Hearing in Noise Test Brazil: standardization for young adults with normal hearing

IntroductionIndividuals with the same ability of speech recognition in quiet can have extremely different results in noisy environments.ObjectiveTo standardize speech perception in adults with normal hearing in the free field using the Brazilian Hearing in Noise Test.MethodsContemporary, cross-sectional cohort study. 79 adults with normal hearing and without cognitive impairment participated in the study. Lists of Hearing in Noise Test sentences were randomly in quiet, noise front, noise right, and noise left.ResultsThere were no significant differences between right and left ears at all frequencies tested (paired t − 1 test). Nor were significant differences observed when comparing gender and interaction between these conditions. A difference was observed among the free field positions tested, except in the situations of noise right and noise left.ConclusionResults of speech perception in adults with normal hearing in the free field during different listening situations in noise indicated poorer performance during the condition with noise and speech in front, i.e., 0°/0°. The values found in the standardization of the Hearing in Noise Test free field can be used as a reference in the development of protocols for tests of speech perception in noise, and for monitoring individuals with hearing impairment.     

携载rhBMP-2微球的新型可注射自凝固复合人工骨的制备及特性研究

[目的]制备一种具有良好降解性和成骨活性、可注射的自凝固新型骨修复材料。[方法]制备携载rhBMP-2的聚乳酸与聚乙醇酸共聚物（PLGA）微球，并将其与rhBMP-2／磷酸钙骨水泥（CPC）复合，制备出rhBMP-2／PLGA微球／CPC复合人工骨。探讨了材料的特性，包括形貌、固化时间、抗压强度及反映材料体外降解速度的指标一体外降解液Ca、P浓度变化，测定复合材料rhBMP乏的释药速度及体外诱导MSCs细胞成骨分化的能力。[结果]与单纯CPC-rhBMP-2相比，复合材料的固化时间少量增加，抗压强度下降明显。体外降解速度及体外释药明显提高，释放的rhBMP-2具有骨诱导活性。[结论]rhBMP-2／PLGA微球／磷酸钙骨水泥新型复合人工骨是具有良好应用前景的骨修复材料。     

