Organización de un programa de implantes cocleares

A cochlear implant (CI) programme brings together a number of professionals who, during the stages of selection, surgery, programming, rehabilitation and monitoring, develop a series of tasks aimed at promoting comprehensive attention to the implanted patient. The aim of this paper was to describe in detail the tasks in each of the phases described in a programme of CI, materials and necessary equipment and the role of the professionals involved. It also raised a number of recommendations on how to develop a CI programme gradually to facilitate the progression from the simplest to the mos

Hearing Impairment and Quality of Life in Adults with Asymmetric Hearing Loss: Benefits of Bimodal Stimulation

Objectives: Bimodal stimulation for asymmetric hearing loss is an emerging treatment with proven audiometric outcomes. Our objectives are to assess the changes of the hearing impairment and the quality of life of patients treated with this type of stimulation, when compared to a unilateral Cochlear Implant (CI) stimulated condition. Materials and methods: 31 patients with asymmetric hearing loss (Group 1) were recruited for the study. They were divided into three groups, based on their hearing loss in the ear treated with the hearing aid: Group 1A (Pure Tone Audiometry (PTA) between 41 and 70 decibels (dB)); Group 1B, (PTA between 71 and 80 dB) and Group 1C (PTA between 81 and 90 dB). 30 patients had profound, bilateral hearing loss. Then, users of a unilateral cochlear implant were recruited for the control group. Their hearing impairment and quality of life were analyzed with questionnaires Abbreviated Profile of Hearing Aid Benefit (APHAB), Speech, Spatial and Qualities of Hearing Scale (SSQ) and the Health Utilities Index (HUI). They were followed up for at least 2 years. Results: The group with the asymmetric hearing loss obtains a statistically significant clinical improvement in the APHAB under category "with hearing aid" compared to "without hearing aid". The group with the asymmetric hearing loss benefits more across basically all variables compared with the control group in the SSQ. Group 1A obtains the best outcome of the sample in the HUI. Conclusion: Bimodal stimulation and better hearing in the ear treated with the hearing aid reduce hearing impairment and improve the quality of life

Comparing Poynting flux dominated magnetic tower jets with kinetic-energy dominated jets

Magnetic Towers represent one of two fundamental forms of MHD outflows. Driven by magnetic pressure gradients, these flows have been less well studied than magneto-centrifugally launched jets even though magnetic towers may well be as common. Here we present new results exploring the behavior and evolution of magnetic tower outflows and demonstrate their connection with pulsed power experimental studies and purely hydrodynamic jets which might represent the asymptotic propagation regimes of magneto-centrifugally launched jets. High-resolution AMR MHD simulations (using the AstroBEAR code) provide insights into the underlying physics of magnetic towers and help us constrain models of their propagation. Our simulations have been designed to explore the effects of thermal energy losses and rotation on both tower flows and their hydro counterparts. We find these parameters have significant effects on the stability of magnetic towers, but mild effects on the stability of hydro jets. Current-driven perturbations in the Poynting Flux Dominated (PDF) towers are shown to be amplified in both the cooling and rotating cases. Our studies of the long term evolution of the towers show that the formation of weakly magnetized central jets within the tower are broken up by these instabilities becoming a series of collimated clumps which magnetization properties vary over time. In addition to discussing these results in light of laboratory experiments, we address their relevance to astrophysical observations of young star jets and outflow from highly evolved solar type stars.Comment: 11 pages, 4 figures, accepted for publication in the High Energy Density Physics Journal corresponding to the proceedings of the 9th International Conference on High Energy Density Laboratory Astrophysics, May 4, 2012, Tallahassee Florid

Aportaciones al conocimiento de la flora muscinal del Pirineo Occidental

In this paper we give citations of 122 taxa of mosses, which have been collected in 31 sites in the Western Pyrenees, in Navarra (Northern Spain). 9 of them are new records to the moss flora of Navarra and 2 are new records both for Navarra and for all the Pyrenees. Some of the more noticeable novelties are Dicranum crassifolium Sérgio, Ochyra & Séneca, Orthotrichum acuminatum H. Phillib. and Orthotrichum shawii Wilson

