Cortical Activation Patterns Correlate with Speech Understanding After Cochlear Implantation

Objectives: Cochlear implants are a standard therapy for deafness, yet the ability of implanted patients to understand speech varies widely. To better understand this variability in outcomes, the authors used functional near-infrared spectroscopy to image activity within regions of the auditory cortex and compare the results to behavioral measures of speech perception. Design: The authors studied 32 deaf adults hearing through cochlear implants and 35 normal-hearing controls. The authors used functional near-infrared spectroscopy to measure responses within the lateral temporal lobe and the superior temporal gyrus to speech stimuli of varying intelligibility. The speech stimuli included normal speech, channelized speech (vocoded into 20 frequency bands), and scrambled speech (the 20 frequency bands were shuffled in random order). The authors also used environmental sounds as a control stimulus. Behavioral measures consisted of the speech reception threshold, consonant-nucleus-consonant words, and AzBio sentence tests measured in quiet. Results: Both control and implanted participants with good speech perception exhibited greater cortical activations to natural speech than to unintelligible speech. In contrast, implanted participants with poor speech perception had large, indistinguishable cortical activations to all stimuli. The ratio of cortical activation to normal speech to that of scrambled speech directly correlated with the consonant-nucleus-consonant words and AzBio sentences scores. This pattern of cortical activation was not correlated with auditory threshold, age, side of implantation, or time after implantation. Turning off the implant reduced the cortical activations in all implanted participants. Conclusions: Together, these data indicate that the responses the authors measured within the lateral temporal lobe and the superior temporal gyrus correlate with behavioral measures of speech perception, demonstrating a neural basis for the variability in speech understanding outcomes after cochlear implantation.

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Salivary Cortisol Profiles of Children with Hearing Loss

Objectives: It has long been speculated that effortful listening places children with hearing loss at risk for fatigue. School-age children with hearing loss experiencing cumulative stress and listening fatigue on a daily basis might undergo dysregulation of hypothalamic–pituitary–adrenal (HPA) axis activity resulting in elevated or flattened cortisol profiles. The purpose of this study was to examine whether school-age children with hearing loss show different diurnal salivary cortisol patterns than children with normal hearing. Design: Participants included 32 children with mild to moderate hearing loss (14 males; 18 females) and 28 children with normal hearing (19 males; 9 females) ranging in age from 6 to 12 years. Saliva samples were obtained six times per day on two separate school days. Cortisol levels were measured by mass spectrometric detection after liquid–liquid extraction. Salivary cortisol levels between children with hearing loss and children with no hearing loss over the course of the day were examined with hierarchical linear modeling using mixed model statistical analysis. Between-group comparisons were also computed for the area under the curve, an analytical approach for calculating overall cortisol secretion throughout the day. Results: Significant differences in the cortisol awakening response (CAR) were observed between children with hearing loss and children with normal hearing; however, no differences were observed between the two groups subsequent to the cortisol awakening response (60-min postawakening, 10:00 A.M., 2:00 P.M., and 8:00 P.M.). Compared with children with normal hearing, children with hearing loss displayed elevated cortisol levels at awakening and a reduced growth in cortisol secretion from awakening to 30-min postawakening. No significant differences in overall cortisol secretion throughout the day were found between groups (area under the curve). Finally, cortisol levels increased with increasing age for children with hearing loss but not for children with normal hearing. Conclusions: Results of this preliminary study indicate a possible dysregulation in HPA axis activity in children with hearing loss characterized by elevated salivary cortisol levels at awakening and a diminished increase in cortisol from awakening to 30-min postawakening. The pattern of elevated cortisol levels at awakening is consistent with some studies on adults with burnout, a condition characterized by fatigue, loss of energy, and poor coping skills. These findings support the idea that children with hearing loss may experience increased vigilance and need to mobilize energy promptly in preparation for the new day.

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Salivary Cortisol Profiles of Children with Hearing Loss

Objectives: It has long been speculated that effortful listening places children with hearing loss at risk for fatigue. School-age children with hearing loss experiencing cumulative stress and listening fatigue on a daily basis might undergo dysregulation of hypothalamic–pituitary–adrenal (HPA) axis activity resulting in elevated or flattened cortisol profiles. The purpose of this study was to examine whether school-age children with hearing loss show different diurnal salivary cortisol patterns than children with normal hearing. Design: Participants included 32 children with mild to moderate hearing loss (14 males; 18 females) and 28 children with normal hearing (19 males; 9 females) ranging in age from 6 to 12 years. Saliva samples were obtained six times per day on two separate school days. Cortisol levels were measured by mass spectrometric detection after liquid–liquid extraction. Salivary cortisol levels between children with hearing loss and children with no hearing loss over the course of the day were examined with hierarchical linear modeling using mixed model statistical analysis. Between-group comparisons were also computed for the area under the curve, an analytical approach for calculating overall cortisol secretion throughout the day. Results: Significant differences in the cortisol awakening response (CAR) were observed between children with hearing loss and children with normal hearing; however, no differences were observed between the two groups subsequent to the cortisol awakening response (60-min postawakening, 10:00 A.M., 2:00 P.M., and 8:00 P.M.). Compared with children with normal hearing, children with hearing loss displayed elevated cortisol levels at awakening and a reduced growth in cortisol secretion from awakening to 30-min postawakening. No significant differences in overall cortisol secretion throughout the day were found between groups (area under the curve). Finally, cortisol levels increased with increasing age for children with hearing loss but not for children with normal hearing. Conclusions: Results of this preliminary study indicate a possible dysregulation in HPA axis activity in children with hearing loss characterized by elevated salivary cortisol levels at awakening and a diminished increase in cortisol from awakening to 30-min postawakening. The pattern of elevated cortisol levels at awakening is consistent with some studies on adults with burnout, a condition characterized by fatigue, loss of energy, and poor coping skills. These findings support the idea that children with hearing loss may experience increased vigilance and need to mobilize energy promptly in preparation for the new day.

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Monothermal Caloric Screening to Improve Healthcare Value

Objectives: To evaluate whether monothermal caloric screening can reduce the number of caloric irrigations required in the vestibular testing battery while maintaining diagnostic accuracy. Design: Prospective controlled cohort study. Three hundred and ninety patients referred for vestibular testing at this tertiary referral health system over a 1-year period were evaluated; 24 patients met exclusion or failure criteria and 366 patients were included in the study. Population was 35.6% male; average age was 50.4 years old. Each patient underwent caloric testing using either warm or cool water irrigation initially and this data was used for monothermal screening data. All patients then completed bithermal binaural caloric testing to obtain the “gold standard” bithermal data for comparison. The sensitivity and specificity of monothermal cool or monothermal warm caloric tests were calculated using a receiver operating characteristic curve analysis. Results: Using a monothermal interear difference threshold of 25%, warm monothermal screening had sensitivity of 98.0%, specificity of 91.3%, false negative rate of 2%, and false positive rate of 8.7%. Cool monothermal screening also had excellent sensitivity (92.3%) and specificity (95.3)%, with a false negative rate of 7.7%, and a false positive rate of 4.7%. The diagnosis associated with the single false negative warm monothermal caloric test was compensated vestibular paresis. In the study population, 71.9% had a negative monothermal screen; if the monothermal data were accepted, 2 fewer irrigations would have been performed resulting in an average saving of $264 (typical Medicare reimbursement for 2 irrigations) billed per patient screened as well as shortening the average testing battery by about 15 min. Conclusions: Warm monothermal caloric screening can reduce time and cost of vestibular testing while nearly matching the diagnostic accuracy of bithermal testing.

