Teleaudiometry as a screening method in school children

OBJECTIVE: To compare the efficacy and feasibility of teleaudiometry with that of sweep audiometry in elementary school children, using pure-tone audiometry as the gold standard. METHODS: A total of 243 students with a mean age of 8.3 years participated in the study. Of these, 118 were boys, and 125 were girls. The following procedures were performed: teleaudiometry screening with software that evaluates hearing at frequencies of 1,000, 2000 and 4000 Hz at 25 dBHL; sweep audiometry screening in an acoustic booth (20 dBHL at the same frequencies); pure-tone audiometry thresholds in an acoustic booth (frequencies of 500, 1000, 2000 and 4000 Hz); and acoustic immittance measurements. RESULTS: The diagnostic capacities of the teleaudiometry/sweep audiometry screening methods were as follows: sensitivity  ϝ  58%/65%; specificity  ϝ  86%/99%; positive predictive value  ϝ  51%/91%; negative predictive value  ϝ  89%/92%; and accuracy  ϝ  81%/92%. Teleaudiometry and sweep audiometry showed moderate agreement. Furthermore, the use of these methods in series with immittance testing improved the specificity, whereas parallel testing improved the sensitivity. CONCLUSION: Teleaudiometry was found to be reliable and feasible for screening hearing in school children. Moreover, teleaudiometry is the preferred method for remote areas where specialized personnel and specific equipment are not available, and its use may reduce the costs of hearing screening programs

The audiological profile of adults with and without hypertension

OBJECTIVE: To determine whether there is any influence of systemic arterial hypertension on the peripheral auditory system. METHODS: This was a cross-sectional study that investigated 40 individuals between 30 and 50 years old, who were divided into groups with and without systemic arterial hypertension, using data from high-frequency audiometry, transient-evoked otoacoustic emissions and distortion-product otoacoustic emissions. The results were compared with those from groups of normal-hearing individuals, with and without systemic arterial hypertension, who underwent the pure-tone audiometry test. All individuals also underwent the following procedures: otoscopy, acoustic immittance measures, pure-tone audiometry at frequencies from 250 to 16000 Hz, transient-evoked otoacoustic emissions test and distortion-product otoacoustic emissions test. RESULTS: No statistically significant difference was observed between the groups with and without systemic arterial hypertension in either conventional or high-frequency audiometry. Regarding transient-evoked otoacoustic emissions, there was a trend toward statistical significance whereby the systemic arterial hypertension group showed lower results. Regarding distortion-product otoacoustic emissions, the systemic arterial hypertension group showed significantly lower results at the following frequencies: 1501, 2002, and 3003 Hz. A discriminant analysis indicated that the distortion-product otoacoustic emissions variables best distinguished individuals with and without systemic arterial hypertension. CONCLUSION: Data from this study suggest cochlear dysfunction in individuals with systemic arterial hypertension because their otoacoustic emission results were lower than those in the systemic arterial hypertension group

Investigating gait, movement, and coordination in children with neurodevelopmental disorders: is there a role for motor abnormalities in atypical neurodevelopment?

Motor abnormalities have been suggested to play a role in most neuropsychiatric disorders, as a potential generic neurodevelopmental vulnerability. However, they still represent a neglected area, with a paucity of empirical studies, especially in pediatric populations. This case-control study aimed to comprehensively assess motor functioning in children with atypical neurodevelopment and investigate whether any socio-demographic or clinical characteristics would concur with motor difficulties to distinguish children with neurodevelopmental disorders (NDD) from healthy controls. Socio-demographic (age and gender) and clinical (intelligence quotient, gait, movement, and coordination) data were collected on 114 children aged 5-15 (83 with NDD, 31 healthy controls). Male children were at significantly higher risk for NDD (OR: 13.023, p < 0.001). Furthermore, there was a statistically significant interaction between the total intelligence quotient and overall coordination such that increasing levels of total intelligence quotient appeared to protect against the likelihood of being diagnosed with an NDD, but only in the context of a preserved coordination (OR: 0.964, p = 0.038). Collectively, results may have important public health implications, as they point towards the development of new approaches to establish an early prognosis in neurodevelopment, including assessing motor difficulties and mitigating their impact on children's quality of life

