scholarly journals The spatial percept of tinnitus is associated with hearing asymmetry: subgroup comparisons

2020 ◽  
Author(s):  
Eleni Genitsaridi ◽  
Theodore Kypraios ◽  
Niklas K. Edvall ◽  
Natalia Trpchevska ◽  
Barbara Canlon ◽  
...  
Keyword(s):  
Spatial Perception ◽  
Hearing Aid ◽  
Important Variable ◽  
Study Data ◽  
Careful Consideration ◽  
Older Age ◽  
Interaural Difference

AbstractThe spatial percept of tinnitus is hypothesized as an important variable for tinnitus subtyping. Hearing asymmetry often associates with tinnitus laterality, but not always. One of the methodological limitations for cross-study comparisons is how the variables for hearing asymmetry and tinnitus spatial perception are defined. In this study, data from two independent datasets were combined (n= 833 adults, age ranging from 20 to 91 years, 404 males, 429 females) to investigate characteristics of subgroups with different tinnitus spatial perception focusing on hearing asymmetry. Three principle findings emerged. First, a hearing asymmetry variable emphasizing the maximum interaural difference most strongly discriminated unilateral from bilateral tinnitus. Merging lateralized bilateral tinnitus (perceived in both ears but worse in one side) with unilateral tinnitus weakened this relationship. Second, there was an association between unilateral tinnitus and ipsilateral asymmetric hearing. Third, unilateral and bilateral tinnitus were phenotypically distinct, with unilateral tinnitus being characterized by older age, asymmetric hearing, more often wearing one hearing aid, older age at tinnitus onset, shorter tinnitus duration, and higher percentage of time being annoyed by tinnitus. We recommend that careful consideration is given to the definitions of hearing asymmetry and tinnitus spatial perception in order to improve the comparability of findings across studies.

Acute heart failure: predicting early in-hospital outcomes

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Santos ◽  
S Paula ◽  
I Almeida ◽  
H Santos ◽  
H Miranda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Logistic Regression ◽  
Acute Heart Failure ◽  
Roc Curve ◽  
Real Life ◽  
Study Data ◽  
Curve Analysis ◽  
Older Age ◽  
Invasive Ventilation ◽  
Roc Curve Analysis

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Patients (P) with acute heart failure (AHF) are a heterogeneous population. Risk stratification at admission may help predict in-hospital complications and needs. The Get With The Guidelines Heart Failure score (GWTG-HF) predicts in-hospital mortality (M) of P admitted with AHF. ACTION ICU score is validated to estimate the risk of complications requiring ICU care in non-ST elevation acute coronary syndromes. Objective To validate ACTION-ICU score in AHF and to compare ACTION-ICU to GWTG-HF as predictors of in-hospital M (IHM), early M [1-month mortality (1mM)] and 1-month readmission (1mRA), using real-life data. Methods Based on a single-center retrospective study, data collected from P admitted in the Cardiology department with AHF between 2010 and 2017. P without data on previous cardiovascular history or uncompleted clinical data were excluded. Statistical analysis used chi-square, non-parametric tests, logistic regression analysis and ROC curve analysis. Results Among the 300 P admitted with AHF included, mean age was 67.4 ± 12.6 years old and 72.7% were male. Systolic blood pressure (SBP) was 131.2 ± 37.0mmHg, glomerular filtration rate (GFR) was 57.1 ± 23.5ml/min. 35.3% were admitted in Killip-Kimball class (KKC) 4. ACTION-ICU score was 10.4 ± 2.3 and GWTG-HF was 41.7 ± 9.6. Inotropes’ usage was necessary in 32.7% of the P, 11.3% of the P needed non-invasive ventilation (NIV), 8% needed invasive ventilation (IV). IHM rate was 5% and 1mM was 8%. 6.3% of the P were readmitted 1 month after discharge. Older age (p < 0.001), lower SBP (p = 0,035) and need of inotropes (p < 0.001) were predictors of IHM in our population. As expected, patients presenting in KKC 4 had higher IHM (OR 8.13, p < 0.001). Older age (OR 1.06, p = 0.002, CI 1.02-1.10), lower SBP (OR 1.01, p = 0.05, CI 1.00-1.02) and lower left ventricle ejection fraction (LVEF) (OR 1.06, p < 0.001, CI 1.03-1.09) were predictors of need of NIV. None of the variables were predictive of IV. LVEF (OR 0.924, p < 0.001, CI 0.899-0.949), lower SBP (OR 0.80, p < 0.001, CI 0.971-0.988), higher urea (OR 1.01, p < 0.001, CI 1.005-1.018) and lower sodium (OR 0.92, p = 0.002, CI 0.873-0.971) were predictors of inotropes’ usage. Logistic regression showed that GWTG-HF predicted IHM (OR 1.12, p < 0.001, CI 1.05-1.19), 1mM (OR 1.10, p = 1.10, CI 1.04-1.16) and inotropes’s usage (OR 1.06, p < 0.001, CI 1.03-1.10), however it was not predictive of 1mRA, need of IV or NIV. Similarly, ACTION-ICU predicted IHM (OR 1.51, p = 0.02, CI 1.158-1.977), 1mM (OR 1.45, p = 0.002, CI 1.15-1.81) and inotropes’ usage (OR 1.22, p = 0.002, CI 1.08-1.39), but not 1mRA, the need of IV or NIV. ROC curve analysis revealed that GWTG-HF score performed better than ACTION-ICU regarding IHM (AUC 0.774, CI 0.46-0-90 vs AUC 0.731, CI 0.59-0.88) and 1mM (AUC 0.727, CI 0.60-0.85 vs AUC 0.707, CI 0.58-0.84). Conclusion In our population, both scores were able to predict IHM, 1mM and inotropes’s usage.