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Monothermal Caloric Screening to Improve Healthcare Value

Objectives: To evaluate whether monothermal caloric screening can reduce the number of caloric irrigations required in the vestibular testing battery while maintaining diagnostic accuracy. Design: Prospective controlled cohort study. Three hundred and ninety patients referred for vestibular testing at this tertiary referral health system over a 1-year period were evaluated; 24 patients met exclusion or failure criteria and 366 patients were included in the study. Population was 35.6% male; average age was 50.4 years old. Each patient underwent caloric testing using either warm or cool water irrigation initially and this data was used for monothermal screening data. All patients then completed bithermal binaural caloric testing to obtain the “gold standard” bithermal data for comparison. The sensitivity and specificity of monothermal cool or monothermal warm caloric tests were calculated using a receiver operating characteristic curve analysis. Results: Using a monothermal interear difference threshold of 25%, warm monothermal screening had sensitivity of 98.0%, specificity of 91.3%, false negative rate of 2%, and false positive rate of 8.7%. Cool monothermal screening also had excellent sensitivity (92.3%) and specificity (95.3)%, with a false negative rate of 7.7%, and a false positive rate of 4.7%. The diagnosis associated with the single false negative warm monothermal caloric test was compensated vestibular paresis. In the study population, 71.9% had a negative monothermal screen; if the monothermal data were accepted, 2 fewer irrigations would have been performed resulting in an average saving of $264 (typical Medicare reimbursement for 2 irrigations) billed per patient screened as well as shortening the average testing battery by about 15 min. Conclusions: Warm monothermal caloric screening can reduce time and cost of vestibular testing while nearly matching the diagnostic accuracy of bithermal testing.

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Masked Speech Perception Thresholds in Infants, Children, and Adults

Objective: The primary goal of this study was to compare infants’ susceptibility to making produced by a two-talker speech and a speech-shaped noise masker. It is well documented that school-age children experience more difficulty recognizing speech embedded in two-talker speech than spectrally matched noise, a result attributed to immaturity in the ability to segregate target from masker speech, and/or to selectively attend to the target while disregarding the perceptually similar speech masker. However, findings from infant psychophysical studies suggest that infants are susceptible to auditory masking even when target and competing sounds are acoustically distinct. Design: Listeners were infants (8 to10 months), children (8 to 10 years), and adults (18 to 33 years). The task was an observer-based, single-interval disyllabic word detection, in the presence of either a speech-shaped noise or a two-talker masker. The masker played continuously at 55 dB SPL, and the target level was adapted to estimate threshold. Results: As observed previously for closed-set consonant and word identification as well as open-set word and sentence recognition, school-age children experienced relatively more masking than adults in the two-talker than the speech-shaped noise masker. The novel result of this study was that infants’ speech detection thresholds were about 24 dB higher than those of adults in both maskers. While response bias differed between listener groups, it did not differ reliably between maskers. Conclusions: It is often assumed that speech perception in a speech masker places greater demands on a listener’s ability to segregate and selectively attend to the target than a noise masker. This assumption is based on results showing larger child/adult differences for speech perception in a speech masker composed of a small number of talkers than in spectrally matched noise. The observation that infants experience equal masking for speech and noise maskers suggests that infants experience informational masking in both maskers and raises the possibility that the cues which make the steady noise a relatively ineffective masker for children are learned.

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Masked Speech Perception Thresholds in Infants, Children, and Adults

Objective: The primary goal of this study was to compare infants’ susceptibility to making produced by a two-talker speech and a speech-shaped noise masker. It is well documented that school-age children experience more difficulty recognizing speech embedded in two-talker speech than spectrally matched noise, a result attributed to immaturity in the ability to segregate target from masker speech, and/or to selectively attend to the target while disregarding the perceptually similar speech masker. However, findings from infant psychophysical studies suggest that infants are susceptible to auditory masking even when target and competing sounds are acoustically distinct. Design: Listeners were infants (8 to10 months), children (8 to 10 years), and adults (18 to 33 years). The task was an observer-based, single-interval disyllabic word detection, in the presence of either a speech-shaped noise or a two-talker masker. The masker played continuously at 55 dB SPL, and the target level was adapted to estimate threshold. Results: As observed previously for closed-set consonant and word identification as well as open-set word and sentence recognition, school-age children experienced relatively more masking than adults in the two-talker than the speech-shaped noise masker. The novel result of this study was that infants’ speech detection thresholds were about 24 dB higher than those of adults in both maskers. While response bias differed between listener groups, it did not differ reliably between maskers. Conclusions: It is often assumed that speech perception in a speech masker places greater demands on a listener’s ability to segregate and selectively attend to the target than a noise masker. This assumption is based on results showing larger child/adult differences for speech perception in a speech masker composed of a small number of talkers than in spectrally matched noise. The observation that infants experience equal masking for speech and noise maskers suggests that infants experience informational masking in both maskers and raises the possibility that the cues which make the steady noise a relatively ineffective masker for children are learned.

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Effects of Threshold Adjustment on Speech Perception in Nucleus Cochlear Implant Recipients

Objective: The objective of this study was to investigate the impact of using smaller and larger electric dynamic ranges on speech perception, aided thresholds, and subjective preference in cochlear implant (CI) subjects with the Nucleus® device. Design: Data were collected from 19 adults using the Nucleus CI system. Current levels (CLs) used to set threshold stimulation levels (T-levels) were set above or below the measured hearing thresholds to create smaller or larger electric output dynamic ranges, respectively, whereas the upper stimulation level (C-level) was fixed. The base (unadjusted) condition was compared against two conditions with higher T-levels (compression), by 30% and 60% of the measured hearing dynamic range, and three conditions with lower T-levels (expansion), by 30%, 60%, and 90% of the measured hearing dynamic range. For each subject, the clinical CL units were adjusted on each electrode to achieve these conditions. The slow-acting dynamic acoustic gains of ADRO® and Autosensitivity™ were enabled. Consonant-nucleus-consonant (CNC) word scores were measured in quiet at 50 dB and 60 dB SPL presentation levels. The signal-to-noise ratios (SNRs) for 50% understanding of sentences in noise were measured for sentences presented at 55 dB and 65 dB SPL in 4-talker babble noise. Free-field aided thresholds were measured at octave frequencies using frequency-modulated (warble) tones. Thirteen of the 19 subjects had take-home experience with the base and experimental conditions and provided subjective feedback via a questionnaire. Results: There were no significant effects of 30% expansion and 30% compression of the electric dynamic range on scores for words in quiet and SNRs for sentences in noise, at the two presentation levels. There was a significant decrement in scores for words in quiet for 60% and 90% expansion compared with the base condition at the 50 dB and 60 dB SPL presentation levels. The score decrement was much less at 60 dB SPL. For the 50 dB SPL presentation level, the decrements in word scores at 60% and 90% expansion were linearly related to the reduction in CL units required to achieve these experimental conditions, with a greater decrement in scores for a larger CL change. There was a significant increase in SNR for sentences in noise for 60% compression compared with the base condition at the 55 dB and 65 dB SPL presentation levels. There was also a significant increase in SNR for sentences at the 55 dB SPL presentation level for 90% expansion. Aided thresholds were significantly elevated for the three expansion conditions compared with the base condition, although the mean elevation at 30% expansion was only 4 dB. The questionnaire results showed no clear preference for any condition; however, subjects reported a reduced preference for the extreme compression (60%) and expansion (90%) conditions. Conclusions: The results showed that CI subjects using the Nucleus sound processor had no significant change in performance or preference for adjustments in T-levels by ±30% of the hearing dynamic range. In quiet, speech perception scores were reduced for the more marked expansion (60% and 90%) conditions, whereas in noise, performance was poorer for the highest compression (60%) condition. Across subjects, the decrement in scores for words at 50 dB SPL for the 60% and 90% expansion conditions was related to the changes in CL units required for these conditions, with greater decrements for larger changes in levels.

