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Traditional clinical approaches diagnose disorders of the nervous system using standardized observational criteria. Although aiming for homogeneity of symptoms, this method often results in highly heterogeneous disorders. A standing question thus is how to automatically stratify a given random cohort of the population, such that treatment can be better tailored to each cluster's symptoms, and severity of any given group forecasted to provide neuroprotective therapies. In this work we introduce new methods to automatically stratify a random cohort of the population composed of healthy controls of different ages and patients with different disorders of the nervous systems. Using a simple walking task and measuring micro-fluctuations in their biorhythmic motions, we combine non-linear causal network connectivity analyses in the temporal and frequency domains with stochastic mapping. The methods define a new type of internal motor timings. These are amenable to create personalized clinical interventions tailored to self-emerging clusters signaling fundamentally different types of gait pathologies. We frame our results using the principle of reafference and operationalize them using causal prediction, thus renovating the theory of internal models for the study of neuromotor control.

Objective: Given the prevalence of neonatal hearing loss (HL) associated with intrauterine viral exposures, the goal of this study is to provide information on neonatal HL in the context of the COVID‐19 pandemic. Methods: Data were drawn from the COVID‐19 Mother Baby Outcomes (COMBO) Initiative. 1007 participants completed the newborn hearing screen as part of routine clinical care (COMBO‐EHR cohort) and 555 completed the National Survey of Children's Health (NSCH) at 2 and/or 3 years of age for research purposes (COMBO‐RSCH cohort). Maternal SARS‐CoV‐2 infection status during pregnancy was determined through electronic health records and maternal‐reported questionnaires. Results: In adjusted multivariate logistic regression models covarying for newborn age at assessment, mode of delivery, and gestational age at delivery, there was no significant association between intrauterine SARS‐CoV‐2 exposure and newborn hearing screening failure (OR = 1.05, 95% CI = 0.39–2.42, p = 0.91) in the COMBO‐EHR cohort. In the COMBO‐RSCH cohort, there were similar non‐significant associations between intrauterine exposure to SARS‐CoV‐2 and maternal‐reported concern for HL on the NSCH (OR = 1.19 [95% CI = 0.30–4.24], p = 0.79). Conclusion: There is no association between intrauterine exposure to SARS‐CoV‐2 and failed hearing screen in neonates. Similarly, based on the NSCH, there is no association between intrauterine exposure to SARS‐CoV‐2 and maternal‐reported concern for hearing in toddlers. These results offer reassurance given the widespread nature of this pandemic with tens of millions of fetuses having a history of intrauterine exposure. Level of Evidence: 4 Laryngoscope, 135:385–392, 2025 [ABSTRACT FROM AUTHOR]

Recent evidence shows that it is possible to identify the elements responsible for sensorineural hearing loss, such as pro-inflammatory cytokines and macrophages, by performing perilymph sampling. However, current studies have only focused on the diagnosis of such as otologic conditions. Hearing loss is a feature of certain neuroinflammatory disorders such as multiple sclerosis, and sensorineural hearing loss (SNHL) is widely detected in Alzheimer's disease. Although the environment of the inner ear is highly regulated, there are several communication pathways between the perilymph of the inner ear and cerebrospinal fluid (CSF). Thus, examination of the perilymph may help understand the mechanism behind the hearing loss observed in certain neuroinflammatory and neurodegenerative diseases. Herein, we review the constituents of CSF and perilymph, the anatomy of the inner ear and its connection with the brain. Then, we discuss the relevance of perilymph sampling in neurology. Currently, perilymph sampling is only performed during surgical procedures, but we hypothesize a simplified and low-invasive technique that could allow sampling in a clinical setting with the same ease as performing an intratympanic injection under direct visual check. The use of this modified technique could allow for perilymph sampling in people with hearing loss and neuroinflammatory/neurodegenerative disorders and clarify the relationship between these conditions; in fact, by measuring the concentration of neuroinflammatory and/or neurodegenerative biomarkers and those typically expressed in the inner ear in aging SNHL, it could be possible to understand if SNHL is caused by aging or neuroinflammation. [ABSTRACT FROM AUTHOR]

