Noise dosimetry for tactical environments

Publication date: Available online 20 November 2016
Source:Hearing Research
Author(s): Christopher J. Smalt, Joe Lacirignola, Shakti Davis, Paul T. Calamia, Paula Collins
Noise exposure and the subsequent hearing loss are well documented aspects of military life. Numerous studies have indicated high rates of noise-induced hearing injury (NIHI) in active-duty service men and women, and recent statistics from the US Department of Veterans Affairs indicate a population of veterans with hearing loss that is growing at an increasing rate. In an effort to minimize hearing loss, the US Department of Defense (DoD) updated its Hearing Conservation Program in 2010, and also has recently revised the DoD Design Criteria Standard Noise Limits (MIL-STD-1474E) which defines allowable noise levels in the design of all military acquisitions including weapons and vehicles. Even with such mandates, it remains a challenge to accurately quantify the noise exposure experienced by a Warfighter over the course of a mission or training exercise, or even in a standard work day. Noise dosimeters are intended for exactly this purpose, but variations in device placement (e.g., free-field, on-body, in/near-ear), hardware (e.g., microphone, analog-to-digital converter), measurement time (e.g., work day, 24-h), and dose metric calculations (e.g., time-weighted energy, peak levels, Auditory Risk Units), as well as noise types (e.g., continuous, intermittent, impulsive) can cause exposure measurements to be incomplete, inaccurate, or inappropriate for a given situation. This paper describes the design of a noise dosimeter capable of acquiring exposure data across tactical environments. Two generations of prototypes have been built at MIT Lincoln Laboratory with funding from the US Army, Navy, and Marine Corps. Details related to hardware, signal processing, and testing efforts are provided, along with example tactical military noise data and lessons learned from early fieldings. Finally, we discuss the continued need to prioritize personalized dosimetry in order to improve models that predict or characterize the risk of auditory damage, to integrate dosimeters with hearing-protection devices, and to inform strategies and metrics for reducing NIHI.



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Noise dosimetry for tactical environments

Publication date: Available online 20 November 2016
Source:Hearing Research
Author(s): Christopher J. Smalt, Joe Lacirignola, Shakti Davis, Paul T. Calamia, Paula Collins
Noise exposure and the subsequent hearing loss are well documented aspects of military life. Numerous studies have indicated high rates of noise-induced hearing injury (NIHI) in active-duty service men and women, and recent statistics from the US Department of Veterans Affairs indicate a population of veterans with hearing loss that is growing at an increasing rate. In an effort to minimize hearing loss, the US Department of Defense (DoD) updated its Hearing Conservation Program in 2010, and also has recently revised the DoD Design Criteria Standard Noise Limits (MIL-STD-1474E) which defines allowable noise levels in the design of all military acquisitions including weapons and vehicles. Even with such mandates, it remains a challenge to accurately quantify the noise exposure experienced by a Warfighter over the course of a mission or training exercise, or even in a standard work day. Noise dosimeters are intended for exactly this purpose, but variations in device placement (e.g., free-field, on-body, in/near-ear), hardware (e.g., microphone, analog-to-digital converter), measurement time (e.g., work day, 24-h), and dose metric calculations (e.g., time-weighted energy, peak levels, Auditory Risk Units), as well as noise types (e.g., continuous, intermittent, impulsive) can cause exposure measurements to be incomplete, inaccurate, or inappropriate for a given situation. This paper describes the design of a noise dosimeter capable of acquiring exposure data across tactical environments. Two generations of prototypes have been built at MIT Lincoln Laboratory with funding from the US Army, Navy, and Marine Corps. Details related to hardware, signal processing, and testing efforts are provided, along with example tactical military noise data and lessons learned from early fieldings. Finally, we discuss the continued need to prioritize personalized dosimetry in order to improve models that predict or characterize the risk of auditory damage, to integrate dosimeters with hearing-protection devices, and to inform strategies and metrics for reducing NIHI.