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Frequency–Amplitude Ratio of Ocular Vestibular-Evoked Myogenic Potentials for Detecting Meniere’s Disease: A Preliminary Investigation

Objective: Several parameters of ocular vestibular-evoked myogenic potential (oVEMP) have been used to identify Meniere’s disease. Nonetheless frequency–amplitude ratio (FAR), which is the ratio of amplitude between two frequencies, is one among the parameters that has failed to attract researchers’ attention despite proving its worth in diagnosis of Meniere’s disease when used in conjunction with cervical VEMP. Thus, the present study aimed at investigating the utility of FAR of oVEMP in identifying Meniere’s disease and finding out an optimum frequency pair for its diagnosis. Design: Using a case–control design, oVEMPs were recorded for tone bursts of 500, 750, 1000, and 1500 Hz from 36 individuals with unilateral definite Meniere’s disease in the age range of 15 to 50 years. For comparison purposes, oVEMP at the above frequencies were also obtained from an equal number of age- and gender-matched healthy individuals. The amplitudes of 750, 1000, 1500 Hz and tuned frequency, which was the frequency with the largest peak to peak amplitude among the above-mentioned frequencies, were divided by the amplitude of 500 Hz to obtain FARs for 750/500, 1000/500, 1500/500, and tuned frequency/500 frequency pairs. Results: The results revealed significantly higher FAR in the Meniere’s disease group than the healthy controls for all the frequency pairs (p

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The Use of the Kurtosis-Adjusted Cumulative Noise Exposure Metric in Evaluating the Hearing Loss Risk for Complex Noise

Objective: To test a kurtosis-adjusted cumulative noise exposure (CNE) metric for use in evaluating the risk of hearing loss among workers exposed to industrial noises. Specifically, to evaluate whether the kurtosis-adjusted CNE (1) provides a better association with observed industrial noise-induced hearing loss, and (2) provides a single metric applicable to both complex (non-Gaussian [non-G]) and continuous or steady state (Gaussian [G]) noise exposures for predicting noise-induced hearing loss (dose–response curves). Design: Audiometric and noise exposure data were acquired on a population of screened workers (N = 341) from two steel manufacturing plants located in Zhejiang province and a textile manufacturing plant located in Henan province, China. All the subjects from the two steel manufacturing plants (N = 178) were exposed to complex noise, whereas the subjects from textile manufacturing plant (N = 163) were exposed to a G continuous noise. Each subject was given an otologic examination to determine their pure-tone HTL and had their personal 8-hr equivalent A-weighted noise exposure (LAeq) and full-shift noise kurtosis statistic (which is sensitive to the peaks and temporal characteristics of noise exposures) measured. For each subject, an unadjusted and kurtosis-adjusted CNE index for the years worked was created. Multiple linear regression analysis controlling for age was used to determine the relationship between CNE (unadjusted and kurtosis adjusted) and the mean HTL at 3, 4, and 6 kHz (HTL346) among the complex noise-exposed group. In addition, each subject’s HTLs from 0.5 to 8.0 kHz were age and sex adjusted using Annex A (ISO-1999) to determine whether they had adjusted high-frequency noise-induced hearing loss (AHFNIHL), defined as an adjusted HTL shift of 30 dB or greater at 3.0, 4.0, or 6.0 kHz in either ear. Dose–response curves for AHFNIHL were developed separately for workers exposed to G and non-G noise using both unadjusted and adjusted CNE as the exposure matric. Results: Multiple linear regression analysis among complex exposed workers demonstrated that the correlation between HTL3,4,6 and CNE controlling for age was improved when using the kurtosis-adjusted CNE compared with the unadjusted CNE (R2 = 0.386 versus 0.350) and that noise accounted for a greater proportion of hearing loss. In addition, although dose–response curves for AHFNIHL were distinctly different when using unadjusted CNE, they overlapped when using the kurtosis-adjusted CNE. Conclusions: For the same exposure level, the prevalence of NIHL is greater in workers exposed to complex noise environments than in workers exposed to a continuous noise. Kurtosis adjustment of CNE improved the correlation with NIHL and provided a single metric for dose–response effects across different types of noise. The kurtosis-adjusted CNE may be a reasonable candidate for use in NIHL risk assessment across a wide variety of noise environments.

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A Binaural Cochlear Implant Sound Coding Strategy Inspired by the Contralateral Medial Olivocochlear Reflex

Objectives: In natural hearing, cochlear mechanical compression is dynamically adjusted via the efferent medial olivocochlear reflex (MOCR). These adjustments probably help understanding speech in noisy environments and are not available to the users of current cochlear implants (CIs). The aims of the present study are to: (1) present a binaural CI sound processing strategy inspired by the control of cochlear compression provided by the contralateral MOCR in natural hearing; and (2) assess the benefits of the new strategy for understanding speech presented in competition with steady noise with a speech-like spectrum in various spatial configurations of the speech and noise sources. Design: Pairs of CI sound processors (one per ear) were constructed to mimic or not mimic the effects of the contralateral MOCR on compression. For the nonmimicking condition (standard strategy or STD), the two processors in a pair functioned similarly to standard clinical processors (i.e., with fixed back-end compression and independently of each other). When configured to mimic the effects of the MOCR (MOC strategy), the two processors communicated with each other and the amount of back-end compression in a given frequency channel of each processor in the pair decreased/increased dynamically (so that output levels dropped/increased) with increases/decreases in the output energy from the corresponding frequency channel in the contralateral processor. Speech reception thresholds in speech-shaped noise were measured for 3 bilateral CI users and 2 single-sided deaf unilateral CI users. Thresholds were compared for the STD and MOC strategies in unilateral and bilateral listening conditions and for three spatial configurations of the speech and noise sources in simulated free-field conditions: speech and noise sources colocated in front of the listener, speech on the left ear with noise in front of the listener, and speech on the left ear with noise on the right ear. In both bilateral and unilateral listening, the electrical stimulus delivered to the test ear(s) was always calculated as if the listeners were wearing bilateral processors. Results: In both unilateral and bilateral listening conditions, mean speech reception thresholds were comparable with the two strategies for colocated speech and noise sources, but were at least 2 dB lower (better) with the MOC than with the STD strategy for spatially separated speech and noise sources. In unilateral listening conditions, mean thresholds improved with increasing the spatial separation between the speech and noise sources regardless of the strategy but the improvement was significantly greater with the MOC strategy. In bilateral listening conditions, thresholds improved significantly with increasing the speech-noise spatial separation only with the MOC strategy. Conclusions: The MOC strategy (1) significantly improved the intelligibility of speech presented in competition with a spatially separated noise source, both in unilateral and bilateral listening conditions; (2) produced significant spatial release from masking in bilateral listening conditions, something that did not occur with fixed compression; and (3) enhanced spatial release from masking in unilateral listening conditions. The MOC strategy as implemented here, or a modified version of it, may be usefully applied in CIs and in hearing aids.

