Cost-Effectiveness of Pediatric Cochlear Implantation in Rural China.

Objectives: To evaluate the cost utility of cochlear implantation (CI) for severe to profound sensorineural hearing loss (SNHL) among children from rural settings in P.R. China (China). Research Design: A cost-utility analysis (CUA) was undertaken using data generated from a single-center substudy of the CochlearTM Pediatric Implanted Recipient Observational Study (Cochlear P-IROS). The data were projected over a 20-year time horizon using a decision tree model. Setting: The Chinese healthcare payer and patient perspectives were adopted. Intervention: Unilateral CI of children with a severe-to-profound SNHL compared with their preimplantation state of no treatment or amplification with hearing aids ("no CI" status). Main Outcome Measure/s: Incremental costs per quality adjusted life year (QALY) gained. Results: The mean total discounted cost of unilateral CI was CNY 252,506 (37,876 USD), compared with CNY 29,005 (4,351 USD) for the no CI status from the healthcare payer plus patient perspective. A total discounted benefit of 8.9 QALYs was estimated for CI recipients compared with 6.7 QALYs for the no CI status. From the healthcare payer plus patient perspective, incremental cost-effectiveness ratio (ICER) for unilateral CI compared with no CI was CNY 100,561 (15,084 USD) per QALY. The healthcare payer perspective yielded an ICER of CNY 40,929 (6,139 USD) per QALY. Both ICERs fell within one to three times China's gross domestic product per capita (GDP, 2011-2015), considered "cost-effective" by World Health Organization (WHO) standards. Conclusions: Treatment with unilateral CI is a cost-effective hearing solution for children with severe to profound SNHL in rural China. Increased access to mainstream education and greater opportunities for employment, are potential downstream benefits of CI that may yield further societal and economic benefits. CI may be considered favorably for broader inclusion in medical insurance schemes across China. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://ift.tt/OBJ4xP Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Análisis bibliométrico de la Revista de Logopedia, Foniatría y Audiología: 2000-2016

Publication date: Available online 5 April 2017
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Gustavo M. Ramírez Santana, Yazmina Pérez Lozano, Gisela Cerdeña García, Víctor M. Acosta Rodríguez
IntroducciónEl objetivo de este trabajo es presentar la producción científica de la Revista de Logopedia, Foniatría y Audiología (RLFA).MetodologíaSe desarrolla un estudio descriptivo-retrospectivo de la RLFA a partir de los 344 artículos recogidos en los 108 números publicados en el período comprendido entre los años 2000 y 2016, ambos incluidos.ResultadosSiguiendo el criterio del índice de colaboración, la RLFA se encuentra en vías de madurez científica. Además, se observa un buen patrón de ajuste a la ley de Lotka. En los 344 artículos analizados se han citado 961 revistas diferentes, destacándose Journal of Speech and Hearing Disorders como la primera, seguida de Journal of Speech Language and Hearing Research y de Brain and Language. Además, se han producido 43 artículos con colaboración internacional entre diferentes instituciones.Discusión y conclusionesSe proponen una serie de sugerencias que la RLFA puede considerar con el propósito de alcanzar una mayor difusión y reconocimiento en el ámbito internacional.IntroductionThe aim of this paper is to present the scientific production of Revista de Logopedia, Foniatría y Audiología (RLFA).MethodologyA descriptive-retrospective study of the RLFA was developed based on the 344 articles collected in the 108 issues published between the years 2000 and 2016, inclusively.ResultsFollowing the criterion of the Collaboration Index, RLFA is in the process of scientific maturity. In addition, a good pattern adjusted to Lotka's Law is observed. In the 344 articles analysed, 961 different journals have been cited, highlighting the Journal of Speech and Hearing Disorders, followed by Journal of Speech Language and Hearing Research, and Brain and Language. In addition, 43 articles have been written with international collaboration between different institutions.Discussion and conclusionsA series of suggestions are proposed for the RLFA to consider in order to achieve greater coverage and recognition at international level.



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Análisis bibliométrico de la Revista de Logopedia, Foniatría y Audiología: 2000-2016

Publication date: Available online 5 April 2017
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Gustavo M. Ramírez Santana, Yazmina Pérez Lozano, Gisela Cerdeña García, Víctor M. Acosta Rodríguez
IntroducciónEl objetivo de este trabajo es presentar la producción científica de la Revista de Logopedia, Foniatría y Audiología (RLFA).MetodologíaSe desarrolla un estudio descriptivo-retrospectivo de la RLFA a partir de los 344 artículos recogidos en los 108 números publicados en el período comprendido entre los años 2000 y 2016, ambos incluidos.ResultadosSiguiendo el criterio del índice de colaboración, la RLFA se encuentra en vías de madurez científica. Además, se observa un buen patrón de ajuste a la ley de Lotka. En los 344 artículos analizados se han citado 961 revistas diferentes, destacándose Journal of Speech and Hearing Disorders como la primera, seguida de Journal of Speech Language and Hearing Research y de Brain and Language. Además, se han producido 43 artículos con colaboración internacional entre diferentes instituciones.Discusión y conclusionesSe proponen una serie de sugerencias que la RLFA puede considerar con el propósito de alcanzar una mayor difusión y reconocimiento en el ámbito internacional.IntroductionThe aim of this paper is to present the scientific production of Revista de Logopedia, Foniatría y Audiología (RLFA).MethodologyA descriptive-retrospective study of the RLFA was developed based on the 344 articles collected in the 108 issues published between the years 2000 and 2016, inclusively.ResultsFollowing the criterion of the Collaboration Index, RLFA is in the process of scientific maturity. In addition, a good pattern adjusted to Lotka's Law is observed. In the 344 articles analysed, 961 different journals have been cited, highlighting the Journal of Speech and Hearing Disorders, followed by Journal of Speech Language and Hearing Research, and Brain and Language. In addition, 43 articles have been written with international collaboration between different institutions.Discussion and conclusionsA series of suggestions are proposed for the RLFA to consider in order to achieve greater coverage and recognition at international level.