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Noise dosimetry for tactical environments

Publication date: Available online 20 November 2016
Source:Hearing Research
Author(s): Christopher J. Smalt, Joe Lacirignola, Shakti Davis, Paul T. Calamia, Paula Collins
Noise exposure and the subsequent hearing loss are well documented aspects of military life. Numerous studies have indicated high rates of noise-induced hearing injury (NIHI) in active-duty service men and women, and recent statistics from the US Department of Veterans Affairs indicate a population of veterans with hearing loss that is growing at an increasing rate. In an effort to minimize hearing loss, the US Department of Defense (DoD) updated its Hearing Conservation Program in 2010, and also has recently revised the DoD Design Criteria Standard Noise Limits (MIL-STD-1474E) which defines allowable noise levels in the design of all military acquisitions including weapons and vehicles. Even with such mandates, it remains a challenge to accurately quantify the noise exposure experienced by a Warfighter over the course of a mission or training exercise, or even in a standard work day. Noise dosimeters are intended for exactly this purpose, but variations in device placement (e.g., free-field, on-body, in/near-ear), hardware (e.g., microphone, analog-to-digital converter), measurement time (e.g., work day, 24-h), and dose metric calculations (e.g., time-weighted energy, peak levels, Auditory Risk Units), as well as noise types (e.g., continuous, intermittent, impulsive) can cause exposure measurements to be incomplete, inaccurate, or inappropriate for a given situation. This paper describes the design of a noise dosimeter capable of acquiring exposure data across tactical environments. Two generations of prototypes have been built at MIT Lincoln Laboratory with funding from the US Army, Navy, and Marine Corps. Details related to hardware, signal processing, and testing efforts are provided, along with example tactical military noise data and lessons learned from early fieldings. Finally, we discuss the continued need to prioritize personalized dosimetry in order to improve models that predict or characterize the risk of auditory damage, to integrate dosimeters with hearing-protection devices, and to inform strategies and metrics for reducing NIHI.



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Development and regeneration of vestibular hair cells in mammals.

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Development and regeneration of vestibular hair cells in mammals.

Semin Cell Dev Biol. 2016 Nov 15;:

Authors: Burns J, Stone J

Abstract
Vestibular sensation is essential for gaze stabilization, balance, and perception of gravity. The vestibular receptors in mammals, Type I and Type II hair cells, are located in five small organs in the inner ear. Damage to hair cells and their innervating neurons can cause crippling symptoms such as vertigo, visual field oscillation, and imbalance. In adult rodents, some Type II hair cells are regenerated and become re-innervated after damage, presenting opportunities for restoring vestibular function after hair cell damage. This article reviews features of vestibular sensory cells in mammals, including their basic properties, how they develop, and how they are replaced after damage. We discuss molecules that control vestibular hair cell regeneration and highlight areas in which our understanding of development and regeneration needs to be deepened.

PMID: 27864084 [PubMed - as supplied by publisher]

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Cochlear Implantation in Ménière's Disease With and Without Labyrinthectomy.

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Cochlear Implantation in Ménière's Disease With and Without Labyrinthectomy.

Otol Neurotol. 2016 Nov 16;

Authors: Mukherjee P, Eykamp K, Brown D, Curthoys I, Flanagan S, Biggs N, McNeill C, Gibson W

Abstract
OBJECTIVE: To investigate outcomes of cochlear implantation (CI) in patients with Ménière's disease (MD) with and without surgical labyrinthectomy.
STUDY DESIGN: Retrospective study.
SETTING: Multiple tertiary referral centers.
SUBJECTS: Thirty one ears from 27 patients (17 men, 10 women, aged 42-84) with CI in ipsilateral MD ear.
INTERVENTION: CI in ears with intact labyrinths (Group 1), CI with simultaneous surgical labyrinthectomy (Group 2), and CI sequential to surgical labyrinthectomy (Group 3).
MAIN OUTCOME MEASURE: Within-subject improvement on Bamford Kowal Bench test or City University of New York open set sentence tests.
RESULTS: Majority of ears achieved excellent open-set speech recognition by 12 months post-CI, irrespective of intervention group. Preoperative details including patient age and sex, implant, MD and previous intervention, and audiological test results did not significantly affect outcomes. Patients with MD undergoing CI only may experience vestibular dysfunction which may cause long-term concerns. Incidental finding was noted of eight ears with fluctuating symptoms in ipsilateral ear during 12-month period post-CI, with five of eight ears showing objective fluctuating impedances and mapping.
CONCLUSION: CI in MD can yield good hearing outcomes in all three groups and this is possible even after a long delay after labyrinthectomy. Bilateral MD patients are complex and prospective quality of life (QoL) measures would be beneficial in being better able to manage the vestibular outcomes as well as the audiological ones.

PMID: 27861194 [PubMed - as supplied by publisher]

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Development and regeneration of vestibular hair cells in mammals.

Related Articles

Development and regeneration of vestibular hair cells in mammals.