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Description of Adults Seeking Hearing Help for the First Time According to Two Health Behavior Change Approaches: Transtheoretical Model (Stages of Change) and Health Belief Model

Objectives: Several models of health behavior change are commonly used in health psychology. This study applied the constructs delineated by two models—the transtheoretical model (in which readiness for health behavior change can be described with the stages of precontemplation, contemplation and action) and the health belief model (in which susceptibility, severity, benefits, barriers, self-efficacy, and cues to action are thought to determine likelihood of health behavior change)—to adults seeking hearing help for the first time. Design: One hundred eighty-two participants (mean age: 69.5 years) were recruited following an initial hearing assessment by an audiologist. Participants’ mean four-frequency pure-tone average was 35.4 dB HL, with 25.8% having no hearing impairment, 50.5% having a slight impairment, and 23.1% having a moderate or severe impairment using the World Health Organization definition of hearing loss. Participants’ hearing-related attitudes and beliefs toward hearing health behaviors were examined using the University of Rhode Island Change Assessment (URICA) and the health beliefs questionnaire (HBQ), which assess the constructs of the transtheoretical model and the health belief model, respectively. Participants also provided demographic information, and completed the hearing handicap inventory (HHI) to assess participation restrictions, and the psychosocial impact of hearing loss (PIHL) to assess the extent to which hearing impacts competence, self-esteem, and adaptability. Results: Degree of hearing impairment was associated with participation restrictions, perceived competence, self-esteem and adaptability, and attitudes and beliefs measured by the URICA and the HBQ. As degree of impairment increased, participation restrictions measured by the HHI, and impacts of hearing loss, as measured by the PIHL, increased. The majority of first-time help seekers in this study were in the action stage of change. Furthermore, relative to individuals with less hearing impairment, individuals with more hearing impairment were at more advanced stages of change as measured by the URICA (i.e., higher contemplation and action scores relative to their precontemplation score), and they perceived fewer barriers and more susceptibility, severity, benefits and cues to action as measured by the HBQ. Multiple regression analyses showed participation restrictions (HHI scores) to be a highly significant predictor of stages of change explaining 30% to 37% of the variance, as were duration of hearing difficulty, and perceived benefits, severity, self-efficacy and cues to action assessed by the HBQ. Conclusions: The main predictors of stages of change in first-time help seekers were reported participation restrictions and duration of hearing difficulty, with constructs from the health belief model also explaining some of the variance in stages of change scores. The transtheoretical model and the health belief model are valuable for understanding hearing health behaviors and can be applied when developing interventions to promote help seeking.

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Cortical Activation Patterns Correlate with Speech Understanding After Cochlear Implantation

Objectives: Cochlear implants are a standard therapy for deafness, yet the ability of implanted patients to understand speech varies widely. To better understand this variability in outcomes, the authors used functional near-infrared spectroscopy to image activity within regions of the auditory cortex and compare the results to behavioral measures of speech perception. Design: The authors studied 32 deaf adults hearing through cochlear implants and 35 normal-hearing controls. The authors used functional near-infrared spectroscopy to measure responses within the lateral temporal lobe and the superior temporal gyrus to speech stimuli of varying intelligibility. The speech stimuli included normal speech, channelized speech (vocoded into 20 frequency bands), and scrambled speech (the 20 frequency bands were shuffled in random order). The authors also used environmental sounds as a control stimulus. Behavioral measures consisted of the speech reception threshold, consonant-nucleus-consonant words, and AzBio sentence tests measured in quiet. Results: Both control and implanted participants with good speech perception exhibited greater cortical activations to natural speech than to unintelligible speech. In contrast, implanted participants with poor speech perception had large, indistinguishable cortical activations to all stimuli. The ratio of cortical activation to normal speech to that of scrambled speech directly correlated with the consonant-nucleus-consonant words and AzBio sentences scores. This pattern of cortical activation was not correlated with auditory threshold, age, side of implantation, or time after implantation. Turning off the implant reduced the cortical activations in all implanted participants. Conclusions: Together, these data indicate that the responses the authors measured within the lateral temporal lobe and the superior temporal gyrus correlate with behavioral measures of speech perception, demonstrating a neural basis for the variability in speech understanding outcomes after cochlear implantation.

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Salivary Cortisol Profiles of Children with Hearing Loss

Objectives: It has long been speculated that effortful listening places children with hearing loss at risk for fatigue. School-age children with hearing loss experiencing cumulative stress and listening fatigue on a daily basis might undergo dysregulation of hypothalamic–pituitary–adrenal (HPA) axis activity resulting in elevated or flattened cortisol profiles. The purpose of this study was to examine whether school-age children with hearing loss show different diurnal salivary cortisol patterns than children with normal hearing. Design: Participants included 32 children with mild to moderate hearing loss (14 males; 18 females) and 28 children with normal hearing (19 males; 9 females) ranging in age from 6 to 12 years. Saliva samples were obtained six times per day on two separate school days. Cortisol levels were measured by mass spectrometric detection after liquid–liquid extraction. Salivary cortisol levels between children with hearing loss and children with no hearing loss over the course of the day were examined with hierarchical linear modeling using mixed model statistical analysis. Between-group comparisons were also computed for the area under the curve, an analytical approach for calculating overall cortisol secretion throughout the day. Results: Significant differences in the cortisol awakening response (CAR) were observed between children with hearing loss and children with normal hearing; however, no differences were observed between the two groups subsequent to the cortisol awakening response (60-min postawakening, 10:00 A.M., 2:00 P.M., and 8:00 P.M.). Compared with children with normal hearing, children with hearing loss displayed elevated cortisol levels at awakening and a reduced growth in cortisol secretion from awakening to 30-min postawakening. No significant differences in overall cortisol secretion throughout the day were found between groups (area under the curve). Finally, cortisol levels increased with increasing age for children with hearing loss but not for children with normal hearing. Conclusions: Results of this preliminary study indicate a possible dysregulation in HPA axis activity in children with hearing loss characterized by elevated salivary cortisol levels at awakening and a diminished increase in cortisol from awakening to 30-min postawakening. The pattern of elevated cortisol levels at awakening is consistent with some studies on adults with burnout, a condition characterized by fatigue, loss of energy, and poor coping skills. These findings support the idea that children with hearing loss may experience increased vigilance and need to mobilize energy promptly in preparation for the new day.