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Análisis bibliométrico de la Revista de Logopedia, Foniatría y Audiología: 2000-2016

Publication date: Available online 5 April 2017
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Gustavo M. Ramírez Santana, Yazmina Pérez Lozano, Gisela Cerdeña García, Víctor M. Acosta Rodríguez
IntroducciónEl objetivo de este trabajo es presentar la producción científica de la Revista de Logopedia, Foniatría y Audiología (RLFA).MetodologíaSe desarrolla un estudio descriptivo-retrospectivo de la RLFA a partir de los 344 artículos recogidos en los 108 números publicados en el período comprendido entre los años 2000 y 2016, ambos incluidos.ResultadosSiguiendo el criterio del índice de colaboración, la RLFA se encuentra en vías de madurez científica. Además, se observa un buen patrón de ajuste a la ley de Lotka. En los 344 artículos analizados se han citado 961 revistas diferentes, destacándose Journal of Speech and Hearing Disorders como la primera, seguida de Journal of Speech Language and Hearing Research y de Brain and Language. Además, se han producido 43 artículos con colaboración internacional entre diferentes instituciones.Discusión y conclusionesSe proponen una serie de sugerencias que la RLFA puede considerar con el propósito de alcanzar una mayor difusión y reconocimiento en el ámbito internacional.IntroductionThe aim of this paper is to present the scientific production of Revista de Logopedia, Foniatría y Audiología (RLFA).MethodologyA descriptive-retrospective study of the RLFA was developed based on the 344 articles collected in the 108 issues published between the years 2000 and 2016, inclusively.ResultsFollowing the criterion of the Collaboration Index, RLFA is in the process of scientific maturity. In addition, a good pattern adjusted to Lotka's Law is observed. In the 344 articles analysed, 961 different journals have been cited, highlighting the Journal of Speech and Hearing Disorders, followed by Journal of Speech Language and Hearing Research, and Brain and Language. In addition, 43 articles have been written with international collaboration between different institutions.Discussion and conclusionsA series of suggestions are proposed for the RLFA to consider in order to achieve greater coverage and recognition at international level.



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A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: II. Validity Studies of the Pause Marker

Purpose

The purpose of this 2nd article in this supplement is to report validity support findings for the Pause Marker (PM), a proposed single-sign diagnostic marker of childhood apraxia of speech (CAS).

Method

PM scores and additional perceptual and acoustic measures were obtained from 296 participants in cohorts with idiopathic and neurogenetic CAS, adult-onset apraxia of speech and primary progressive apraxia of speech, and idiopathic speech delay.

Results

Adjusted for questionable specificity disagreements with a pediatric Mayo Clinic diagnostic standard, the estimated sensitivity and specificity, respectively, of the PM were 86.8% and 100% for the CAS cohort, yielding positive and negative likelihood ratios of 56.45 (95% confidence interval [CI]: [1.15, 2763.31]) and 0.13 (95% CI [0.06, 0.30]). Specificity of the PM for 4 cohorts totaling 205 participants with speech delay was 98.5%.

Conclusion

These findings are interpreted as providing support for the PM as a near-conclusive diagnostic marker of CAS.

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A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: I. Development and Description of the Pause Marker

Purpose

The goal of this article (PM I) is to describe the rationale for and development of the Pause Marker (PM), a single-sign diagnostic marker proposed to discriminate early or persistent childhood apraxia of speech from speech delay.

Method

The authors describe and prioritize 7 criteria with which to evaluate the research and clinical utility of a diagnostic marker for childhood apraxia of speech, including evaluation of the present proposal. An overview is given of the Speech Disorders Classification System, including extensions completed in the same approximately 3-year period in which the PM was developed.

Results

The finalized Speech Disorders Classification System includes a nosology and cross-classification procedures for childhood and persistent speech disorders and motor speech disorders (Shriberg, Strand, & Mabie, 2017). A PM is developed that provides procedural and scoring information, and citations to papers and technical reports that include audio exemplars of the PM and reference data used to standardize PM scores are provided.

Conclusions

The PM described here is an acoustic-aided perceptual sign that quantifies one aspect of speech precision in the linguistic domain of phrasing. This diagnostic marker can be used to discriminate early or persistent childhood apraxia of speech from speech delay.

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A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: III. Theoretical Coherence of the Pause Marker with Speech Processing Deficits in Childhood Apraxia of Speech

Purpose

Previous articles in this supplement described rationale for and development of the pause marker (PM), a diagnostic marker of childhood apraxia of speech (CAS), and studies supporting its validity and reliability. The present article assesses the theoretical coherence of the PM with speech processing deficits in CAS.

Method

PM and other scores were obtained for 264 participants in 6 groups: CAS in idiopathic, neurogenetic, and complex neurodevelopmental disorders; adult-onset apraxia of speech (AAS) consequent to stroke and primary progressive apraxia of speech; and idiopathic speech delay.

Results

Participants with CAS and AAS had significantly lower scores than typically speaking reference participants and speech delay controls on measures posited to assess representational and transcoding processes. Representational deficits differed between CAS and AAS groups, with support for both underspecified linguistic representations and memory/access deficits in CAS, but for only the latter in AAS. CAS–AAS similarities in the age–sex standardized percentages of occurrence of the most frequent type of inappropriate pauses (abrupt) and significant differences in the standardized occurrence of appropriate pauses were consistent with speech processing findings.

Conclusions

Results support the hypotheses of core representational and transcoding speech processing deficits in CAS and theoretical coherence of the PM's pause-speech elements with these deficits.

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A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: IV. The Pause Marker Index

Purpose

Three previous articles provided rationale, methods, and several forms of validity support for a diagnostic marker of childhood apraxia of speech (CAS), termed the pause marker (PM). Goals of the present article were to assess the validity and stability of the PM Index (PMI) to scale CAS severity.

Method

PM scores and speech, prosody, and voice precision-stability data were obtained for participants with CAS in idiopathic, neurogenetic, and complex neurodevelopmental disorders; adult-onset apraxia of speech consequent to stroke and primary progressive apraxia; and idiopathic speech delay. Three studies were completed including criterion and concurrent validity studies of the PMI and a temporal stability study of the PMI using retrospective case studies.

Results

PM scores were significantly correlated with other signs of CAS precision and stability. The best fit of the distribution of PM scores to index CAS severity was obtained by dividing scores into 4 ordinal severity classifications: mild, mild-moderate, moderate-severe, and severe. Severity findings for the 4 classifications and retrospective longitudinal findings from 8 participants with CAS supported the validity and stability of the PMI.

Conclusion

Findings support research and clinical use of the PMI to scale the severity of CAS.

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A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: II. Validity Studies of the Pause Marker

Purpose

The purpose of this 2nd article in this supplement is to report validity support findings for the Pause Marker (PM), a proposed single-sign diagnostic marker of childhood apraxia of speech (CAS).

Method

PM scores and additional perceptual and acoustic measures were obtained from 296 participants in cohorts with idiopathic and neurogenetic CAS, adult-onset apraxia of speech and primary progressive apraxia of speech, and idiopathic speech delay.

Results

Adjusted for questionable specificity disagreements with a pediatric Mayo Clinic diagnostic standard, the estimated sensitivity and specificity, respectively, of the PM were 86.8% and 100% for the CAS cohort, yielding positive and negative likelihood ratios of 56.45 (95% confidence interval [CI]: [1.15, 2763.31]) and 0.13 (95% CI [0.06, 0.30]). Specificity of the PM for 4 cohorts totaling 205 participants with speech delay was 98.5%.

Conclusion

These findings are interpreted as providing support for the PM as a near-conclusive diagnostic marker of CAS.

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A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: I. Development and Description of the Pause Marker

Purpose

The goal of this article (PM I) is to describe the rationale for and development of the Pause Marker (PM), a single-sign diagnostic marker proposed to discriminate early or persistent childhood apraxia of speech from speech delay.

