Factors Related to Self-Identification of Candidacy, Device Selection, and Self-Fitting of Over-The-Counter Hearing Aids

Purpose: The Over-The-Counter (OTC) Hearing Aid Act was introduced in an effort to make hearing aids more accessible and affordable. Implementation of this law will go into effect in 2020. It is assumed that the average consumer will be able to self-navigate an OTC hearing aid fitting. In the OTC hearing aid model consumers are expected to self-diagnose, self-treat, and self manage their hearing loss. The purpose of the present study was to assess how well the average consumer can perform each step in the OTC hearing aid model, and identify factors related to self-identification of candidacy, device selection, and self-fitting of an OTC hearing aid. Method: Participants included 52 adults who were 40 years of age and older, self-reported having trouble hearing and were interested in trying an OTC hearing aid. They had to have owned a smartphone and had no prior hearing aid experience. Data was collected over two tests sessions. During the first session all participants were asked to report their degree of hearing loss, identify if they thought they were at risk for having ear disease, and completed questionnaires related to demographics, health literacy, hearing aid self-efficacy, health locus of control, and technology commitment and usage. Also, participants completed three cognitive tasks and were given a hearing test and administered three cognitive measures: the Reading-SPAN, Digit Symbol Substitution Task, and the Simon task. During the second test session participants were asked to browse three different OTC hearing aids online and select the device they preferred. They were asked to complete a questionnaire regarding potential reasons for why they selected a particular device. The OTC hearing aid they selected was given in its original packaging, and participants were asked to set the device up without any assistance. The Practical Hearing Aid Skills Test- Revised (PHAST-R) along with three questions related to Bluetooth connectivity was used to evaluate the participants’ hearing aid handling skills. Real-ear verification was performed to assess how closely the participant’s settings were to NAL-NL2 prescriptive targets. Last, participants completed the Consumer Ear Disease Risk Assessment (CEDRA) to determine if participants correctly self-identified the risk for ear-disease. Results: Only 38% of participants were able to correctly classify their hearing status in both ears, with pure tone average being a significant predictor of correct hearing status classification. A majority of the participants who misclassified their hearing status had normal hearing, but self-reported they had a hearing loss. Eighty-eight percent of the participants who were identified for being at risk for ear disease misclassified their risk for ear disease. Years of education was inversely related to correctly self-identifying risk for ear disease. Sixty percent of the participants who were flagged by the CEDRA and 30% of normal-hearing participants indicated that they would purchase an OTC hearing aid at the end of the study. Participants’ scores ranged from 45-100% on the PHAST-R and Bluetooth connectivity assessment. The type of the manufacturer’s instructional material was significantly associated with participants’ hearing aid and Bluetooth connectivity skills. For the normal-hearing participants all of the OTC devices attenuated speech, and none of the devices met NAL-NL2 targets in the high frequencies for the hearing-impaired participants. Income status and technology commitment was not predictive of OTC hearing aid device selection and all participants ranked ‘easy to read descriptions’ and ‘website appearance’ as the main factors that influenced their decision to select a device. Conclusions: Most participants were unable to successfully navigate all of the steps in the OTC hearing aid model. Some of the participants who had normal hearing but self-reported a hearing loss and the participants who were at risk for ear disease said they would purchase an OTC hearing aid as a treatment option. Unfortunately, both groups are not the intended user of an OTC hearing aid. Manufacturer instructional material can impact set up and programming of an OTC device. However, users may still run into fitting and programming challenges that will require the assistance of a hearing health care professional

A study regarding the availability and utilization of water supply and sanitation practices in rural Amritsar, Punjab, India

