Study on gene therapy for DPOAE and ABR threshold changes in adult Otof-/- mice / 临床耳鼻咽喉头颈外科杂志

Objective:This study aims to analyze the threshold changes in distortion product otoacoustic emissions（DPOAE） and auditory brainstem response（ABR） in adult Otof-/- mice before and after gene therapy, evaluating its effectiveness and exploring methods for assessing hearing recovery post-treatment. Methods:At the age of 4 weeks, adult Otof-/- mice received an inner ear injection of a therapeutic agent containing intein-mediated recombination of the OTOF gene, delivered via dual AAV vectors through the round window membrane（RWM）. Immunofluorescence staining assessed the proportion of inner ear hair cells with restored otoferlin expression and the number of synapses.Statistical analysis was performed to compare the DPOAE and ABR thresholds before and after the treatment. Results:AAV-PHP. eB demonstrates high transduction efficiency in inner ear hair cells. The therapeutic regimen corrected hearing loss in adult Otof-/- mice without impacting auditory function in wild-type mice. The changes in DPOAE and ABR thresholds after gene therapy are significantly correlated at 16 kHz. Post-treatment,a slight increase in DPOAE was observeds,followed by a recovery trend at 2 months post-treatment. Conclusion:Gene therapy significantly restored hearing in adult Otof-/- mice, though the surgical delivery may cause transient hearing damage. Precise and gentle surgical techniques are essential to maximize gene therapy's efficacy.

Epidemiological Profile of Neonates in Hearing Screening at a Maternity of a Tertiary Hospital in the state of Santa Catarina, Brazil

Abstract Introduction The newborn hearing screening (NHS) test aims the early diagnostic of hearing deficits that may also harm the full development of communication and learning of the affected child. Objective Trace the clinical and epidemiological profile of children born between July 2016 and July 2019; in addition to the outcome of the NHSs and factors related to failure in the hearing tests at a maternity of a tertiary hospital in Santa Catarina, Brazil. Methods The present is a cross-sectional study. A census of those born in the period defined for study was performed and a script was developed for the review of medical records, based on the literature. Results The sample can be considered homogeneous in relation to gender and age. The pregnant women had an average of 30.9 years. There were 30 neonates (1.9%) that did not undergo NHS. New evaluations were required in 288 patients (18.2%). Finally, 24 (1.5% of the population) remained with insufficient results in the retest. The following variables achieved statistical relevance with higher failure rates in tests and/or retests: natural delivery (p = 0.007), arterial hypertension present (p = 0.002), use of hydralazine (p = 0.038), and use of dipyrone in the test (p = 0.041) and retest (p = 0.003). Younger mothers had higher levels of normality in the test (p = 0.003) and retest (p = 0.161). The correlations between the other variables and the outcomes were not statistically significant. Conclusion False positives (62.8%) in the first test showed a value higher than the ideal goal; those who did not undergo the NHS (1.9%) and who needed evaluation by a specialist, due to failure in the retest (1.5%), are within the quality goals defined by the Joint Committee on Infant Hearing (JCIH) in 2007.

Benchmark Dose Assessment for Coke Oven Emissions-Induced Mitochondrial DNA Copy Number Damage Effects / 生物医学与环境科学（英文）

OBJECTIVE@#The study aimed to estimate the benchmark dose (BMD) of coke oven emissions (COEs) exposure based on mitochondrial damage with the mitochondrial DNA copy number (mtDNAcn) as a biomarker.@*METHODS@#A total of 782 subjects were recruited, including 238 controls and 544 exposed workers. The mtDNAcn of peripheral leukocytes was detected through the real-time fluorescence-based quantitative polymerase chain reaction. Three BMD approaches were used to calculate the BMD of COEs exposure based on the mitochondrial damage and its 95% confidence lower limit (BMDL).@*RESULTS@#The mtDNAcn of the exposure group was lower than that of the control group (0.60 ± 0.29 vs. 1.03 ± 0.31; P < 0.001). A dose-response relationship was shown between the mtDNAcn damage and COEs. Using the Benchmark Dose Software, the occupational exposure limits (OELs) for COEs exposure in males was 0.00190 mg/m 3. The OELs for COEs exposure using the BBMD were 0.00170 mg/m 3 for the total population, 0.00158 mg/m 3 for males, and 0.00174 mg/m 3 for females. In possible risk obtained from animal studies (PROAST), the OELs of the total population, males, and females were 0.00184, 0.00178, and 0.00192 mg/m 3, respectively.@*CONCLUSION@#Based on our conservative estimate, the BMDL of mitochondrial damage caused by COEs is 0.002 mg/m 3. This value will provide a benchmark for determining possible OELs.

Cribaje neonatal precoz de déficit auditivo mediante el registro de otoemisiones acústicas

La alta prevalencia de déficit auditivo, establecido ya antes del nacimiento del niño o adquirido en el periodo perinatal o posnatal inmediato, es alarmante, unido a la repercusión de esta discapacidad sobre el lenguaje y otros procesos cognitivos, la convierten en un serio problema de salud, por lo que un diagnóstico precoz, es esencial para una rehabilitación oportuna. El objetivo de nuestro trabajo es caracterizar los resultados del registro de otoemisiones acústicas en recién nacidos. Se utilizó el método de investigación descriptiva, retrospectiva y transversal de serie de 4176 neonatos, a los cuales se le realizó registro de otoemisiones acústicas en el hospital provincial general "Carlos Manuel de Céspedes" de Bayamo, Granma, durante el periodo comprendido del 1ro de enero hasta el 31 de diciembre del 2022.Más del 96 % de los neonatos fueron pesquisados; la prevalencia de pruebas fallidas, sugestivas de déficit auditivo fue de 0,4 %. El comportamiento de los hallazgos del examen, fue próximo al 50 % en cada sexo y la afectación de ambos oídos se encontró en el 53 % de los casos. Los neonatos con factores de riesgo auditivo, representaron cerca del 5 % del total de recién nacidos y de este subgrupo, el 5,3 % no pasaron el tamizaje. El bajo peso al nacer, fue el factor de riesgo más comúnmente encontrado. Podemos considerar que el cribaje realizado, cumple los criterios establecidos para calificarlo de, universal. La prevalencia de pruebas fallidas fue alta, aunque acorde con los criterios de la Junta del Comité de Audición infantil (JCIH) y no mostró diferencia alguna según el sexo. La presencia de factores de riesgo, fue baja, aunque en correspondencia con resultados a nivel global, destacándose como el más común, el bajo peso al nacer.

