Outcomes of Hearing Aid Use by Individuals with Unilateral Sensorineural Hearing Loss (USNHL).

BACKGROUND: Unilateral sensorineural hearing loss (USNHL) can have a negative impact on functions associated with the advantages of balanced, binaural hearing. Although single-sided deafness, which is a complete loss of audibility in one ear, has gained increased interest in the published research, there is a gap in the literature concerning hearing aid outcomes for individuals with residual, or otherwise "aidable," hearing in the affected ear. PURPOSE: To assess hearing aid outcomes for a group of individuals with USNHL with residual, aidable function. RESEARCH DESIGN: A quasi-experimental study of hearing aid outcomes with paired comparisons made between unaided and aided test conditions. STUDY SAMPLE: A convenience sample of twenty-two individuals with USNHL, with sufficient residual hearing in the affected ear as to receive audibility from use of a hearing aid, were recruited into the study from September 2011 to August 2012. INTERVENTION: Each participant was fit with a digital behind-the-ear hearing aid coupled to a custom ear mold. DATA COLLECTION AND ANALYSIS: Assessments were performed at baseline (unaided) and after a three-month field trial (aided) with primary outcomes involving objective measures in sound field yielding signal-to-noise ratio loss (SNR Loss) via the Quick Speech-in-Noise Test and word recognition scores (WRS) via the Northwestern University Auditory Test, No. 6. Outcomes also involved the administration of two well-established subjective benefit questionnaires: The Abbreviated Profile of Hearing Aid Benefit (APHAB) and the 49-item Speech, Spatial, and Qualities of Hearing Scale (SSQ49). RESULTS: As a group, participants showed significantly improved median SNR Loss thresholds when aided in a test condition that included spatial separation of speech and noise, with speech stimuli directed toward the worse ear and noise stimuli directed toward the better ear (diff. = -4.5; p < 0.001). Hearing aid use had a small, though statistically significant, negative impact on median SNR Loss thresholds, when speech and noise stimuli originated from the same 0° azimuth (diff. = 1.0; p = 0.018). This was also evidenced by the median WRS in sound field (diff. = -6.0; p = 0.006), which was lowered from 98% in the unaided state to 92% in the aided state. Results from the SSQ49 showed statistically significant improvement on all subsection means when participants were aided (p < 0.05), whereas results from the APHAB were generally found to be unremarkable between unaided and aided conditions as benefit was essentially equal to the 50th percentile of the normative data. At the close of the study, it was observed that only slightly more than half of all participants chose to continue use of a hearing aid after their participation. CONCLUSIONS: We observed that hearing aid use by individuals with USNHL can improve the SNR Loss associated with the interference of background noise, especially in situations when there is spatial separation of the stimuli and speech is directed toward the affected ear. In addition, hearing aid use by these individuals can provide subjective benefit, as evidenced by the APHAB and SSQ49 subjective benefit questionnaires.

Sustained Release of Demineralized Bone Matrix Protein in Osteoporotic Rats.

Demineralized bone matrix protein (DBM) was considered highly effective in stimulating bone healing. The objective of the study was to explore the use of tricalcium phosphate (TCP) delivery system to continuously deliver DBM in an osteoporotic condition and to evaluate changes in bone density and preservation of the spine. Ovariectomized Sprague Dawley rats were divided into three equal groups (n=16 per group). Animals in group I served as control, animals in groups II and III were surgically implanted with either empty (SHAM) or DBM filled TCP implants adjacent to L4/L5. Eight animals from each group were euthanized at 2 and 8 weeks post implantation. Femurs were evaluated for changes in density, and the lumbar spine was evaluated for changes in the endplate. Results of this study revealed (1) TCP implants were capable of delivering DBM for long duration, (2) use of sustained delivery of DBM did not induce untoward effects in the vital organs or in the uterus, fallopian tubes, or vaginal tissues, (3) DBM had no effect on chondrocyte differentiation in the spine, and (4) DBM did not increase bone density in osteoporotic female rats.

U.S. Dental students' and faculty members' attitudes about technology, instructional strategies, student diversity, and school duration: a comparative study.

