bluuebunny/crossref_metadata_2025 huggingface dataset:
A Study on the Notion of Freedom in Tourism
Authors:   The Tourism Sciences Society Of Korea, Park Chang-Hwan , Kim Soo-Yong , Lee Hoon
Published: May 2021

Freedom is an important concept in tourism, as it distinguishes tourism activities from other activities. Freedom is a prerequisite for tourism and an important factor influencing tourism motivation, tourism experience, and tourism outcomes. However, despite the change in the liberal paradigm and the diversified demand of tourists, freedom in tourism does not reflect this trend. Hitherto based on the classical philosophy of freedom, the concept of freedom in tourism only explains individual choice opportunities. Under the consciousness of this problem, first, the context and discussion of the concept of freedom are reviewed to examine the limitations of the concept of freedom in tourism literature. This paper proposes the expanded concept of freedom in the field of tourism, named tourism freedom. Tourism freedom consists of tourist-level psychological freedom, behavioral freedom, and communal freedom formed through tourism activities. This includes an understanding of community freedom within the scope of tourism, beyond individual and subjective benefits. In addition, freedom at the tourism-based level can be understood as internal resources of tourists necessary to realize freedom in tourism, external resources as a tourism environment, and institutional resources that promote them smoothly. Consequently, it is emphasized that freedom in tourism is a comprehensive examination of the aspects of tourist-level and tourism-based level, leading the issues related to tourism freedom to public rather than to individuals.
Наука. Технологии. Инновации: 2019
Authors: Городникова Наталья , Гохберг Леонид , Дитковский Кирилл , Дьяченко Екатерина , Коцемир Максим , Кузнецова Ирина , Лукинова Евгения , Мартынова Светлана , Нефедова Алёна , Ратай Татьяна , Росовецкая Лариса , Сагиева Галина , Стрельцова Екатерина , Суслов Антон , Тарасенко Ирина , Фридлянова Светлана , Фурсов Константин , Варзановцева Ирина
Published: May 2021

Краткий статистический сборник содержит основные показатели, характеризующие научный и инновационный потенциал Российской Федерации. Приводятся сведения об интеллектуальной собственности, результативности исследований и разработок, данные международных сопоставлений. В сборнике использованы материалы Росстата, Минобрнауки России, Роспатента, ОЭСР, Евростата, ЮНЕСКО, ВОИС, национальных статистических служб зарубежных стран, а также разработки Института статистических исследований и экономики знаний Национального исследовательского университета «Высшая школа экономики». Отдельные данные по итогам 2017 г. носят предварительный характер.
Наука. Технологии. Инновации: 2020
Authors: Гохберг Леонид , Дитковский Кирилл , Евневич Евгения , Коцемир Максим , Кузнецова Ирина , Мартынова Светлана , Полякова Валентина , Ратай Татьяна , Росовецкая Лариса , Сагиева Галина , Стрельцова Екатерина , Суслов Антон , Тарасенко Ирина , Фридлянова Светлана , Фурсов Константин , Варзановцева Ирина
Published: May 2021

Краткий статистический сборник содержит основные показатели, характеризующие научный и инновационный потенциал Российской Федерации. Приводятся сведения о результативности исследований и разработок, данные международных сопоставлений. В сборнике использованы материалы Росстата, Минобрнауки России, Роспатента, ОЭСР, Евростата, ЮНЕСКО, ВОИС, национальных статистических служб зарубежных стран, а также разработки Института статистических исследований и экономики знаний Национального исследовательского университета «Высшая школа экономики». Отдельные данные по итогам 2018 г. носят предварительный характер.
POSTLINGUAL SENSORINEURAL HEARING LOSS
DUE TO A VERY RARE COCH PATHOGENIC
VARIANT
Authors: Ozieblo Dominika , Tacikowska Grazyna , Skarzynski Henryk , Oldak Monika
Published: May 2021

Background

The COCH gene encoding cochlin is highly expressed in the inner ear but the exact physiological function of the protein still
remains unknown. Pathogenic variants located in COCH cause autosomal dominant hearing loss with possible vestibular involvement.

Material and Methods

A five-generation Polish family with autosomal dominant hearing loss and tinnitus was recruited for the study. Audiological and vestibular assessments were conducted and clinical exome sequencing was performed in the index patient. Next, co-segregation of the detected variant with hearing loss in the family was confirmed using Sanger sequencing

Results

All affected individuals presented postlingual, progressive hearing loss mainly affecting high frequencies. No vestibular dysfunction
was detected. In this study, we have identified a very rare COCH p.Ile374Thr pathogenic variant that segregated with the disease.

Conclusions

Our study provides an independent confirmation of the pathogenic role of COCH c.1115T>C in hearing loss. In addition to
hearing loss, individuals with COCH pathogenic variants may also suffer from tinnitus and vertigo.
EVALUATION OF THE FREQUENCY
FOLLOWING RESPONSE IN ITALIAN CHILDREN:
A PILOT STUDY
Authors: Sanfins Milaine , Hatzopoulos Stavros , Hein Thais , Bordin Tatiana , Skarzynski Piotr , Colella-Santos Maria
Published: May 2021

Background

Speech-ABR is an electrophysiological procedure that makes it possible to monitor the processing of auditory information in the
subcortical region, easily and quickly, applicable even to very young subjects. So far there are no data in the literature describing the standards of normality of FFR in Italian children and adolescents. So the objective of the study was to assess the FFR in Italian children and adolescents with normal hearing.