The high prevalence of hearing deficit, established already before the birth of the child or acquired in the immediate perinatal or postnatal period, is alarming, together with the impact of this disability on language and other cognitive processes, make it a serious health problem, so an early diagnosis is essential for timely rehabilitation. The objective of our work is to characterize the results of the registration of otoacoustic emissions in newborns. The descriptive, retrospective and cross-sectional research method of series of 4176 neonates was used, to which acoustic otoemissions were recorded in the general provincial hospital "Carlos Manuel de Céspedes" of Bayamo, Granma, during the period from January 1 to December 31, 2022. More than 96% of neonates were screened; the prevalence of failed tests suggestive of hearing deficit was 0.4%. The behavior of the examination findings was close to 50% in each sex and the involvement of both ears was found in 53% of cases. Neonates with auditory risk factors represented about 5% of all newborns and of this subgroup, 5.3% did not pass screening. Low birth weight was the most commonly found risk factor. We can consider that the screening carried out meets the criteria established to qualify it as universal. The prevalence of failed tests was high, although in line with the criteria of the Board of the Child Hearing Committee (JCIH) and showed no difference by sex. The presence of risk factors was low, although in correspondence with results at the global level, standing out as the most common, low birth weight.

A alta prevalência do déficit auditivo, estabelecido já antes do nascimento da criança ou adquirido no período perinatal oupós-natal imediato, é alarmante, juntamente com o impacto desta deficiência na linguagem e em outros processos cognitivos, tornando-a um grave problema de saúde, sendo essencial o diagnóstico precoce para a reabilitação em tempo hábil. O objetivo do nosso trabalho é caracterizar os resultados do registro das emissões otoacústicas em recém-nascidos. Utilizou-se o método de pesquisa descritiva, retrospectiva e transversal de série de 4176 neonatos, para a qual foram registradas otoemissões acústicas no hospital geral provincial "Carlos Manuel de Céspedes" de Bayamo, Granma, durante o período de 1º de janeiro a 31 de dezembro de 2022. Mais de 96% dos neonatos foram triados; A prevalência de falha nos testes sugestivos de déficit auditivo foide 0,4%. O comportamento dos achados do exame foi próximo de 50% em cada sexo e o acometimento de ambas as orelhas foi encontrado em 53% dos casos. Neonatos com fatores de risco auditivo representaram cerca de 5% de todos os recém-nascidos e, deste subgrupo, 5,3% não passaram na triagem. O baixo peso ao nascer foi o fator de risco mais encontrado. Podemos considerar que a triagem realizada atende aos critérios estabelecidos para qualificá-la como universal. A prevalência de reprovação nos testes foi alta, embora de acordo com os critérios do Board of the Child Hearing Committee (JCIH) e não mostrou diferença por sexo. A presença de fatores de risco foi baixa, embora em correspondência com os resultados em nível global, destacando-se como o mais comum, o baixo peso ao nascer.

Validação de simulador de emissões otoacústicas para o ensino em audiologia / Otoacoustic emissions simulator validation for audiology education / Validación del simulador de emisiones otoacuticas para la educación en audiología

O teste Emissões Otoacústicas (EOA) é parte da avaliação Audiológica para detecção precoce da surdez na infância. Desse modo, o aprendizado das EOA na graduação do curso de Fonoaudiologia é fundamental conforme a Diretriz Curricular Nacional (DCN). As diretrizes educacionais sugerem a inclusão de tecnologias de informação no ensino da graduação para melhor desempenho dos futuros profissionais da saúde. Objetivo: Validar o protótipo simulador OTOBABY para o Teste de Emissões Otoacústicas como ferramenta de ensino em Fonoaudiologia. Metodologia: Trata-se de uma pesquisa metodológica, experimental, com a participação de dez fonoaudiólogos professores e/ou preceptores, denominados juízes e 20 alunos de graduação de Fonoaudiologia em Belém do Pará/Brasil. Os juízes responderam a um questionário de validação de Escala Likert sobre a usabilidade e efetividade do simulador OTOBABY como ferramenta de ensino. Os alunos participaram de um curso de capacitação com o uso do protótipo e foram avaliados com checklists antes e depois do curso para a verificação da eficácia do simulador como instrumento de ensino. Os dados foram analisados estatisticamente com o teste de Wilcoxon. Resultados: O simulador alcançou 98% de aprovação como ferramenta de ensino para as EOA pelos juízes. Quanto a habilidade dos alunos, observou-se que era de 60,3%, antes do curso, obtendo-se um desempenho de 97,7% após curso com o OTOBABY. Conclusão: Conclui-se que o protótipo simulador OTOBABY foi aprovado e validado como um instrumento facilitador do aprendizado das Emissões Otoacústicas no ensino da prática Audiológica.