Method

The authors describe and prioritize 7 criteria with which to evaluate the research and clinical utility of a diagnostic marker for childhood apraxia of speech, including evaluation of the present proposal. An overview is given of the Speech Disorders Classification System, including extensions completed in the same approximately 3-year period in which the PM was developed.

Results

The finalized Speech Disorders Classification System includes a nosology and cross-classification procedures for childhood and persistent speech disorders and motor speech disorders (Shriberg, Strand, & Mabie, 2017). A PM is developed that provides procedural and scoring information, and citations to papers and technical reports that include audio exemplars of the PM and reference data used to standardize PM scores are provided.

Conclusions

The PM described here is an acoustic-aided perceptual sign that quantifies one aspect of speech precision in the linguistic domain of phrasing. This diagnostic marker can be used to discriminate early or persistent childhood apraxia of speech from speech delay.

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A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: III. Theoretical Coherence of the Pause Marker with Speech Processing Deficits in Childhood Apraxia of Speech

Purpose

Previous articles in this supplement described rationale for and development of the pause marker (PM), a diagnostic marker of childhood apraxia of speech (CAS), and studies supporting its validity and reliability. The present article assesses the theoretical coherence of the PM with speech processing deficits in CAS.

Method

PM and other scores were obtained for 264 participants in 6 groups: CAS in idiopathic, neurogenetic, and complex neurodevelopmental disorders; adult-onset apraxia of speech (AAS) consequent to stroke and primary progressive apraxia of speech; and idiopathic speech delay.

Results

Participants with CAS and AAS had significantly lower scores than typically speaking reference participants and speech delay controls on measures posited to assess representational and transcoding processes. Representational deficits differed between CAS and AAS groups, with support for both underspecified linguistic representations and memory/access deficits in CAS, but for only the latter in AAS. CAS–AAS similarities in the age–sex standardized percentages of occurrence of the most frequent type of inappropriate pauses (abrupt) and significant differences in the standardized occurrence of appropriate pauses were consistent with speech processing findings.

Conclusions

Results support the hypotheses of core representational and transcoding speech processing deficits in CAS and theoretical coherence of the PM's pause-speech elements with these deficits.

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A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: IV. The Pause Marker Index

Purpose

Three previous articles provided rationale, methods, and several forms of validity support for a diagnostic marker of childhood apraxia of speech (CAS), termed the pause marker (PM). Goals of the present article were to assess the validity and stability of the PM Index (PMI) to scale CAS severity.

Method

PM scores and speech, prosody, and voice precision-stability data were obtained for participants with CAS in idiopathic, neurogenetic, and complex neurodevelopmental disorders; adult-onset apraxia of speech consequent to stroke and primary progressive apraxia; and idiopathic speech delay. Three studies were completed including criterion and concurrent validity studies of the PMI and a temporal stability study of the PMI using retrospective case studies.

Results

PM scores were significantly correlated with other signs of CAS precision and stability. The best fit of the distribution of PM scores to index CAS severity was obtained by dividing scores into 4 ordinal severity classifications: mild, mild-moderate, moderate-severe, and severe. Severity findings for the 4 classifications and retrospective longitudinal findings from 8 participants with CAS supported the validity and stability of the PMI.

Conclusion

Findings support research and clinical use of the PMI to scale the severity of CAS.

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A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: II. Validity Studies of the Pause Marker

Purpose

The purpose of this 2nd article in this supplement is to report validity support findings for the Pause Marker (PM), a proposed single-sign diagnostic marker of childhood apraxia of speech (CAS).

Method

PM scores and additional perceptual and acoustic measures were obtained from 296 participants in cohorts with idiopathic and neurogenetic CAS, adult-onset apraxia of speech and primary progressive apraxia of speech, and idiopathic speech delay.

Results

Adjusted for questionable specificity disagreements with a pediatric Mayo Clinic diagnostic standard, the estimated sensitivity and specificity, respectively, of the PM were 86.8% and 100% for the CAS cohort, yielding positive and negative likelihood ratios of 56.45 (95% confidence interval [CI]: [1.15, 2763.31]) and 0.13 (95% CI [0.06, 0.30]). Specificity of the PM for 4 cohorts totaling 205 participants with speech delay was 98.5%.

Conclusion

These findings are interpreted as providing support for the PM as a near-conclusive diagnostic marker of CAS.

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A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: I. Development and Description of the Pause Marker

Purpose

The goal of this article (PM I) is to describe the rationale for and development of the Pause Marker (PM), a single-sign diagnostic marker proposed to discriminate early or persistent childhood apraxia of speech from speech delay.

Method

The authors describe and prioritize 7 criteria with which to evaluate the research and clinical utility of a diagnostic marker for childhood apraxia of speech, including evaluation of the present proposal. An overview is given of the Speech Disorders Classification System, including extensions completed in the same approximately 3-year period in which the PM was developed.

Results

The finalized Speech Disorders Classification System includes a nosology and cross-classification procedures for childhood and persistent speech disorders and motor speech disorders (Shriberg, Strand, & Mabie, 2017). A PM is developed that provides procedural and scoring information, and citations to papers and technical reports that include audio exemplars of the PM and reference data used to standardize PM scores are provided.

Conclusions

The PM described here is an acoustic-aided perceptual sign that quantifies one aspect of speech precision in the linguistic domain of phrasing. This diagnostic marker can be used to discriminate early or persistent childhood apraxia of speech from speech delay.

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A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: III. Theoretical Coherence of the Pause Marker with Speech Processing Deficits in Childhood Apraxia of Speech

Purpose

Previous articles in this supplement described rationale for and development of the pause marker (PM), a diagnostic marker of childhood apraxia of speech (CAS), and studies supporting its validity and reliability. The present article assesses the theoretical coherence of the PM with speech processing deficits in CAS.

Method

PM and other scores were obtained for 264 participants in 6 groups: CAS in idiopathic, neurogenetic, and complex neurodevelopmental disorders; adult-onset apraxia of speech (AAS) consequent to stroke and primary progressive apraxia of speech; and idiopathic speech delay.

Results

Participants with CAS and AAS had significantly lower scores than typically speaking reference participants and speech delay controls on measures posited to assess representational and transcoding processes. Representational deficits differed between CAS and AAS groups, with support for both underspecified linguistic representations and memory/access deficits in CAS, but for only the latter in AAS. CAS–AAS similarities in the age–sex standardized percentages of occurrence of the most frequent type of inappropriate pauses (abrupt) and significant differences in the standardized occurrence of appropriate pauses were consistent with speech processing findings.

Conclusions

Results support the hypotheses of core representational and transcoding speech processing deficits in CAS and theoretical coherence of the PM's pause-speech elements with these deficits.

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A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: IV. The Pause Marker Index

Purpose

Three previous articles provided rationale, methods, and several forms of validity support for a diagnostic marker of childhood apraxia of speech (CAS), termed the pause marker (PM). Goals of the present article were to assess the validity and stability of the PM Index (PMI) to scale CAS severity.