Methods

Twenty-four children and young adolescents, 12 female and 12 male, participated in the study. Their age ranged from 9 to 14 years (average 11.8 years). All subjects were Italian native speakers, right handed and with normal hearing. All subjects had normal behavioral and electrophysiological hearing thresholds. The speech-ABR recordings were acquired by a Biologic Navigator Pro (Natus, USA) with BioMark software.

Results

The analysis for absolute latency of speech sounds (specifically for the syllable /da/) gave: latency (ms) (male/female) wave V (6.57/6.41),
wave A (7.49/7.54), wave C (18.34/18.57), wave D (22.07/22.22), wave E (30.74/30.50), wave F (39.12/39.19), and wave O (48.06/47.88). For
amplitude (µV), the responses were: (male/female) wave V (0.10/0.11), wave A (0.21/0.22), wave C (0.11/0.11), wave D (0.12/0.13), wave E
(0.19/0.24), wave F (0.22/0.21), and wave O (0.18/0.09). Complex VA: Slope (male/female), 0.33/0.30; Area (male/female), 0.28/0.37.

Conclusions

We found different FFR profiles in the 24 children to those reported in the literature in adult subjects.
A FAST, “ZERO SYNAPSE” ACOUSTIC REFLEX:
MIDDLE EAR MUSCLES PHYSICALLY SENSE
EARDRUM VIBRATION
Authors: Bell Andrew
Published: May 2021

The middle ear muscles may be inconspicuous, but they are special. Silently standing guard at the entrance to the inner ear, their role is to
spring into action whenever sound input rises, protecting the highly sensitive cochlea from overload. Such a task requires the utmost speed,
for sounds can reach damaging levels within milliseconds. Neural-mediated mechanisms are slow, with the acoustic reflex arc taking up to a
hundred milliseconds or more. Here, evidence is assembled that the middle ear muscles have recruited an additional, faster mechanism. The
proposal is made that these muscles have developed a preflex mechanism – a zero-synapse system inherent to muscle fibres which, in response
to vibration, rapidly stiffens the muscles. Preflexes are a developed form of sensitivity to perturbation common to all muscles, and have recently been identified in leg muscles, for example. However, the advantages that preflexes confer to an animal’s auditory system have not yet been
recognized. Applied to the middle ear muscles, heightened sensitivity to vibration means that any loud sound entering the middle ear causes the muscles to immediately stiffen, providing instant, on-the-spot overload protection. The muscles are therefore self-reflexive – they are
both sensors and actuators. It is shown here how the middle ear muscles appear to have the special anatomical and physiological properties required for preflex action. There are strong resemblances to the superfast muscles of bats, birds, and fish, and to the fast flight muscles of insects.
USE OF THE VIBRANT SOUNDBRIDGE MIDDLE
EAR IMPLANT WITH SHORT PROCESS INCUS
COUPLER FOR CHRONIC OBSTRUCTIVE
INFLAMMATION OF THE EXTERNAL EAR CANAL:
CASE STUDY
Authors: Skarzynski Piotr , Osinska Kamila , Krol Bartłomiej , Wawszczyk Sandra , Matusiak Monika , Ratuszniak Anna , Skarzynski Henryk
Published: May 2021

Objective

Chronic obstructive inflammation of the external ear canal after different kinds of surgeries often leads to restenosis. There are
different approaches to treatment of such cases, and one solution is a middle ear implant. Here we analyze the efficacy of using the Vibrant
Soundbridge middle ear implant with a new incus short process (SP) coupler in this type of case.

Material and Methods

We present a case study of a 29-year old patient with bilateral mixed hearing loss caused by bilateral obstructive inflammation of the external ear canals. He had undergone meatoplasty with very short-lived improvement. Afterwards he qualified for middle ear implantation to restore hearing, and the Vibrant Soundbridge was implanted with a new SP coupler to which the floating mass transducer (FMT)
is attached. Postoperative hearing tests included pure tone audiometry, free field audiometry, speech recognition, and APHAB questionnaire.

Results

Speech recognition after implantation improved to 100%. Pre- and postoperative bone conduction thresholds were unchanged. Vibrometry thresholds 10 months after surgery did not deteriorate. There was a decrease in global APHAB score by 61% from 2 to 10 months
after implantation.