The Otoacoustic Emissions (OAE) test is part of the Audiological evaluation for early detection of childhood deafness. Thus, the learning of OAE in the undergraduate course of Speech Therapy is fundamental according to the National Curriculum Guideline (NCD). The educational guidelines suggest the inclusion of information technologies in undergraduate education for better performance of future health professionals. Objective: Validate the prototype OTOBABY simulator for the Otoacoustic Emissions Test as a teaching tool in Speech Therapy. Methodology: This is a methodological, experimental research, with the participation of ten phonoaudiologists, professors and/or preceptors, called judges and 20 undergraduate students of Speech Therapy in Belém do Pará/Brazil. The judges responded to a Likert Scale validation questionnaire on the usability and effectiveness of the OTOBABY simulator as a teaching tool. Students took part in a training course using the prototype and were evaluated with checklists before and after the course to verify the simulator's effectiveness as a teaching instrument. The data were statistically analyzed with the Wilcoxon test. Results: The simulator achieved 98% approval as a teaching tool for OAE by the judges. As for the ability of the students, it was observed that it was 60.3%, before the course, obtaining a performance of 97.7% after course with OTOBABY. Conclusion: It is concluded that the prototype simulator OTOBABY was approved and validated as a facilitator instrument of the learning of Otoacoustic Emissions in the teaching of Audiological practice.

La prueba EOA es parte de la evaluación auditiva para la sordera temprana en la niñez. En consecuencia, el aprendizaje de las EOA en el curso de posgrado de fonoaudiología es fundamental de acuerdo con la Directriz Nacional de Planes de Estudio (NCN). Las directrices educativas sugieren la inclusión de las tecnologías de la información en la enseñanza de cursos de pregrado para mejorar el desempeño de futuros profesionales de la salud. Objetivo: Validar el prototipo de simulador OTOBABY para la Prueba de Emisiones Otoacústicas como herramienta docente en fonoaudiología. Metodología: Estamos tratando con la investigación metodológica, experimental, con la participación de diez audiólogos de idiomas, profesores y/o preceptores, llamados jueces y 20 estudiantes universitarios de fonoaudiología en Belém do Pará/Brasil. Los jueces respondieron a un cuestionario de validación de la Escala Likert sobre la utilidad y la eficacia del simulador OTOBABY como instrumento de enseñanza. Los estudiantes participaron en un curso de capacitación utilizando el prototipo y fueron evaluados con checklists de verificación antes y después del curso para verificar la efectividad del simulador como instrumento educativo. Los datos se analizaron estadísticamente con el test de Wilcoxon. Resultados: El simulador alcanzó el 98% de la aprobación como herramienta de enseñanza para la EOA por parte de los jueces. En cuanto a la capacidad de los estudiantes, se observó que era del 60,3% antes del curso, alcanzando un desempeño del 97,7% después del curso con OTOBABY. Conclusión: Se concluye que el prototipo de simulador OTOBABY ha sido aprobado y validado como instrumento que facilita el aprendizaje de emisiones ópticas en la enseñanza de la práctica audiológica.

The Relationship between Contralateral Suppression of Transient Evoked Otoacoustic Emission and Unmasking of Speech Evoked Auditory Brainstem Response

Abstract Introduction Several studies have shown that efferent pathways of the auditory system improve perception of speech-in-noise. But, the majority of investigations assessing the role of efferent pathways on speech perception have used contralateral suppression of otoacoustic emissions as a measure of efferent activity. By studying the effect of efferent activity on the speech-evoked auditory brainstem response (ABR), some more light could be shed on the effect of efferent pathways on the encoding of speech in the auditory pathway. Objectives To investigate the relationship between contralateral suppression of transient evoked otoacoustic emission (CSTEOAE) and unmasking of speech ABR. Methods A total of 23 young adults participated in the study. The CSTEOAE was measured using linear clicks at 60 dB peSPL and white noise at 60 dB sound pressure level (SPL). The speech ABR was recorded using the syllable /da/ at 80 dB SPL in quiet, ipsilateral noise, and binaural noise conditions. In the ipsilateral noise condition, white noise was presented to the test ear at 60 dB SPL, and, in the binaural noise condition, two separate white noises were presented to both ears. Results The F0 amplitude of speech ABR was higher in quiet condition; however, the mean amplitude of F0 was not significantly different across conditions. Correlation analysis showed a significant positive correlation between the CSTEOAE and the magnitude of unmasking of F0 amplitude of speech ABR. Conclusions The findings of the present study suggests that the efferent pathways are involved in speech-in-noise processing.

5° Congreso Nacional y 1° Internacional de Ciencias Ambientales "Las Ciencias Ambientales en el Antropoceno". Emisiones generadas y evitadas / 5th National and 1st International Congress of Environmental Sciences "Environmental Sciences in the Anthropocene". Emissions generated and avoided

RESUMEN Las actividades académicas, como los congresos, son muy importantes para la investigación y el desarrollo; sin embargo, las emisiones de carbono derivadas de la realización de eventos presenciales han mostrado estar muy por encima de las que producen eventos en línea. El objetivo de este trabajo fue estimar las emisiones generadas por el 5º Congreso Nacional y 1º Internacional de Ciencias Ambientales "Las Ciencias Ambientales en el Antropoceno", celebrado virtualmente, en su mayor parte. Se estimaron las emisiones del uso directo de computadores y de software (emisiones de los computadores, emisiones de la transferencia de los datos) y las emisiones de otras fuentes (reuniones de los organizadores, búsquedas y visitas a la página Web, uso de monitores externos y lámparas), así como las emisiones evitadas por transporte aéreo y terrestre. El congreso emitió 4,8 tCO2eq y evitó 33 tCO2eq. El desarrollo de eventos online o híbridos es más sostenible ambientalmente y podría ser más accesibles, a un mayor número de personas.

