A Heterogeneous Sample of a Spanish Tinnitus Cohort.

Taking into account heterogeneity has been highly recommended in tinnitus studies both to disentangle all diverse factors that can contribute to their complexity and to design personalized treatments. To this aim, a heterogeneous sample of 270 tinnitus subjects is analyzed considering the gender (male/female), hearing condition (hearing-impaired/normal-hearing), and tinnitus severity (compensated/decompensated) subgroups. Two categorical variables (tinnitus laterality and tinnitus sound type) and four quantitative variables (average auditory threshold, age of tinnitus onset, tinnitus frequency, and tinnitus severity) are used. The percentages (for categorical variables) and mean values (for quantitative variables) of the whole sample are compared with these of each subgroup. Furthermore, correlational and hypothesis testing is applied to calculate the correlation coefficients and statistical significance, respectively. The results show that the male and female subgroups contrast in the sound type and frequency of their tinnitus, hearing-impaired and normal-hearing individuals differ, in addition, in their average auditory threshold, and the compensated/decompensated tinnitus subgroup provides significantly distinct values in tinnitus laterality and tinnitus sound.

Special Issue "New Insights into Pathophysiology, Diagnosis and Treatment of Tinnitus".

We are honoured to have been involved with Brain Sciences in the production of the Special Issue "New Insights into Pathophysiology; Diagnosis and Treatment of Tinnitus" aiming to address recent advances in the field of tinnitus [...].

Efficacy of Sound Therapy for Tinnitus Using an Enriched Acoustic Environment with Hearing-Loss Matched Broadband Noise.

BACKGROUND: Tinnitus is a rather heterogeneous chronic condition/disorder which is difficult to treat. Some tinnitus treatments combine sound therapy with counselling. The main goal of this study is to report the efficacy of a customized sound therapy combined with counselling on a cohort of 83 tinnitus patients. METHODS: 119 tinnitus subjects, recruited between January 2018 and June 2021, were subjected to a treatment consisting of a combination of an initial counselling session and four-month sound therapy. The sound stimulus was a personalized broadband noise colored by the audiometry of the subjects. These stimuli were given to the patients in mp3 format to be heard 1 h per day over 4 months. The tinnitus severity of the patients was evaluated monthly through the validated Spanish version of the Tinnitus Handicap Inventory. RESULTS: Of the patients, 30% (36 of 119) withdrew from the treatment before finishing, and 96% (80 of 83) of the subjects completing the therapy attained some relief after 4 months. The overall average THI decrease of these 80 participants was 23. However, when the THI was analyzed by severity scales, it was found that patients with initial mild, moderate, severe and catastrophic handicap had an average THI decrease of 14, 20, 31 and 42 points, respectively. Thus, the average THI decrease depended on the baseline severity scale of patients. CONCLUSIONS: Consequently, the proposed treatment was demonstrated to be effective in providing clinically relevant relief in tinnitus distress patients in just 4 months.

Comparison of Tinnitus Handicap Inventory and Tinnitus Functional Index as Treatment Outcomes.

BACKGROUND: Tinnitus is an audiological disorder for which there are no objective measuring tools. Thus, many self-report questionnaires have been proposed to assess its severity. These questionnaires have been judged for their capacity to assess the tinnitus severity at baseline, their sensitivity to treatment-related changes (responsiveness), and their resolution. METHODS: The most widely used questionnaires for clinical and research studies are the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI). While both questionnaires have been recognized as good evaluators of the baseline tinnitus severity, the latter is considered to be more responsive to changes following treatments. OBJECTIVES: The aim of this work is to provide a preliminary comparison of the performance of both questionnaires in the initial and final tinnitus severity assessment of a cohort of patients undergoing a four-month Enriched Acoustic Environment (EAE) therapy. RESULTS: The EAE therapy provided a 30 and 26 point reduction in THI and TFI, respectively. A good correlation is obtained between the THI and TFI questionnaires at baseline and after the treatment. CONCLUSION: At baseline, the THI provided a higher score than the TFI for a higher degree of tinnitus but a lower score for lower tinnitus severity. Both THI and TFI were good questionnaires for baseline assessment and for treatment-related changes. The THI provided a slightly higher score drop than the TFI following the treatment, although the TFI had better resolution.

Audiometric Characteristics and Tinnitus Features in a Cohort of 170 Spanish Patients.