A review of the effectiveness of aspartame in helping with weight control

Summary Strategies to reverse the upward trend in obesity rates need to focus on both reducing energy intake and increasing energy expenditure. The provision of low‐ or reduced‐energy‐dense foods is one way of helping people to reduce their energy intake and so enable weight maintenance or weight loss to occur. The use of intense sweeteners as a substitute for sucrose potentially offers one way of helping people to reduce the energy density of their diet without any loss of palatability. This report reviews the evidence for the effect of aspartame on weight loss, weight maintenance and energy intakes in adults and addresses the question of how much energy is compensated for and whether the use of aspartame‐sweetened foods and drinks is an effective way to lose weight. All studies which examined the effect of substituting sugar with either aspartame alone or aspartame in combination with other intense sweeteners on energy intake or bodyweight were identified. Studies which were not randomised controlled trials in healthy adults and which did not measure energy intakes for at least 24 h (for those with energy intakes as an outcome measure) were excluded from the analysis. A minimum of 24‐h energy intake data was set as the cut‐off to ensure that the full extent of any compensatory effects was seen. A total of 16 studies were included in the analysis. Of these 16 studies, 15 had energy intake as an outcome measure. The studies which used soft drinks as the vehicle for aspartame used between 500 and about 2000 ml which is equivalent to about two to six cans or bottles of soft drinks every day. A significant reduction in energy intakes was seen with aspartame compared with all types of control except when aspartame was compared with non‐sucrose controls such as water. The most relevant comparisons are the parallel design studies which compare the effects of aspartame with sucrose. These had an overall effect size of 0.4 standardised difference (SD). This corresponds to a mean reduction of about 10% of energy intake. At an average energy intake of 9.3 MJ/day (average of adult men and women aged 19–50 years) this is a deficit of 0.93 MJ/day (222 kcal/day or 1560 kcal/week), which would be predicted (using an energy value for obese tissue of 7500 kcal/kg) to result in a weight loss of around 0.2 kg/week with a confidence interval 50% either side of this estimate. Information on the extent of compensation was available for 12 of the 15 studies. The weighted average of these figures was 32%. Compensation is likely to vary with a number of factors such as the size of the caloric deficit, the type of food or drink manipulated, and timescale. An estimate of the amount of compensation with soft drinks was calculated from the four studies which used soft drinks only as the vehicle. A weighted average of these figures was 15.5%. A significant reduction in weight was seen. The combined effect figure of 0.2 SD is a conservative figure as it excludes comparisons where the controls gained weight because of their high‐sucrose diet and the long‐term follow‐up data in which the aspartame groups regained less weight than the control group. An effect of 0.2 SD corresponds to about a 3% reduction in bodyweight (2.3 kg for an adult weighing 75 kg). Given the weighted average study length was 12 weeks, this gives an estimated rate of weight loss of around 0.2 kg/week for a 75‐kg adult. The meta‐analyses demonstrate that using foods and drinks sweetened with aspartame instead of sucrose results in a significant reduction in both energy intakes and bodyweight. Meta‐analyses both of energy intake and of weight loss produced an estimated rate of weight loss of about 0.2 kg/week. This close agreement between the figure calculated from reductions in energy intake and actual measures of weight loss gives confidence that this is a true effect. The two meta‐analyses used different sets of studies with widely differing designs and controls. Although this makes comparisons between them difficult, it suggests that the final figure of around 0.2 kg/week is robust and is applicable to the variety of ways aspartame‐containing foods are used by consumers. This review has shown that using foods and drinks sweetened with aspartame instead of those sweetened with sucrose is an effective way to maintain and lose weight without reducing the palatability of the diet. The decrease in energy intakes and the rate of weight loss that can reasonably be achieved is low but meaningful and, on a population basis, more than sufficient to counteract the current average rate of weight gain of around 0.007 kg/week. On an individual basis, it provides a useful adjunct to other weight loss regimes. Some compensation for the substituted energy does occur but this is only about one‐third of the energy replaced and is probably less when using soft drinks sweetened with aspartame. Nevertheless, these compensation values are derived from short‐term studies. More data are needed over the longer term to determine whether a tolerance to the effects is acquired. To achieve the average rate of weight loss seen in these studies of 0.2 kg/week will require around a 220‐kcal (0.93 MJ) deficit per day based on an energy value for obese tissue of 7500 kcal/kg. Assuming the higher rate of compensation (32%), this would require the substitution of around 330 kcal/day (1.4 MJ/day) from sucrose with aspartame (which is equivalent to around 88 g of sucrose). Using the lower estimated rate of compensation for soft drinks alone (15.5%) would require the substitution of about 260 kcal/day (1.1 MJ/day) from sucrose with aspartame. This is equivalent to 70 g of sucrose or about two cans of soft drinks every day.     

Critical study of hair growth analysis with computer-assisted methods

BACKGROUND: Computer-assisted image analysis has been proposed for human hair growth studies. METHODS: The performances of Trichoscan, a commercially available automated system combining epiluminiscence microscopy with digital image analysis, developed for office-based hair growth measurements, have been evaluated comparatively on the same skin sites using standardized photographic equipment and calibrated processing for contrast-enhanced phototrichogram (CE-PTG) analysis. This reference method has been validated with scalp biopsies and histological examination of serial sectioning. RESULTS: Besides edge effects, hair fibres escaped the Trichoscan analysis for various reasons including, but not limited to, thickness, pigmentation, closeness and crossing. CONCLUSION: Most of these problems have been identified in the late 1980s and remain largely unsolved by the processing software that was evaluated in 2004. Therefore claims promoting the Trichoscan method for accurate hair measurements in clinical trials on scalp and body hair are not supported by the present investigation. The speed at which the analysis is performed is outweighed by the errors in signal detection. Therefore we suggest that improvements must be clearly documented before Trichoscan is established for quantified diagnostic purposes and detailed hair cycle monitoring during hair trials.     

Pseudoathetosis: report of three patients.

We report on 3 patients with pseudoathetosis, which are involuntary, slow, writhing movements due to loss of proprioception.