scholarly journals Predictors of Development of Atrial Fibrillation in Patients With Embolic Stroke Of Undetermined Source: An Analysis of the RE-SPECT ESUS Trial

Circulation ◽  
2021 ◽  
Author(s):  
Maria Cecilia Bahit ◽  
Ralph L. Sacco ◽  
J. Donald Easton ◽  
Juliane Meyerhoff ◽  
Lisa Cronin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Body Mass ◽  
Recurrent Stroke ◽  
Controlled Trial ◽  
Clinical Care ◽  
Important Variable ◽  
Older Age ◽  
Embolic Stroke ◽  
Cardiac Monitoring

Background: A proportion of patients with embolic stroke of undetermined source (ESUS) have silent atrial fibrillation (AF) or develop AF after the initial evaluation. Better understanding of risk for development of AF is critical to implement optimal monitoring strategies with the goal of preventing recurrent stroke due to underlying AF. The RE-SPECT ESUS trial provides an opportunity to assess predictors for developing AF and associated recurrent stroke. Methods: RE-SPECT ESUS was a randomized, controlled trial (564 sites, 42 countries) assessing dabigatran versus aspirin for the prevention of recurrent stroke in patients with ESUS. Of 5390 patients enrolled and followed for a median of 19 months, 403 (7.5%) were found to develop AF reported as an adverse event or using cardiac monitoring per standard clinical care. Univariable and multivariable regression analyses were performed to define predictors of AF. Results: In the multivariable model, older age (odds ratio [OR] for 10-year increase 1.99 [1.78-2.23]; P<0.001), hypertension (1.36 [1.03-1.79]; P=0.0304), diabetes (OR 0.74 [0.56-0.96]; P=0.022), and body mass index (OR for 5-unit increase 1.29 [1.16-1.43]; P<0.001) were independent predictors of AF during the study. In a sensitivity analysis restricted to 1117 patients with baseline N-terminal prohormone of brain natriuretic peptide (NT-proBNP) measurements, only older age and higher NT-proBNP were significant independent predictors of AF. Performances of several published predictive models were assessed, including the HAVOC and CHA2DS2-VASc scores, and higher scores were associated with higher rates of developing AF. Conclusions: Besides age as the most important variable, several other factors, including hypertension, higher body mass index, and lack of diabetes, are independent predictors of AF after ESUS. When baseline NT-proBNP was available, only older age and elevation of this biomarker were predictive of subsequent AF. Understanding who is at higher risk of developing AF will assist in identifying patients who may benefit from more intense, long-term cardiac monitoring.