BACKGROUND: Tinnitus is a rather prevalent, quite heterogeneous, and difficult to treat auditory disorder. The aim of this article is to provide the design and results of a cross-sectional study related to audiological and tinnitus features in a group of 170 Spanish patients. METHODS: Audiometric characteristics were assessed on the basis of the pure-tone audiometry of both ears in 170 tinnitus patients and 85 control subjects. The audiometric status of each tinnitus participant was assessed on the basis of the average auditory threshold (AAT) in the whole frequency range (from 125 Hz to 8 kHz), and low (from 125 Hz to 2 kHz) and high (from 3 kHz to 8 kHz)-frequency intervals. Tinnitus features were evaluated through personal interview with patients and included tinnitus duration, laterality, pitch, sound, and distress (Tinnitus Handicap Inventory, THI). Correlational analysis was carried out between audiological (AAT) and tinnitus (THI) variables. RESULTS: A very weak Spearman rank correlation factor is found between both variables. CONCLUSIONS: The subjective outcome of tinnitus distress (THI) was not correlated with the objective measure of hearing loss (AAT) in our cohort.

Broadband Sound Equalized by The Hearing Loss Curves as an Improved Stimulus for Tinnitus Retraining Therapy-A Pilot, Non-Controlled Observational Study.

OBJECTIVES: This study aimed to assess if a short tinnitus treatment, combining counseling with broadband noise filtered by the hearing loss curves, provided significant relief in tinnitus patients. MATERIALS AND METHODS: 25 tinnitus subjects of heterogeneous etiology were subjected to sound therapy, 1 hour per day, for 4 months. All of them underwent a unique initial counseling session aimed at undoing previous negative perceptions of tinnitus and highlighting the real expectations from tinnitus therapies. Customized stereo sound stimuli were designed by filtering broadband noise using the hearing loss curves of each ear. A monthly follow-up was carried out by assessing the severity of tinnitus through a validated Spanish version of the Tinnitus Handicap Inventory (THI). RESULTS: 88% (22 of 25) of the patients completing the treatment obtained significant relief after 4 months. After 4 months of treatment, the average decrease in THI from its initial value for the 22 successful participants was 29. CONCLUSION: The average THI score reduction after 4 months of treatment can be considered to be an excellent improvement when compared with other similar studies. The proposed customized sound therapy was effective in reducing tinnitus in patients of heterogeneous etiology.

Effect of Olive-Pine Bottom Ash on Properties of Geopolymers Based on Metakaolin.

In this research, the feasibility of using bottom ashes generated by the combustion of biomass (olive pruning and pine pruning) as a source of aluminosilicates (OPBA) has been studied, replacing the metakaolin precursor (MK) in different proportions (0, 25, 50, 75, and 100 wt.% substitution) for the synthesis of geopolymers. As alkaline activator an 8 M NaOH solution and a Na2SiO3 have been used. The geopolymers were cured 24 h in a climatic chamber at 60 °C in a water-saturated atmosphere, subsequently demoulded and cured at room temperature for 28 days. The results indicated that the incorporation of OPBA waste, which have 19.7 wt.% of Ca, modifies the characteristics of the products formed after alkaline activation. In general terms, the incorporation of increasing amounts of calcium-rich ashes results in geopolymers with higher bulk density. The compressive strength increases with the addition of up to 50 wt.% of OPBA with respect to the control geopolymers, contributing the composition of the residue to the acquisition of better mechanical behavior. The results indicate the potential use of these OPBA waste as raw material to produce unconventional cements with 28-day curing strengths greater than 10 MPa, and thermal conductivities less than 0.35 W/mK.

Assessing Auditory Processing Deficits in Tinnitus and Hearing Impaired Patients with the Auditory Behavior Questionnaire.

