Effects of Hearing Aid Amplification on the Ability of Individuals With Hearing Loss to Perceive Spectral Information

Individuals with sensorineural hearing loss often struggle to understand speech even with the use of hearing aids; simply making sounds louder is not enough. Listeners decode various speech sounds with the help of spectral information, but how hearing aid amplification affects individuals’ ability to perceive those cues is not currently well understood. Altering the way hearing aids are programmed to provide amplification can potentially improve the ability of listeners with sensorineural hearing loss to access spectral information. The purpose of this study was to quantify the effects that hearing aid amplification has on the perception of spectral cues. Outcomes could help clinicians select hearing aid prescriptions that improve the adult listener’s ability to perceive spectral cues in speech. Participants with sensorineural hearing loss (normal middle ear function) were tested in aided conditions including alteration of compression channels (4, 8, and 16). Psychophysical tuning curves were collected from each participant, with a target frequency of 2 kHz and a presentation level of 10 dB SL in reference to a threshold obtained in quiet conditions. Data were compared to psychophysical tuning curves collected from participants with normal hearing. We hypothesized that the 16-channel condition would produce psychophysical tuning curves that matched the normal hearing individuals’ psychophysical tuning curves most accurately; an increased number of compression channels would provide better audibility across all frequencies, thereby improving access to spectral information. Indeed, as the number of compression channels was increased, the low-frequency side of the psychophysical tuning curves showed improvement

Population Density, Group Size or Something in Between: Effects of a Variable Social Structure on Parasite Transmission

Critical to our understanding of disease dynamics and effective disease control strategies is the relationship between host density and parasite transmission rates. To accurately describe this relationship, it is important to measure host density at the scale in which transmission is occurring. In social species, for example, transmission may be more related to group size than the population as a whole. But when aggregation patterns vary in size across space and time, our ability to quantify the density-transmission relationship may depend on measuring density somewhere in between population density and group size. To address this issue, we examined elk (Cervus elaphus) populations in western Wyoming that have been exposed to the bacteria (Brucella abortus) that causes brucellosis. We measured elk density at multiple scales ranging from population density to group size, and evaluated the functional relationship between density and brucellosis seroprevalence. Our study found that low elk density did not explain why Brucella had not effectively invaded several populations. However, in populations with multiple years of seropositive test results, the rates of increase in seroprevalence saturate with increasing elk density regardless of the density measure used. The different densities were poorly correlated with one another, and therefore high elk densities at broad scales did not guarantee high elk densities at fine scales, but both may be important to the transmission of Brucella. This suggests that reducing or altering elk density may not effectively reduce transmission

Understanding the quality of life experiences of older or frail adults following a new dens fracture: non-surgical management in a hard collar versus early removal of collar

Introduction: In the UK, fractures of the cervical dens process in older and/or frail patients are usually managed non-surgically in a hard collar. However, hard collars can lead to complications and this management approach is now being questioned, with growing interest in maximising patients’ short-term quality-of-life. It is vital that patient’s perspectives are considered, yet there is a dearth of literature examining the aspect. To help inform wider decision-making about use of collar/no collar management of dens fractures in older/frail people, we explored older/frail people’s experience of the two management approaches and how they affected their perceived quality-of-life. Methods: We interviewed older and/or frail adults with a recent dens fracture (aged ≥65 years or with a clinical frailty score of ≥5) or their caregiver. Participants were recruited from both arms of a clinical trial comparing management using a hard collar for 12 weeks (SM) with early removal of the collar (ERC) and were interviewed following randomisation and again, 12-16 weeks later. Data were analysed using a framework approach. Results: Both participant groups (SM/ERC) reported substantial, negative QoL experiences, with the fall itself, and lack of access to care services and information being frequent major contributory factors. Many negative experiences cut across both participant groups, including pain, fatigue, diminished autonomy and reduced involvement in personally meaningful activities. However, we identified some subtle, yet discernible, ways in which using SM/ERC reinforced or alleviated (negative) QoL impacts, with the perceived benefits/burdens to using SM/ERC varying between different individuals.Conclusion: Study findings can be used to support informed decision-making about SM/ERC management of dens fractures in older/frail patients.Patient or Public Contribution: Public and patient involvement (PPI) contributors were involved in the study design, development of interview topic guides and interpretation of study findings. <br/

Akt1-Inhibitor of DNA binding2 is essential for growth cone formation and axon growth and promotes central nervous system axon regeneration.