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Monothermal Caloric Screening to Improve Healthcare Value

Objectives: To evaluate whether monothermal caloric screening can reduce the number of caloric irrigations required in the vestibular testing battery while maintaining diagnostic accuracy. Design: Prospective controlled cohort study. Three hundred and ninety patients referred for vestibular testing at this tertiary referral health system over a 1-year period were evaluated; 24 patients met exclusion or failure criteria and 366 patients were included in the study. Population was 35.6% male; average age was 50.4 years old. Each patient underwent caloric testing using either warm or cool water irrigation initially and this data was used for monothermal screening data. All patients then completed bithermal binaural caloric testing to obtain the “gold standard” bithermal data for comparison. The sensitivity and specificity of monothermal cool or monothermal warm caloric tests were calculated using a receiver operating characteristic curve analysis. Results: Using a monothermal interear difference threshold of 25%, warm monothermal screening had sensitivity of 98.0%, specificity of 91.3%, false negative rate of 2%, and false positive rate of 8.7%. Cool monothermal screening also had excellent sensitivity (92.3%) and specificity (95.3)%, with a false negative rate of 7.7%, and a false positive rate of 4.7%. The diagnosis associated with the single false negative warm monothermal caloric test was compensated vestibular paresis. In the study population, 71.9% had a negative monothermal screen; if the monothermal data were accepted, 2 fewer irrigations would have been performed resulting in an average saving of $264 (typical Medicare reimbursement for 2 irrigations) billed per patient screened as well as shortening the average testing battery by about 15 min. Conclusions: Warm monothermal caloric screening can reduce time and cost of vestibular testing while nearly matching the diagnostic accuracy of bithermal testing.

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Masked Speech Perception Thresholds in Infants, Children, and Adults

Objective: The primary goal of this study was to compare infants’ susceptibility to making produced by a two-talker speech and a speech-shaped noise masker. It is well documented that school-age children experience more difficulty recognizing speech embedded in two-talker speech than spectrally matched noise, a result attributed to immaturity in the ability to segregate target from masker speech, and/or to selectively attend to the target while disregarding the perceptually similar speech masker. However, findings from infant psychophysical studies suggest that infants are susceptible to auditory masking even when target and competing sounds are acoustically distinct. Design: Listeners were infants (8 to10 months), children (8 to 10 years), and adults (18 to 33 years). The task was an observer-based, single-interval disyllabic word detection, in the presence of either a speech-shaped noise or a two-talker masker. The masker played continuously at 55 dB SPL, and the target level was adapted to estimate threshold. Results: As observed previously for closed-set consonant and word identification as well as open-set word and sentence recognition, school-age children experienced relatively more masking than adults in the two-talker than the speech-shaped noise masker. The novel result of this study was that infants’ speech detection thresholds were about 24 dB higher than those of adults in both maskers. While response bias differed between listener groups, it did not differ reliably between maskers. Conclusions: It is often assumed that speech perception in a speech masker places greater demands on a listener’s ability to segregate and selectively attend to the target than a noise masker. This assumption is based on results showing larger child/adult differences for speech perception in a speech masker composed of a small number of talkers than in spectrally matched noise. The observation that infants experience equal masking for speech and noise maskers suggests that infants experience informational masking in both maskers and raises the possibility that the cues which make the steady noise a relatively ineffective masker for children are learned.

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MEMRO 2015 – Basic Science meets Clinical Otology

Publication date: Available online 26 April 2016
Source:Hearing Research
Author(s): Michael Gaihede, Joris Dirckx, Magnus von Unge, John J. Rosowski




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MEMRO 2015 – Basic Science meets Clinical Otology

Publication date: Available online 26 April 2016
Source:Hearing Research
Author(s): Michael Gaihede, Joris Dirckx, Magnus von Unge, John J. Rosowski




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Reevaluation of the Amsterdam Inventory for Auditory Disability and Handicap Using Item Response Theory

Purpose

We reevaluated the psychometric properties of the Amsterdam Inventory for Auditory Disability and Handicap (AIADH; Kramer, Kapteyn, Festen, & Tobi, 1995) using item response theory. Item response theory describes item functioning along an ability continuum.

Method

Cross-sectional data from 2,352 adults with and without hearing impairment, ages 18–70 years, were analyzed. They completed the AIADH in the web-based prospective cohort study “Netherlands Longitudinal Study on Hearing.” A graded response model was fitted to the AIADH data. Category response curves, item information curves, and the standard error as a function of self-reported hearing ability were plotted.

Results

The graded response model showed a good fit. Item information curves were most reliable for adults who reported having hearing disability and less reliable for adults with normal hearing. The standard error plot showed that self-reported hearing ability is most reliably measured for adults reporting mild up to moderate hearing disability.

Conclusions

This is one of the few item response theory studies on audiological self-reports. All AIADH items could be hierarchically placed on the self-reported hearing ability continuum, meaning they measure the same construct. This provides a promising basis for developing a clinically useful computerized adaptive test, where item selection adapts to the hearing ability of individuals, resulting in efficient assessment of hearing disability.

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Reevaluation of the Amsterdam Inventory for Auditory Disability and Handicap Using Item Response Theory

Purpose

We reevaluated the psychometric properties of the Amsterdam Inventory for Auditory Disability and Handicap (AIADH; Kramer, Kapteyn, Festen, & Tobi, 1995) using item response theory. Item response theory describes item functioning along an ability continuum.

Method

Cross-sectional data from 2,352 adults with and without hearing impairment, ages 18–70 years, were analyzed. They completed the AIADH in the web-based prospective cohort study “Netherlands Longitudinal Study on Hearing.” A graded response model was fitted to the AIADH data. Category response curves, item information curves, and the standard error as a function of self-reported hearing ability were plotted.

Results

The graded response model showed a good fit. Item information curves were most reliable for adults who reported having hearing disability and less reliable for adults with normal hearing. The standard error plot showed that self-reported hearing ability is most reliably measured for adults reporting mild up to moderate hearing disability.

Conclusions

This is one of the few item response theory studies on audiological self-reports. All AIADH items could be hierarchically placed on the self-reported hearing ability continuum, meaning they measure the same construct. This provides a promising basis for developing a clinically useful computerized adaptive test, where item selection adapts to the hearing ability of individuals, resulting in efficient assessment of hearing disability.

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Reevaluation of the Amsterdam Inventory for Auditory Disability and Handicap Using Item Response Theory

Purpose

We reevaluated the psychometric properties of the Amsterdam Inventory for Auditory Disability and Handicap (AIADH; Kramer, Kapteyn, Festen, & Tobi, 1995) using item response theory. Item response theory describes item functioning along an ability continuum.

Method

Cross-sectional data from 2,352 adults with and without hearing impairment, ages 18–70 years, were analyzed. They completed the AIADH in the web-based prospective cohort study “Netherlands Longitudinal Study on Hearing.” A graded response model was fitted to the AIADH data. Category response curves, item information curves, and the standard error as a function of self-reported hearing ability were plotted.

Results

The graded response model showed a good fit. Item information curves were most reliable for adults who reported having hearing disability and less reliable for adults with normal hearing. The standard error plot showed that self-reported hearing ability is most reliably measured for adults reporting mild up to moderate hearing disability.

Conclusions

This is one of the few item response theory studies on audiological self-reports. All AIADH items could be hierarchically placed on the self-reported hearing ability continuum, meaning they measure the same construct. This provides a promising basis for developing a clinically useful computerized adaptive test, where item selection adapts to the hearing ability of individuals, resulting in efficient assessment of hearing disability.

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Socially meaningful sounds can change ear, improve hearing, study finds

Hearing socially meaningful sounds can change the ear and enable it to better detect those sounds, according to researchers at Georgia State University who studied the phenomenon in green treefrogs.