In this study, attitudes and perceptions of U.S. dental students and faculty members were evaluated regarding four aspects of dental education: technology integration, instructional strategies, student diversity, and school duration. A survey instrument with eight statements using a five-point Likert scale and a free-text comment section was developed and distributed through Survey Monkey. A total of 426 students and 187 faculty members from ten U.S. dental schools participated, a response rate of 17 percent of those surveyed. Faculty and student responses were compared using the Mann-Whitney U test. The results of this analytic procedure revealed that the groups differed in their average responses for seven of the eight statements. Analysis of the faculty and student comments revealed similar themes between the two groups. Both dental students and dental faculty members stated that technology integration should be viewed as only a supplement to conventional instruction and showed mixed opinions about electronic textbooks. Further, both groups had positive views of the roles of problem-based learning, community service, and the integration of research practice into dental education. Both groups also valued diversity in the student body and supported the current four-year duration of dental school.

Effects of polystyrene particle density on type II pneumocytes.

Studies into the effects of ultrafine particles on the lung have shown adverse outcomes and are do in part to the particle size. Inhalation of small particles is associated with exacerbation of respiratory diseases in epidemiological studies. Ultrafine particles have been hypothesized to play an important role, but it is unclear as to whether a dose response type of relationship exists. The aim of the present study was to investigate the role of ultrafine particle number on lung cells and to describe the effects due to phagocytosis of particles by the cells. A549 cells are a transformed cell line similar to type II lung pneumocytes. A549 cells seeded at a density of 5 x 10(4) cells were treated with 1000, 5000, and 10,000 polystyrene particles and incubated at 37 degrees C for periods of 24, 48, and 72 hours. Cell number, protein, and MDA levels were determined on the treated cells and compared with untreated controls. The lung cells were also observed microscopically to assess cell damage. Lung cells exposed for 24 hours with 1,000 and 5,000 particles showed the greatest increase in cell number. Cellular protein levels were similar for all groups (p > 0.05) for the duration of the study. MDA levels for treated groups at 24 and 72 hours were not statistically different from the control groups. Cells treated at 48 hours with 5,000 and 10,000 particles showed slight increases in the MDA levels above low particle number and control treated groups. Morphological evaluation of the cells revealed increased inclusions with increasing dose. The results from this study indicate the ability of A549 cells to respond to a challenge with ultrafine particles. The concentrations tested caused an initial stimulation cell proliferation at 24 hours followed by increased damage at 48 hours. Future studies will focus on the inflammatory products formed by ingestion of the ultrafine particles.

Differential effects of cortisol on MRC-5 fibroblasts and hypertrophic LL-29 fibroblasts.

Cortisol is a glucocorticoid secreted by the adrenal cortex that helps facilitate the body's response to stress and regulates the immune system. Glucocorticoid receptors can be found on most cell types and as a consequence, cortisol hormone plays an essential role on the body's physiologic systems. Cortisol has been shown to elicit differing responses from normal fibroblasts in comparison to hypertrophic fibroblasts. The purpose of this experiment was to analyze the differential effects of cortisol on normal MRC-5 fetal lung fibroblasts and hypertrophic LL-29 lung fibroblasts from a patient with idiopathic pulmonary fibrosis. The objectives of the experiment are to obtain and culture normal and hypertrophic lung fibroblasts, to challenge cells with subphysiological, physiological, and supraphysiological doses of cortisol (0.01 microg/dL, 0.2 microg/dL, 1 microg/dL) for 24, 48, and 72 hour incubation periods and to analyze cellular activity using the methods of cell count, protein assay, MDA, and morphological evaluation. Data collected from this study demonstrated variable response to cortisol by both cell lines. Striking results revealed that in LL-29 cells, supraphysiological dose of cortisol stimulated cell growth only in the 24-hour incubation period without showing any changes in number of micronucleoli or structural damage. In contrast, MRC-5 cells showed increased growth at a later stage (48 hours) with a dose specific increase with significantly increased micronucleoli numbers. In conclusion, the two cell lines differ in their response to cortisol concentration in a dose and time dependent manner. Cortisol concentrations did not induce structural damage throughout the experiment. These observations could help significantly in minimizing the traumatic side effects induced through stress conditions by employing intervention modalities to regulate systemic cortisol.

Possible role of ependymal proliferation in improving experimental allergic encephalomyelitis in Lewis rats.

