting in total resolution of disease in 1 ear. Time to total resolution of disease ranged from 1 to 16 months (mean, 2.95 months)., Conclusions: We used carbon dioxide laser microsurgery to treat intractable primary CM and describe its efficacy in a retrospective review of laser resurfacing covering 10 years. We believe that laser microsurgery has the advantages of less invasiveness and higher applicability compared with aggressive surgical treatment. In patients with CM refractory to conservative medical treatment, carbon dioxide laser microsurgery could be an effective alternative when aggressive surgical procedures are not under consideration.

Madelung's disease is a rare disease of undetermined cause characterized by symmetric deposits of painless, diffuse, subcutaneous adipose tissue on the suboccipital area, the cheeks, the neck, the shoulders and the upper trunk. It is commonest in countries bordering the Mediterranean. The patients are usually middle-aged male alcoholics. Although lesions can initially mimic a head and neck malignancy, management is essentially symptomatic, with conservative removals done as indicated clinically or for cosmesis. Oriental reports about Madelung's disease are very rare. Here a case of Madelung's disease in a 59-year-old male is described. We describe his clinical course and review the literature.