GIN Test (Gaps-in-Noise) in normal listeners with and without tinnitus

TEMA: o teste Gaps-in-Noise (GIN) avalia a habilidade auditiva de resolução temporal. Estudos têm mostrado o teste GIN como um instrumento de fácil aplicação, com boa sensibilidade e especificidade. OBJETIVO: comparar os resultados do teste GIN em ouvintes normais com e sem zumbido e fazer a correlação entre os resultados deste, os limiares tonais e idade. MÉTODO: foram avaliados 44 adultos (limiares tonais 25 dBNA nas freqüências de 0,25 a 8 kHz), formando 2 grupos: Grupo Controle composto por 23 sujeitos, 8 homens e 15 mulheres, sem queixa de zumbido, idade entre 22 e 40 anos (média 29,7); Grupo Pesquisa formado por 18 indivíduos, 3 homens e 15 mulheres, com queixa de zumbido, idade entre 21 e 45 anos (média 31,3). Os sujeitos foram submetidos à audiometria tonal e vocal, imitanciometria e ao teste GIN. Para a análise estatística foi adotado nível de significância de 0.05. RESULTADOS: na audiometria tonal, a média global dos limiares tonais foi mais elevada para o Grupo Pesquisa, comparado ao Grupo Controle (p = 0,001). A comparação do desempenho no teste GIN mostrou que o Grupo Controle detectou intervalos de silêncio em média com intervalo de tempo menor que o Grupo Pesquisa (p < 0,001). Não houve correlação entre a idade dos sujeitos e o limiar do GIN. CONCLUSÃO: o teste GIN identificou prejuízo na habilidade auditiva de resolução temporal nos indivíduos com zumbido. Na faixa etária pesquisada (entre 21 e 45 anos) não houve correlação entre a idade e os resultados do teste GIN.BACKGROUND: the Gaps-in-Noise (GIN) test assesses the auditory temporal resolution skill. Studies have described the GIN test an instrument of easy application and with good sensitivity and specificity. AIM: to compare the results of the GIN test in normal listeners with and without tinnitus and to correlate the obtained results with pure tone thresholds and age. METHOD: hearing tests were performed in 44 subjects (hearing threshold up to 25 dB HL in the frequencies of 0.25 to 8 kHz). Two groups were considered for comparison: the Control Group with 23 subjects, 8 men and 15 women, aged between 22-40 (mean 29.7), and the Research Group with 18 tinnitus patients, 3 men and 15 women, aged between 21-45 (mean 31.3). All subjects underwent pure tone audiometry, speech tests, acoustic immittance measurements and the GIN test. For the statistical analysis, the significance level of 0.05 was adopted. RESULTS: considering pure tone audiometry, the overall mean for hearing thresholds was significantly higher for the Research Group when compared to the Control Group (p = 0.001). The comparison between the groups for the performance in the GIN test indicated that the Control Group detected gaps with a shorter time interval than the Research Group (p < 0.001). There was no correlation between the age of the subjects and the level of the GIN test. CONCLUSION: the GIN test identified deficit in the hearing skill of temporal resolution in patients with tinnitus. In the studied age group (21 to 45 years) there was no correlation between age and the results obtained in the GIN test

Rehabilitation and biomarkers of stroke recovery: study protocol for a randomized controlled trial

