Logistic Regression Analysis of Factors Influencing the Effectiveness of Intensive Sound Masking Therapy in Patients with Tinnitus

Objectives: To investigate factors influencing the effectiveness intensive sound masking therapy on tinnitus using Logistic Regression Analysis. Design: The study used a retrospective cross-section analysis. Participants: 102 patients with tinnitus were recruited at the Sun Yat-sen Memorial Hospital of Sun Yat-sen University, China. Intervention: Intensive sound masking therapy was used as an intervention approach for patients with tinnitus. Primary and secondary outcome measures: participants underwent audiological investigations and tinnitus pitch and loudness matching measurements, followed by intensive sound masking therapy. The Tinnitus Handicap Inventory (THI) was used as the outcome measure pre- and post-treatment. Multivariate logistic regression was performed to investigate the association of demographic and audiological factors with effective therapy. Results: According to the THI score changes pre-and post-sound masking intervention, fifty-one participants were categorised into an effective group, the remaining 51 participants were placed in a non-effective group. Those in the effective group were significantly younger than those in the non-effective group (p=0.012). Significantly more participants had flat audiogram configurations in the effective group (p=0.04). Multivariable logistic regression analysis showed that age (OR=0.96, 95% CI: 0.93, 0.99, p=0.007), audiometric configuration (p=0.027) and THI score pre-treatment (OR=1.04, 95% CI: 1.02, 1.07, p<0.001) were significantly associated with therapeutic effectiveness. Further analysis showed that patients with flat audiometric configurations were 5.45 times more likely to respond to intervention than those with high-frequency steeply sloping audiograms (OR=5.45, 95% CI: 1.67, 17.86, p=0.005). Conclusion: Audiometric configuration, age and THI scores appear to be predictive for the effectiveness of sound masking treatment. Gender, tinnitus characteristics and hearing threshold measures seem not to be related to treatment effectiveness. Further randomized control study is needed to provide further evidence of the effectiveness of prognostic factors in tinnitus interventions

Influence of Audiovisual Training on Horizontal Sound Localization and Its Related ERP Response

The objective was to investigate the influence of audiovisual training on horizontal sound localization and the underlying neurological mechanisms using a combination of psychoacoustic and electrophysiological (i.e., event-related potential, ERP) measurements on sound localization. Audiovisual stimuli were used in the training group, whilst the control group was trained using auditory stimuli only. Training sessions were undertaken once per day for three consecutive days. Sound localization accuracy was evaluated daily after training, using psychoacoustic tests. ERP responses were measured on the first and last day of tasks. Sound localization was significantly improved in the audiovisual training group when compared to the control group. Moreover, a significantly greater reduction in front-back confusion ratio for both trained and untrained angles was found between pre- and post-test in the audiovisual training group. ERP measurement showed a decrease in N1 amplitude and an increase in P2 amplitude in both groups. However, changes in late components were only found in the audiovisual training group, with an increase in P400 amplitude and decrease in N500 amplitude. These results suggest that the interactive effect of audiovisual localization training is likely to be mediated at a relatively late cognitive processing stage

Ketamine Safety and Use in the Emergency Department for Pain and Agitation/Delirium: A Health System Experience

Introduction: Two protocols were developed to guide the use of subdissociative dose ketamine (SDDK) for analgesia and dissociative sedation ketamine for severe agitation/excited delirium in the emergency department (ED). We sought to evaluate the safety of these protocols implemented in 18 EDs within a large health system.Methods: We conducted a retrospective chart review to evaluate all adult patients who received intravenous (IV) SDDK for analgesia and intramuscular (IM) dissociative sedation ketamine for severe agitation/excited delirium in 12 hospital-based and six freestanding EDs over a one-year period from the protocol implementation. We developed a standardized data collection form and used it to record patient information regarding ketamine use, concomitant medication use, and any comorbidities that could have impacted the incidence of adverse events.Results: Approximately 570,000 ED visits occurred during the study period. SDDK was used in 210 ED encounters, while dissociative sedation ketamine for severe agitation/excited delirium was used in 37 ED encounters. SDDK was used in 83% (15/18) of sites while dissociative sedation ketamine was used in 50% (9/18) of sites. Endotracheal intubation, non-rebreather mask, and nasal cannula ≥ four liters per minute were identified in one, five, and three patients, respectively. Neuropsychiatric adverse events were identified in 4% (9/210) of patients who received SDDK.Conclusion: Patients experienced limited neuropsychiatric adverse events from SDDK. Additionally, dissociative sedation ketamine for severe agitation/excited delirium led to less endotracheal intubation than reported in the prehospital literature. The favorable safety profile of ketamine use in the ED may prompt further increases in usage

Data from: Logistic regression analysis of factors influencing the effectiveness of intensive sound masking therapy in patients with tinnitus

Objectives: To investigate factors influencing the effectiveness intensive sound masking therapy on tinnitus using Logistic Regression Analysis. Design: The study used a retrospective cross-section analysis. Participants: 102 patients with tinnitus were recruited at the Sun Yat-sen Memorial Hospital of Sun Yat-sen University, China. Intervention: Intensive sound masking therapy was used as an intervention approach for patients with tinnitus. Primary and secondary outcome measures: participants underwent audiological investigations and tinnitus pitch and loudness matching measurements, followed by intensive sound masking therapy. The Tinnitus Handicap Inventory (THI) was used as the outcome measure pre- and post-treatment. Multivariate logistic regression was performed to investigate the association of demographic and audiological factors with effective therapy. Results: According to the THI score changes pre-and post-sound masking intervention, fifty-one participants were categorised into an effective group, the remaining 51 participants were placed in a non-effective group. Those in the effective group were significantly younger than those in the non-effective group (p=0.012). Significantly more participants had flat audiogram configurations in the effective group (p=0.04). Multivariable logistic regression analysis showed that age (OR=0.96, 95% CI: 0.93, 0.99, p=0.007), audiometric configuration (p=0.027) and THI score pre-treatment (OR=1.04, 95% CI: 1.02, 1.07, p<0.001) were significantly associated with therapeutic effectiveness. Further analysis showed that patients with flat audiometric configurations were 5.45 times more likely to respond to intervention than those with high-frequency steeply sloping audiograms (OR=5.45, 95% CI: 1.67, 17.86, p=0.005). Conclusion: Audiometric configuration, age and THI scores appear to be predictive for the effectiveness of sound masking treatment. Gender, tinnitus characteristics and hearing threshold measures seem not to be related to treatment effectiveness. Further randomized control study is needed to provide further evidence of the effectiveness of prognostic factors in tinnitus interventions

Vinylogous Elimination/Heck Coupling/Allylation Domino Reactions: Access to 2‑Substituted 2,3-Dihydrobenzofurans and Indolines

A highly regio- and stereoselctive palladium-catalyzed domino reaction of functionalized aryl allyl ethers has been developed. Various aryl allyl ethers derived from the phosphine-catalyzed addition of electron-deficient allenes with phenol are found to be efficient substrates for the synthesis of 2-substituted 2,3-dihydrobenzofurans and indolines. It is the first example of aryl allyl ether used as an ideal and practical precursor of hard to get functionalized 1,3-butadiene for the heterocyclic compound synthesis