ABSTRACT Academic activities such as conferences are very important for research and development, however, carbon emissions derived from face-to-face events have been shown to be much higher than those produced by online events. The aim of this work was to estimate CO2 emissions generated by the 5th National Congress and 1st International Congress of Environmental Sciences "Environmental Sciences in the Anthropocene". Emissions from direct use of computers and software (emissions from computers, emissions from data transfer) and emissions from other sources (meetings of the organizers, searches and visits to the website, use of external monitors and lamps), as well as emissions avoided by air and land transport. The congress emitted 4.8 tCO2eq and avoided 33 tCO2eq. The development of online or hybrid events is more environmentally sustainable and could be more accessible to a greater number of people.

Eficacia del «Programa de tamizaje auditivo neonatal universal¼ de la Caja Costarricense del Seguro Social en la detección de sordera en niñas y niños, entre 2016 y 2018 / Effectiveness of «Universal Newborn Hearing Screening program¼ of Caja Costarricense del Seguro Social, in detecting deafness in children, from 2016 to 2018

Resumen Introducción: el tamizaje auditivo es un método de detección y su propósito es intervenir de forma temprana para reducir las consecuencias negativas de una eventual afección auditiva en el desarrollo integral del infante. Costa Rica ha implementado en el sistema de salud público un programa de tamizaje auditivo neonatal universal, donde se examina todo niño o niña antes del primer mes de vida. Aunque se han percibido múltiples beneficios, es importante demostrar con evidencia científica si cumple sus objetivos. Metodología: se analizó la eficacia del «Programa de tamizaje auditivo neonatal universal» (TANU) de la Caja Costarricense de Seguro Social, a partir de la información registrada de 37 656 infantes evaluados entre los años 2016 y 2018, mediante el contraste empírico con las técnicas descriptivas de distribución de frecuencias de variables, y las pruebas inferenciales chi cuadrado y análisis de varianza (ANOVA). Resultados: en cuanto a la edad al momento del examen, el 71 % de la muestra tenía entre 0 y 3 días. Su desempeño a través del tiempo y la extensión a distintos centros de salud ha sido satisfactorio, así mismo, la cantidad de infantes valorados ha sido hasta del 98 % de la población. Conclusiones: el programa TANU es eficaz en la mayoría de aspectos analizados, destaca la identificación de factores de riesgo y la detección temprana de afecciones auditivas, sin embargo, se proponen mejoras en relación con el manejo de la información.

Abstract Introduction: Hearing screening is a detection method, its objective is to provide an early intervention that allows reducing the negative consequences of an eventual hearing impairment, in the integral development of the infant. Costa Rica has implemented a universal neonatal hearing screening program in the public health system, where the hearing of every child born in the country is examined before the first month of life. Although multiple benefits have been perceived, it is important to demonstrate with scientific evidence if it accomplishes its objectives. Methodology: the effectiveness of the Universal Newborn Hearing Screening Program in Costa Rica was analyzed, based on the information recorded from 37,656 children evaluated since 2016 to 2018, through empirical contrast using both descriptive techniques: frequency distribution of variables, as well as the use of inferential tests: chi square and analysis of variance (ANOVA). Results: 71 % of the sample was between 0 and 3 days old at the moment of being examined. Its performance over time and extension to different health centers has been satisfactory, likewise, the number of infants evaluated has been up to 98 % of the population. Conclusions: the TANU program is effective in most of the aspects analyzed, the identification of risk factors and the early detection of hearing disorders are outstanding, however, improvements are proposed in relation to the handling of information.

Distortion Product Otoacoustic Emissions (DPOAEs) In Tinnitus Patients

Abstract Introduction Tinnitus is the perception of sound in the absence of external sound stimulation. There is a general agreement that it is a direct consequence of irreversible and permanent cochlear damage. Objectives The present work is designed to study the distortion product otoacoustic emissions (DPOAEs) in tinnitus patients with normal hearing in comparison with normal hearing control and to study any possible correlation between DPOAEs recording and patients' complaints. Methods The present study included 80 subjects divided into 2 groups: Control group: consisted of 30 normal-hearing adults not complaining of tinnitus and Study group: consisted of 50 normal-hearing adults complaining of tinnitus. The methodology includes full audiological history, otoscopic examination, basic audiological evaluation, DPOAEs including both DP-gram and DPOAEs input/output functions. Results Basic audiological evaluation showed within normal hearing sensitivity in both groups, however, with significant higher hearing thresholds in tinnitus patients at all frequency ranges. The Tinnitus Handicap Inventory Questionnaire showed mean scores of 35.2 ± 16.9 in the study group. The DP-gram showed higher amplitudes in the control group when compared with tinnitus patients. The DPOAEs input-output functions at different frequencies (1, 2, 4 and 6kHz) also showed higher amplitudes at all frequencies and different input levels. The slope of the I/O function tends to be steeper in tinnitus cases. Conclusion Patients with tinnitus might have neural dysfunction at either the level of the cochlea, as shown in reduced DPOAE levels, and changes in the normal DP-I/O function recorded in the present work.

Modeling of Brazilian Carbon Dioxide Emissions: a Review

Abstract: Brazil is a signatory to the Paris Agreement and aims to reduce 43% of CO2 emissions by 2030, compared to 2005. However, changes in energy policies are needed to achieve this goal, evaluating the produced effects on emissions. One way to predict these effects is through mathematical modeling. In this paper, we carried out a literature review to identify the most used model types and independent variables to forecasting Brazilian CO2 emissions. The review showed that gray models and artificial neural networks are the most used ones. Furthermore, we also identified that economic growth and energy consumption are the main independent variables.

