The Prevalence and Severity of External Auditory Exostosis in Young to Quadragenarian-Aged Warm-Water Surfers: A Preliminary Study

External auditory exostosis (EAE) has previously only been shown to occur in cold water surfers. We assessed young surfers living and surfing in Queensland, Australia, for EAE in water temp ranges from 20.6 °C (69.1 °F, Winter) to 28.2 °C (82.8 °F, Summer). All participants underwent a bilateral otoscopic examination to assess the presence and severity of EAE. A total of 23 surfers participated with a mean age of 35.4 years (8.3 years) and a mean surfing experience of 20.0 years (9.9 years). Nearly two-thirds of participants (n = 14, 60.9%) had regular otological symptoms, most commonly water trapping (n = 13, 56.5%), pain (n = 8, 34.8%), and hearing loss (n = 6, 26.1%). Only 8.7% (n = 2) of all surfers reported regular use of protective equipment (e.g., earplugs) on a regular basis. The overall prevalence of exostosis was 69.6% (n = 16), and the majority (n = 12, 80.0%) demonstrated bilateral lesions of a mild grade (<33% obstruction of the external auditory canal). This is the first study assessing EAE in young surfers exposed to only warm waters (above 20.6 °C). The prevalence of EAE in this study highlights that EAE is not restricted to cold water conditions, as previously believed. Warm water surfing enthusiasts should be screened on a regular basis by their general medical practitioner and utilize prevention strategies such as earplugs to minimize exposure to EAE development.

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Auditory Exostosis in Australian Warm Water Surfers: a Cross-sectional Study

10.21203/rs.3.rs-228176/v1 ◽

2021 ◽

Author(s):

Vini Simas ◽

Wayne Hing ◽

Evelyne Rathbone ◽

Rodney Pope ◽

Mike Climstein

Keyword(s):

Water Temperature ◽

Cold Water ◽

Cross Sectional Study ◽

Gold Coast ◽

Warm Water ◽

Future Research ◽

Protective Equipment ◽

Cross Sectional ◽

Water Trapping ◽

Bilateral Lesions

Abstract BackgroundSurfing is a popular sport in Australia, accounting for nearly 10 percent of the population. External auditory exostosis (EAE), also referred to as surfer’s ear, is recognized as a potentially serious complication of surfing. Cold water (water temperature below 19⁰C) is a commonly cited risk factor, with prevalence of EAE in cold water surfers ranging from 61 to 80 percent.However, there is a paucity of studies reporting the prevalence of EAE in surfers exposed to water temperatures above 19⁰C. With mean water temperature ranging from 19°C to 28°C, the Gold Coast region of Australia provides the ideal environment to assess the main goal of this study: to assess the prevalence and severity of EAE in warm water surfers.MethodsEligible participants were surfers living and surfing on the Gold Coast (Queensland, Australia). Currently active surfers over 18 years of age, surfing year-round, with a minimum of five consecutive years of surfing experience were recruited to participate. Included individuals were asked to complete a questionnaire and underwent bilateral otoscopy.ResultsA total of 85 surfers were included, with mean age 52.1 years (standard deviation [SD] ±12.6 years) and mean surfing experience of 35.5 years (SD ±14.7 years). Nearly two-thirds of participants (65.9%) had regular otological symptoms, most commonly water trapping (66%), hearing loss (48.2%), and cerumen impaction (35.7%). Less than one-fifth of the surfers (17.7%) reported regular use of protective equipment for EAE. The overall prevalence of exostosis was 71.8%, with most of the individuals having bilateral lesions (59%) and a mild grade (grade 1, 47.5%). There was insufficient evidence for any significant associations between the main outcomes (presence and severity of EAE) and factors related to age, surfing experience, winter exposure, surfing ability, symptoms, and use of protective equipment.ConclusionTo the best of our knowledge, this is the first study assessing EAE in surfers exposed to warm waters (above 19oC). The prevalence of 71.8% highlights the high prevalence of the condition in the surfing population, regardless of water temperature. Future research should focus on ways to prevent EAE.

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Auditory exostosis in Australian warm water surfers: a cross-sectional study

BMC Sports Science Medicine and Rehabilitation ◽

10.1186/s13102-021-00281-5 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Vini Simas ◽

Wayne Hing ◽

Evelyne Rathbone ◽

Rodney Pope ◽

Mike Climstein

Keyword(s):

