Analysis of Clinical Characteristics and Psychoacoustic Indexes in Different TCM Syndromes of Idiopathic Tinnitus

Objective. To explore the differences in clinical characteristics and psychoacoustic indexes of various traditional Chinese medicine (TCM) syndromes in patients with idiopathic tinnitus. Methods. 312 patients with idiopathic tinnitus in our hospital from December 2017 to March 2020 were selected; divided into the wind evil invasion group (n = 61), the liver fire disturbance group (n = 69), the phlegm fire stagnation group (n = 42), the spleen and stomach weakness group (n = 48), and the kidney essence loss group (n = 92) according to the medical syndrome type and the detailed medical history; and clinical characteristics of patients in each group were compared. Results. The kidney essence loss group’s age and course of disease were older and longer than those of other syndrome groups, and the wind evil invasion group’s disease course was shorter than the liver fire disturbance, phlegm fire stagnation, and spleen and stomach weakness groups ( P < 0.05 ). The PSQI score of all patients was higher than 7 points, but there was no obvious difference between the groups ( P > 0.05 ). The SAS score of the liver fire disturbance and the phlegm-fire stagnation groups was higher than that of the wind evil invasion, the spleen and stomach weakness, and the kidney essence loss groups, and the SDS score of the spleen and stomach weakness and the kidney essence loss groups was higher than that of the wind evil invasion, the liver fire disturbance, and the phlegm and fire stagnation groups ( P < 0.05 ). The kidney essence loss group’s total hearing loss rate (92.39%) was higher than the other syndrome groups, and the wind evil invasion group’s total hearing loss rate (8.19%) was lower than the other syndrome groups ( P < 0.05 ); the low to medium frequency tone of tinnitus’s rate in the wind evil invasion group, liver fire disturbance group, and phlegm fire stagnation group was higher than the spleen and stomach weakness group and the kidney essence loss group, but the high frequency tone of tinnitus’s rate was opposite. The tinnitus loudness in these groups was higher than the spleen and stomach weakness and kidney essence loss group ( P < 0.05 ). Conclusion. In addition to the wind evil invasion type, most tinnitus patients may have different levels of psychological disorders. So, in the treatment of idiopathic tinnitus, in addition to the disease itself, paying more attention to the psychological status of the patient is one better therapeutic method. Besides, clinical characteristics and the psychoacoustic indexes of patients with idiopathic tinnitus have a certain correlation with the TCM syndromes.

Optimizing smoke alarm signals: Testing the effectiveness of children’s smoke alarms for sleeping adults

Background Being asleep is an important risk factor for death during a residential fire; however, the high-frequency tone smoke alarms in many homes will not adequately awaken children who are old enough to self-rescue. In a series of previous studies, we identified smoke alarm signals that effectively awaken children 5–12 years old and prompt their escape. Because it is impractical to have separate alarms for children and adults in a household, the purpose of this study is to test whether alarms that are effective in awakening children and prompting their escape are also effective among adults. Methods Using a randomized, non-blinded, repeated measures design, 150 adults 20–49 years old were exposed during stage 4 sleep to four different smoke alarms. Statistical tests included the Kaplan-Meier estimator, generalized Wilcoxon test, and hazard ratios with Wald’s 95% confidence intervals. Results The median age of study subjects was 30.0 years and 67.3% were female. Almost all (n = 149) subjects awakened and performed the escape procedure to all four alarms; one individual did not awaken or escape to the high-frequency tone alarm. The median time-to-awaken was 2.0 s for the high-frequency tone alarm and 1.0 s for the other three alarms. The median time-to-escape for the high-frequency tone alarm was 12.0 s, compared with 10.0 s for the low-frequency tone alarm and 9.0 s each for the female and male voice alarms. All pairwise comparisons between the high-frequency tone alarm and each of the other three alarms were statistically significant for the probability functions for time-to-awaken and time-to-escape. There were no significant differences in these outcome measures between the latter three alarms, except for female voice versus low-frequency tone alarms for time-to-escape. Conclusions All alarms performed well, demonstrating that smoke alarms developed for the unique developmental requirements of sleeping children are also effective among sleeping adults. Compared with a high-frequency tone alarm, use of these alarms may reduce residential fire-related injuries and deaths among children, while also successfully alerting adult members of the household.

Cochlear compound action potentials from high-level tone bursts originate from wide cochlear regions that are offset toward the most sensitive cochlear region

Little is known about the spatial origins of auditory nerve (AN) compound action potentials (CAPs) evoked by moderate to intense sounds. We studied the spatial origins of AN CAPs evoked by 2- to 16-kHz tone bursts at several sound levels by slowly injecting kainic acid solution into the cochlear apex of anesthetized guinea pigs. As the solution flowed from apex to base, it sequentially reduced CAP responses from low- to high-frequency cochlear regions. The times at which CAPs were reduced, combined with the cochlear location traversed by the solution at that time, showed the cochlear origin of the removed CAP component. For low-level tone bursts, the CAP origin along the cochlea was centered at the characteristic frequency (CF). As sound level increased, the CAP center shifted basally for low-frequency tone bursts but apically for high-frequency tone bursts. The apical shift was surprising because it is opposite the shift expected from AN tuning curve and basilar membrane motion asymmetries. For almost all high-level tone bursts, CAP spatial origins extended over 2 octaves along the cochlea. Surprisingly, CAPs evoked by high-level low-frequency (including 2 kHz) tone bursts showed little CAP contribution from CF regions ≤ 2 kHz. Our results can be mostly explained by spectral splatter from the tone-burst rise times, excitation in AN tuning-curve “tails,” and asynchronous AN responses to high-level energy ≤ 2 kHz. This is the first time CAP origins have been identified by a spatially specific technique. Our results show the need for revising the interpretation of the cochlear origins of high-level CAPs-ABR wave 1. NEW & NOTEWORTHY Cochlear compound action potentials (CAPs) and auditory brain stem responses (ABRs) are routinely used in laboratories and clinics. They are typically interpreted as arising from the cochlear region tuned to the stimulus frequency. However, as sound level is increased, the cochlear origins of CAPs from tone bursts of all frequencies become very wide and their centers shift toward the most sensitive cochlear region. The standard interpretation of CAPs and ABRs from moderate to intense stimuli needs revision.

Mother–Daughter Sexual Communication: Differences by Maternal Sexual Victimization History

Women who experience childhood sexual victimization (CSV) report more problems with sexuality and with parenting during adulthood. Consequently, mothers with a CSV history may have particular difficulty with parent–child sexual communication. We examine this possibility in 184 diverse, low-income mother–adolescent daughter dyads. Mothers and daughters reported on the frequency, tone, and comfort of their sexual communication. Using dyadic approaches to analyses, we tested whether mothers’ and daughters’ reports, and their level of agreement, differ by maternal CSV history. In dyads with maternal CSV, daughters reported more frequent communication in which they felt less embarrassed, and they perceived their mothers as less embarrassed. Mothers with a CSV history were also more accurate in judging how their daughters feel during sexual communication. Although CSV is associated with many negative outcomes, our results suggest mothers with CSV may approach mother–daughter sexual communication in ways that could reduce sexual risk in offspring.