Tipos de implantes activos de oído medio

Active middle ear implants are classified as piezoelectric implants, which use the properties of piezoelectric materials. There are two types of piezoelectric implants: monomorphic and dimorphic; electromagnetic transduction uses a magnet, usually a rare earth magnet (e.g. samarium cobalt) and an energizing coil. This magnetic field causes the magnet to vibrate, which in turn, through the tympanic-ossicular chain, causes movement of the cochlear fluids. Electromechanical transduction is a variation of electromagnetic transduction

On the structure and stability of magnetic tower jets

Modern theoretical models of astrophysical jets combine accretion, rotation, and magnetic fields to launch and collimate supersonic flows from a central source. Near the source, magnetic field strengths must be large enough to collimate the jet requiring that the Poynting flux exceeds the kinetic-energy flux. The extent to which the Poynting flux dominates kinetic energy flux at large distances from the engine distinguishes two classes of models. In magneto-centrifugal launch (MCL) models, magnetic fields dominate only at scales $\lesssim 100$ engine radii, after which the jets become hydrodynamically dominated (HD). By contrast, in Poynting flux dominated (PFD) magnetic tower models, the field dominates even out to much larger scales. To compare the large distance propagation differences of these two paradigms, we perform 3-D ideal MHD AMR simulations of both HD and PFD stellar jets formed via the same energy flux. We also compare how thermal energy losses and rotation of the jet base affects the stability in these jets. For the conditions described, we show that PFD and HD exhibit observationally distinguishable features: PFD jets are lighter, slower, and less stable than HD jets. Unlike HD jets, PFD jets develop current-driven instabilities that are exacerbated as cooling and rotation increase, resulting in jets that are clumpier than those in the HD limit. Our PFD jet simulations also resemble the magnetic towers that have been recently created in laboratory astrophysical jet experiments.Comment: 16 pages, 11 figures, published in ApJ: ApJ, 757, 6

Seed transcriptome annotation reveals enhanced expression of genes related to ros homeostasis and ethylene metabolism at alternating temperatures in wild cardoon

The association among environmental cues, ethylene response, ABA signaling, and reactive oxygen species (ROS) homeostasis in the process of seed dormancy release is nowadays well-established in many species. Alternating temperatures are recognized as one of the main environmental signals determining dormancy release, but their underlying mechanisms are scarcely known. Dry after-ripened wild cardoon achenes germinated poorly at a constant temperature of 20, 15, or 10◦C, whereas germination was stimulated by 80% at alternating temperatures of 20/10◦C. Using an RNA-Seq approach, we identified 23,640 and annotated 14,078 gene transcripts expressed in dry achenes and achenes exposed to constant or alternating temperatures. Transcriptional patterns identified in dry condition included seed reserve and response to dehydration stress genes (i.e., HSPs, peroxidases, and LEAs). At a constant temperature, we observed an upregulation of ABA biosynthesis genes (i.e., NCED9), ABA-responsive genes (i.e., ABI5 and TAP), as well as other genes previously related to physiological dormancy and inhibition of germination. However, the alternating temperatures were associated with the upregulation of ethylene metabolism (i.e., ACO1, 4, and ACS10) and signaling (i.e., EXPs) genes and ROS homeostasis regulators genes (i.e., RBOH and CAT). Accordingly, the ethylene production was twice as high at alternating than at constant temperatures. The presence in the germination medium of ethylene or ROS synthesis and signaling inhibitors reduced significantly, but not completely, germination at 20/10◦C. Conversely, the presence of methyl viologen and salicylhydroxamic acid (SHAM), a peroxidase inhibitor, partially increased germination at constant temperature. Taken together, the present study provides the first insights into the gene expression patterns and physiological response associated with dormancy release at alternating temperatures in wild cardoon (Cynara cardunculus var. sylvestris).Fil: Huarte, Hector Roberto. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Lomas de Zamora; ArgentinaFil: Puglia, Giuseppe. D.. Consiglio Nazionale delle Ricerche; ItaliaFil: Prjibelski, Andrey D.. Academia de Ciencias de Rusia.; RusiaFil: Raccuia, Salvatore A.. Consiglio Nazionale delle Ricerche; Itali

Tenebrionid secretions and a fungal benzoquinone oxidoreductase form competing components of an arms race between a host and pathogen

