Early repolarisation among athletes.

OBJECTIVES: Traditionally, early repolarisation (ER) is considered a benign ECG variant, predominantly found in youths and athletes. However, a limited number of studies have reported an association between ER and the incidental occurrence of ventricular fibrillation or sudden cardiac death. Yet definite, direct comparisons of the incidence of ER in unselected, contemporary populations in athletes as compared with non-athletes and across different sports are lacking. This study therefore aimed to investigate whether ER is more common among athletes as compared with non-athletes, and if ER patterns differ between sport disciplines based on static and dynamic intensity. METHODS: To assess ER we retrospectively analysed ECGs of 2241 adult subjects (2090 athletes, 151 non-athletes), who had a sports medical screening between 2010 and 2014 in an outpatient clinic. The outcome was tested for confounders in a multivariable logistic regression analysis. RESULTS: ER was found in 502 athletes (24%). We found a 50% higher prevalence of ER in the athlete group compared with the control group (OR 1.5 (SE 0.34), adjusted 95% CI 1.0 to 2.4) in multivariable analysis. A 30% higher prevalence of ER in the inferior leads only (OR 1.3 (SE 0.38), adjusted 95% CI 0.74 to 2.3), a 120% higher prevalence of ER in the lateral leads only (OR 2.2 (SE 1.0), adjusted 95% CI 0.87 to 5.4), and a 20% higher prevalence of ER in the inferior and lateral leads (OR 1.2 (SE 0.49), adjusted 95% CI 0.55 to 2.7) was found in athletes. CONCLUSION: Athletes had a 50% higher prevalence of ER and a 30% higher prevalence of ER in the inferior leads specifically. There was no association between training duration or sports discipline and ER.

Effect of maximum power output and noise reduction on speech recognition in noise.

BACKGROUND: The maximum power output (MPO) of a hearing aid was typically discussed in the context of avoiding loudness discomfort. However, an MPO that is too low, as in the cases to avoid discomfort for people with a severe loudness tolerance problem and hearing losses that exceed the fitting range of the hearing aids, could negatively affect sound quality and speech intelligibility in noise. PURPOSE: The current study was designed to demonstrate the degradation in speech intelligibility in noise on the HINT (Hearing in Noise Test) when the MPO of the wearers' hearing aids was lowered by 10 dB from the default. The interactions with noise reduction (NR) algorithms (classic [NR-classic] and Speech Enhancer [NR-SE]) were also examined. RESEARCH DESIGN: A single-blinded, factorial repeated-measures design was used to study the effect of noise input level (68 dBC, 75 dBC), MPO setting (default and default-10), and NR algorithm (off, classic, SE) on HINT performance. STUDY SAMPLE: Eleven adults with a severe sensorineural hearing loss participated. INTERVENTION: Participants were fit with the Widex m4-19 behind-the-ear hearing aids binaurally in the default frequency response and MPO settings. The hearing aids were adjusted to six MPO (default, default-10) by NR (off, classic, SE conditions). Testing was completed within one 2 hr session. DATA COLLECTION AND ANALYSIS: The RTS (reception threshold for speech) for 50% correct on the HINT was measured in each of the six hearing aid conditions at two input levels (68 and 75 dBC) with speech and noise stimuli presented from the front. Repeated-measures ANOVAs were conducted using SPSS software to examine significant differences. RESULTS: A repeated-measures ANOVA showed that noise level was not significant while NR algorithm and MPO were significant. The interaction between noise level and NR algorithm was also significant. Post hoc analysis with Bonferroni adjustment for the effect of NR algorithm showed that performance with NR-off was significantly poorer than performance with NR-classic and NR-SE (p < 0.05). However, NR-classic and NR-SE were not significantly different from each other (p > 0.05). CONCLUSIONS: An MPO that was 10 dB lower than the default could negatively affect the signal-to-noise ratio (SNR) of the listening environment. However, NR could compensate for the degradation in SNR.

Development of the ORCA nonsense syllable test.

OBJECTIVES: Many new processing features in hearing aids have their primary effects on information located in the high frequencies. Speech perception tests that are optimized for evaluating high-frequency processing are needed to adequately study its effects on speech identification. The goal of the current research was to develop a medium for evaluating the effects of high-frequency processing in hearing aids. DESIGN: A list of 115 consonant-vowel-consonant-vowel-consonant nonsense syllables with American English consonants in all word positions was created in an open-set phoneme identification format. The source material was spoken by a male and a female speaker. A custom computer program was developed for administration of the test and automatic analysis of the test results. Nine normal-hearing listeners were employed in the collection of the normative data. The test was presented to the listeners in quiet (at 68 dB SPL), in noise at five signal-to-noise ratios (SNRs; -10, -5, 0, 5, and 10), and in a low-pass filter condition with cutoff frequencies at 500, 1000, 1500, 2000, and 4000 Hz. The data were examined to evaluate the psychometric properties of the test for different phoneme positions and phoneme classes. In addition, a shortened version of the test was developed based on the data from normal-hearing listeners. The test-retest reliability was verified at 0 dB SNR. The full and shortened versions of the test were repeated in 10 hearing-impaired listeners at their most comfortable listening level in quiet and in noise at various SNRs. RESULTS: The availability of high-frequency output was verified with acoustic analysis. The performance intensity functions for both versions of the test (i.e., male and female speakers) showed expected monotonic growth with SNR and cutoff frequencies. High reliability was seen between test and retest identification scores in normal-hearing and hearing-impaired listeners. CONCLUSIONS: The current nonsense syllable test provided a reliable and efficient means for phoneme identification testing.

Subjective and objective evaluation of noise management algorithms.

PURPOSE: To measure the subjective and objective improvement of speech intelligibility in noise offered by a commercial hearing aid that uses a fully adaptive directional microphone and a noise reduction algorithm that optimizes the Speech Intelligibility Index (SII). RESEARCH DESIGN: Comparison of results on the Hearing in Noise Test (HINT) and the Acceptable Noise Level task (ANL). STUDY SAMPLE: Eighteen participants with varying configurations of sensorineural hearing loss. RESULTS: Both the directional microphone and the noise reduction algorithm improved the speech-in-noise performance of the participants. The benefits reported were higher for the directional microphone than the noise reduction algorithm. A moderate correlation was noted between the benefits measured on the HINT and the ANL for the directional microphone condition, the noise reduction condition, and the directional microphone plus noise reduction conditions. CONCLUSIONS: These results suggest that the directional microphone and the SII-based noise reduction algorithm may improve the SNR of the listening environments, and both the HINT and the ANL may be used to study their benefits.