Water Temperature ◽

Cold Water ◽

Cross Sectional Study ◽

Gold Coast ◽

Warm Water ◽

Future Research ◽

Protective Equipment ◽

Cross Sectional ◽

Water Trapping ◽

Bilateral Lesions

Abstract Background Surfing is a popular sport in Australia, accounting for nearly 10% of the population. External auditory exostosis (EAE), also referred to as surfer’s ear, is recognized as a potentially serious complication of surfing. Cold water (water temperature below 19 °C) is a commonly cited risk factor, with prevalence of EAE in cold water surfers ranging from 61 to 80%. However, there is a paucity of studies reporting the prevalence of EAE in surfers exposed to water temperatures above 19 °C. With mean water temperature ranging from 19 °C to 28 °C, the Gold Coast region of Australia provides the ideal environment to assess the main goal of this study: to assess the prevalence and severity of EAE in warm water surfers. Methods Eligible participants were surfers living and surfing on the Gold Coast (Queensland, Australia). Currently active surfers over 18 years of age, surfing year-round, with a minimum of five consecutive years of surfing experience were recruited to participate. Included individuals were asked to complete a questionnaire and underwent bilateral otoscopy. Results A total of 85 surfers were included, with mean age 52.1 years (standard deviation [SD] ±12.6 years) and mean surfing experience of 35.5 years (SD ±14.7 years). Nearly two-thirds of participants (65.9%) had regular otological symptoms, most commonly water trapping (66%), hearing loss (48.2%), and cerumen impaction (35.7%). Less than one-fifth of the surfers (17.7%) reported regular use of protective equipment for EAE. The overall prevalence of exostosis was 71.8%, with most of the individuals having bilateral lesions (59%) and a mild grade (grade 1, 47.5%). There was insufficient evidence for any significant associations between the main outcomes (presence and severity of EAE) and factors related to age, surfing experience, winter exposure, surfing ability, symptoms, and use of protective equipment. Conclusion To the best of our knowledge, this is the first study assessing EAE in surfers exposed to warm waters (above 19 °C). The prevalence of 71.8% highlights the high prevalence of the condition in the surfing population, regardless of water temperature. Future research should focus on ways to prevent EAE.

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Predicting cold-water bleaching in corals: role of temperature, and potential integration of light exposure

Marine Ecology Progress Series ◽

10.3354/meps13336 ◽

2020 ◽

Vol 642 ◽

pp. 133-146

Author(s):

PC González-Espinosa ◽

SD Donner

Keyword(s):

Coral Bleaching ◽

Cold Water ◽

Light Exposure ◽

Light Attenuation ◽

Florida Keys ◽

Cold Temperature ◽

Warm Water ◽

Coral Tissue ◽

Effect Of Temperature ◽

Type I

Warm-water growth and survival of corals are constrained by a set of environmental conditions such as temperature, light, nutrient levels and salinity. Water temperatures of 1 to 2°C above the usual summer maximum can trigger a phenomenon known as coral bleaching, whereby disruption of the symbiosis between coral and dinoflagellate micro-algae, living within the coral tissue, reveals the white skeleton of coral. Anomalously cold water can also lead to coral bleaching but has been the subject of limited research. Although cold-water bleaching events are less common, they can produce similar impacts on coral reefs as warm-water events. In this study, we explored the effect of temperature and light on the likelihood of cold-water coral bleaching from 1998-2017 using available bleaching observations from the Eastern Tropical Pacific and the Florida Keys. Using satellite-derived sea surface temperature, photosynthetically available radiation and light attenuation data, cold temperature and light exposure metrics were developed and then tested against the bleaching observations using logistic regression. The results show that cold-water bleaching can be best predicted with an accumulated cold-temperature metric, i.e. ‘degree cooling weeks’, analogous to the heat stress metric ‘degree heating weeks’, with high accuracy (90%) and fewer Type I and Type II errors in comparison with other models. Although light, when also considered, improved prediction accuracy, we found that the most reliable framework for cold-water bleaching prediction may be based solely on cold-temperature exposure.

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Physical exercise and internet-based cognitive–behavioural therapy in the treatment of depression: Randomised controlled trial

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.160101 ◽

2015 ◽

Vol 207 (3) ◽

pp. 227-234 ◽

Cited By ~ 65

Author(s):

Mats Hallgren ◽

Martin Kraepelien ◽

Agneta öjehagen ◽

Nils Lindefors ◽

Zangin Zeebari ◽

...

Keyword(s):

Physical Exercise ◽

Cognitive Behavioural Therapy ◽

Controlled Trial ◽

Medical Practitioner ◽

Work Capacity ◽

Behavioural Therapy ◽

General Medical Practitioner ◽

Treatment As Usual ◽

Moderate Depression ◽

Cognitive Behavioural

BackgroundDepression is common and tends to be recurrent. Alternative treatments are needed that are non-stigmatising, accessible and can be prescribed by general medical practitioners.AimsTo compare the effectiveness of three interventions for depression: physical exercise, internet-based cognitive–behavioural therapy (ICBT) and treatment as usual (TAU). A secondary aim was to assess changes in self-rated work capacity.MethodA total of 946 patients diagnosed with mild to moderate depression were recruited through primary healthcare centres across Sweden and randomly assigned to one of three 12-week interventions (trail registry: KCTR study ID: KT20110063). Patients were reassessed at 3 months (response rate 78%).ResultsPatients in the exercise and ICBT groups reported larger improvements in depressive symptoms compared with TAU. Work capacity improved over time in all three groups (no significant differences).ConclusionsExercise and ICBT were more effective than TAU by a general medical practitioner, and both represent promising non-stigmatising treatment alternatives for patients with mild to moderate depression.