Estudo das emissões otoacústicas residuais nas perdas auditivas neurossensoriais com diferenciação de artefatos e respostas fisiológicas / Study of residual otoacoustic emissions in hearing loss with artifact differentiation and physiological responses

RESUMO Objetivo avaliar o efeito da variação da intensidade de estimulação sobre as respostas das emissões otoacústicas produto de distorção em indivíduos com perda auditiva neurossensorial, utilizando um protocolo de gradiente de fase das emissões. Métodos estudo observacional transversal. Participaram 38 indivíduos com diagnóstico de perda auditiva neurossensorial de grau leve, moderado ou severo. Foram realizadas anamnese, meatoscopia, audiometria tonal liminar, logoaudiometria, imitanciometria, emissões otoacústicas produto de distorção e emissões otoacústicas residuais. As emissões otoacústicas residuais foram coletadas com o equipamento Echodia, modelo Elios®. O protocolo utilizado permite a variação dos parâmetros frequência e intensidade e as respostas são analisadas por meio do teste do Gradiente de Fase. As respostas registradas nas emissões residuais foram consideradas como "presente", "ausente" e "artefato", considerando a variação da fase em função de f1. Resultados Foram incluídas 72 orelhas. Houve diferença estatisticamente significativa nas frequências de 1300 Hz e 2000 Hz, ao comparar os resultados das emissões residuais. Ao correlacionar o resultado da audiometria e a intensidade de estimulação que evocou a emissão residual, houve correlação positiva para as frequências de 1000 Hz e 4000Hz. O "artefato" foi registrado, principalmente, nas frequências mais agudas: 56,2% em 3000 Hz e 58,2% em 4000 Hz. A emissão otoacústica residual presente foi registrada em 18,6% em 1000 Hz, 13,4% em 2000 Hz, 6,3% em 3000 Hz e 7,5% em 4000 Hz. Conclusão o aumento da intensidade de estimulação no exame de emissões pode auxiliar no estudo das células ciliadas residuais, desde que seja utilizado um protocolo capaz de diferenciar respostas fisiológicas de artefatos.

ABSTRACT Purpose To study the effect of stimulation intensity variation on the responses of distortion products in subjects with sensorineural hearing loss using a new protocol to register the otoacoustic emissions. Methods This is a cross-sectional observational study. The following procedures were performed: anamnesis, otoscopy, pure tone audiometry, speech audiometry, tympanometry, distortion product and residual otoacoustic emissions. The residual DPOAE were collected with the Echodia equipment, Elios®. The protocol that was developed allows the variation of frequency and intensity parameters and the responses are analyzed by phase gradient test. Responses recorded in residual otoacoustic emissions were considered "present", "absent" or "artifact". Results The total included ears was 72. On residual otoacoustic emissions test, at a frequency of 1300Hz and 2000Hz, there was statistically significant difference. By analyzing the average found in the audiometry and the results of residual emissions, only the frequency of 1300Hz showed a statistically significant association in all groups. By correlating the results of the audiometry and the stimulation intensity used to evoke the residual emission, there was positive correlation for the frequencies of 1000Hz and 4000Hz. The "artifact" was mostly recorded in the higher frequencies: 56.2% in 3000Hz and 58.2% in 4000 Hz. Residual EOAPD present was recorded as 18.6% at 1000Hz, 13.4% at 2000Hz, 6.3% at 3000Hz and 7.5% at 4000Hz. Conclusion The increased stimulation intensity in the otoacoustic emissions test can aid in the study of residual outer hair cells, as long as a protocol is used to check the correctness of the responses.

Efeito inibitório da via auditiva eferente na síndrome de Turner / Efferent Auditory Pathways Inhibition in Turner syndrome

RESUMO Objetivo investigar o efeito inibitório da via auditiva eferente na síndrome de Turner e relacionar com o perfil citogenético. Método estudo descritivo transversal com grupo de comparação. Amostra: Grupo estudo formado por 40 pacientes com síndrome de Turner (17,6 anos); e Grupo controle constituído por 54 indivíduos (18,9 anos), do sexo feminino sem síndrome. Os indivíduos selecionados foram submetidos à pesquisa do efeito inibitório da via auditiva eferente. Resultados A média do Efeito inibitório da via auditiva eferente no grupo estudo na orelha direita foi 0,4 dB e no grupo comparação foi de 1,9 dB, entretanto na orelha esquerda a média do efeito inibitório da via auditiva eferente foi 1,4 dB no grupo estudo e 0,8 dB no grupo comparação. O efeito inibitório da via auditiva eferente foi presente em 14 indivíduos com monossomia e em 15 com outras alterações citogenéticas. Conclusão No grupo estudo o valor do efeito inibitório da via auditiva eferente foi significantemente maior na orelha esquerda e significativamente menor que o grupo controle na direita. Não houve diferença significativa no efeito inibitório da via auditiva eferente entre os tipos de cariótipo.

ABSTRACT Purpose The goal of this study is to investigate the efferent auditory pathways inhibition in Turner's syndrome and to relate it to the cytogenetic profile. Methods This is a cross-sectional study with a comparison group. A sample with 94 participants divided into two groups: The study group was a sample of 40 patients diagnosed with Turner's syndrome (17.6 years of age). The control group was composed of 54 volunteers (18.9 years of age), female, without syndrome. The selected individuals were submitted to efferent auditory pathways inhibition research. Results The mean of the inhibitory effect of the efferent auditory pathway in the study group in the right ear was 0.4 dB and in the comparison group it was 1.9 dB, however in the left ear the mean of the inhibitory effect of the efferent auditory pathway was 1.4 dB in the study group and 0.8 dB in the comparison group. The inhibitory effect of the efferent auditory pathway was present in 14 individuals with monosomy and in 15 with other cytogenetic alterations. Conclusions In the study group, the efferent auditory pathways inhibition value was significantly higher in the left ear and significantly lower than the control group in the right ear. There was no significant difference in efferent auditory pathways inhibition of right ear and left ear between the karyotype types.

