The 40 Hz Modulation-following Response: Prediction of Low-frequency Uncomfortable Loudness Levels in Normally Hearing Adults

Preliminary investigations have been made in normally hearing alert adults to establish whether the 40 Hz modulation-following response (MFR) can be used to predict 400 Hz uncomfortable loudness levels (ULLs). The MFR stimulus was a 400 Hz carrier, amplitude- and frequency-modulated by a 40 Hz sine function. Subjective ULLs were obtained using standard procedures. 1 Objective ULLs were obtained from MFR parameter-intensity functions using rms amplitude, phase angle and magnitude-squared coherence (40 Hz components). The best predictions of the subjective ULL were made using objective ULLs calculated from the gradients of linear best-fit lines for individual phase-intensity functions (80 per cent predicted within 10 dB of the subjective ULL; maximum deviation = 16 dB). Poorest predictions were based on inter-subject average rms amplitude-intensity functions, where as few as 14 per cent were within 10 dB of the subjective value. The best predictions were considered sufficiently accurate to warrant further investigation using a variety of modulation and carrier frequencies in different age groups and with varying degrees of hearing loss.     

Effects of Middle-Ear Disease and Cleft Palate on High-Frequency Hearing in Children

High-frequency hearing loss in children with cleft palate has been documented recently. The present study was designed to investigate whether hearing loss can result solely as a consequence of middle-ear disease in early life or as a result of cleft palate and its sequelae which include middle-ear disease. Our results demonstrate that auditory functions for test frequencies 250-6 000 Hz were not significantly different among the two investigational groups of children with high incidence of middle-ear disease, and a control group of children with virtually no middle-ear disease. However, for high-frequency thresholds (8 000-20 000 Hz), both groups of children with high incidence of middle-ear disease were statistically different from the control group. Moreover, the children with cleft palate had high-frequency hearing that was statistically similar to that of children with normal orofacial structures and high incidence of middle-ear disease. Middle-ear disease alone, then, is a sufficient condition for loss of high-frequency sensitivity.

La perte auditive des hautes fréquences chez les enfants porteurs d'une fissure palatine a fait l'objet d'une documentation récente. Cette étude a été organisée de façon à établir si la perte auditive pouvait résulter uniquement d'une maladie de l'oreille moyenne dans la petite enfance, ou d'une fissure palatine et de ses séquelles qui comprennent les otites moyennes. Entre les deux groupes d'enfants prédisposés aux otites moyennes, et un groupe de contro?le constitué d'enfants rarement atteints d'otites moyennes, nos résultats n'indiquent pas de différences significatives quant aux fonctions auditives pour des fréquences d'essai de 250 à 6 000 Hz. Néanmoins, en ce qui concerne les seuils aux hautes fréquences (de 8 000 à 20 000 Hz), les deux groupes d'enfants prédisposés aux otites moyennes étaient statistiquement différents du groupe de contro?le. En outre, les enfants porteurs d'une fissure palatine avaient une audition des hautes fréquences qui était statistiquement semblable à celle des enfants porteurs de structures orofaciales normales et qui étaient prédisposés aux otites moyennes. A elle seule, une atteinte de l'oreille moyenne semble done ětre une condition suffisante pour l'apparition d'une perte auditive sur les hautes fréquences.     

A Comparison of Evoked Response Audiometry and Routine Clinical Audiometry

Auditory thresholds were determined by evoked response audiometry (ERA) and by routine clinical audiometry at two frequencies (500 and 2 000 Hz) for 50 adult patients by five audiologists. The differences between ERA results and routine audiometric results in this study suggest caution in the clinical use of data obtained by ERA.     

Multicentre investigation on electrically evoked compound action potential and stapedius reflex: how do these objective measures relate to implant programming parameters?

Abstract

Objectives

The aims of this study were to collect data on electrically evoked compound action potential (eCAP) and electrically evoked stapedius reflex thresholds (eSRT) in HiResolution^TM cochlear implant (CI) users, and to explore the relationships between these objective measures and behavioural measures of comfort levels (M-levels).

Methods

A prospective study on newly implanted subjects was designed. The eCAP was measured intra-operatively and at first fitting through neural response imaging (NRI), using the SoundWave^TM fitting software. The eSRT was measured intra-operatively by visual monitoring of the stapes, using both single-electrode stimulation and speech bursts (four electrodes stimulated at the same time). Measures of M-levels were performed according to standard clinical practice and collected at first fitting, 3 and 6 months of CI use.

Results

One hundred seventeen subjects from 14 centres, all implanted unilaterally with a HiResolution CII Bionic Ear^® or HiRes 90K^®, were included in the study. Speech burst stimulation elicited a significantly higher eSRT success rate than single-electrode stimulation, 84 vs. 64% respectively. The NRI success rate was 81% intra-operatively, significantly increasing to 96% after 6 months. Fitting guidelines were defined on the basis of a single NRI measurement. Correlations, analysis of variance, and multiple regression analysis were applied to generate a predictive model for the M-levels.

Discussion

Useful insights were produced into the behaviour of objective measures according to time, electrode location, and fitting parameters. They may usefully assist in programming the CI when no reliable feedback is obtained through standard behavioural procedures.     