Background: Access to safe water and sanitation practices is an important issue of health and development at local, regional and national levels. The government has come up with various facilities regarding the water supply and sanitation but there are various factors which curtail their utilization. The present study deals with the extent of utilization and factors impeding the utilization of such services at the village level.Methods: The present impeding cross-sectional study was carried out in village Nagkalan, Amritsar, where the eldest adult member present in the house at the time of the visit was interviewed. Every house of the village was visited during the period of January 2017 to December 2017, and a total of 1123 families were included in the final analysis. Thereafter, data was compiled and analyzed.Results: Out of total 1123 families, only 31.4% were using government water supply (tap water); while 42.7% had no government connection at all and used submersible as their sole source of water supply. 20.2% did not have a toilet at their house and therefore practiced open defecation; out of which majority families belonged to lower socio-economic status (statistically significant). Out of total 896 families having a toilet at their house, there were only 30 families (3.4%) who responded that some of the family members practice open defecation. Also, only 6.1% of the respondents were aware about the functions of Village Health Sanitation and Nutrition Committee (VHSNC).Conclusions: More number of families (42.7%) were dependent on submersible pump as sole source of water supply. 20.2% lacked separate toilet facility, mostly belonging to lower socio- economic status. Only 6.1% were aware regarding the VHSNC. All the families disposed of their household waste on the roads

Impact on quality-of-life: before and after topical combinational treatment in patients of acne vulgaris

Background: The objective was to study quality-of-life in patients of acne vulgaris before and after treatment by benzoyl peroxide 2.5% gel and clindamycin 1% gel or benzoyl peroxide 2.5% gel and nadifloxacin 1% cream or tretinoin 0.025% and clindamycin 1% gel.Methods: This was a prospective, open, randomized, parallel comparative study of 60 patients of acne vulgaris attending the Department of Dermatology and Venereal Diseases, Government Medical College, Rajindra Hospital, Patiala. Three groups were made 20 in each group, one group received benzoyl peroxide 2.5% gel and clindamycin 1% gel, the second group received benzoyl peroxide 2.5% gel, and nadifloxacin 1% cream and the third group received tretinoin 0.025% and clindamycin 1% gel. Cardiff acne disability index questionnaire was filled before starting and after the treatment.Results: In these three groups, it was found that the group on benzoyl peroxide 2.5% gel and clindamycin 1% gel, mean score, before starting treatment was 8.35±3.48 and after treatment was 2.95±2.09 (p<0.001), group on benzoyl peroxide 2.5% gel and nadifloxacin 1% cream, mean score, before starting treatment was 7.60±3.75 and after treatment was 5.80±2.98 (p<0.001) and group on tretinoin 0.025% and clindamycin 1% gel mean score is 8.00±3.06 and after treatment was 5.40±2.93 (p<0.001).Conclusion: Quality-of-life improves more in patients taking benzoyl peroxide 2.5% gel and clindamycin 1% gel, and then, tretinoin 0.025% and clindamycin 1% gel and then benzoyl peroxide 2.5% gel and nadifloxacin 1% cream

Progress in the performance of HIV early infant diagnosis services in Zambia using routinely collected data from 2006 to 2016.

BACKGROUND: Early diagnosis and treatment initiation of HIV-infected infants can greatly reduce the risk of infant mortality. The WHO recommends testing HIV-exposed infants at 6 weeks of age and immediate initiation of antiretroviral therapy if positive. This study aimed to determine the feasibility of using an electronic health records system to evaluate the performance of Zambia's HIV Early Infant Diagnosis services. METHODS: A retrospective analysis of routinely collected data from the Zambian SmartCare database was performed for the period January 2006 to December 2016. The study population includes all HIV-infected infants (n = 32,593) registered during this period on treatment for HIV. Univariable logistic regression was conducted to identify factors associated with later infant testing and treatment initiation. RESULTS: The mean age at infant HIV test decreased from 10.10 months in 2006 to 3.49 months in 2016. Infants born in 2015 were almost 4 times more likely to be tested under 2 months of age compared to infants born in 2006 (OR: 3.72, p-value: < 0.001). The mean time from diagnosis to treatment initiation decreased from 220 days in 2006 to 9 days in 2015. There was substantial regional variability with infants in the provinces of Copperbelt, Luapula and Southern performing best in outcomes and Eastern, Lusaka and Western performing the worst. CONCLUSIONS: HIV-exposed infants born more recently have significantly better outcomes than infants born a decade ago in Zambia, which could be as a result of increased attention and funding for HIV programmes

Highlights from the 16th International Society for Computational Biology Student Council Symposium 2020.