Síntomas respiratorios en agentes civiles de tránsito expuestos a smog en Quito en el año 2021 / Respiratory symptoms in civil traffic police agents exposed to smog in Quito in 2021

INTRODUCCIÓN. Existe relación entre la exposición de contaminantes en el aire y problemas respiratorios que van desde síntomas leves en vías respiratorias altas hasta enfermedades que pueden comprometer la vida de los pacientes como: neumonía, enfermedad pulmonar obstructiva crónica y cáncer pulmonar. OBJETIVO. Registrar los síntomas respiratorios presentados por agentes civiles de tránsito expuestos a smog. MATERIALES Y MÉTODOS. Estudio analítico transversal. Población de 3 458 y muestra de 454 participantes entre agentes civiles de tránsito, fiscalizadores de tránsito y personal administrativo de la Agencia Metropolitana de Tránsito en el año 2021, seleccionados por muestreo aleatorio simple estratificado para los dos grupos de participantes; se aplicó un sondeo digital basado en las encuestas: European Community Respiratory Health Survey y condiciones de trabajo. Para el análisis de datos se utilizó la herramienta EPI INFO, donde se realizó pruebas estadísticas bivariadas de Chi2 y análisis multivariado como regresiones logísticas crudas y ajustadas. RESULTADOS. Se observó que la población de trabajadores operativos en vía tuvo alrededor de dos veces más riesgo de desarrollar sibilancias en comparación a la población administrativa OR=2,1 (IC 95% 1,01­4,39); el personal operativo tuvo más del doble de riesgo de desarrollar bronquitis crónica versus la población administrativa OR=2,5 (IC 95% 1,14­5,73). Los resultados fueron ajustados mediante regresión logística con variables de condiciones de trabajo y salud (p=<0,05). CONCLUSIÓN. Se registró una relación significativa entre la contaminación ambiental por smog y enfermedades respiratorias a largo plazo.

INTRODUCTION. There is a relationship between exposure to air pollutants and respiratory problems ranging from mild upper respiratory symptoms to life-threatening diseases such as pneumonia, chronic obstructive pulmonary disease and lung cancer is evident. OBJECTIVE. To record the respiratory symptoms presented by civilian traffic officers exposed to smog. MATERIALS AND METHODS. Cross-sectional analytical study. Population of 3 458 and sample of 454 participants among civilian traffic agents, traffic inspectors and administrative personnel of the Metropolitan Traffic Agency in the year 2021, selected by simple stratified random sampling for the two groups of participants; a digital survey was applied based on the European Community Respiratory Health Survey and working conditions. For data analysis, the EPI INFO tool was used, where bivariate Chi2 statistical tests and multivariate analysis such as crude and adjusted logistic regressions were performed. RESULTS. It was observed that the population of operational track workers had about twice the risk of developing wheezing compared to the administrative population OR=2,1 (95% CI 1,01-4,39); operational personnel had more than twice the risk of developing chronic bronchitis versus the administrative population OR=2,5 (95% CI 1,14­5,73). Results were adjusted by logist regression with working conditions and health variables (p=<0,05). CONCLUSION. There was a significant relationship between smog pollution and long-term respiratory diseases.

Impacto da pandemia de COVID-19 nas emissões veiculares no Brasil no período de janeiro a maio de 2020 / Impact of the COVID-19 pandemic on vehicle emissions in Brazil from January to May 2020

RESUMO No presente trabalho foi realizada a estimativa das emissões dos gases de efeito estufa (CO2eq), monóxido de carbono (CO), óxido de nitrogênio (NOx), material particulado (MP), aldeído (RCHO) e hidrocarboneto não metano (NMHC) dos veículos licenciados nos cinco primeiro meses do ano de 2020 no Brasil. Os resultados foram comparados com as emissões veiculares da frota licenciada no mesmo período do ano de 2019 a fim de verificar o impacto da pandemia de COVID-19 nos referidos licenciamentos, nas emissões e, consequentemente, na qualidade do ar do país. Os resultados apontaram redução de 14% nas emissões dos gases de efeito estufa, com diminuição observada para todos os veículos, exceto para os caminhões semipesados, que tiveram incremento nas emissões de gases de efeito estufa de 12,8%. Os demais poluentes também reduziram, em 12,5% para o CO, em 29,6% para o NOx, em 24,1% para o MP, em 21,5% para o RCHO e em 16,3% para o NMHC. Por fim, quanto ao total de poluentes acumulados, entre todos os veículos analisados, os únicos que tiveram aumento nas emissões em relação a 2019, de 2,1%, foram as motocicletas com tecnologia flexfuel, que são abastecidas preferencialmente com etanol hidratado. Com isso, pôde-se concluir que a pandemia da COVID-19, por meio das medidas de restrição e isolamento social adotadas no país para frear a transmissão da doença, impactou positivamente a qualidade do ar no Brasil no período analisado.

ABSTRACT The estimated emissions of greenhouse gases (CO2eq), carbon monoxide (CO), nitrogen oxide (NOx), particulate matter (PM), aldehyde (RCHO) and non-methane hydrocarbon (NMHC) from vehicles licensed in the first five months of 2020 in Brazil were calculated in the present study, and the results compared with vehicular emissions from the licensed fleet in the same period of the year 2019, in order to verify the impact of the COVID-19 pandemic on these permits, emissions and, consequently, air quality in the country. The results showed a 14% reduction in greenhouse gas emissions, with a decrease observed for all vehicles, except for semi heavy trucks, which had a 12.8% increase in GHG emissions. The other pollutants also decreased, being 12.5% for CO, 29.6% for NOx, 24.1% for PM, 21.5% for RCHO, and 16.3% for NMHC. Finally, in relation to the total accumulated pollutants, among all vehicles analyzed, the only ones that had a 2.1% increase in emissions in relation to 2019 were the motorcycles with flexfuel technology, which are preferably fueled with hydrated ethanol. Thus, it was concluded that the COVID-19 pandemic, through the measures of restriction and social isolation adopted in the country to curb the transmission of the disease, had a positive impact on air quality in Brazil during the analyzed period.