Mechanistic studies of axon growth during development are beneficial to the search for neuron-intrinsic regulators of axon regeneration. Here, we discovered that, in the developing neuron from rat, Akt signaling regulates axon growth and growth cone formation through phosphorylation of serine 14 (S14) on Inhibitor of DNA binding 2 (Id2). This enhances Id2 protein stability by means of escape from proteasomal degradation, and steers its localization to the growth cone, where Id2 interacts with radixin that is critical for growth cone formation. Knockdown of Id2, or abrogation of Id2 phosphorylation at S14, greatly impairs axon growth and the architecture of growth cone. Intriguingly, reinstatement of Akt/Id2 signaling after injury in mouse hippocampal slices redeemed growth promoting ability, leading to obvious axon regeneration. Our results suggest that Akt/Id2 signaling is a key module for growth cone formation and axon growth, and its augmentation plays a potential role in CNS axonal regeneration

Inferential consequences of modeling rather than measuring snow accumulation in studies of animal ecology

It is increasingly common for studies of animal ecology to use model-based predictions of environmental variables as explanatory or predictor variables, even though model prediction uncertainty is typically unknown. To demonstrate the potential for misleading inferences when model predictions with error are used in place of direct measurements, we compared snow water equivalent (SWE) and snow depth as predicted by the Snow Data Assimilation System (SNODAS) to field measurements of SWE and snow depth. We examined locations on elk (Cervus canadensis) winter ranges in western Wyoming, because modeled data such as SNODAS output are often used for inferences on elk ecology. Overall, SNODAS predictions tended to overestimate field measurements, prediction uncertainty was high, and the difference between SNODAS predictions and field measurements was greater in snow shadows for both snow variables compared to non-snow shadow areas. We used a simple simulation of snow effects on the probability of an elk being killed by a predator to show that, if SNODAS prediction uncertainty was ignored, we might have mistakenly concluded that SWE was not an important factor in where elk were killed in predatory attacks during the winter. In this simulation, we were interested in the effects of snow at finer scales (\u3c1 km2) than the resolution of SNODAS. If bias were to decrease when SNODAS predictions are averaged over coarser scales, SNODAS would be applicable to population-level ecology studies. In our study, however, averaging predictions over moderate to broad spatial scales (9–2200 km2) did not reduce the differences between SNODAS predictions and field measurements. This study highlights the need to carefully evaluate two issues when using model output as an explanatory variable in subsequent analysis: (1) the model\u27s resolution relative to the scale of the ecological question of interest and (2) the implications of prediction uncertainty on inferences when using model predictions as explanatory or predictor variables

“It’s about our bodies… we have the right to know this stuff”: a qualitative focus group study on Australian women’s perspectives on breast density

Objective This study aimed to explore Australian women’s current knowledge, perspectives and attitudes about breast density (BD); and information needs to inform effective evidence-based communication strategies. Methods Fourteen online focus group sessions with a total of 78 women in New South Wales and Queensland, Australia aged 40–74 years without a personal diagnosis of breast cancer were conducted. Audio-recorded data was transcribed and analysed thematically. Results Women had a very limited knowledge of BD. Overall, women expressed a preference for more frequent mammograms and/or supplemental screening should they be told they had dense breasts, despite being presented with information on potential downsides of additional testing. The majority of women were supportive of the notion of BD notification, often suggesting they had a ‘right to know’ and they would prefer to be educated and informed about it. Conclusion The potential of being informed and notified of BD is found to be of interest and importance to Australian women of breast screening age despite lacking current knowledge. Practice Implications This study highlights that policy makers and screening services need to consider how to weigh up these views and preferences of women with current evidence surrounding BD in deciding about implementing population-based BD notification

Sex differences in treatment and outcomes of patients with in-hospital ST-elevation myocardial infarction.