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Socially meaningful sounds can change ear, improve hearing, study finds

Hearing socially meaningful sounds can change the ear and enable it to better detect those sounds, according to researchers at Georgia State University who studied the phenomenon in green treefrogs.

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Socially meaningful sounds can change ear, improve hearing, study finds

Hearing socially meaningful sounds can change the ear and enable it to better detect those sounds, according to researchers at Georgia State University who studied the phenomenon in green treefrogs.

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Prince’s Philanthropic Side

To many Minnesotans, Prince Rogers Nelson was a larger-than-life character who transformed Minnesota’s music scene in the early 1980s with his provocative, charismatic, and engaging style. His magnum opus, “Purple Rain,” dominated the album charts for nearly one-half of 1984, and the movie opened at #1 when it opened in July 1984. He was definitely at the top of his game when he came to Washington, DC, in the fall that year, where he performed seven sold-out shows at Landover’s Capital Centre over a two-week time period.

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The Voice Track multiband single-channel modified Wiener-filter noise reduction system for cochlear implants: patients' outcomes and subjective appraisal.

The Voice Track multiband single-channel modified Wiener-filter noise reduction system for cochlear implants: patients' outcomes and subjective appraisal.

Int J Audiol. 2016 Apr 25;:1-8

Authors: Guevara N, Bozorg-Grayeli A, Bebear JP, Ardoint M, Saaï S, Gnansia D, Hoen M, Romanet P, Lavieille JP

Abstract
OBJECTIVE: The aim of this study was to evaluate the potential improvements of speech perception and sound quality provided by a multiband single channel noise-reduction algorithm based on the modified Wiener-filter adapted to cochlear implant sound processing.
DESIGN: This study was a longitudinal trial with a repeated-measures design. Outcome measures were performed on the first day when the noise reduction feature was provided and after a one month habituation period. Objective measures included pure-tone thresholds and vocal audiometry assessments. Speech perception was measured in quiet and in the presence of two types of noise: a stationary speech shaped noise and a two-talker cocktail noise. Subjective sound quality was assessed using a ten item questionnaire.
STUDY SAMPLE: Thirteen post-lingual deaf adults, experienced users of a cochlear implant system, took part in this study.
RESULTS: The noise-reduction algorithm provided a benefit for the perception of speech presented in a stationary speech shaped noise and an overall improvement in subjective sound quality ratings.
CONCLUSIONS: It was shown that a single channel noise reduction system based on a modified Wiener-filter approach can improve speech in noise perception performance and subjective sound quality in cochlear implant patients.

PMID: 27108635 [PubMed - as supplied by publisher]

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The Voice Track multiband single-channel modified Wiener-filter noise reduction system for cochlear implants: patients' outcomes and subjective appraisal.

The Voice Track multiband single-channel modified Wiener-filter noise reduction system for cochlear implants: patients' outcomes and subjective appraisal.

Int J Audiol. 2016 Apr 25;:1-8

Authors: Guevara N, Bozorg-Grayeli A, Bebear JP, Ardoint M, Saaï S, Gnansia D, Hoen M, Romanet P, Lavieille JP

Abstract
OBJECTIVE: The aim of this study was to evaluate the potential improvements of speech perception and sound quality provided by a multiband single channel noise-reduction algorithm based on the modified Wiener-filter adapted to cochlear implant sound processing.
DESIGN: This study was a longitudinal trial with a repeated-measures design. Outcome measures were performed on the first day when the noise reduction feature was provided and after a one month habituation period. Objective measures included pure-tone thresholds and vocal audiometry assessments. Speech perception was measured in quiet and in the presence of two types of noise: a stationary speech shaped noise and a two-talker cocktail noise. Subjective sound quality was assessed using a ten item questionnaire.
STUDY SAMPLE: Thirteen post-lingual deaf adults, experienced users of a cochlear implant system, took part in this study.
RESULTS: The noise-reduction algorithm provided a benefit for the perception of speech presented in a stationary speech shaped noise and an overall improvement in subjective sound quality ratings.
CONCLUSIONS: It was shown that a single channel noise reduction system based on a modified Wiener-filter approach can improve speech in noise perception performance and subjective sound quality in cochlear implant patients.

PMID: 27108635 [PubMed - as supplied by publisher]

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Corrigendum.

Corrigendum.

Int J Audiol. 2016 Apr 25;:1

Authors:

PMID: 27108535 [PubMed - as supplied by publisher]

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Corrigendum.

Corrigendum.

Int J Audiol. 2016 Apr 25;:1

Authors:

PMID: 27108535 [PubMed - as supplied by publisher]

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The Voice Track multiband single-channel modified Wiener-filter noise reduction system for cochlear implants: patients' outcomes and subjective appraisal.

The Voice Track multiband single-channel modified Wiener-filter noise reduction system for cochlear implants: patients' outcomes and subjective appraisal.

Int J Audiol. 2016 Apr 25;:1-8

Authors: Guevara N, Bozorg-Grayeli A, Bebear JP, Ardoint M, Saaï S, Gnansia D, Hoen M, Romanet P, Lavieille JP

Abstract
OBJECTIVE: The aim of this study was to evaluate the potential improvements of speech perception and sound quality provided by a multiband single channel noise-reduction algorithm based on the modified Wiener-filter adapted to cochlear implant sound processing.
DESIGN: This study was a longitudinal trial with a repeated-measures design. Outcome measures were performed on the first day when the noise reduction feature was provided and after a one month habituation period. Objective measures included pure-tone thresholds and vocal audiometry assessments. Speech perception was measured in quiet and in the presence of two types of noise: a stationary speech shaped noise and a two-talker cocktail noise. Subjective sound quality was assessed using a ten item questionnaire.
STUDY SAMPLE: Thirteen post-lingual deaf adults, experienced users of a cochlear implant system, took part in this study.
RESULTS: The noise-reduction algorithm provided a benefit for the perception of speech presented in a stationary speech shaped noise and an overall improvement in subjective sound quality ratings.
CONCLUSIONS: It was shown that a single channel noise reduction system based on a modified Wiener-filter approach can improve speech in noise perception performance and subjective sound quality in cochlear implant patients.

PMID: 27108635 [PubMed - as supplied by publisher]

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Corrigendum.

Corrigendum.

Int J Audiol. 2016 Apr 25;:1

Authors:

PMID: 27108535 [PubMed - as supplied by publisher]

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The Voice Track multiband single-channel modified Wiener-filter noise reduction system for cochlear implants: patients' outcomes and subjective appraisal.

The Voice Track multiband single-channel modified Wiener-filter noise reduction system for cochlear implants: patients' outcomes and subjective appraisal.

Int J Audiol. 2016 Apr 25;:1-8

Authors: Guevara N, Bozorg-Grayeli A, Bebear JP, Ardoint M, Saaï S, Gnansia D, Hoen M, Romanet P, Lavieille JP

Abstract
OBJECTIVE: The aim of this study was to evaluate the potential improvements of speech perception and sound quality provided by a multiband single channel noise-reduction algorithm based on the modified Wiener-filter adapted to cochlear implant sound processing.
DESIGN: This study was a longitudinal trial with a repeated-measures design. Outcome measures were performed on the first day when the noise reduction feature was provided and after a one month habituation period. Objective measures included pure-tone thresholds and vocal audiometry assessments. Speech perception was measured in quiet and in the presence of two types of noise: a stationary speech shaped noise and a two-talker cocktail noise. Subjective sound quality was assessed using a ten item questionnaire.
STUDY SAMPLE: Thirteen post-lingual deaf adults, experienced users of a cochlear implant system, took part in this study.
RESULTS: The noise-reduction algorithm provided a benefit for the perception of speech presented in a stationary speech shaped noise and an overall improvement in subjective sound quality ratings.
CONCLUSIONS: It was shown that a single channel noise reduction system based on a modified Wiener-filter approach can improve speech in noise perception performance and subjective sound quality in cochlear implant patients.