Semin Cell Dev Biol. 2016 Nov 15;:

Authors: Burns J, Stone J

Abstract
Vestibular sensation is essential for gaze stabilization, balance, and perception of gravity. The vestibular receptors in mammals, Type I and Type II hair cells, are located in five small organs in the inner ear. Damage to hair cells and their innervating neurons can cause crippling symptoms such as vertigo, visual field oscillation, and imbalance. In adult rodents, some Type II hair cells are regenerated and become re-innervated after damage, presenting opportunities for restoring vestibular function after hair cell damage. This article reviews features of vestibular sensory cells in mammals, including their basic properties, how they develop, and how they are replaced after damage. We discuss molecules that control vestibular hair cell regeneration and highlight areas in which our understanding of development and regeneration needs to be deepened.

PMID: 27864084 [PubMed - as supplied by publisher]

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Cochlear Implantation in Ménière's Disease With and Without Labyrinthectomy.

Related Articles

Cochlear Implantation in Ménière's Disease With and Without Labyrinthectomy.

Otol Neurotol. 2016 Nov 16;

Authors: Mukherjee P, Eykamp K, Brown D, Curthoys I, Flanagan S, Biggs N, McNeill C, Gibson W

Abstract
OBJECTIVE: To investigate outcomes of cochlear implantation (CI) in patients with Ménière's disease (MD) with and without surgical labyrinthectomy.
STUDY DESIGN: Retrospective study.
SETTING: Multiple tertiary referral centers.
SUBJECTS: Thirty one ears from 27 patients (17 men, 10 women, aged 42-84) with CI in ipsilateral MD ear.
INTERVENTION: CI in ears with intact labyrinths (Group 1), CI with simultaneous surgical labyrinthectomy (Group 2), and CI sequential to surgical labyrinthectomy (Group 3).
MAIN OUTCOME MEASURE: Within-subject improvement on Bamford Kowal Bench test or City University of New York open set sentence tests.
RESULTS: Majority of ears achieved excellent open-set speech recognition by 12 months post-CI, irrespective of intervention group. Preoperative details including patient age and sex, implant, MD and previous intervention, and audiological test results did not significantly affect outcomes. Patients with MD undergoing CI only may experience vestibular dysfunction which may cause long-term concerns. Incidental finding was noted of eight ears with fluctuating symptoms in ipsilateral ear during 12-month period post-CI, with five of eight ears showing objective fluctuating impedances and mapping.
CONCLUSION: CI in MD can yield good hearing outcomes in all three groups and this is possible even after a long delay after labyrinthectomy. Bilateral MD patients are complex and prospective quality of life (QoL) measures would be beneficial in being better able to manage the vestibular outcomes as well as the audiological ones.

PMID: 27861194 [PubMed - as supplied by publisher]

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Identification of a de novo mutation of SOX10 in a Chinese patient with Waardenburg syndrome type IV.

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Identification of a de novo mutation of SOX10 in a Chinese patient with Waardenburg syndrome type IV.

Int J Pediatr Otorhinolaryngol. 2016 Dec;91:67-71

Authors: Liang F, Zhao M, Fan L, Zhang H, Shi Y, Han R, Qu C

Abstract
OBJECTIVES: Waardenburg syndrome is a rare genetic disorder, characterized by the association of sensorineural hearing loss and pigmentation abnormalities. Four subtypes have been classified. The present study aimed to analyze the clinical feature and investigate the genetic cause for a Chinese case of Waardenburg type IV (WS4).
METHODS: The patient and his family members were subjected to mutation detection in the candidate gene SOX10 by Sanger sequencing.
RESULTS: The patient has the clinical features of WS4, including sensorineural hearing loss, bright blue irides, premature graying of the hair and Hirschsprung disease. A novel heterozygous frameshift mutation, c.752_753ins7 (p.Gly252Alafs*31) in the exon 5 of SOX10 was detected in the patient, but not found in the unaffected family members and 100 normal controls. This mutation results in a premature stop codon 31 amino acid downstream.
CONCLUSIONS: The novel mutation c.752_753ins7 (p.Gly252Alafs*31) arose de novo and was considered as the cause of WS4 in the proband. This study further characterized the molecular complexity of WS4 and provided a clinical case for genotype-phenotype correlation studies of different phenotypes caused by SOX10 mutations.

PMID: 27863645 [PubMed - in process]

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Identification of SLC26A4 mutations p.L582LfsX4, p.I188T and p.E704K in a Chinese family with large vestibular aqueduct syndrome (LVAS).

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Identification of SLC26A4 mutations p.L582LfsX4, p.I188T and p.E704K in a Chinese family with large vestibular aqueduct syndrome (LVAS).