Reflejo olivococlear contralateral y su relación con ansiedad y calidad de vida en pacientes con tinnitus

Resumen Introducción: La presencia de tinnitus se asocia a un incremento del nivel de ansiedad y empeoramiento de la calidad de vida, sin embargo, aún no existe claridad de si el sistema eferente auditivo podría influir en estas relaciones. Objetivo: Determinar si las amplitudes de las emisiones otoacústicas por producto de distorsión (EOAPD) y el efecto supresor del reflejo olivococlear gatillado con ruido contralateral (ROC) se asocian al grado del impacto psicoemocional y nivel de ansiedad en pacientes con tinnitus. Material y Método: Se evaluaron las amplitudes de EOAPD y magnitud del ROC para cada oído de manera independiente en una cohorte de 32 sujetos tinnitus y 26 controles, cuyos valores fueron correlacionados con State-Trait Anxiety Inventory (STAI) y Tinnitus Handicap Inventory (THI). Resultados: Los pacientes con tinnitus tuvieron una correlación significativa entre la magnitud del ROC del oído izquierdo y los puntajes en las pruebas de STAI y THI. Conclusión: Una mayor carga de ansiedad y peor calidad de vida en sujetos con tinnitus puede estar asociada con un empeoramiento del efecto supresor del ROC de la vía eferente auditiva.

Abstract Introduction: Tinnitus is associated with an increase in the degree of anxiety and with worse quality of life. However, whether there are relations between the function of the auditory efferent system and anxiety and tinnitus distress levels is not known. Aim: To determine possible associations between the distortion product otoacoustic emission (DPOAE) amplitudes and the suppressing effect of the olivo-cochlear reflex (OCR) with anxiety and psycho-emotional impact in tinnitus. Material and Method: DPOAE amplitudes and OCR strength were evaluated for each ear independently in a cohort of 32 tinnitus and 26 controls, whose values were correlated with the State-Trait Anxiety Inventory (STAI) and Tinnitus Handicap Inventory (THI). Results: A significant correlation of STAI and THI scales with the OCR strength measured in the left ear was found in subjects with tinnitus. Conclusion: A higher anxiety load and worse quality of life in subjects with tinnitus may be associated with an impaired olivocochlear reflex suppressing effect.

Análise do monitoramento ambiental da incineração de resíduos sólidos urbanos na Europa e a necessidade de alterações na legislação brasileira / Environmental monitoring analysis of municipal solid waste incineration in Europe and the needs for changes in brazilian legislation

RESUMO A incineração é uma tecnologia de tratamento térmico de resíduos sólidos cujo principal objetivo é a redução do volume e da massa dos resíduos a serem depositados em aterros. Os incineradores construídos nas últimas décadas trazem a possibilidade de recuperação energética dos resíduos, na forma de vapor e/ou energia elétrica, entretanto essa tecnologia ainda gera questionamentos sobre possíveis impactos ambientais relacionados às suas emissões. A incineração é regulada na Europa por legislação específica que, entre outras questões, obriga a divulgação de dados de monitoramento ambiental de incineradores. No presente trabalho, são analisados dados de emissões atmosféricas de incineradores associados à Confederation of European Waste-to-Energy Plants (CEWEP), por meio de buscas nos websites dos respectivos incineradores, em artigos científicos e relatórios técnicos. Foram examinados dados de monitoramento de todos os poluentes de medição contínua e periódica definidos na legislação da UE, em séries temporais de 2010 a 2017. Todos os valores médios anuais de emissões nos incineradores analisados estiveram abaixo dos limites definidos pela diretiva europeia, com pequena variação ao longo dos anos observados. A comparação dos padrões de emissão europeus com os brasileiros mostra a necessidade de mudança na legislação local referente à incineração para que, caso essa tecnologia seja implementada no Brasil, ela possa operar respeitando limites seguros, com garantia de minimização de impactos ao ambiente e às populações do entorno.

Abstract Incineration is a solid waste treatment technology whose main purpose is to reduce the volume and mass of the waste to be disposed of in landfills. The incinerators built in the last decades bring the possibility of energy recovery from waste, in the form of steam and/or electric energy. However, this technology still raises questions about possible environmental impacts related to its emissions. Incineration is regulated in Europe through specific legislation which, among other issues, requires the disclosure of environmental monitoring data for incinerators. In the present work, atmospheric emissions data from incinerators associated with the Confederation of European Waste-to-Energy Plants (CEWEP) are analyzed by searching the websites of the respective incinerators, scientific articles and technical reports. Monitoring data on all continuous and periodic measured pollutants defined in the legislation in time series from 2010 to 2017 were analyzed. All annual average emission values of the incinerators analyzed were below the limits defined by the European Union's Directive, with little variation over the observed years. The comparison of European with Brazilian emission standards shows the need for a change in local legislation on incineration so that, if this technology is implemented in Brazil, it will operate within safe limits, with a guarantee of minimizing impacts on the environment and surrounding populations.