PMID: 27108635 [PubMed - as supplied by publisher]

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Corrigendum.

Corrigendum.

Int J Audiol. 2016 Apr 25;:1

Authors:

PMID: 27108535 [PubMed - as supplied by publisher]

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A small molecule mitigates hearing loss in a mouse model of Usher syndrome III.

A small molecule mitigates hearing loss in a mouse model of Usher syndrome III.

Nat Chem Biol. 2016 Apr 25;

Authors: Alagramam KN, Gopal SR, Geng R, Chen DH, Nemet I, Lee R, Tian G, Miyagi M, Malagu KF, Lock CJ, Esmieu WR, Owens AP, Lindsay NA, Ouwehand K, Albertus F, Fischer DF, Bürli RW, MacLeod AM, Harte WE, Palczewski K, Imanishi Y

Abstract
Usher syndrome type III (USH3), characterized by progressive deafness, variable balance disorder and blindness, is caused by destabilizing mutations in the gene encoding the clarin-1 (CLRN1) protein. Here we report a new strategy to mitigate hearing loss associated with a common USH3 mutation CLRN1(N48K) that involves cell-based high-throughput screening of small molecules capable of stabilizing CLRN1(N48K), followed by a secondary screening to eliminate general proteasome inhibitors, and finally an iterative process to optimize structure-activity relationships. This resulted in the identification of BioFocus 844 (BF844). To test the efficacy of BF844, we developed a mouse model that mimicked the progressive hearing loss associated with USH3. BF844 effectively attenuated progressive hearing loss and prevented deafness in this model. Because the CLRN1(N48K) mutation causes both hearing and vision loss, BF844 could in principle prevent both sensory deficiencies in patients with USH3. Moreover, the strategy described here could help identify drugs for other protein-destabilizing monogenic disorders.

PMID: 27110679 [PubMed - as supplied by publisher]

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A small molecule mitigates hearing loss in a mouse model of Usher syndrome III.

A small molecule mitigates hearing loss in a mouse model of Usher syndrome III.

Nat Chem Biol. 2016 Apr 25;

Authors: Alagramam KN, Gopal SR, Geng R, Chen DH, Nemet I, Lee R, Tian G, Miyagi M, Malagu KF, Lock CJ, Esmieu WR, Owens AP, Lindsay NA, Ouwehand K, Albertus F, Fischer DF, Bürli RW, MacLeod AM, Harte WE, Palczewski K, Imanishi Y

Abstract
Usher syndrome type III (USH3), characterized by progressive deafness, variable balance disorder and blindness, is caused by destabilizing mutations in the gene encoding the clarin-1 (CLRN1) protein. Here we report a new strategy to mitigate hearing loss associated with a common USH3 mutation CLRN1(N48K) that involves cell-based high-throughput screening of small molecules capable of stabilizing CLRN1(N48K), followed by a secondary screening to eliminate general proteasome inhibitors, and finally an iterative process to optimize structure-activity relationships. This resulted in the identification of BioFocus 844 (BF844). To test the efficacy of BF844, we developed a mouse model that mimicked the progressive hearing loss associated with USH3. BF844 effectively attenuated progressive hearing loss and prevented deafness in this model. Because the CLRN1(N48K) mutation causes both hearing and vision loss, BF844 could in principle prevent both sensory deficiencies in patients with USH3. Moreover, the strategy described here could help identify drugs for other protein-destabilizing monogenic disorders.

PMID: 27110679 [PubMed - as supplied by publisher]

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Comprehensive molecular diagnosis of 67 Chinese Usher syndrome probands: high rate of ethnicity specific mutations in Chinese USH patients.

Related Articles

Comprehensive molecular diagnosis of 67 Chinese Usher syndrome probands: high rate of ethnicity specific mutations in Chinese USH patients.

Orphanet J Rare Dis. 2015;10:110

Authors: Jiang L, Liang X, Li Y, Wang J, Zaneveld JE, Wang H, Xu S, Wang K, Wang B, Chen R, Sui R

Abstract
BACKGROUND: Usher syndrome (USH) is the most common disease causing combined deafness and blindness. It is predominantly an autosomal recessive genetic disorder with occasionally digenic cases. Molecular diagnosis of USH patients is important for disease management. Few studies have tried to find the genetic cause of USH in Chinese patients. This study was designed to determine the mutation spectrum of Chinese USH patients.
METHODS: We applied next generation sequencing to characterize the mutation spectrum in 67 independent Chinese families with at least one member diagnosed with USH. Blood was collected at Peking Union Medical College Hospital. This cohort is one of the largest USH cohorts reported. We utilized customized panel and whole exome sequencing, variant analysis, Sanger validation and segregation tests to find disease causing mutations in these families.
RESULTS: We identified biallelic disease causing mutations in known USH genes in 70 % (49) of our patients. As has been previously reported, MYO7A is the most frequently mutated gene in our USH type I patients while USH2A is the most mutated gene in our USH type II patients. In addition, we identify mutations in CLRN1, DFNB31, GPR98 and PCDH15 for the first time in Chinese USH patients. Together, mutations in CLRN1, DNFB31, GPR98 and PCDH15 account for 11.4 % of disease in our cohort. Interestingly, although the spectrum of disease genes is quite similar between our Chinese patient cohort and other patient cohorts from different (and primarily Caucasian) ethnic backgrounds, the mutations themselves are dramatically different. In particular, 76 % (52/68) of alleles found in this study have never been previously reported. Interestingly, we observed a strong enrichment for severe protein truncating mutations expected to have severe functional consequence on the protein in USH II patients compared to the reported mutation spectrum in RP patients, who often carry partial protein truncating mutations.
CONCLUSIONS: Our study provides the first comprehensive genetic characterization of a large collection of Chinese USH patients. Up to 90 % of USH patients have disease caused by mutations in known USH disease genes. By combining NGS-based molecular diagnosis and patient clinical information, a more accurate diagnosis, prognosis and personalized treatment of USH patients can be achieved.