Background: Stroke is a leading cause of disability. Nonetheless, the care pathway for stroke rehabilitation takes partially into account the needs of chronic patients. This is due in part to the lack of evidence about the mechanisms of recovery after stroke, together with the poor knowledge of related and influencing factors. Here we report on the study protocol \u201cRehabilitation and Biomarkers of Stroke Recovery,\u201d which consists of 7 work-packages and mainly aim to investigate the effects of long-term neurorehabilitation on stroke patients and to define a related profile of (clinical-biological, imaging, neurophysiological, and genetic-molecular) biomarkers of long-term recovery after stroke. The work-package 1 will represent the main part of this protocol and aims to compare the long-term effects of intensive self-rehabilitation vs. usual (rehabilitation) care for stroke. Methods: We planned to include a total of 134 adult subacute stroke patients (no more than 3 months since onset) suffering from multidomain disability as a consequence of first-ever unilateral ischemic stroke. Eligible participants will be randomly assigned to one of the following groups: intensive self-rehabilitation (based on the principles of \u201cGuided Self-Rehabilitation Contract\u201d) vs. usual care (routine practice). Treatment will last 1 year, and patients will be evaluated every 3 months according to their clinical presentation. The following outcomes will be considered in the main work-package: Fugl-Meyer assessment, Cognitive Oxford Screen Barthel Index, structural and functional neuroimaging, cortical excitability, and motor and somatosensory evoked potentials. Discussion: This trial will deal with the effects of an intensive self-management rehabilitation protocol and a related set of biomarkers. It will also investigate the role of training intensity on long-term recovery after stroke. In addition, it will define a set of biomarkers related to post-stroke recovery and neurorehabilitation outcome in order to detect patients with greater potential and define long-term individualized rehabilitation programs. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT04323501

Effects of robot-assisted training for the unaffected arm in patients with hemiparetic cerebral palsy: a proof-of-concept pilot study

On a voluntary basis, 10 adolescents with hemiparesis due to cerebral palsy and 11 neurologically healthy control subjects participated in this proof-of-concept pilot study. The aim was to examine the effects of robot-assisted training for the unaffected arm in patients with hemiparetic cerebral palsy. Baseline comparison between the unaffected arm of the hemiparetic patients with cerebral palsy and the dominant arm of healthy control subjects showed significant differences on the Jebsen-Taylor Hand Function test and action planning ability tests. Within-group comparison after ten 30-minute sessions (five days a week for two consecutive weeks) of robot-assisted training for the unaffected arm showed significant improvements in patients with cerebral palsy on the Jebsen-Taylor Hand Function test (performed at both hands) and action planning ability test (evaluated at the unaffected arm). Our findings are in line with previous evidences of action planning deficits at the unaffected arm in patients with hemiparetic cerebral palsy and support the hypothesis that robot-assisted training for the unaffected arm may be useful to improve manual dexterity and action planning in patients with hemiparesis due to cerebral palsy

Effects of Robot-Assisted Training for the Unaffected Arm in Patients with Hemiparetic Cerebral Palsy: A Proof-of-Concept Pilot Study

On a voluntary basis, 10 adolescents with hemiparesis due to cerebral palsy and 11 neurologically healthy control subjects participated in this proof-of-concept pilot study. The aim was to examine the effects of robot-assisted training for the unaffected arm in patients with hemiparetic cerebral palsy. Baseline comparison between the unaffected arm of the hemiparetic patients with cerebral palsy and the dominant arm of healthy control subjects showed significant differences on the Jebsen-Taylor Hand Function test and action planning ability tests. Within-group comparison after ten 30-minute sessions (five days a week for two consecutive weeks) of robot-assisted training for the unaffected arm showed significant improvements in patients with cerebral palsy on the Jebsen-Taylor Hand Function test (performed at both hands) and action planning ability test (evaluated at the unaffected arm). Our findings are in line with previous evidences of action planning deficits at the unaffected arm in patients with hemiparetic cerebral palsy and support the hypothesis that robot-assisted training for the unaffected arm may be useful to improve manual dexterity and action planning in patients with hemiparesis due to cerebral palsy

Tavola Rotonda sull’architettura moderna e contemporanea brasiliana: "La tradizione del nuovo"

Ciclo di incontri a cura di Maria Vittoria Marini Clarelli e Matilde Amaturo.Tavola Rotonda sull’architettura moderna e contemporanea brasiliana. Prendendo spunto dalla sensibiltà moderna in chiave contemporanea del Brasil Arquitetura (studio di architetti brasiliani) il dibattito intende portare all'attenzione sul senso di una architettura interessata alla complessitàdei contesti storici e attenta alle tradizioni popolari