Toward a better understanding of nonoccupational sound exposures and associated health impacts: Methods of the Apple Hearing Study.

Globally, noise exposure from occupational and nonoccupational sources is common, and, as a result, noise-induced hearing loss affects tens of millions of people. Occupational noise exposures have been studied and regulated for decades, but nonoccupational sound exposures are not well understood. The nationwide Apple Hearing Study, launched using the Apple research app in November 2019 (Apple Inc., Cupertino, CA), is characterizing the levels at which participants listen to headphone audio content, as well as their listening habits. This paper describes the methods of the study, which collects data from several types of hearing tests and uses the Apple Watch noise app to measure environmental sound levels and cardiovascular metrics. Participants, all of whom have consented to participate and share their data, have already contributed nearly 300 × 106 h of sound measurements and 200 000 hearing assessments. The preliminary results indicate that environmental sound levels have been higher, on average, than headphone audio, about 10% of the participants have a diagnosed hearing loss, and nearly 20% of the participants have hearing difficulty. The study's analyses will promote understanding of the overall exposures to sound and associated impacts on hearing and cardiovascular health. This study also demonstrates the feasibility of collecting clinically relevant exposure and health data outside of traditional research settings.

Correction to: The Weibull Fréchet distribution and its applications.

Afify et al. [The Weibull Fréchet distribution and its applications, J. Appl. Stat., 43 (2016), pp. 2608-2626] defined and studied a new four-parameter lifetime model called the Weibull Fréchet distribution. They made some mistakes in presenting the log-likelihood function and the components of score vector. In this note, we will correct them.

Ranking Factors Affecting the Attraction of Foreign Medical Tourists in Hospitals Affiliated to Mashhad University of Medical Sciences Based on Marketing Mix Model.

BACKGROUND: This study was designed to rank factors affecting attraction of foreign medical tourists based on marketing mix model. METHODS: In this descriptive study, data were collected through a questionnaire. Foreign patients, hospitalized from Jan 2015 to Sep 2016 in all hospitals of Mashhad were chosen as the study population (13 hospitals). Data analysis was conducted using Friedman test and Wilcoxon test in SPSS 21 at a significance level of 0. 05. RESULTS: Factors of staff, service and process gained the highest score from the perspective of patients; while price, facilities and promotion scored the lowest among parameters affecting the attraction of medical tourists to hospitals of Mashhad. In this context, factors of staff (96%) and price (66%) had the highest and lowest effect on absorption of tourists, respectively. CONCLUSION: To promote medical tourism, important factors such as staff, service, and process should be further stressed and variables of price, facilities and promotion demand for a revision by the authorities in this industry.

Comparison balance and footprint parameters in normal and overweight children.

BACKGROUND: The present study was done in order to compare balance and footprint parameters in two groups of normal and overweight children. METHODS: This semi-experimental study included randomly selected 22 male children (11 normal and 11 overweight boys). To measure the footprint parameters, an ink paper system was used, i.e., after putting their feet in the ink, the subjects were asked to stand comfortably on paper and their footprints were recorded. Then, with the use of ImageJ software, the areas of anterior, middle, and posterior parts, the total area, and the arch index parameter were calculated. For measuring balance in three posterolateral, posteromedial, and anterior directions as well as the total balance, Y-balance test was done. Finally, to analyze the data, mean and standard deviation were calculated and ANOVA test was used to compare the parameters. RESULTS: Data analysis showed a significant difference between normal and overweight subjects in the anterior and posterior areas, whereas, in balance test, only the anterior areas showed significant difference (P < 0.05). CONCLUSIONS: It seems that area parameters in these two groups do not have significant difference; hence, it cannot be used as the criteria for analyzing the effects of being overweight on these parameters. In addition, it is probable that, in a dynamic situation, recorded footprints are more valid parameters for analyzing foot structure.

Inhibition of intraocular fibrin formation after infusion of low-molecular-weight heparin during combined phacoemulsification-trabeculectomy surgery.

PURPOSE: To evaluate the effect of intraocular infusion of dalteparin, a low-molecular-weight heparin (LMWH) administered in the infusion fluid to prevent early postoperative fibrin formation in combined phacoemulsification-trabeculectomy surgery (phacotrabeculectomy). SETTING: Farabi Eye Hospital, Tehran, Iran. METHODS: Standard combined phacotrabeculectomy was performed prospectively in a masked fashion in 60 eyes; 35 eyes received 5 IU/mL LMWH in the infusate and 25 eyes served as controls. Masked postoperative examinations assessed visual acuity, intraocular pressure (IOP), anterior chamber cell and flare, and fibrin formation with slitlamp examinations 1, 3, 7, 30, and 90 days after surgery. RESULTS: The rate of intraocular fibrin/membrane formation was significantly lower in the LMWH group than in the control group at each follow-up (P<.001, Student t test) . The amount of IOP was lower in LMWH group at each follow up (P<.01, Student t test). Final visual acuity was better in LMWH group (P = .03, Student t test). The frequency of synechia formation was lower in the LMWH group on day 90 (P = .002, chi-square test). CONCLUSIONS: Infusion of dalteparin, a LMWH, may be an effective inhibitor of postoperative fibrin formation in phacotrabeculectomy surgery. It may reduce the frequency of synechia formation and improve visual acuity. It may not be associated with increased risk for intraoperative or postoperative complications at the tested dose. This drug may be a useful adjunct in combined surgery.