Do morphological differences in orientation of the Eustachian tube and dilator tubae muscle distinguish populations with high rates of middle ear disease?
Bibliographic record
Abstract
Middle ear disease or otitis media (OM) is among the most common pediatric conditions globally. It is nearly ubiquitous among every human population, usually occurring within the first three postnatal years. The etiology of OM is known to be rooted in the short, horizontal cartilaginous Eustachian tubes (CET) of infants which are mechanically inefficient relative to those of adults. Yet, despite the presence of OM among all human populations, Inuit and Aboriginal Australian communities have been documented as exhibiting some of the highest rates globally. Little information exists on the normal morphology of the bony nasopharyngeal boundaries of these groups. We tested whether they could be distinguished from other human populations in the orientation of the cartilaginous Eustachian tube and dilator tubae (DT) belly of the tensor veli palatini muscle (TVP), the sole dilatory apparatus of the CET. Any morphological feature distinguishing groups with higher rates of OM may impact susceptibility. We reconstructed soft tissue CET and DT morphology from adult dry crania. The sample represented eight populations: Alaska (n=156); Aleutian Islands (n=14); China (n=37); Greenland (n=28); Australia (n=39); Germany (n=22); India (n=15); and West Africa (n=19). Alaskans, Aleuts, Greenlanders, and Australians were considered populations with high rates of OM while the remainder were used as comparator populations with relatively lower documented rates of OM. We assessed morphology from coordinate data collected along the posterior edges of the medial pterygoid plates, the hard palate, the basicranial midline, and the osseous orifice of the Eustachian tube. Angular measures were assessed from the coordinate data and Bonferroni‐Dunn‐adjusted multiple t‐tests were performed. Results showed that the Alaskans exhibited the most horizontal orientation of the DT relative to the axis of its common tendon with the TVP palatal sub‐belly (an infant‐like trait), being significantly more horizontal (P<0.05) than among all other groups. This trait could impact the function of the CET, especially among infants whose DT orientation would be even more horizontal. The only measure that distinguished Alaskans, Greenlanders, and Australians from all other populations was the sagittal orientation of the CET, an additional trait that may impact DT function. The presence of these morphological features may thus be related to increased rates of OM.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".