Entomopathogenic fungi and their insect hosts represent a model system for examining invertebrate-pathogen coevolutionary selection processes. Here we report the characterization of competing components of an arms race consisting of insect protective antimicrobial compounds and evolving fungal mechanisms of detoxification. The insect pathogenic fungus Beauveria bassiana has a remarkably wide host range; however, some insects are resistant to fungal infection. Among resistant insects is the tenebrionid beetle Tribolium castaneum that produces benzoquinone-containing defensive secretions. Reduced fungal germination and growth was seen in media containing T. castaneum dichloromethane extracts or synthetic benzoquinone. In response to benzoquinone exposure, the fungus expresses a 1,4-benzoquinone oxidoreductase, BbbqrA, induced >40-fold. Gene knockout mutants (ΔBbbqrA) showed increased growth inhibition, whereas B. bassiana overexpressing BbbqrA (Bb::BbbqrAO) displayed increased resistance to benzoquinone compared with wild type. Increased benzoquinone reductase activity was detected in wild-type cells exposed to benzoquinone and in the overexpression strain. Heterologous expression and purification of BbBqrA in Escherichia coli confirmed NAD(P)H-dependent benzoquinone reductase activity. The ΔBbbqrA strain showed decreased virulence toward T. castaneum, whereas overexpression of BbbqrA increased mortality versus T. castaneum. No change in virulence was seen for the ΔBbbqrA or Bb::BbbqrAO strains when tested against the greater wax moth Galleria mellonella or the beetle Sitophilus oryzae, neither of which produce significant amounts of cuticular quinones. The observation that artificial overexpression of BbbqrA results in increased virulence only toward quinone-secreting insects implies the lack of strong selection or current failure of B. bassiana to counteradapt to this particular host defense throughout evolution.Instituto de Investigaciones Bioquímicas de La Plat

Treatment for hearing loss among the elderly: auditory outcomes and impact on quality of life

The study aim was to determine the benefit of cochlear im- plantation and hearing aids in older adults diagnosed with hearing loss and to evaluate the index of depression, anxiety and quality of life after such treatments. A retrospective co- hort comprised 117 patients older than 65 years and diag- nosed with moderate to profound hearing loss who were included and classified into 2 groups (treated vs. non-treat- ed). A battery of tests including auditory (pure-tone average, disyllabic words in quiet at 65 dB SPL) and findings from a series of questions relevant to quality of life were compared between both groups. Auditory outcomes for disyllabic words were 58.21% for the cochlear implant-treated group and 82.8% for the hearing aid-treated group. There was a positive effect on anxiety, depression, health status and quality of life in the cochlear implant group versus the pro- found hearing loss control group. We conclude that older adults with moderate to profound hearing loss gain benefit from hearing aids or cochlear implants not only in terms of improved hearing function, but also in terms of positive ef- fects on anxiety, depression, health status and quality of life

Revisión de los criterios audiométricos en el tratamiento de la hipoacusia neurosensorial mediante audífonos y prótesis auditivas implantables

Sensorineural hearing loss has a high incidence in our population; as a matter of fact, 50 % of people above 75 years of age suffer this impairment. Due to the advances in the devices to alleviate this condition and their verified efficacy, it is now appropriate to review the indications for these devices and provide a detailed description of the audioprosthetic systems used. These systems can be classified as external non-implantable devices (hearing aids) and implantable prostheses. The latter can be sub-divided into active implants in the external ear or middle ear, cochlear implants, and auditory brainstem implants (ABI). Indications for each group are determined by the type and location of the underlying condition as well as by the anatomic, functional, and social characteristics of each patient. It must be stressed that the selection and monitoring of the treatment is up to the specialist. Generally speaking, an attempt is made to facilitate the integration of the hypoacusic patients to their sound setting by enhancing their understanding of the spoken word and restoring binaurality, while at the same time, seeking to retain the plasticity of central auditory routes through the stimulation provided by any of these systems. In the course of this review, we refer to newly-emerging indications in both the field of cochlear implants (bimodal stimulation, implantation in patients with residual hearing, bilateral implants, etc) and in the area of ABI in patients with tumoural disease previously treated with radiosurgery or patients with non-tumour pathologies presenting malformations or bilateral cochlear ossification