Increasing Innovation in Change Situations through Leadership Skills

1972 ◽  
Vol 31 (2) ◽  
pp. 343-354 ◽  
Author(s):  
Norman R. F. Maier ◽  
Ellen Panza McRay
Keyword(s):  
Skill Training ◽  
Leadership Skills ◽  
Role Playing ◽  
Important Variable ◽  
Study Data ◽  
New Method ◽  
Problem Situation ◽  
Time Study ◽  
Integrative Method ◽  
Favorable Light

A role-playing format was used to determine the effect of skill training in the use of leadership acts previously found to be critical. These were: (1) the degree to which the discussion issue is posed as a problem rather than a solution and (2) the readiness to share available data. Trained leaders were not permitted to make suggestions or to favor a solution. Their role was to accept ideas without evaluating them. The problem situation involved a foreman who would like to have three crew members change their work procedure so as to increase production. In 25 groups the leader was trained in the two above-mentioned leadership skills, and in 29 groups the leader was untrained. The solutions were of three types: (1) Old method, or refusal to change; (2) New method, indicated by the time-study data; and (3) an Integrative method which assimilates the facts and feelings of conflicting parties and, in addition, requires innovation. The Trained leader groups produced 68.0% Integrative solutions in contrast to the Untrained leader groups 10 3% The acceptance of their group decisions were significantly higher than in the Untrained groups, and the members of the Trained leader groups perceived their leaders in a more favorable light. The important variable in the Trained leaders was their skill rather than their knowledge.

scholarly journals Self-Perceived Loneliness and Depression During the COVID-19 Pandemic: a Two-Wave Replication Study

2021 ◽  
Author(s):  
Alessandro Carollo ◽  
Andrea Bizzego ◽  
Giulio Gabrieli ◽  
Keri Ka-Yee Wong ◽  
Adrian Raine ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Statistical Analysis ◽  
Important Variable ◽  
Study Data ◽  
Support Vector ◽  
Shape Pattern ◽  
Support Vector Regressor ◽  
The Uk ◽  
Second Wave ◽  
Shaped Pattern

COVID-19 studies to date have documented some of the initial health consequences of lockdown restrictions adopted by many countries. Combining a data-driven machine learning paradigm and a statistical analysis approach, our previous paper documented a U-shape pattern in levels of self-perceived loneliness in both the UK and Greek populations during the first lockdown (17 April to 17 July 2020). The current paper aimed to test the robustness of these results. Specifically, we tested a) for the dependence of the chosen model by adopting a new one - namely, support vector regressor (SVR). Furthermore, b) whether the patterns of self-perceived loneliness found in data from the first UK national lockdown could be generalizable to the second wave of the UK lockdown (17 October 2020 to 31 January 2021). The first part of the study involved training an SVR model on the 75% of the UK dataset from wave 1 (n total = 435). This SVR model was then tested on the remaining 25% of data (MSE training = 2.04; MSE test = 2.29), which resulted in depressive symptoms to be the most important variable - followed by self-perceived loneliness. Statistical analysis of depressive symptoms by week of lockdown resulted in a significant U-shape pattern between week 3 to 7 of lockdown. In the second part of the study, data from wave 2 of the UK lockdown (n = 263) was used to conduct a graphical and statistical inspection of the week-by-week distribution of scores regarding self-perceived loneliness. Despite a graphical U-shaped pattern between week 3 and 9 of lockdown, levels of loneliness were not between weeks of lockdown. Consistent with past studies, study findings suggest that self-perceived loneliness and depressive symptoms may be two of the most relevant symptoms to address when imposing lockdown restrictions.

scholarly journals Phenotypes of engagement with mobile health technology for heart rhythm monitoring

JAMIA Open ◽  
2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Jihui Lee ◽  
Meghan Reading Turchioe ◽  
Ruth Masterson Creber ◽  
Angelo Biviano ◽  
Kathleen Hickey ◽  
...  
Keyword(s):  
Mobile Health ◽  
Multinomial Logistic Regression ◽  
Secondary Analysis ◽  
Heart Rhythm ◽  
Important Variable ◽  
Left Ventricular ◽  
Older Age ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Clinical Records