Background and Purpose: Auditory processing disorders (APD), tinnitus and hearing loss (HL) are typical issues reported by patients in audiologic clinics. These auditory impairments can be concomitant or mutually excluding. APD are not necessarily accompanied by significant HL, whereas many adults exhibit peripheral HL and typical cognitive deficits often associated with APD. Since HL, tinnitus and APD affects to several parts of the ascending auditory pathway from the periphery to the auditory cortex, there could be some interrelationship between them. For instance, tinnitus has been reported to degrade the auditory localization capacity. Tinnitus is believed to be triggered by deafferentation of normal peripheral input to the central auditory system. This peripheral deficit can be accompanied by HL or not, since a type of permanent cochlear damage (thus deafferentation) without an elevation of hearing thresholds might persist. Therefore, a combined study of APD, tinnitus and HL on the same cohort of patients can be audiologically relevant and worthy. Methods: Statistical analysis is applied to a cohort of 305 patients attending an audiology clinic in Madrid (Spain). This group of patients is first categorized in four subgroups, namely, HLTG (with tinnitus and HL), NHLTG (with tinnitus and without HL), HLNTG (with HL but no tinnitus), and NHLNTG (neither tinnitus nor HL). The statistical variables include Age, Average Auditory Threshold (ATT), for assessing HL, Tinnitus Handicap Inventory (THI), for measuring tinnitus, and a new 25-item Auditory Behavior Questionnaire (ABQ), for scoring APD. Factor analysis is applied to arrange these items into 4 subscales. The internal consistency reliability of this ABQ is confirmed by calculating Cronbach's coefficients α. The test-retest reliability is assessed by the intraclass correlation coefficients, ICC. Statistical techniques applied to the data set include descriptive analysis of variables and Spearman rank correlations (ρ) between them. Results: Overall reliability of ABQ is confirmed by an α value of 0.89 and by an ICC of 0.91. Regarding the internal consistency reliability, the four subscales prove a fairly good consistency with α coefficients above 0.7. Average values of statistical variables show significantly lower age of patients with tinnitus and no HL, which can provide a cue of noise overexposure of this segment of population. These younger patients show also decreased ABQ and similar THI in comparison with patients in the other subgroups. A strong correlation (ρ = 0.63) was found between AAT and Age for the HLNTG subgroup. For the HLTG subgroup, a moderate correlation (ρ = 0.44) was found between ABQ and THI. Conclusion: The utilized questionnaire (ABQ), together with AAT and THI, can help to study comorbid hearing impairments in patients regularly attending an audiological clinic.

Corrigendum to: Swept-sine noise-induced damage as a hearing loss model for preclinical assays.

[This corrects the article on p. 7 in vol. 7, PMID: 25762930.].

Swept-sine noise-induced damage as a hearing loss model for preclinical assays.

Mouse models are key tools for studying cochlear alterations in noise-induced hearing loss (NIHL) and for evaluating new therapies. Stimuli used to induce deafness in mice are usually white and octave band noises that include very low frequencies, considering the large mouse auditory range. We designed different sound stimuli, enriched in frequencies up to 20 kHz ("violet" noises) to examine their impact on hearing thresholds and cochlear cytoarchitecture after short exposure. In addition, we developed a cytocochleogram to quantitatively assess the ensuing structural degeneration and its functional correlation. Finally, we used this mouse model and cochleogram procedure to evaluate the potential therapeutic effect of transforming growth factor ß1 (TGF-ß1) inhibitors P17 and P144 on NIHL. CBA mice were exposed to violet swept-sine noise (VS) with different frequency ranges (2-20 or 9-13 kHz) and levels (105 or 120 dB SPL) for 30 min. Mice were evaluated by auditory brainstem response (ABR) and otoacoustic emission tests prior to and 2, 14 and 28 days after noise exposure. Cochlear pathology was assessed with gross histology; hair cell number was estimated by a stereological counting method. Our results indicate that functional and morphological changes induced by VS depend on the sound level and frequency composition. Partial hearing recovery followed the exposure to 105 dB SPL, whereas permanent cochlear damage resulted from the exposure to 120 dB SPL. Exposure to 9-13 kHz noise caused an auditory threshold shift (TS) in those frequencies that correlated with hair cell loss in the corresponding areas of the cochlea that were spotted on the cytocochleogram. In summary, we present mouse models of NIHL, which depending on the sound properties of the noise, cause different degrees of cochlear damage, and could therefore be used to study molecules which are potential players in hearing loss protection and repair.