A New Masking Transducer with Low Contralateral Transmission

A new making transducer is presented which uses a large moving coil driving unit acoustically shielded in a plastic shell. Sound waves are conveyed to the ear by means of a flexible plastic tube and an insert nipple. In tests made under normal clinical situations, it has been found ot provide an interaural isolation from 20-50 dB better than the conventional supra-aural audio-metric earphone and 16-34 dB better than the common hearing-aid type of insert erphone, while being more rugged and more reliable than the latter. It is therefore proposed as a supplementary tool to the clinician, for masking in all cases where other types of transducers are inadequate     

学生标准化病人在内科护理学客观结构化临床考试中的应用

目的了解内科护理学客观结构化临床考试（OSCE）中学生标准化病人（SSP）的模拟水平，分析SSP在模拟病人方面存在的问题，从而为进一步改进SSP提供依据。方法自行设计问卷，以我院参加内科护理学出科考试的74名学生作为调查对象，评价SSP的模拟水平。结果学生对SSP模拟病人逼真程度评价总分为（15．69±1．951）分，其中SPP能自然地回答学生提出的问题评价评价得分为（3．24±0．463）分。所有学生均认为运用SSP考核学生的临床能力是有效的，97％学生认为与传统考试模式相比标准化病人考核模式更能真实地反映学生的临床实际水平。结论培训护理专业学生为sP用于内科护理学OSCE考试可行性好，但需要进一步采取措施提高SSP模拟体征的逼真程度及各站SSP表演的协调一致性程度。     

Experiences in Computer Audiometry (ECoG and ERA)

By the ear-drum arrangement of electrode action potentials of the 8th nerve may be recorded down to the threshold intensities of click stimuli. A decrease in the amplitude of these potentials was observed with ipsilateral presentation of a masking noise. Contralateral conditioning sound stimulation caused either an increase or a decrease of click-evoked action potentials. The increase was observed with intensities of conditioning stimuli exceeding 50-60 dB SL, whereas the decrease was stated at higher stimulation levels. The former effect was ascribed to the activity of the olivo-cochlear fibres and the latter effect to reflex contraction of the middle ear muscles

Scalp-derived slow auditory evoked responses were studied in different conditions of sound stimulation. The peak latencies of these responses were longer, and the peak amplitude was lower for tone bursts as compared to effects of intensity-modulated tonal stimuli. With equal intensities of tonal increments, the peak latencies of derived responses were shorter and the amplitude was greater at higher steady-tone levels. In most cases, there was a close correspondence of the objective and subjective thresholds for both tone bursts and intensity-modulated stimuli. On the grounds of data obtained, the problems related to cross-examination and control test procedures during computer audiometry are discussed     

Comparison of physical activity assessed using hip- and wrist-worn accelerometers

ObjectivesIt is unclear how physical activity estimates differ when assessed using hip- vs wrist-worn accelerometers. The objective of this study was to compare physical activity assessed by hip- and wrist-worn accelerometers in free-living older women.DesignA cross-sectional study collecting data in free-living environment.MethodsParticipants were from the Women's Health Study, in which an ancillary study is objectively measuring physical activity using accelerometers (ActiGraph GT3X+). We analyzed data from 94 women (mean (SD) age = 71.9 (6.0) years) who wore a hip-worn and wrist-worn accelerometers simultaneously for 7 days.ResultsUsing triaxial data (vector magnitude, VM), total activity volume (counts per day) between the two locations was moderately correlated (Spearman's r = 0.73). Hip and wrist monitors wear locations identically classified 71% individuals who were at the highest 40% or lowest 40% of their respective distributions. Similar patterns and slightly stronger agreements were observed when examining steps instead of VM counts.ConclusionsAccelerometer-assessed physical activity using hip- vs wrist-worn devices was moderately correlated in older, free-living women. However, further research needs to be conducted to examine comparisons of specific activities or physical activity intensity levels.     

Is Subjective Outcome Evaluation Related to Objective Outcome Evaluation? Insights from a Longitudinal Study in Hong Kong

Study ObjectivesEmpirical studies investigating the inter-relationships among subjective outcomes and objective outcomes are sparse in the scientific literature. This study examined the relationship between these 2 forms of outcome evaluation data in Chinese adolescents, utilizing longitudinal data.DesignIn Wave 3 and Wave 4 of a randomized group trial, 2,784 Chinese secondary school students responded to the Chinese Positive Youth Development Scale (CPYDS) assessing objective outcome at pretest (Wave 3) and posttest (Wave 4). Students in the experimental schools also responded to a measure of client satisfaction assessing the subjective outcome of a positive youth development program at posttest (Wave 4).ResultsSubjective outcome evaluation measures (eg, process, program, and effectiveness) at Wave 3 were significantly correlated with CPYDS scores at Wave 4 and difference scores. Subjective outcome evaluation measures also predicted changes in the objective outcome evaluation measures scores across time.ConclusionsThe present findings replicated the previous findings that subjective outcome and objective outcome evaluation findings were intimately related, and subjective outcome measures predicted posttest measures and their changes over time. The present study suggests that subjective outcome evaluation findings may yield useful information regarding program effectiveness in youth work settings.