Int J Pediatr Otorhinolaryngol. 2016 Dec;91:1-5

Authors: Li Y, Zhu B, Su J, Yin Y, Yu F

Abstract
Large vestibular aqueduct syndrome (LVAS) is a type of hearing loss characterized by an autosomal recessive inheritance. LVAS has been shown to be associated with mutations in SLC26A4 gene. In the present study, we report the clinical, genetic and molecular characterization of a Chinese family with LVAS. By using the targeted sequence capture and next-generation sequencing, we identified heterozygous mutations of SLC26A4 p.I188T (c.563T > C), p.L582LfsX4 (c.1746 delG) and p.E704K (c.2110G > A) in the affected individual of this family, of which SLC26A4 p.E704K is a novel mutation associated with LVAS. By tracing the transmission and functional prediction of these mutations in the pedigree, the heterozygous mutations of p.I188T, p.L582LfsX4 and p.E704K in SLC26A4 gene were responsible for the LVAS of the affected individual. This is the first case of LVAS caused by these mutations.

PMID: 27863619 [PubMed - in process]

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Increased risk of depression in patients with acquired sensory hearing loss: A 12-year follow-up study.

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Increased risk of depression in patients with acquired sensory hearing loss: A 12-year follow-up study.

Medicine (Baltimore). 2016 Nov;95(44):e5312

Authors: Hsu WT, Hsu CC, Wen MH, Lin HC, Tsai HT, Su P, Sun CT, Lin CL, Hsu CY, Chang KH, Hsu YC

Abstract
Acquired sensory hearing loss (SHL) is suggested to be associated with depression. However, some studies have reported conflicting results. Our study investigated the relationship between the prevalence of SHL and the incidence of depression over 12 years of follow-up by using data from the Taiwan National Health Insurance Research Database (NHIRD). We sought to determine the association between SHL and subsequent development of depression and discuss the pathophysiological mechanism underlying the association.Patients with SHL were identified from the NHIRD (SHL cohort). A non-SHL cohort, comprising patients without SHL frequency-matched with the SHL patients according to age group, sex, and the year of diagnosis of SHL at the ratio of 1:4, was constructed, and the incidence of depression was evaluated in both cohorts. A multivariable model was adjusted for age, sex, and comorbidity.The SHL cohort and non-SHL cohort comprised 5043 patients with SHL and 20,172 patients without SHL, respectively. The incidences density rates were 9.50 and 4.78 per 1000 person-years in the SHL cohort and non-SHL cohort, respectively. After adjustment for age, sex, and comorbidities, the risk of depression was higher in the SHL cohort than in the non-SHL cohort (hazard ratio = 1.73, 95% confidence interval = 1.49-2.00).Acquired SHL may increase the risk of subsequent depression. The results demonstrated that SHL was an independent risk factor regardless of sex, age, and comorbidities. Moreover, a strong association between hearing loss and subsequent depression among Taiwanese adults of all ages, particularly those aged ≤49 and >65 years and without using steroids for the treatment of SHL was observed. Prospective clinical and biomedical studies on the relationship between hearing loss and depression are warranted for determining the etiopathology.

PMID: 27858911 [PubMed - in process]

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Evaluation of benign paroxysmal positional vertigo following Le Fort I osteotomy.

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Evaluation of benign paroxysmal positional vertigo following Le Fort I osteotomy.

Int J Oral Maxillofac Surg. 2016 Nov 14;:

Authors: Deniz K, Akdeniz SS, Koç AÖ, Uçkan S, Ozluoğlu LN

Abstract
The Le Fort I osteotomy is widely used to correct dentofacial deformities. Benign paroxysmal positional vertigo (BPPV) is a common vestibular end organ disorder characterized by short, often recurrent episodes of vertigo. Head trauma is one of the known causes of BPPV. During pterygoid osteotomy, the surgical trauma induced by percussion with the surgical mallet and osteotomes can displace otoliths into the semicircular canal, resulting in BPPV. The aim of this study was to evaluate the potential risk of occurrence of BPPV in individuals undergoing Le Fort I osteotomy. Twenty-three patients were included in this study. The Dix-Hallpike manoeuvre, positional tests using electronystagmography, and vestibular evoked myogenic potential (VEMP) tests were performed 1 week before surgery (T0), 1 week after surgery (T1), and 1 month after surgery (T2). The results were compared statistically. BPPV was observed in three patients. Eleven patients had nystagmus at the T1 evaluation and seven at the T2 evaluation. The difference between the T0 and T1 time points was statistically significant (P=0.001). BPPV is a possible complication of Le Fort I osteotomy. Surgeons should be aware of this complication, and the diagnosis of BPPV should be considered in patients who have undergone Le Fort I osteotomy.

PMID: 27856148 [PubMed - as supplied by publisher]

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