In this meeting overview, we summarise the scientific program and organisation of the 16th International Society for Computational Biology Student Council Symposium in 2020 (ISCB SCS2020). This symposium was the first virtual edition in an uninterrupted series of symposia that has been going on for 15 years, aiming to unite computational biology students and early career researchers across the globe. [Abstract copyright: Copyright: © 2021 Cuypers WL et al.

The NRPD1 N-terminus contains a Pol IV-specific motif that is critical for genome surveillance in Arabidopsis

RNA-guided surveillance systems constrain the activity of transposable elements (TEs) in host genomes. In plants, RNA polymerase IV (Pol IV) transcribes TEs into primary transcripts from which RDR2 synthesizes double-stranded RNA precursors for small interfering RNAs (siRNAs) that guide TE methylation and silencing. How the core subunits of Pol IV, homologs of RNA polymerase II subunits, diverged to support siRNA biogenesis in a TE-rich, repressive chromatin context is not well understood. Here we studied the N-terminus of Pol IV’s largest subunit, NRPD1. Arabidopsis lines harboring missense mutations in this N-terminus produce wild-type (WT) levels of NRPD1, which co-purifies with other Pol IV subunits and RDR2. Our in vitro transcription and genomic analyses reveal that the NRPD1 N-terminus is critical for robust Pol IV-dependent transcription, siRNA production and DNA methylation. However, residual RNA-directed DNA methylation observed in one mutant genotype indicates that Pol IV can operate uncoupled from the high siRNA levels typically observed in WT plants. This mutation disrupts a motif uniquely conserved in Pol IV, crippling the enzyme's ability to inhibit retrotransposon mobilization. We propose that the NRPD1 N-terminus motif evolved to regulate Pol IV function in genome surveillance

Switchable DNA-origami nanostructures that respond to their environment and their applications

Structural DNA nanotechnology, in which Watson-Crick base pairing drives the formation of self-assembling nanostructures, has rapidly expanded in complexity and functionality since its inception in 1981. DNA nanostructures can now be made in arbitrary three-dimensional shapes and used to scaffold many other functional molecules such as proteins, metallic nanoparticles, polymers, fluorescent dyes and small molecules. In parallel, the field of dynamic DNA nanotechnology has built DNA circuits, motors and switches. More recently, these two areas have begun to merge—to produce switchable DNA nanostructures, which change state in response to their environment. In this review, we summarise switchable DNA nanostructures into two major classes based on response type: molecular actuation triggered by local chemical changes such as pH or concentration and external actuation driven by light, electric or magnetic fields. While molecular actuation has been well explored, external actuation of DNA nanostructures is a relatively new area that allows for the remote control of nanoscale devices. We discuss recent applications for DNA nanostructures where switching is used to perform specific functions—such as opening a capsule to deliver a molecular payload to a target cell. We then discuss challenges and future directions towards achieving synthetic nanomachines with complexity on the level of the protein machinery in living cells.This work was supported by Australian Research Council Discovery Early Career Research Fellowship DE180101635 (SW), University of Sydney Nano Institute Scholarship (JKDS, MTL)

Assembly of a dsRNA synthesizing complex: RNA-DEPENDENT RNA POLYMERASE 2 contacts the largest subunit of NUCLEAR RNA POLYMERASE IV

In plants, transcription of selfish genetic elements such as transposons and DNA viruses is suppressed by RNA-directed DNA methylation. This process is guided by 24-nt short-interfering RNAs (siRNAs) whose double-stranded precursors are synthesized by DNA-dependent NUCLEAR RNA POLYMERASE IV (Pol IV) and RNA-DEPENDENT RNA POLYMERASE 2 (RDR2). Pol IV and RDR2 coimmunoprecipitate, and their activities are tightly coupled, yet the basis for their association is unknown. Here, we show that an interval near the RDR2 active site contacts the Pol IV catalytic subunit, NRPD1, the largest of Pol IV's 12 subunits. Contacts between the catalytic regions of the two enzymes suggests that RDR2 is positioned to rapidly engage the free 3' ends of Pol IV transcripts and convert these single-stranded transcripts into double-stranded RNAs (dsRNAs)