Method

PM scores and speech, prosody, and voice precision-stability data were obtained for participants with CAS in idiopathic, neurogenetic, and complex neurodevelopmental disorders; adult-onset apraxia of speech consequent to stroke and primary progressive apraxia; and idiopathic speech delay. Three studies were completed including criterion and concurrent validity studies of the PMI and a temporal stability study of the PMI using retrospective case studies.

Results

PM scores were significantly correlated with other signs of CAS precision and stability. The best fit of the distribution of PM scores to index CAS severity was obtained by dividing scores into 4 ordinal severity classifications: mild, mild-moderate, moderate-severe, and severe. Severity findings for the 4 classifications and retrospective longitudinal findings from 8 participants with CAS supported the validity and stability of the PMI.

Conclusion

Findings support research and clinical use of the PMI to scale the severity of CAS.

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Claudin expression in the rat endolymphatic duct and sac - first insights into regulation of the paracellular barrier by vasopressin.

Related Articles

Claudin expression in the rat endolymphatic duct and sac - first insights into regulation of the paracellular barrier by vasopressin.

Sci Rep. 2017 Apr 04;7:45482

Authors: Runggaldier D, Pradas LG, Neckel PH, Mack AF, Hirt B, Gleiser C

Abstract
Hearing and balance functions of the inner ear rely on the homeostasis of the endolymphatic fluid. When disturbed, pathologic endolymphatic hydrops evolves as observed in Menière's disease. The molecular basis of inner ear fluid regulation across the endolymphatic epithelium is largely unknown. In this study we identified the specific expression of the tight junction (TJ) molecules Claudin 3, 4, 6, 7, 8, 10, and 16 in epithelial preparations of the rat inner ear endolymphatic duct (ED) and endolymphatic sac (ES) by high-throughput qPCR and immunofluorescence confocal microscopy. Further we showed that Claudin 4 in the ES is a target of arginine-vasopressin (AVP), a hormone elevated in Menière's disease. Moreover, our transmission-electron microscopy (TEM) analysis revealed that the TJs of the ED were shallow and shorter compared to the TJ of the ES indicating facilitation of a paracellular fluid transport across the ED epithelium. The significant differences in the subcellular localization of the barrier-forming protein Claudin 3 between the ED and ES epithelium further support the TEM observations. Our results indicate a high relevance of Claudin 3 and Claudin 4 as important paracellular barrier molecules in the ED and ES epithelium with potential involvement in the pathophysiology of Menière's disease.

PMID: 28374851 [PubMed - in process]

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Claudin expression in the rat endolymphatic duct and sac - first insights into regulation of the paracellular barrier by vasopressin.

Related Articles

Claudin expression in the rat endolymphatic duct and sac - first insights into regulation of the paracellular barrier by vasopressin.

Sci Rep. 2017 Apr 04;7:45482

Authors: Runggaldier D, Pradas LG, Neckel PH, Mack AF, Hirt B, Gleiser C

Abstract
Hearing and balance functions of the inner ear rely on the homeostasis of the endolymphatic fluid. When disturbed, pathologic endolymphatic hydrops evolves as observed in Menière's disease. The molecular basis of inner ear fluid regulation across the endolymphatic epithelium is largely unknown. In this study we identified the specific expression of the tight junction (TJ) molecules Claudin 3, 4, 6, 7, 8, 10, and 16 in epithelial preparations of the rat inner ear endolymphatic duct (ED) and endolymphatic sac (ES) by high-throughput qPCR and immunofluorescence confocal microscopy. Further we showed that Claudin 4 in the ES is a target of arginine-vasopressin (AVP), a hormone elevated in Menière's disease. Moreover, our transmission-electron microscopy (TEM) analysis revealed that the TJs of the ED were shallow and shorter compared to the TJ of the ES indicating facilitation of a paracellular fluid transport across the ED epithelium. The significant differences in the subcellular localization of the barrier-forming protein Claudin 3 between the ED and ES epithelium further support the TEM observations. Our results indicate a high relevance of Claudin 3 and Claudin 4 as important paracellular barrier molecules in the ED and ES epithelium with potential involvement in the pathophysiology of Menière's disease.

PMID: 28374851 [PubMed - in process]

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The impact of ethnicity on cochlear implantation in Norwegian children.

Related Articles

The impact of ethnicity on cochlear implantation in Norwegian children.

Int J Pediatr Otorhinolaryngol. 2017 Feb;93:30-36

Authors: Amundsen VV, Wie OB, Myhrum M, Bunne M

Abstract
OBJECTIVES: To explore the impact of parental ethnicity on cochlear implantation in children in Norway with regard to incidence rates of cochlear implants (CIs), comorbidies, age at onset of profound deafness (AOD), age at first implantation, uni- or bilateral CI, and speech recognition.
METHOD: This retrospective cohort study included all children (N = 278) aged <18 years in Norway who received their first CI during the years 2004-2010.
RESULTS: 86 children (30.9%) in our study sample had parents of non-Nordic ethnicity, of whom 46 were born in Nordic countries with two non-Nordic parents. Compared with the background population, children with non-Nordic parents were 1.9 times more likely to have received CI than Nordic children (i.e., born in Nordic countries with Nordic parents). When looking at AOD, uni-vs. bilateral CIs, and comorbidities, no significant differences were found between Nordic children and children with a non-Nordic ethnicity. Among children with AOD <1 year (n = 153), those born in non-Nordic countries with two non-Nordic parents (n = 6) and adopted non-Nordic children (n = 6) received their first CI on average 14.9 and 21.1 months later than Nordic children (n = 104), respectively (p = 0.006 and 0.005). Among children with AOD <1 year, those born in Nordic countries with two non-Nordic parents (n = 31) received their CI at an older age than Nordic children, but this difference was not significant after adjusting for calendar year of implantation and excluding comorbidity as a potential cause of delayed implantation. The mean age at implantation for children with AOD <1 year dropped 2.3 months/year over the study period. The mean monosyllable speech recognition score was 84.7% for Nordic children and 76.3% for children born in Norway with two non-Nordic parents (p = 0.002).
CONCLUSIONS: The incidence of CI was significantly higher in children with a non-Nordic vs. a Nordic ethnicity, reflecting a higher incidence of profound deafness. Children born in Norway have equal access to CIs regardless of their ethnicity, but despite being born and receiving care in Norway, prelingually deaf children with non-Nordic parents are at risk of receiving CI later than Nordic children. Moreover, prelingually deaf children who arrive in Norway at an older age may be at risk for a worse prognosis after receiving a CI due to lack of auditory stimulation in early childhood, which is critical for language development and late implantation; this is a serious issue with regard to deafness among refugees.

