Results of this study suggest that the use of hearing aids alone or hearing aids plus the use of sound generators both provide significant benefit with respect to alleviating effects of tinnitus. A larger controlled clinical trial is needed to obtain more definitive results regarding the two configurations of hearing aids.
SummaryTo initiate an investigation into the biochemistry and mechanism of group B b-hemolytic Streptococcus virulence, bacterial cultures grown in suspension were centrifuged, and the bacteria and media were subjected to extensive fractionation. Each fraction was assayed for physiologic activity by repeated intravenous infusion into adult unanesthetized sheep. Pulmonary artery pressure, arterial P*, and rectal temperature were monitored. The media fraction, but not the bacteria, contained a component (molecular weight, 2 x lo6) composed of 84% carbohydrate and 16% protein with physiblogic~ activity. Two mg quantities, when infused, caused the ~ulmonarv artery pressure to increase 100%. Po2 to decrease by iO% and -chills -i d fever. The active component could be degraded by hot phenol-water extraction into a pure polysaccharide (molecular weight, 200,000). This lower molecular weight polysaccharide retained the identical physiologic properties when infused in the sheep. The degraded component precipitated with group B-specific antiserum.This study demonstrates that, in the sheep, a pure polysaccharide is the physiologically active part of a high-molecular-weight toxin synthesized by group B b-hemolytic Streptococcus type 111 and that this component has a different carbohydrate composition from the group ~-c a~s u l a r antigen. SpeculationThe clinical syndrome associated with group B /3-hemolytic Streptococci in early onset disease is caused by the interactions of an extracellular bacterial component and a specific target tissue in the infected infant.Group B P-hemolytic Streptococcus has become a major pathogen in newborn nurseries in the United States (19). Two distinct clinical syndromes have been described (1) depending on the age of presentation. The early onset disease, characterized by a shortlived picture and with a mortality rate in some series of over 50% (18,34), has been compared clinically by many investigators (13,20,25) to gram-negative endotoxin shock. Although the clinical and laboratory picture suggests the presence of bacterial products with endotoxin-like properties, such products have so far not been identified.The presence of extracellular toxins has been described for a number of strains of group A hemolytic Streptococci. They have been associated with the erythema of scarlet fever, a pyrogenic response in rabbits, and the enhancement of gram-negative endotoxin shock in mice, monkeys, and rabbits (10,21,38). Several workers have attempted to characterize potentially pathogenic extracellular products produced by group B P-hemolytic Streptococci. Todd, in 1934 (33), described the production of an oxygen stable, non-immunogenic hemolysin; McClean, in 1941 (26), demonstrated that these organisms elaborated a hyaluronidase; Brown et al., in 1974 (6), reported the isolation of the protein's cyclic adenosine 3'5'-monophosphate factor; and Milligan et al. in 1977 (27), described the presence of neuroaminidase (sialidase) in concentrated culture filtrates. The role of these products in the pathoph...
Background Although hearing loss is a common health issue, hearing healthcare (HHC) is poorly accessed. Screening to identify hearing loss is an important part of HHC access, specifically for those who screen positive for hearing loss and would benefit from seeing a HHC provider. New technologies can be automated to provide information and recommendations that are tailored to the needs of individual users, potentially enhancing rates of HHC access after positive screens. A greater understanding of the facilitators of post-screening HHC access that could be leveraged in such systems is needed. Purpose The purpose of this project was to identify facilitators of post-screening HHC access that can be employed in automated screening systems. Research Design This qualitative study utilized focus groups (FGs) to understand perceived barriers, perceived benefits, and potential cues to action, as informed by the Health Belief Model, for accessing HHC after use of automated hearing screening systems. Study Sample Fifty individuals participated in one of seven FGs. FGs were conducted separately with three types of stakeholders: four FGs included adults who reported some degree of perceived hearing loss and had recently completed a hearing screening; two FGs included adults who had recently sought HHC for the first time due to hearing loss; and one FG involved significant others/family members of individuals with hearing loss. Data Collection and Analysis FGs were 60–90 minutes in length and were led by a trained facilitator following a discussion guide. A research audiologist was present at each FG and served as a notetaker. FGs were recorded and transcribed by research team members, and transcripts were then coded in an iterative process by multiple team members. Qualitative content analysis was used to reduce data and to identify salient themes and sub-themes, following an inductive approach. We focused on identifying themes that were related to facilitators of HHC access after positive screens for hearing loss and, separately, potential enhancements to automated hearing screening systems that would leverage these facilitators to improve HHC access. Results We identified five key themes related to HHC access after a positive screen for hearing loss, along with ideas for enhancing automated hearing screening systems based on these themes. The themes included: knowledge, trust, access, quality of life, and interpersonal influence. Conclusions Results of our work help inform the development of innovative hearing screening systems that can be automated to leverage individual facilitators of HHC access.
In the absence of other congruent multisensory motion cues, sound contribution to illusions of self-motion (vection) is relatively weak and often attributed to purely cognitive, top-down processes. The present study addressed the influence of cognitive and perceptual factors in the experience of circular, yaw auditorily-induced vection (AIV), focusing on participants imagery vividness scores. We used different rotating sound sources (acoustic landmark vs. movable types) and their filtered versions that provided different binaural cues (interaural time or level differences, ITD vs. ILD) when delivering via loudspeaker array. The significant differences in circular vection intensity showed that (1) AIV was stronger for rotating sound fields containing auditory landmarks as compared to movable sound objects; (2) ITD based acoustic cues were more instrumental than ILD based ones for horizontal AIV; and (3) individual differences in imagery vividness significantly influenced the effects of contextual and perceptual cues. While participants with high scores of kinesthetic and visual imagery were helped by vection “rich” cues, i.e., acoustic landmarks and ITD cues, the participants from the low-vivid imagery group did not benefit from these cues automatically. Only when specifically asked to use their imagination intentionally did these external cues start influencing vection sensation in a similar way to high-vivid imagers. These findings are in line with the recent fMRI work which suggested that high-vivid imagers employ automatic, almost unconscious mechanisms in imagery generation, while low-vivid imagers rely on more schematic and conscious framework. Consequently, our results provide an additional insight into the interaction between perceptual and contextual cues when experiencing purely auditorily or multisensory induced vection.
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