Background: Universal newborn hearing screening (UNHS) is effective in identifying newborns with possible hearing loss (HL). Outpatient follow-up for newborns referred after hospital-based screening remains a potential area of improvement. In this study, we evaluate the efficacy of a community health worker (CHW) intervention in promoting adherence to outpatient rescreening for newborns referred after initial UNHS. Methods: A mixed prospective-retrospective cohort study was performed to evaluate a CHW intervention at an academic medical center. Caregivers of referred newborns were contacted by CHWs prior to discharge and educated about HL and the importance of follow-up screening. The CHW outreach intervention was performed for 297 referred newborns between May 2020 and June 2021 and compared to a cohort of 238 newborns without the CHW intervention between March 2019 and June 2021. Statistical analyses were conducted using 2 × 2 Chi-square tests, two-tailed unpaired t -tests, multinomial logistic regression, and multiple linear regression. Results: In the intervention group, 236 of 297 newborns (79.5%) completed their outpatient follow-up rescreening; in the comparison group, 170 of 238 newborns (71.4%) completed their follow-up rescreening (P =.031, OR = 1.55 with regression P =.04). In the intervention group, the average time to follow-up was 13.4 days versus 12.5 days for the comparison group (P =.449, multiple R 2 =.02 with P =.78). Conclusions: CHW outreach intervention may increase adherence to outpatient follow-up rescreening for newborns referred after initial, hospital-based UNHS. Expansion of nursery teams to include CHWs may thus improve completion of recommended follow-up hearing screens. [ABSTRACT FROM AUTHOR]

Objectives: Oral or intratympanic corticosteroids are commonly used to treat sudden sensorineural hearing loss (SSHL), tinnitus, and Meniere disease. Direct intracochlear delivery has been proposed to overcome the variability in bioavailability and efficacy of systemic or middle ear delivery. In this study, we aim to characterize the physiologic consequences of microneedle‐mediated direct intracochlear injection of dexamethasone through the round window membrane (RWM). Methods: In Hartley guinea pigs (n = 5), a post‐auricular incision followed by bullostomy was made to access the round window membrane. Using 100 μm diameter hollow microneedles, 1.0 μl of 10 mg/ml dexamethasone was injected through the RWM over 1 min. Compound action potential (CAP) and distortion product otoacoustic action emissions (DPOAE) were measured before perforation, at 1 h, and at 5 h following injection. CAP hearing thresholds were measured from 0.5 to 40 kHz, and DPOAE f2 frequencies ranged from 1.0 and 32 kHz. Repeated measures ANOVA followed by pairwise t‐tests were used for statistical analysis. Results: ANOVA identified significant CAP threshold shifts at four frequencies (4, 16, 36, and 40 kHz) and differences in DPOAE at 1 frequency (6 kHz). Paired t‐tests revealed differences between the pre‐perforation and 1 h time point. By 5 h post injection, both CAP hearing thresholds and DPOAE recover and are not significantly different from baseline thresholds. Conclusion: Direct intracochlear delivery of dexamethasone via microneedles results in temporary shifts in hearing thresholds that resolve by 5 hours, thus supporting microneedle technology for the treatment of inner ear disorders. Level of Evidence: NA Laryngoscope, 134:388–392, 2024 [ABSTRACT FROM AUTHOR]

The declining trend of international student enrollment in the United States has been investigated from the standpoint of social discrimination, and more recently, by accounting for the compounding effects of COVID-19-based campus closures and remote learning operations. The purpose of this study was to explore whether experiences of campus alienation are related to difficulties international students faced while accessing campus services remotely. A survey was developed and validated for the study. It was completed by 417 international students attending US postsecondary institutions. A canonical correlation was conducted to evaluate the multivariate shared relationships between campus exclusion, COVID-19 racism, and country of origin as one set of variables, and difficulties accessing campus services remotely (DASCR) and international travel difficulties as the other set. Results revealed one significant canonical function; this model explained 27% of variance shared between the two variable sets. Indicators of shared variance provided evidence for significant relationships between experiences characterizing campus alienation and DASCR. Implications are drawn in light of policy and program development, and practical examples are provided for postsecondary educators on how to offer pertinent outreach to their international students and advocate for inclusive campus policies in managing international student engagement remotely during campus closure. [ABSTRACT FROM AUTHOR]