Uso tradicional de la ruda como planta medicinal en el canton Vicotz, del municipio de Nebaj, departamento del Quiché / Traditional use of rue as a medicinal plant in Vicotz canton, municipality of Nebaj, department of Quiché

El presente trabajo se llevó a cabo con la finalidad de identificar los principales beneficios de la ruda como planta medicinal en la salud de los habitantes del cantón Vicotz del municipio de Nebaj, así como su uso, sus propiedades medicinales, su preparación para las dolencias de diferentes enfermedades que aquejan en la vida de las personas en dicha comunidad. Basándose en conocimientos y experiencias vividas por la propia comunidad, al igual las personas curanderas han aportado su conocimiento ancestral sobre el uso de las plantas medicinales como la ruda que es muy conocida en el cantón Vicotz y muy efectiva al momento de usarla para el tratamiento de enfermedades comunes. Durante la realización de la investigación se tomaron en cuenta los pasos y técnicas a seguir durante el proceso de investigación hasta el final en donde se entregará el informe a las autoridades del Centro Universitario de Quiché, como también haciendo la entrega de una guía pedagógica al centro Educativo ubicado en dicho cantón la cual es útil para los docentes a que puedan guiarse a implementar el manejo de las plantas medicinales y que los alumnos tengan la noción sobre el uso de la ruda, sus propiedades y advertencias sobre su uso inadecuado o mala preparación de la dosis.

Acoustic properties of plates with unevenly distributed macroperforations backed by woven meshes.

A hybrid model describing the acoustic properties of plates with macroperforations that can be unevenly distributed on the plate surface and backed by woven or precision woven meshes with microscopic perforations is proposed. The plate perforations may be of circular or rectangular shapes. Since the perforated plate may not necessarily be considered as an equivalent fluid, its impedance is calculated by the Maa model [Noise Control Eng. J. 29, 77-84 (1987)], whereas the Johnson-Champoux-Allard model [J. Appl. Phys. 70, 1975-1979 (1991)] is used for the mesh, considered as an equivalent fluid. A simple model for the elementary cell of the mesh structure is proposed in order to calculate parameters that can be considered as the thermal characteristic length Λ' and the viscous characteristic length Λ. An effective airflow resistivity is introduced to account for the increase of particle velocity through the mesh placed behind the carrying macroperforated plate and is used in the transfer matrix approach to obtain the impedance of the whole multilayer system. The hybrid model seems to represent a good approach of this multilayer system. The theoretical predictions are compared with experimental measurements.

Measuring hybrid passive-active sound absorption of a microperforated liner at oblique incidence.

The performance of hybrid passive-active absorbers at normal incidence has been previously demonstrated. However, their feasibility in realistic environments remains to be confirmed. This paper proposes a hybrid passive-active liner absorbing at oblique incidence. The passive absorber is a 2.44x2.44x1 mm(3) microperforated panel backed by a 5 cm deep air layer and a rigid ending. An active multichannel cell, composed of five single-input single-output controllers, releases the sound pressure at the entrance of the air cavity in a reduced area of the microperforated panel absorber. Hybrid passive/active absorption of the prototype is measured in an anechoic room up to a maximum incidence angle of 21 degrees . For instance, at 20 degrees such a system is able to provide an average absorption of 94% between 266 and 1500 Hz. In addition, the performance that would provide such a hybrid absorber in a reverberant room has been quantified theoretically by an index describing the active-to-passive reverberation time ratio in terms of the active-to-passive absorption area and absorption coefficient ratios. The proposed prototype, implementing 7% of the active proportion area, would afford a reverberation time reduction between 77.5% and 12% from 100 to 500 Hz.

Hybrid passive-active absorption of a microperforated panel in free field conditions.

Although hybrid passive-active absorption in impedance tubes has been widely analyzed, its study in more realistic conditions remains to be accomplished. This letter describes the practical measurement of the passive-active absorption coefficient in a free field. The passive absorber consists of a microperforated panel backed by an air cavity and a wooden panel. A multichannel active system controls the sound pressure in a reduced cell behind the absorber. Measured absorption coefficients between 200 and 400 Hz account for 0.2-0.4 and 0.72-0.75, in the passive and active cases, respectively, and above 500 Hz both are comparable.

Low-frequency absorption using a two-layer system with active control of input impedance.

Broadband noise absorption, including low frequencies, may be obtained by a hybrid passive-active two-layer system. A porous layer in front of an air layer provides passive absorption, at medium and high frequencies. Active control of the input impedance of the two-layer system yields absorption at low frequencies. The active control system can implement either pressure-release or impedance-matching conditions. A simple analytical model based upon plane waves propagating in a tube permits the comparison of both control strategies. The results of this simple model show that the pressure-release condition affords higher absorption than the impedance-matching condition for some combinations of geometrical and material parameters. Experimental results corroborate the good performance of the pressure-release condition under the prescribed geometrical setup.