Effects of Low Birth Weight Babies on Cochlear Function In Newborns at Dr Soetomo Hospital Surabaya

@#Introduction: The prevalence of hearing loss ranges from 1 to 3 per 1000 live births and 2-4 per 100 high-risk babies as in low birth weight babies. Hearing screening in all newborns has not been fully implemented at Dr. Soetomo Hospital Surabaya so this research is expected to be the basis for hearing screening in all babies born especially low birth weight babies (LBW). The objective of the study was to predict the effect of low birth weight babies on impaired cochlear function in newborns. Methods: Cross-sectional comparative study was conducted from September 2018 to March 2019 in Dr. Soetomo Hospital. The subjects of this study were infants aged 2-28 days old in the nursery. Distortion Product Otoacoustic Emissions (DPOAE) was used to examineselected babies who fulfilled the selection criteria. Results: Twenty babies (≥2500 gram) and 20 babies (<2500 grams) were selected in this study. The proportion of cochlear dysfunction in infants with birth weights <1500 grams and 1500-2500 grams in Dr. Soetomo Hospital Surabaya was 50% and 35.7%. In multivariate analysis birth weight <1500 and birth weight 1500-2499 had a risk respectively 2.06 (95% Confidence Interval 0.08-48.26 P = 0.653) and 1.20 (95% Confidence Interval 0.07-20.34 P = 0.899) respectively. The proportion of cochlear dysfuntion in babies with birth weight ≥2500 grams is the highest which is 65 %. Conclusion: In this study Low Birth Weight Babies have a risk of 35.7 % of impaired cochlear function We would recommend DPOAE as screening method in all babies at Dr. Soetomo Hospital, Surabaya which is continued by second screening examination within one month on high risk babies and failed first test.

Efeito inibitório da via eferente auditiva no transtorno de processamento auditivo central / Auditory efferent inhibitory effect in central auditory processing disorder

RESUMO Objetivo verificar e comparar a ocorrência e magnitude do efeito inibitório da via auditiva eferente em crianças e adolescentes com processamento auditivo normal e alterado, identificando um valor de corte para uso na prática clínica. Métodos estudo prospectivo, com amostra composta por 30 crianças de 7 a 14 anos, sendo 15 com avaliação de processamento auditivo normal (grupo controle) e 15 com processamento auditivo alterado (grupo estudo). Ambos os grupos foram submetidos à anamnese e avaliados por meio dos testes de emissões otoacústicas evocadas por estímulos transientes na ausência e presença de ruído contralateral, avaliação audiológica básica e de processamento auditivo. Resultados houve menor ocorrência do efeito inibitório da via eferente no grupo estudo (p-valor=0,038). Os valores médios obtidos no grupo controle foram 0,71 na orelha direita e 0,87 na orelha esquerda e no grupo estudo, 0,55 na orelha direita e 0,41 na orelha esquerda. Os grupos controle e estudo diferiram de modo significativo na orelha esquerda. Conclusão houve redução do efeito inibitório da via eferente em crianças e adolescentes com transtorno de processamento auditivo, sugerindo alteração funcional do sistema eferente olivococlear medial. O valor que separou as crianças com e sem alteração do sistema eferente foi de 0,55 dB na prática clínica, com 70% de sensibilidade e 66,7% de especificidade.

ABSTRACT Purpose Verify and compare the occurrence and magnitude of the inhibitory effect of the efferent auditory pathway in children and adolescents with normal and auditory processing disorder, identifying a cutoff value to use in clinical settings. Methods A prospective study, with a total sample of 30 children aged 7 to 14 years, half with normal auditory processing assessment (Control Group) and the other half with auditory processing disorder (Study Group). Both groups were submitted to anamnesis and evaluated using the otoacoustic emissions tests evoked by transient stimuli in the absence and presence of contralateral noise, basic audiological evaluation and auditory processing. Results The study group presented a lower occurrence of the inhibitory effect of the efferent pathway when compared to the control group (p value=0.038). The mean values ​​obtained for the control group were 0.71 in the right ear and 0.87 in the left ear and for the study group, 0.55 in the right ear and 0.41 in the left ear. The two groups showed a statistically significant difference for the left ear. Conclusion There was a reduction in the inhibitory effect of the efferent pathway in children and adolescents with auditory processing disorder, suggesting a functional change in the medial olivocochlear efferent system. In this study, the cutoff value of 0.55 dB separated children with and without alteration of the efferent system with 70% sensitivity and 66.7% specificity.

Registro de emisiones otoacústicas transientes basado en microcontroladores de alto rendimiento / Transient Otoacoustic Emissions Register based on High Performance Microcontrollers

La hipoacusia tiene una incidencia notable entre los recién nacidos. Una intervención temprana durante el período de maduración auditiva permite minimizar los efectos en el desarrollo intelectual del infante. Se propone el desarrollo de un Registrador de Emisiones Otoacústicas Transientes como parte de un sistema de cribado neonatal basado en microcontroladores de alto rendimiento. La prueba consiste en aplicar periódicamente un estímulo tipo chasquido para obtener la respuesta coclear. Se promedian las señales adquiridas y se aplica la Transformada Rápida de Fourier. El espectro obtenido es dividido en bandas de media octava para analizar la correlación y la relación señal-ruido. Si estos parámetros son mayores que los umbrales de referencia en la mayoría de las bandas, se considera al paciente apto para el desarrollo normal. El firmware fue implementado sobre el procesador STM32F405 y evaluado con el simulador Baby Isao; obteniéndose una sensibilidad del 87.5 por ciento y una especificidad del 93.75 por ciento(AU)

Hearing loss is highly incident among newborns. Early intervention during the period of auditory maturation allows adequate levels of intellectual development to be achieved. The development of a Transient Otoacoustic Emissions Recorder is proposed as part of a neonatal screening system based on high-performance microcontrollers. The test consists of periodically applying a click stimulus to obtain the cochlear response. The acquired signals are averaged and the Fast Fourier Transform is applied. The spectrum obtained is divided into half-octave bands to assess the correlation as well as the signal-noise ratio. If these parameters are greater than the reference thresholds in most of the bands, the patient is considered suitable for normal cognitive development. The firmware was implemented on the STM32F405 processor and evaluated with the Baby Isao simulator; obtaining a sensitivity of 87.5 percent and a specificity of 93.75 percent(AU)