PMID: 28109494 [PubMed - indexed for MEDLINE]

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Abnormal loading and functional deficits are present in both limbs before and after unilateral knee arthroplasty

Publication date: Available online 4 April 2017
Source:Gait & Posture
Author(s): A.J. Metcalfe, C.J. Stewart, N.J. Postans, P.R. Biggs, G.M. Whatling, C.A. Holt, A.P. Roberts
Unilateral knee replacement is often followed by a contralateral replacement in time and the biomechanics of the other knee before and after knee replacement remains poorly understood. The aim of this paper is to distinguish the features of arthritic gait in the affected and unaffected legs relative to a normal population and to assess the objective recovery of gait function post-operatively, with the aim of defining patients at risk of poor post-operative function. Twenty patients with severe knee OA but no pain or deformity in any other lower limb joint were compared to twenty healthy subjects of the same age. Gait analysis was performed and quadriceps and hamstrings co-contraction was measured. Fifteen subjects returned 1year following knee arthroplasty. Moments and impulses were calculated, principal component analysis was used to analyse the waveforms and a classification technique (the Cardiff Classifier) was used to select the most discriminant data and define functional performance. Comparing pre-operative function to healthy function, classification accuracies for the affected and unaffected knees were 95% and 92.5% respectively. Post-operatively, the affected limb returned to the normal half of the classifier in 8 patients, and 7 of those patients returned to normal function in the unaffected limb. Recovery of normal gait could be correctly predicted 13 out of 15 times at the affected knee, and 12 out of 15 times at the unaffected knee based on pre-operative gait function. Focused rehabilitation prior to surgery may be beneficial to optimise outcomes and protect the other joints following knee arthroplasty.



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Concurrent validation of an index to estimate fall risk in community dwelling seniors through a wireless sensor insole system: a Pilot Study

Publication date: Available online 4 April 2017
Source:Gait & Posture
Author(s): Mirko Di Rosa, Jeff M. Hausdorff, Vera Stara, Lorena Rossi, Liam Glynn, Monica Casey, Stefan Burkard, Antonio Cherubini
Falls are a major health problem for older adults with immediate effects, such as fractures and head injuries, and longer term effects including fear of falling, loss of independence, and disability. The goals of the WIISEL project were to develop an unobtrusive, self-learning and wearable system aimed at assessing gait impairments and fall risk of older adults in the home setting; assessing activity and mobility in daily living conditions; identifying decline in mobility performance and detecting falls in the home setting. The WIISEL system was based on a pair of electronic insoles, able to transfer data to a commercially available smartphone, which was used to wirelessly collect data in real time from the insoles and transfer it to a backend computer server via mobile internet connection and then onwards to a gait analysis tool. Risk of falls was calculated by the system using a novel Fall Risk Index (FRI) based on multiple gait parameters and gait pattern recognition. The system was tested by twenty-nine older users and data collected by the insoles were compared with standardized functional tests with a concurrent validity approach. The results showed that the FRI captures the risk of falls with accuracy that is similar to that of conventional performance-based tests of fall risk. These preliminary findings support the idea that theWIISEL system can be a useful research tool and may have clinical utility for long-term monitoring of fall risk at home and in the community setting.



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Parkinsonian Signs are a Risk Factor for Falls

Publication date: Available online 4 April 2017
Source:Gait & Posture
Author(s): Nabila Dahodwala, Chinwe Nwadiogbu, Whitney Fitts, Helen Partridge, Jason Karlawish
BackgroundParkinsonian signs are common, non-specific findings in older adults and associated with increased rates of dementia and mortality. It is important to understand which motor outcomes are associated with parkinsonian signs.ObjectivesTo determine the role of parkinsonian signs on fall rates among older adults.MethodsWe conducted a longitudinal study of primary care patients from the University of Pennsylvania Health System. Adults over 55 years were assessed at baseline through surveys and a neurological examination. We recorded falls over the following 2 years. Parkinsonian signs were defined as the presence of 2 of 4 cardinal signs. Incident falls were compared between subjects with and without parkinsonian signs, and modified Poisson regression used to adjust for potential confounders in the relationship between parkinsonian signs and falls.Results982 subjects with a mean age of 68 (s.d. 8.8) years participated. 29% of participants fell and 12% exhibited parkinsonian signs at baseline. The unadjusted RR for falls among individuals with parkinsonian signs was 1.36 (95% CI 1.05-1.76, p=0.02). After adjusting for age, cognitive function, urinary incontinence, depression, diabetes, stroke and arthritis, individuals with parkinsonian signs were still 38% more likely to fall than those without parkinsonian signs (RR 1.38, 95% CI 1.04-1.82; p=0.03). Falls among those with parkinsonian signs were more likely to lead to injury (53% vs 37%; p=0.04).ConclusionsParkinsonian signs are a significant, independent risk factor for falls. Early detection of this clinical state is important in order to implement fall prevention programs among primary care patients.



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Falls in people with Parkinson’s disease: A prospective comparison of community and home-based falls

Publication date: Available online 4 April 2017
Source:Gait & Posture
Author(s): Robyn M. Lamont, Meg E. Morris, Hylton B. Menz, Jennifer L. McGinley, Sandra G. Brauer
BackgroundFalls are common and debilitating in people with Parkinson’s disease (PD) and restrict participation in daily activities. Understanding circumstances of falls in the community and at home may assist clinicians to target therapy more effectively.ObjectiveTo compare the characteristics of community and home fallers and the circumstances that contribute to falls in people living with PD.MethodsPeople with mild-moderately severe PD (n=196) used a daily falls diary and telephone hotline to report prospectively the occurrence, location and circumstances of falls over 14 months.Results62% of people with PD fell, with most falling at least once in the community. Compared to people who fell at home, the community-only fallers had shorter durations of PD (p=0.012), less severe disease (p=0.008) and reported fewer falls in the year prior to the study (p=0.003). Most falls occurred while people were ambulant, during postural transitions and when medication was working well. Community-based falls were frequently attributed to environmental factors such as challenging terrains (p < 0.001), high attention demands (p=0.029), busy or cluttered areas (p < 0.001) and tasks requiring speed (p=0.020). Physical loads were more often present in home than community-based falls (p=0.027).ConclusionFalls that occur in the community typically affect people with earlier PD and less severe disease than home-based falls. Individuals experiencing community-based falls may benefit from physiotherapy to manage challenging environments and high attention demands.



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Letter to the editor on “Textured and stimulating insoles for balance and gait impairments in patients with multiple sclerosis and Parkinson’s disease: A systematic review and meta-analysis” by Martin Alfuth, Gait & Posture (2017) 51, 132–141

Publication date: Available online 4 April 2017
Source:Gait & Posture
Author(s): Ana Paula da Silva Salazar, Cinara Stein, Aline de Souza Pagnussat




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Abnormal loading and functional deficits are present in both limbs before and after unilateral knee arthroplasty

Publication date: Available online 4 April 2017
Source:Gait & Posture
Author(s): A.J. Metcalfe, C.J. Stewart, N.J. Postans, P.R. Biggs, G.M. Whatling, C.A. Holt, A.P. Roberts
Unilateral knee replacement is often followed by a contralateral replacement in time and the biomechanics of the other knee before and after knee replacement remains poorly understood. The aim of this paper is to distinguish the features of arthritic gait in the affected and unaffected legs relative to a normal population and to assess the objective recovery of gait function post-operatively, with the aim of defining patients at risk of poor post-operative function. Twenty patients with severe knee OA but no pain or deformity in any other lower limb joint were compared to twenty healthy subjects of the same age. Gait analysis was performed and quadriceps and hamstrings co-contraction was measured. Fifteen subjects returned 1year following knee arthroplasty. Moments and impulses were calculated, principal component analysis was used to analyse the waveforms and a classification technique (the Cardiff Classifier) was used to select the most discriminant data and define functional performance. Comparing pre-operative function to healthy function, classification accuracies for the affected and unaffected knees were 95% and 92.5% respectively. Post-operatively, the affected limb returned to the normal half of the classifier in 8 patients, and 7 of those patients returned to normal function in the unaffected limb. Recovery of normal gait could be correctly predicted 13 out of 15 times at the affected knee, and 12 out of 15 times at the unaffected knee based on pre-operative gait function. Focused rehabilitation prior to surgery may be beneficial to optimise outcomes and protect the other joints following knee arthroplasty.