BACKGROUND AND HYPOTHESIS Two cohorts face high mortality after ST-elevation myocardial infarction (STEMI): females and patients with in-hospital STEMI. The aim of this study was to evaluate sex differences in ischemic times and outcomes of in-hospital STEMI patients. METHODS Consecutive STEMI patients treated with percutaneous coronary intervention (PCI) were prospectively recruited from 30 hospitals into the Victorian Cardiac Outcomes Registry (2013-2018). Sex discrepancies within in-hospital STEMIs were compared with out-of-hospital STEMIs. The primary endpoint was 12-month all-cause mortality. Secondary endpoints included symptom-to-device (STD) time and 30-day major adverse cardiovascular events (MACE). To investigate the relationship between sex and 12-month mortality for in-hospital versus out-of-hospital STEMIs, an interaction analysis was included in the multivariable models. RESULTS A total of 7493 STEMI patients underwent PCI of which 494 (6.6%) occurred in-hospital. In-hospital versus out-of-hospital STEMIs comprised 31.9% and 19.9% females, respectively. Female in-hospital STEMIs were older (69.5 vs. 65.9 years, p = .003) with longer adjusted geometric mean STD times (104.6 vs. 94.3 min, p < .001) than men. Female versus male in-hospital STEMIs had no difference in 12-month mortality (27.1% vs. 20.3%, p = .92) and MACE (22.8% vs. 19.3%, p = .87). Female sex was not independently associated with 12-month mortality for in-hospital STEMIs which was consistent across the STEMI cohort (OR: 1.26, 95% CI: 0.94-1.70, p = .13). CONCLUSIONS In-hospital STEMIs are more frequent in females relative to out-of-hospital STEMIs. Despite already being under medical care, females with in-hospital STEMIs experienced a 10-min mean excess in STD time compared with males, after adjustment for confounders. Adjusted 12-month mortality and MACE were similar to males

Bleeding Severity in Percutaneous Coronary Intervention (PCI) and Its Impact on Short-Term Clinical Outcomes

Bleeding severity in patients undergoing percutaneous coronary intervention (PCI), defined by the Bleeding Academic Research Consortium (BARC), portends adverse prognosis. We analysed data from 37,866 Australian patients undergoing PCI enrolled in the Victorian Cardiac Outcomes Registry (VCOR), and investigated the association between increasing BARC severity and in-hospital and 30-day major adverse cardiac and cerebrovascular events (MACCE) (a composite of mortality, myocardial infarction, stent thrombosis, target vessel revascularisation, or stroke). Independent predictors associated with major bleeding (BARC groups 3&5), and MACCE were also assessed. There was a stepwise increase in in-hospital and 30-day MACCE with greater severity of bleeding. Independent predictors of bleeding included female sex (Odds Ratio (OR) 1.34), age (OR 1.02), fibrinolytic therapy (OR 1.77), femoral access (OR 1.51), and ticagrelor (OR 1.42), all significant at the p < 0.001 level. Following adjustment of clinically important variables, BARC 3&5 bleeds (OR 4.37) were still predictive of cumulative in-hospital and 30-day MACCE. In conclusion, major bleeding is an uncommon but potentially fatal PCI complication and was independently associated with greater MACCE rates. Efforts to mitigate the occurrence of bleeding, including radial access and judicious use of potent antiplatelet therapies, may ameliorate the risk of short-term adverse clinical outcomes

Mammal species composition reveals new insights into Earth’s remaining wilderness

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156493/8/fee2192-sup-0004-FigS4.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156493/7/fee2192-sup-0005-FigS5.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156493/6/fee2192-sup-0006-FigS6.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156493/5/fee2192.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156493/4/fee2192-sup-0003-FigS3.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156493/3/fee2192-sup-0002-FigS2.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156493/2/fee2192-sup-0001-FigS1.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156493/1/fee2192_am.pd