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Different Ways of Hydrogen Bonding in Water - Why Does Warm Water Freeze Faster than Cold Water?

Journal of Chemical Theory and Computation ◽

10.1021/acs.jctc.6b00735 ◽

2016 ◽

Vol 13 (1) ◽

pp. 55-76 ◽

Cited By ~ 42

Author(s):

Yunwen Tao ◽

Wenli Zou ◽

Junteng Jia ◽

Wei Li ◽

Dieter Cremer

Keyword(s):

Hydrogen Bonding ◽

Cold Water ◽

Warm Water

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Preliminary Study: Environmental Assessment of Perchloroethylene in Dry-Cleaning Facilities in the UAE

Journal of Environmental and Public Health ◽

10.1155/2018/1732906 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Sedra Habib ◽

Hafiz O. Ahmed ◽

Naema Al-Muhairi ◽

Reem Ziad

Keyword(s):

Environmental Assessment ◽

Personal Protective Equipment ◽

International Agency ◽

Protective Equipment ◽

Dry Cleaning ◽

Local Exhaust Ventilation ◽

Exhaust Ventilation ◽

Human Carcinogen ◽

Preliminary Study ◽

Monitoring Devices

Background. Perchloroethylene (PERC) is a widely spread cleaning solvent, used in nearly all dry-cleaning facilities. It has been declared as “probable human carcinogen” by the International Agency for Research on Cancer (IARC) due to its hazardous and toxic effects on human health. The study aimed at assessing the exposure of PERC among dry-cleaning workers at four different dry-cleaning facilities in the UAE. Methods. The four dry-cleaning facilities, using PERC in one of the cities of the UAE, were selected. Draeger perchloroethylene 10/b detector tubes along with a Draeger accuro pump were used to estimate the levels of PERC exposure in three main selected positions in each of the facilities. Results. The results showed that the second selected position had the highest amounts of PERC exposure above the international and local standards in 3 out of 4 selected facilities. The workers at position 2, who were not using any of the provided personal protective equipment, were at the highest risk of developing PERC-related health problems. Conclusion. It is important to install local exhaust ventilation systems and monitoring devices of PERC concentrations in these facilities, along with raising the awareness of workers about the health effects of PERC and the importance of using personal protective equipment (PPE) while performing their job.

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Cost-effectiveness analysis of SARS-CoV-2 infection prevention strategies including pre-endoscopic virus testing and use of high risk personal protective equipment

Endoscopy ◽

10.1055/a-1294-0427 ◽

2020 ◽

Author(s):

Alanna Ebigbo ◽

Christoph Römmele ◽

Christina Bartenschlager ◽

Selin Temizel ◽

Elisabeth Kling ◽

...

Keyword(s):

Cost Effectiveness ◽

High Risk ◽

Personal Protective Equipment ◽

Infection Prevention ◽

High Volume ◽

Protective Equipment ◽

Prevalence Rates ◽

Prevention Strategies ◽

Universal Testing ◽

Asymptomatic Patients

Abstract Background Infection prevention strategies to protect healthcare workers in endoscopy units during the post-peak phase of the COVID-19 pandemic are currently under intense discussion. In this paper, the cost-effectiveness of routine pre-endoscopy testing and high risk personal protective equipment (PPE) is addressed. Method A model based on theoretical assumptions of 10 000 asymptomatic patients presenting to a high volume center was created. Incremental cost-effectiveness ratios (ICERs) and absolute costs per endoscopy were calculated using a Monte Carlo simulation. Results ICER values for universal testing decreased with increasing prevalence rates. For higher prevalence rates (≥ 1 %), ICER values were lowest for routine pre-endoscopy testing coupled with use of high risk PPE, while cost per endoscopy was lowest for routine use of high risk PPE without universal testing. Conclusion In general, routine pre-endoscopy testing combined with high risk PPE becomes more cost-effective with rising prevalence rates of COVID-19.