Abstract Objectives Guided by the concept of digital phenotypes, the objective of this study was to identify engagement phenotypes among individuals with atrial fibrillation (AF) using mobile health (mHealth) technology for 6 months. Materials and Methods We conducted a secondary analysis of mHealth data, surveys, and clinical records collected by participants using mHealth in a clinical trial. Patterns of participants’ weekly use over 6 months were analyzed to identify engagement phenotypes via latent growth mixture model (LGMM). Multinomial logistic regression models were fitted to compute the effects of predictors on LGMM classes. Results One hundred twenty-eight participants (mean age 61.9 years, 75.8% male) were included in the analysis. Application of LGMM identified 4 distinct engagement phenotypes: “High-High,” “Moderate-Moderate,” “High-Low,” and “Moderate-Low.” In multinomial models, older age, less frequent afternoon mHealth use, shorter intervals between mHealth use, more AF episodes measured directly with mHealth, and lower left ventricular ejection fraction were more strongly associated with the High-High phenotype compared to the Moderate-Low phenotype (reference). Older age, more palpitations, and a history of stroke or transient ischemic attack were more strongly associated with the Moderate-Moderate phenotype compared to the reference. Discussion Engagement phenotypes provide a nuanced characterization of how individuals engage with mHealth over time, and which individuals are more likely to be highly engaged users. Conclusion This study demonstrates that engagement phenotypes are valuable in understanding and possibly intervening upon engagement within a population, and also suggests that engagement is an important variable to be considered in digital phenotyping work more broadly.

Students’ verbal exchanges and dynamics during Sport Education

2016 ◽  
Vol 23 (3) ◽  
pp. 354-365 ◽  
Author(s):  
Sheri Brock ◽  
Peter Hastie
Keyword(s):  
Study Data ◽  
Careful Consideration ◽  
High Status ◽  
Sport Education ◽  
Optimal Learning ◽  
Social Exchanges ◽  
Unit Design ◽  
Class 1 ◽  
Depth Study ◽  
Verbal Exchanges

In physical education (PE), children frequently participate in teams and the exchanges that transpire shape their perspectives and subsequently, influence learning. While Sport Education is one pedagogical model designed to enhance social exchanges through team membership, we previously identified the need for additional research to monitor these exchanges more closely. This study examined the verbal exchanges of students in two fourth grade PE classes participating in a season of team handball. One mixed-skill team from Class 1 (a heterogeneous skill league) and one low-skill team from Class 2 (a homogeneous skill league) were selected for in-depth study. Data collection included videotaped lessons from each team. Data analysis produced descriptive results of the frequency and focus of students’ individual exchanges. Our results indicated middle-to-high status students had higher rates of exchanges at the commencement of the season segments. Students in the homogeneous league had higher frequencies of exchanges than those in the heterogeneous league, and the focus of exchanges predominantly included on-task exchanges for the skill, in both skill leagues. This study highlights the potential for varied rates of exchange, based on student characteristics and unit design. Careful consideration for these factors should be employed to determine optimal learning environments for students.

Acoustic and perceptual effects of magnifying interaural difference cues in a simulated “binaural” hearing aid

2017 ◽  
Vol 57 (sup3) ◽  
pp. S81-S91 ◽  
Author(s):  
Tobias de Taillez ◽  
Giso Grimm ◽  
Birger Kollmeier ◽  
Tobias Neher
Keyword(s):  
Hearing Aid ◽  
Binaural Hearing ◽  
Interaural Difference

Teachers' Stereotypes of Children Who Wear Hearing Aids

1981 ◽  
Vol 12 (3) ◽  
pp. 139-144 ◽  
Author(s):  
Cletus G. Fisher ◽  
Kenneth Brooks
Keyword(s):  
Elementary School ◽  
School Child ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Social Implications ◽  
Elementary School Child ◽  
Classroom Teachers ◽  
Frequency Of Occurrence ◽  
Service Training

Classroom teachers were asked to list the traits they felt were characteristic of the elementary school child who wears a hearing aid. These listings were evaluated according to the desirability of the traits and were studied regarding frequency of occurrence, desirability, and educational, emotional, and social implications. The results of the groupings are discussed in terms of pre-service and in-service training.

Hearing Aid Gain Usage by Children

1989 ◽  
Vol 20 (2) ◽  
pp. 149-152 ◽  
Author(s):  
Kenneth W. Berger
Keyword(s):  
Hearing Aid ◽  
Appreciable Difference ◽  
Significant Difference ◽  
Clinically Significant

Hearing aid gain usage by two groups of children was examined. No appreciable difference was noted between the groups, nor was there a clinically significant difference between gain usage by these children as compared with a sample of adult hearing aid wearers.

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