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Concurrent validation of an index to estimate fall risk in community dwelling seniors through a wireless sensor insole system: a Pilot Study

Publication date: Available online 4 April 2017
Source:Gait & Posture
Author(s): Mirko Di Rosa, Jeff M. Hausdorff, Vera Stara, Lorena Rossi, Liam Glynn, Monica Casey, Stefan Burkard, Antonio Cherubini
Falls are a major health problem for older adults with immediate effects, such as fractures and head injuries, and longer term effects including fear of falling, loss of independence, and disability. The goals of the WIISEL project were to develop an unobtrusive, self-learning and wearable system aimed at assessing gait impairments and fall risk of older adults in the home setting; assessing activity and mobility in daily living conditions; identifying decline in mobility performance and detecting falls in the home setting. The WIISEL system was based on a pair of electronic insoles, able to transfer data to a commercially available smartphone, which was used to wirelessly collect data in real time from the insoles and transfer it to a backend computer server via mobile internet connection and then onwards to a gait analysis tool. Risk of falls was calculated by the system using a novel Fall Risk Index (FRI) based on multiple gait parameters and gait pattern recognition. The system was tested by twenty-nine older users and data collected by the insoles were compared with standardized functional tests with a concurrent validity approach. The results showed that the FRI captures the risk of falls with accuracy that is similar to that of conventional performance-based tests of fall risk. These preliminary findings support the idea that theWIISEL system can be a useful research tool and may have clinical utility for long-term monitoring of fall risk at home and in the community setting.



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Parkinsonian Signs are a Risk Factor for Falls

Publication date: Available online 4 April 2017
Source:Gait & Posture
Author(s): Nabila Dahodwala, Chinwe Nwadiogbu, Whitney Fitts, Helen Partridge, Jason Karlawish
BackgroundParkinsonian signs are common, non-specific findings in older adults and associated with increased rates of dementia and mortality. It is important to understand which motor outcomes are associated with parkinsonian signs.ObjectivesTo determine the role of parkinsonian signs on fall rates among older adults.MethodsWe conducted a longitudinal study of primary care patients from the University of Pennsylvania Health System. Adults over 55 years were assessed at baseline through surveys and a neurological examination. We recorded falls over the following 2 years. Parkinsonian signs were defined as the presence of 2 of 4 cardinal signs. Incident falls were compared between subjects with and without parkinsonian signs, and modified Poisson regression used to adjust for potential confounders in the relationship between parkinsonian signs and falls.Results982 subjects with a mean age of 68 (s.d. 8.8) years participated. 29% of participants fell and 12% exhibited parkinsonian signs at baseline. The unadjusted RR for falls among individuals with parkinsonian signs was 1.36 (95% CI 1.05-1.76, p=0.02). After adjusting for age, cognitive function, urinary incontinence, depression, diabetes, stroke and arthritis, individuals with parkinsonian signs were still 38% more likely to fall than those without parkinsonian signs (RR 1.38, 95% CI 1.04-1.82; p=0.03). Falls among those with parkinsonian signs were more likely to lead to injury (53% vs 37%; p=0.04).ConclusionsParkinsonian signs are a significant, independent risk factor for falls. Early detection of this clinical state is important in order to implement fall prevention programs among primary care patients.



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Falls in people with Parkinson’s disease: A prospective comparison of community and home-based falls

Publication date: Available online 4 April 2017
Source:Gait & Posture
Author(s): Robyn M. Lamont, Meg E. Morris, Hylton B. Menz, Jennifer L. McGinley, Sandra G. Brauer
BackgroundFalls are common and debilitating in people with Parkinson’s disease (PD) and restrict participation in daily activities. Understanding circumstances of falls in the community and at home may assist clinicians to target therapy more effectively.ObjectiveTo compare the characteristics of community and home fallers and the circumstances that contribute to falls in people living with PD.MethodsPeople with mild-moderately severe PD (n=196) used a daily falls diary and telephone hotline to report prospectively the occurrence, location and circumstances of falls over 14 months.Results62% of people with PD fell, with most falling at least once in the community. Compared to people who fell at home, the community-only fallers had shorter durations of PD (p=0.012), less severe disease (p=0.008) and reported fewer falls in the year prior to the study (p=0.003). Most falls occurred while people were ambulant, during postural transitions and when medication was working well. Community-based falls were frequently attributed to environmental factors such as challenging terrains (p < 0.001), high attention demands (p=0.029), busy or cluttered areas (p < 0.001) and tasks requiring speed (p=0.020). Physical loads were more often present in home than community-based falls (p=0.027).ConclusionFalls that occur in the community typically affect people with earlier PD and less severe disease than home-based falls. Individuals experiencing community-based falls may benefit from physiotherapy to manage challenging environments and high attention demands.



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Letter to the editor on “Textured and stimulating insoles for balance and gait impairments in patients with multiple sclerosis and Parkinson’s disease: A systematic review and meta-analysis” by Martin Alfuth, Gait & Posture (2017) 51, 132–141

Publication date: Available online 4 April 2017
Source:Gait & Posture
Author(s): Ana Paula da Silva Salazar, Cinara Stein, Aline de Souza Pagnussat




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Abnormal loading and functional deficits are present in both limbs before and after unilateral knee arthroplasty

Publication date: Available online 4 April 2017
Source:Gait & Posture
Author(s): A.J. Metcalfe, C.J. Stewart, N.J. Postans, P.R. Biggs, G.M. Whatling, C.A. Holt, A.P. Roberts
Unilateral knee replacement is often followed by a contralateral replacement in time and the biomechanics of the other knee before and after knee replacement remains poorly understood. The aim of this paper is to distinguish the features of arthritic gait in the affected and unaffected legs relative to a normal population and to assess the objective recovery of gait function post-operatively, with the aim of defining patients at risk of poor post-operative function. Twenty patients with severe knee OA but no pain or deformity in any other lower limb joint were compared to twenty healthy subjects of the same age. Gait analysis was performed and quadriceps and hamstrings co-contraction was measured. Fifteen subjects returned 1year following knee arthroplasty. Moments and impulses were calculated, principal component analysis was used to analyse the waveforms and a classification technique (the Cardiff Classifier) was used to select the most discriminant data and define functional performance. Comparing pre-operative function to healthy function, classification accuracies for the affected and unaffected knees were 95% and 92.5% respectively. Post-operatively, the affected limb returned to the normal half of the classifier in 8 patients, and 7 of those patients returned to normal function in the unaffected limb. Recovery of normal gait could be correctly predicted 13 out of 15 times at the affected knee, and 12 out of 15 times at the unaffected knee based on pre-operative gait function. Focused rehabilitation prior to surgery may be beneficial to optimise outcomes and protect the other joints following knee arthroplasty.