PMID: 26338283 [PubMed - indexed for MEDLINE]

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The Voice Track multiband single-channel modified Wiener-filter noise reduction system for cochlear implants: patients' outcomes and subjective appraisal

10.3109/14992027.2016.1172267<br/>Nicolas Guevara

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Corrigendum

10.1080/14992027.2016.1176344<br/>

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The Voice Track multiband single-channel modified Wiener-filter noise reduction system for cochlear implants: patients' outcomes and subjective appraisal

10.3109/14992027.2016.1172267<br/>Nicolas Guevara

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Corrigendum

10.1080/14992027.2016.1176344<br/>

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The Voice Track multiband single-channel modified Wiener-filter noise reduction system for cochlear implants: patients' outcomes and subjective appraisal

10.3109/14992027.2016.1172267<br/>Nicolas Guevara

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Corrigendum

10.1080/14992027.2016.1176344<br/>

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The Voice Track multiband single-channel modified Wiener-filter noise reduction system for cochlear implants: patients' outcomes and subjective appraisal

10.3109/14992027.2016.1172267<br/>Nicolas Guevara

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Corrigendum

10.1080/14992027.2016.1176344<br/>

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The Voice Track multiband single-channel modified Wiener-filter noise reduction system for cochlear implants: patients' outcomes and subjective appraisal

10.3109/14992027.2016.1172267<br/>Nicolas Guevara

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Corrigendum

10.1080/14992027.2016.1176344<br/>

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The Potential Role of Subglottal Convergence Angle and Measurement

Publication date: Available online 25 April 2016
Source:Journal of Voice
Author(s): Xinlin Xu, Jingan Wang, Erin E. Devine, Yong Wang, Hua Zhong, Maxwell R. Courtright, Li Zhou, PeiYun Zhuang, Jack J. Jiang
ObjectiveThis study aimed to explore subglottal convergence angle measurement. We hypothesize that the angle will change with glottis closure condition. Changes to the angle may alter vocal fold stress distribution, which could result in vocal fold pathologies.MethodsThree vocal fold positions were evaluated by the degree of glottal closure and divided into three groups. Neck computed tomographic images of the subjects were gathered, and three-dimensional (3D) models of the vocal folds and the airway were reconstructed using Mimics software, through which the subglottal convergence angle was measured. Using one-way factor analysis of variance, we compared the angle among three groups. We explored the effect of the angle on vibration based on the material oblique section stress analysis.ResultsThe subglottal convergence angle was effectively measured from 3D models. The angle changed with degree of glottal closure, with statistically significant differences among the three groups (P < 0.01). Changes to the angle alter subglottal stress distribution in the subglottal shear or normal direction by the material oblique section stress analysis theory. Larger subglottal convergence angle might reduce subglottal pressure in the shear direction below the vocal folds, which would make vibration and vocal fold mucosal wave generation more difficult.Conclusion3D model generation from computed tomographic data is an effective method of measuring the subglottal convergence angle, which changes with the degree of glottis closure, and may affect subglottal pressure distribution in the subglottal shear or normal direction and influence vocal fold vibration.



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An ICF Perspective on Voice-related Quality of Life of American Transgender Women

Publication date: Available online 25 April 2016
Source:Journal of Voice
Author(s): Adrienne B. Hancock
PurposeThe factors and correlates of voice-related quality of life (vQOL) in American transgender women (ie, male-to-female) were examined using two questionnaires and were reviewed in the context of the International Classification of Functioning, Disability, and Health (ICF) model. This information will assist clinicians to be culturally and clinically competent providers of voice and communication feminization services.MethodsA diverse group of 81 transgender women completed a survey to report relevant demographic information, as well as the Voice Handicap Index and the Transgender Self-evaluation Questionnaire (TSEQ). Descriptive statistics for the overall levels of vQOL were calculated. Items from the TSEQ were sorted to correspond to the ICF components to allow for description and ranking of factors impacting health function. Spearman correlations were used to examine the relationships between questionnaire scores and to select demographic and gender transition characteristics (ie, personal factors in the ICF).ResultsThese transgender women reported a wide range of vQOL; some are severely restricted by their voice and communication, whereas others are not. The most common concerns are emotional reactions to activity limitations and participation restrictions. Personal factors related to demographics and gender transition generally were not significant contributors to the vQOL scores.ConclusionsIn addition to addressing the physiological functions of the voice, speech language pathologists should cultivate cultural competence and consider transgender clients' emotional reactions to voice function impairments and related life participation restrictions.



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Phonetic Approaches of Laryngopharyngeal Reflux Disease: A Prospective Study

Publication date: Available online 25 April 2016
Source:Journal of Voice
Author(s): Jérôme R. Lechien, Véronique Delvaux, Kathy Huet, Mohamad Khalife, Anne-Françoise Fourneau, Myriam Piccaluga, Bernard Harmegnies, Sven Saussez
ObjectivesThe study aimed to explore the impact of the selection of the analyzed time interval on the significance of acoustic measurements used to investigate laryngopharyngeal reflux (LPR) treatment efficacy, and based on these results to develop an alternative statistical approach in data analysis focusing on individual patient vocal behavior.Study DesignThis is a prospective case series.MethodsFrom September 2013 to July 2015, 41 patients with a reflux finding score (RFS) > 7 and a reflux symptom index (RSI) > 13 were enrolled and treated with pantoprazole 20 mg twice daily and diet behavioral changes for 3 months. Voice recordings were performed at baseline and after 3 months of treatment. Most stable time intervals of 1, 2, 3, 4, and 5 seconds, and a 1-second time interval positioned at mid-production, were subjected to acoustic analysis. Based on the latter, we developed an “informativeness coefficient” for each acoustic parameter that aimed at assessing its sensitivity to clinical resolution in the case of LPR disease.ResultsSignificant clinical improvement (RSI and RFS) was observed after treatment (P < 0.05). The acoustic analysis revealed that acoustic parameters significantly improving from pre- to posttreatment varied across time intervals. The duration and the position of the analyzed time interval in the production yielded considerable differences in the results. Analysis of the informativeness coefficient indicated that jitter, jitter percent, relative average perturbation (RAP), pitch perturbation quotient (PPQ), shimmer (ShdB), shimmer percent (Shim), amplitude perturbation quotient (APQ), and smoothed amplitude perturbation quotient (sAPQ) were the indices most sensitive to medical treatment efficacy, with a coefficient ranging from 75.86% to 86.21%.ConclusionsDepending on the selection of the time interval over which the acoustic parameters are measured, the potential effect of the treatment may or may not be statistically demonstrated. Future studies are needed to establish standardized methodological procedures for acoustic data analysis.



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The Physiological Basis of Chinese Höömii Generation

Publication date: Available online 26 April 2016
Source:Journal of Voice
Author(s): Gelin Li, Qian Hou
ObjectiveThe study aimed to investigate the physiological basis of vibration mode of sound source of a variety of Mongolian höömii forms of singing in China.MethodsThe participant is a Mongolian höömii performing artist who was recommended by the Chinese Medical Association of Art. He used three types of höömii, namely vibration höömii, whistle höömii, and overtone höömii, which were compared with general comfortable pronunciation of /i:/ as control. Phonation was observed during /i:/. A laryngostroboscope (Storz) was used to determine vibration source-mucosal wave in the throat.ResultsFor vibration höömii, bilateral ventricular folds approximated to the midline and made contact at the midline during pronunciation. Ventricular and vocal folds oscillated together as a single unit to form a composite vibration (double oscillator) sound source. For whistle höömii, ventricular folds approximated to the midline to cover part of vocal folds, but did not contact each other. It did not produce mucosal wave. The vocal folds produced mucosal wave to form a single vibration sound source. For overtone höömii, the anterior two-thirds of ventricular folds touched each other during pronunciation. The last one-third produced the mucosal wave. The vocal folds produced mucosal wave at the same time, which was a composite vibration (double oscillator) sound source mode.ConclusionsThe Höömii form of singing, including mixed voices and multivoice, was related to the presence of dual vibration sound sources. Its high overtone form of singing (whistle höömii) was related to stenosis at the resonance chambers' initiation site (ventricular folds level).



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