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The effects of environmental temperature on the properties of myofibrillar adenosine triphosphatase from various species of fish

Biochemical Journal ◽

10.1042/bj1330735 ◽

1973 ◽

Vol 133 (4) ◽

pp. 735-738 ◽

Cited By ~ 72

Author(s):

Ian A. Johnston ◽

Neil Frearson ◽

Geoffrey Goldspink

Keyword(s):

Low Temperatures ◽

Half Life ◽

Adenosine Triphosphatase ◽

Environmental Temperature ◽

Cold Water ◽

Warm Water ◽

Adenosine Triphosphatase Activity ◽

Water Fish ◽

Different Temperatures ◽

Myotomal Muscle

1. Myofibrillar adenosine triphosphatase (ATPase) activities were measured for white myotomal muscle of 19 species of fish. 2. The activity was measured at different temperatures and after periods of preincubation at 37°C. 3. The inactivation half-life at 37°C depended on environmental temperature, increasing as the temperature increased. 4. Cold-water fish had higher myofibrillar adenosine triphosphatase activity at low temperatures than had warm-water fish. 5. The significance of these results is discussed.

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A simple technique to prolong molding time during application of a fiberglass cast: An in vitro study

Orthopedic Reviews ◽

10.4081/or.2018.7314 ◽

2018 ◽

Vol 10 (1) ◽

Cited By ~ 1

Author(s):

Mark Ayzenberg ◽

Michael Narvaez ◽

James Raphael

Keyword(s):

Cold Water ◽

In Vitro Study ◽

Operative Management ◽

Peak Temperature ◽

Warm Water ◽

Ambient Water ◽

Simple Method ◽

Cast Material ◽

Cure Time

Casting is routinely used for acute andpost-operative immobilization and remains a cornerstone in the non-operative management of fractures and deformities. Theapplication of a properly fitted and well-molded cast, especially for a trainee, can bechallenging. We present a simple method ofprolonging cure time of fiberglass cast — placing ice in the dip water. Eight-ply, five-inch fiberglass cast was circumferentially applied to an aluminum-wrapped cardboard cylinder. An electronic, 2-channel temperature sensor (TR-71wf Temp Logger, T&D Corporation, Matsumoto, Japan), accurateto 0.1ºC and accurate to ±0.3ºC, was placed between the fourth and fifth layers of fiberglass. Thirty total casts were tested using 9±1ºC (cold), 22±1ºC (ambient), and 36±1ºC (warm) dip water. Room temperature was maintained at 24±1ºC. Cast temperatures were measured during theexothermic reaction generated by the castcuring. Peak temperatures and cure timeswere recorded. Cure time was defined as the point of downward deflection on the time-temperature curve immediately after peak. Cure and peak temperatures were compared among groups using analysis of variance. Mean cure time was 3.5±0.1 minutes forwarm water, 5.0±0.4 minutes for ambient water and 7.0±0.5 minutes for cold water. Peak temperature, measured between layers 4 and 5 of the cast material, was 36.6±0.8ºC for warm water, 31.1±1.4ºC for ambient water and 25.2±0.5ºC for cold water. Cold afforded, on average, an additional 2 minutes (40% increase) in cure time compared to ambient water and an additional 3.5 minutes (100% increase) compared to warm water. Cure time differences were significant (P<0.001) for all groups, as were peak temperature differences (P<0.001). Temperatures concerning for development of burns were never reached. Utilizing iceddip water when casting is a simple andeffective method to prolong the time available for cast application. Orthopedic residents and trainees may find this useful in learning to fabricate a high quality cast. For the experienced orthopedic surgeon, this method eliminates the need to bridge long-limb casts and facilitates the application of complex casts.

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Hypertension − an update for the dental (sedation) team

Dental Update ◽

10.12968/denu.2019.46.6.508 ◽

2019 ◽

Vol 46 (6) ◽

pp. 508-513

Author(s):

Ross Leader ◽

Tom Thayer ◽

Bridget Maher ◽

Chris Bell

Keyword(s):

Public Health ◽

Blood Pressure ◽

Primary Care ◽

Medical Practitioner ◽

Global Burden ◽

General Medical Practitioner ◽

British Hypertension Society ◽

Dental Practitioners ◽

Blood Pressures ◽

Detailed Assessment

Hypertension is the commonest risk factor contributing to the global burden of disease. Public Health England estimates that, in England, 24% of the population are hypertensive, with 40% possibly undiagnosed. With this in mind, dentists, in particular those undertaking sedation, are in a perfect position to screen for high blood pressure and refer on for further detailed assessment. This paper outlines when a referral to the General Medical Practitioner (GP) should be considered, when sedation should be deferred and how hypertension is diagnosed and managed in primary care based on the National Institute for Health and Care Excellence (NICE)/British Hypertension Society (BHS) guidelines.CPD/Clinical Relevance: The purpose of this article is to update General Dental Practitioners (GDPs), including those who practise IV Midazolam sedation, on how patients who present with suspected hypertension are managed by their GP. Consideration is given to what blood pressures are deemed safe to sedate and what blood pressures should be referred for further assessment, even if considered safe to sedate.

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