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Concurrent validation of an index to estimate fall risk in community dwelling seniors through a wireless sensor insole system: a Pilot Study

Publication date: Available online 4 April 2017
Source:Gait & Posture
Author(s): Mirko Di Rosa, Jeff M. Hausdorff, Vera Stara, Lorena Rossi, Liam Glynn, Monica Casey, Stefan Burkard, Antonio Cherubini
Falls are a major health problem for older adults with immediate effects, such as fractures and head injuries, and longer term effects including fear of falling, loss of independence, and disability. The goals of the WIISEL project were to develop an unobtrusive, self-learning and wearable system aimed at assessing gait impairments and fall risk of older adults in the home setting; assessing activity and mobility in daily living conditions; identifying decline in mobility performance and detecting falls in the home setting. The WIISEL system was based on a pair of electronic insoles, able to transfer data to a commercially available smartphone, which was used to wirelessly collect data in real time from the insoles and transfer it to a backend computer server via mobile internet connection and then onwards to a gait analysis tool. Risk of falls was calculated by the system using a novel Fall Risk Index (FRI) based on multiple gait parameters and gait pattern recognition. The system was tested by twenty-nine older users and data collected by the insoles were compared with standardized functional tests with a concurrent validity approach. The results showed that the FRI captures the risk of falls with accuracy that is similar to that of conventional performance-based tests of fall risk. These preliminary findings support the idea that theWIISEL system can be a useful research tool and may have clinical utility for long-term monitoring of fall risk at home and in the community setting.



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Parkinsonian Signs are a Risk Factor for Falls

Publication date: Available online 4 April 2017
Source:Gait & Posture
Author(s): Nabila Dahodwala, Chinwe Nwadiogbu, Whitney Fitts, Helen Partridge, Jason Karlawish
BackgroundParkinsonian signs are common, non-specific findings in older adults and associated with increased rates of dementia and mortality. It is important to understand which motor outcomes are associated with parkinsonian signs.ObjectivesTo determine the role of parkinsonian signs on fall rates among older adults.MethodsWe conducted a longitudinal study of primary care patients from the University of Pennsylvania Health System. Adults over 55 years were assessed at baseline through surveys and a neurological examination. We recorded falls over the following 2 years. Parkinsonian signs were defined as the presence of 2 of 4 cardinal signs. Incident falls were compared between subjects with and without parkinsonian signs, and modified Poisson regression used to adjust for potential confounders in the relationship between parkinsonian signs and falls.Results982 subjects with a mean age of 68 (s.d. 8.8) years participated. 29% of participants fell and 12% exhibited parkinsonian signs at baseline. The unadjusted RR for falls among individuals with parkinsonian signs was 1.36 (95% CI 1.05-1.76, p=0.02). After adjusting for age, cognitive function, urinary incontinence, depression, diabetes, stroke and arthritis, individuals with parkinsonian signs were still 38% more likely to fall than those without parkinsonian signs (RR 1.38, 95% CI 1.04-1.82; p=0.03). Falls among those with parkinsonian signs were more likely to lead to injury (53% vs 37%; p=0.04).ConclusionsParkinsonian signs are a significant, independent risk factor for falls. Early detection of this clinical state is important in order to implement fall prevention programs among primary care patients.



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Falls in people with Parkinson’s disease: A prospective comparison of community and home-based falls

Publication date: Available online 4 April 2017
Source:Gait & Posture
Author(s): Robyn M. Lamont, Meg E. Morris, Hylton B. Menz, Jennifer L. McGinley, Sandra G. Brauer
BackgroundFalls are common and debilitating in people with Parkinson’s disease (PD) and restrict participation in daily activities. Understanding circumstances of falls in the community and at home may assist clinicians to target therapy more effectively.ObjectiveTo compare the characteristics of community and home fallers and the circumstances that contribute to falls in people living with PD.MethodsPeople with mild-moderately severe PD (n=196) used a daily falls diary and telephone hotline to report prospectively the occurrence, location and circumstances of falls over 14 months.Results62% of people with PD fell, with most falling at least once in the community. Compared to people who fell at home, the community-only fallers had shorter durations of PD (p=0.012), less severe disease (p=0.008) and reported fewer falls in the year prior to the study (p=0.003). Most falls occurred while people were ambulant, during postural transitions and when medication was working well. Community-based falls were frequently attributed to environmental factors such as challenging terrains (p < 0.001), high attention demands (p=0.029), busy or cluttered areas (p < 0.001) and tasks requiring speed (p=0.020). Physical loads were more often present in home than community-based falls (p=0.027).ConclusionFalls that occur in the community typically affect people with earlier PD and less severe disease than home-based falls. Individuals experiencing community-based falls may benefit from physiotherapy to manage challenging environments and high attention demands.



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Letter to the editor on “Textured and stimulating insoles for balance and gait impairments in patients with multiple sclerosis and Parkinson’s disease: A systematic review and meta-analysis” by Martin Alfuth, Gait & Posture (2017) 51, 132–141

Publication date: Available online 4 April 2017
Source:Gait & Posture
Author(s): Ana Paula da Silva Salazar, Cinara Stein, Aline de Souza Pagnussat




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Audiological Results in SSD With an Active Transcutaneous Bone Conduction Implant at a Retrosigmoidal Position.

Objective: One option for patients with single sided deafness (SSD) who experience problems with insufficient hearing in different surroundings is the treatment with percutaneous bone-anchored hearing aids. Common medical problems associated to a skin penetrating abutment can be avoided by active transcutaneous bone conduction hearing implants. The purpose of our study was to evaluate the benefit of an active transcutaneous bone conduction hearing implant in patients with SSD. Patients and Methods: Patients suffering from SSD who are implanted with an active transcutaneous bone conduction hearing implant in retrosigmoidal position were audiologically analyzed. The audiological test battery included air and bone conduction thresholds, word recognition score (WRS) in quiet and speech intelligibility (Oldenburg Sentence Test [OLSA]) in noise. Patient satisfaction was evaluated with the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Bern-Benefit in Single-Sided Deafness (BBSS) questionnaire. Results: The monosyllable WRS and the signal-to-noise ratio (SNR) assessed by the OLSA was significantly better in all aided conditions. Also, the APHAB categories ease of communication and reverberation and the average benefit in the BBSS improved significantly if using the device. Conclusion: The Bonebridge is a transcutaneous alternative to the well-established percutaneous bone conducting devices in patients with single sided deafness. An improvement in hearing in noise and quiet as well as a decrease of the head shadow effect can be expected. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Cochlear Implantation in Cases of Unilateral Hearing Loss: Initial Localization Abilities.