Experimental autoimmune encephalomyelitis (EAE) animal models is an autoimmune demyelinating disease of the central nervous system, which is widely accepted as an animal for human multiple sclerosis (MS). Ependymal cells line the spinal canal and cerebral ventricles and proliferate in response to damage. These cells have the potential to differentiate into neural support cells. However, there is controversy as whether the response of the ependymal cells is a result of injury or repair. This study demonstrates using the rat EAE model a proliferative response of the ependymal cells occurred as a result of the disease. Interestingly, a more pronounced ependymal proliferative effect was seen in animals being fed a phase 2 enzyme inducer. The data suggests ependymal cells play a role in the post-inflammatory response of the brain and also may be involved in the remyelination process.

Evaluation of bioflavonoids as potential chemotherapeutic agents.

Bioflavonoids are compounds that are natural plant antioxidants. Antioxidants have been shown to prevent damage caused by free radicals to DNA and other molecules. Bioflavonoids have demonstrated several cancer preventive properties. In addition to antioxidant activity, these compounds may reduce abnormal cell growth and inflammation; help the body get rid of cancer-causing agents; and restore communication between different cells in the body. The objective of this study is to compare nontoxic phenols as cancer chemotherapeutic, agents and to apply these agents in treating human cancers. In this study the effects of a single dose of 10 microM Green Tea Extract (EGCG), 5 microM Tannic Acid (TA), or 5 microM Thymoquinone (TQ) on Hep-2 cells were determined. Compounds were evaluated in their effectiveness to reduce cell number. The cells were also evaluated for membrane damage, and alterations in cellular morphology after 24, 48, and 72 hours in culture. The results showed a 50% reduction in Hep-2 cell numbers after 24 hours in TQ treated cells. After 48 hours, the cells treated with TQ and TA exhibited a four-fold decrease in total cell number compared to the control and EGCG treated cells. Cell numbers were similar in all treatment groups by 72 hours. At 48 hours the only significant increase in cell damage was seen in cells treated with EGCG. The results indicated that naturally occurring bioflavonoids given in a bolus dose could alter cellular viability. It appears the drug is either utilized by the cells or chemically degraded in the media leading to increased cell numbers back toward control values with time in culture. In order for the compounds to be effective chemotherapeutic agents, the data also suggests a need for continuous administration over bolus dosing.

Identifying barriers to the adoption of new technology in rural hospitals: a case report.

The purpose of this study is to identify barriers to the adoption of new technology in rural settings. Specifically, this paper focuses on identifying and overcoming barriers to the adoption of a medication error reporting system in eight rural hospitals. Prior research has generally focused on barriers to the adoption of new technology in urban areas, medical centers, or large hospitals. The literature has identified six primary barriers to the adoption of new technology: cost, legality, time, fear, usefulness, and complexity. Although our research recognizes these same barriers, the means through which these barriers may be mitigated are different in rural settings. Our research identified three additional barriers to the adoption of new technology that may be specific to rural areas: personnel, physical space, and Internet access. Our outcome variable, in order to demonstrate our success, is the number of reported medication errors.

The effects of sustained delivery of glucocorticoids on the adrenal gland of male rats.

The role of stress on the structural and functional capacity of multiple organs has not been well investigated. The objective of this investigation was to morphometrically evaluate the effect of sustained delivery of corticosteroids alone or in combination with selenomethionine (SE), by tricalcium phosphate (TCP) ceramic capsule, on the adrenals of adult male rats. Nine adult male rats were randomly divided into three equal groups. Control animals were not implanted, and thus served as the control group. Group I was implanted with TCP capsules loaded with 50-mg cortisol. Group II animals were also implanted with TCP capsules loaded with both 50-mg cortisol and selenomethionine, respectively. Surgical aseptic techniques performed following standard lab protocols. At the end of the experimental phase, the animals were euthanized and the adrenal glands were collected and weights were recorded. The retrieved adrenals were fixed, processed, embedded and sectioned (5 microns) following standard laboratory procedure. The sections were subjected to qualitative and quantitative evaluation using Image Pro Digital Analysis System. Data collected expressed in mean +/- SE and analyzed for statistical significance using analysis of variance. The results indicated that Group II animals had a significant increase in body weight compared to the control group. There was a slight increase in wet adrenal weights observed in the Group II animals compared to the control animals. Histopathological evaluation of the adrenal gland revealed a decreased in the zona fasciculata lengths in Group I, a slightly decrease in Group II, compared to the control group.