Objectives: The present study evaluated early auditory localization abilities of cochlear implant (CI) recipients with normal or near-normal hearing (NH) in the contralateral ear. The goal of the study was to better understand the effect of CI listening experience on localization in this population. Design: Twenty participants with unilateral hearing loss enrolled in a prospective clinical trial assessing outcomes of cochlear implantation (ClinicalTrials.gov Identifier: NCT02203305). All participants received the MED-EL Standard electrode array, were fit with an ear-level audio processor, and listened with the FS4 coding strategy. Localization was assessed in the sound field using an 11-speaker array with speakers uniformly positioned on a horizontal, semicircular frame. Stimuli were 200-msec speech-shaped noise bursts. The intensity level (52, 62, and 72 dB SPL) and sound source were randomly interleaved across trials. Participants were tested preoperatively, and 1, 3, and 6 months after activation of the audio processor. Performance was evaluated in two conditions at each interval: (1) unaided (NH ear alone [NH-alone] condition), and (2) aided, with either a bone conduction hearing aid (preoperative interval; bone conduction hearing aid + NH condition) or a CI (postoperative intervals; CI + NH condition). Performance was evaluated by comparing root-mean-squared (RMS) error between listening conditions and between measurement intervals. Results: Mean RMS error for the soft, medium, and loud levels were 66[degrees], 64[degrees], and 69[degrees] in the NH-alone condition and 72[degrees], 66[degrees], and 70[degrees] in the bone conduction hearing aid + NH condition. Participants experienced a significant improvement in localization in the CI + NH condition at the 1-month interval (38[degrees], 35[degrees], and 38[degrees]) as compared with the preoperative NH-alone condition. Localization in the CI + NH condition continued to improve through the 6-month interval. Mean RMS errors were 28[degrees], 25[degrees], and 28[degrees] in the CI + NH condition at the 6-month interval. Conclusions: Adult CI recipients with normal or near-normal hearing in the contralateral ear experienced significant improvement in localization after 1 month of device use, and continued to improve through the 6-month interval. The present results show that binaural acclimatization in CI users with unilateral hearing loss can progress rapidly, with marked improvements in performance observed after only 1 month of listening experience. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Cochlear Implantation in Cases of Unilateral Hearing Loss: Initial Localization Abilities.

Objectives: The present study evaluated early auditory localization abilities of cochlear implant (CI) recipients with normal or near-normal hearing (NH) in the contralateral ear. The goal of the study was to better understand the effect of CI listening experience on localization in this population. Design: Twenty participants with unilateral hearing loss enrolled in a prospective clinical trial assessing outcomes of cochlear implantation (ClinicalTrials.gov Identifier: NCT02203305). All participants received the MED-EL Standard electrode array, were fit with an ear-level audio processor, and listened with the FS4 coding strategy. Localization was assessed in the sound field using an 11-speaker array with speakers uniformly positioned on a horizontal, semicircular frame. Stimuli were 200-msec speech-shaped noise bursts. The intensity level (52, 62, and 72 dB SPL) and sound source were randomly interleaved across trials. Participants were tested preoperatively, and 1, 3, and 6 months after activation of the audio processor. Performance was evaluated in two conditions at each interval: (1) unaided (NH ear alone [NH-alone] condition), and (2) aided, with either a bone conduction hearing aid (preoperative interval; bone conduction hearing aid + NH condition) or a CI (postoperative intervals; CI + NH condition). Performance was evaluated by comparing root-mean-squared (RMS) error between listening conditions and between measurement intervals. Results: Mean RMS error for the soft, medium, and loud levels were 66[degrees], 64[degrees], and 69[degrees] in the NH-alone condition and 72[degrees], 66[degrees], and 70[degrees] in the bone conduction hearing aid + NH condition. Participants experienced a significant improvement in localization in the CI + NH condition at the 1-month interval (38[degrees], 35[degrees], and 38[degrees]) as compared with the preoperative NH-alone condition. Localization in the CI + NH condition continued to improve through the 6-month interval. Mean RMS errors were 28[degrees], 25[degrees], and 28[degrees] in the CI + NH condition at the 6-month interval. Conclusions: Adult CI recipients with normal or near-normal hearing in the contralateral ear experienced significant improvement in localization after 1 month of device use, and continued to improve through the 6-month interval. The present results show that binaural acclimatization in CI users with unilateral hearing loss can progress rapidly, with marked improvements in performance observed after only 1 month of listening experience. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Cochlear Implantation in Cases of Unilateral Hearing Loss: Initial Localization Abilities.

Objectives: The present study evaluated early auditory localization abilities of cochlear implant (CI) recipients with normal or near-normal hearing (NH) in the contralateral ear. The goal of the study was to better understand the effect of CI listening experience on localization in this population. Design: Twenty participants with unilateral hearing loss enrolled in a prospective clinical trial assessing outcomes of cochlear implantation (ClinicalTrials.gov Identifier: NCT02203305). All participants received the MED-EL Standard electrode array, were fit with an ear-level audio processor, and listened with the FS4 coding strategy. Localization was assessed in the sound field using an 11-speaker array with speakers uniformly positioned on a horizontal, semicircular frame. Stimuli were 200-msec speech-shaped noise bursts. The intensity level (52, 62, and 72 dB SPL) and sound source were randomly interleaved across trials. Participants were tested preoperatively, and 1, 3, and 6 months after activation of the audio processor. Performance was evaluated in two conditions at each interval: (1) unaided (NH ear alone [NH-alone] condition), and (2) aided, with either a bone conduction hearing aid (preoperative interval; bone conduction hearing aid + NH condition) or a CI (postoperative intervals; CI + NH condition). Performance was evaluated by comparing root-mean-squared (RMS) error between listening conditions and between measurement intervals. Results: Mean RMS error for the soft, medium, and loud levels were 66[degrees], 64[degrees], and 69[degrees] in the NH-alone condition and 72[degrees], 66[degrees], and 70[degrees] in the bone conduction hearing aid + NH condition. Participants experienced a significant improvement in localization in the CI + NH condition at the 1-month interval (38[degrees], 35[degrees], and 38[degrees]) as compared with the preoperative NH-alone condition. Localization in the CI + NH condition continued to improve through the 6-month interval. Mean RMS errors were 28[degrees], 25[degrees], and 28[degrees] in the CI + NH condition at the 6-month interval. Conclusions: Adult CI recipients with normal or near-normal hearing in the contralateral ear experienced significant improvement in localization after 1 month of device use, and continued to improve through the 6-month interval. The present results show that binaural acclimatization in CI users with unilateral hearing loss can progress rapidly, with marked improvements in performance observed after only 1 month of listening experience. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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