Conclusions

Application of the Vibrant Soundbridge middle ear implant can be an effective treatment in cases of hearing loss caused by obstructive inflammation of the external ear canals. The new incus SP coupler seems to be an effective method of stimulating the middle ear
in mixed hearing loss.
OSSICULOPLASTY IN HEARING LOSS
TREATMENT OF PATIENTS WITH OSTEOGENESIS
IMPERFECTA
Authors: Osinska Kamila , Skarzynski Henryk , Skarzynski Piotr
Published: May 2021

Osteogenesis imperfecta is a connective tissue disease manifested by abnormalities within organs and structures rich in collagen. Typically, symptoms arise from the osteoarticular system. Excessive brittleness of the bones causes multiple fractures. Among patients with hearing loss, osteogenesis imperfecta manifests as changes to the stapes: the legs are broken and the footplate is immobilized and thickened. Changes to the malleus and
incus are rarely reported. This location is associated with difficult conditions during surgery, difficult access to the ossicles. This research presents
the characteristics and hearing results of patients who have undergone ossiculoplasty as a treatment of hearing loss in osteogenesis imperfecta.
Two case reports present massively altered conditions within the middle ear in patients with type III osteogenesis imperfecta – the most severe among live births, who have undergone multiple surgeries due to hearing loss, resulting in a moderate improvement in hearing.
ACADEMIC ACHIEVEMENT OF POLISH
CHILDREN WITH COCHLEAR IMPLANTS
AT THE END OF THEIR PRIMARY EDUCATION
Authors: Zgoda Malgorzata , Lorens Artur , Obrycka Anita , Skarzynski Henryk
Published: May 2021

Background

Pediatric cochlear implant programs have been running in clinics around the world for more than 30 years. Application of a cochlear
implant gives a deaf child the possibility of acquiring communication skills as good as those of their hearing peers. Reports of the school performance
of deaf students who use cochlear implants are scarce. Reliable information is constrained by the difficulty of obtaining results from large groups of
students with cochlear implants and of standardised tools to assess their academic abilities. The aim of this study was to evaluate the scores on a primary school competency test from children using cochlear implants and to compare them with scores from their typical hearing peers from Poland.

Materials and Methods

The study group comprised 160 children with prelingual hearing loss. The measures for evaluating school achievements were the results of a standardised test at the end of primary school. Twenty one percent of the CI children did the standard version
of the test (without any adjustments to the needs of students with a hearing loss), while the other 79% did an adjusted version of the test.

Results

In general, the mean scores achieved by the CI children who did the standard version of the school test were slightly better than the mean
results of the typical hearing group sitting the same test. The differences of means in favor of CI children were 3.4 points in overall score (which
had a maximum of 40 points), and 0.3, 1.3, 0.7, 0.7, and 0.6 respectively on the subscales of reading, writing, reasoning, using information, and
practical application of knowledge. However, on an adjusted version of the test, the mean scores obtained by the CI children were somewhat lower
than the mean scores for all the children doing the same test (2 points in overall score, and 1.1, 0.5, 0.4, 0.02, and 0.2 on each respective subscale).

The 21% of CI children who did the standard version of the school test (without any adjustments) had results which were on a par
with those of children with normal hearing. The 79% who did the adjusted version of the test had results which were comparable to those of
hard-of-hearing children.
SPEECH DIFFICULTIES AND POOR SPEECH INTELLIGIBILITY IN ADULTS WITH DOWN SYNDROME: A REVIEW OF THE LITERATURE
Authors: Coppens-Hofman Marjolein , Maassen Ben , van Schrojenstein Lantman-de Valk Henny , Snik Ad
Published: May 2021

Background

This review gives an overview of studies on speech difficulties in adults with Down syndrome to identify causes and major determinants of poor speech intelligibility for this group and to suggest areas requiring further research.

Material and Methods

Exactly 39 published articles were selected by using the following MEsH search terms: speech disorders, articulatory apraxia, phonological impairment, articulation disorders, short-term memory, speech articulation disorders, and speech intelligibility. Articles were grouped for analysis based on themes related to underlying causes of speech difficulties and the diagnosis and treatment of speech difficulties. Future research needs are also presented.

Results

Speech problems in adults with Down syndrome are not clearly defined. There is no specific data on underlying mechanisms that negatively impact on speech and there is no systematic assessment procedure available for evaluating the speech of adults with Down syndrome. Few studies have investigated treatment possibilities for speech disorders in adults and future research is needed into speech difficulties in adults with Down syndrome.

Conclusions

Research is required into therapeutic programs to improve the speech of adults with Down syndrome. One clinical consideration as to why this research is lacking might be that the speech problem is seen as a characteristic of the Down syndrome itself rather than being seen as the result of distinct underlying deficits that may be sensitive to speech therapy. To aid therapeutic program development, longitudinalstudies of adolescents and adults with Down syndrome are required. Special attention could be given to investigating oral-motor characteristics and apraxia of speech.
FUNCTIONAL MAGNETIC RESONANCE IMAGING OF
AUDITORY CORTEX IN PARTIAL DEAFNESS TREATMENT
Authors: Skarzynski Henryk , Wolak Tomasz , Pluta Agnieszka , Lewandowska Monika , Rusiniak Mateusz , Lorens Artur , Sliwa Lech , Skarzynski Piotr , Olszewski Lukasz
Published: May 2021

Background

Recently, there has been a surge of interest in neuroimaging techniques that might help to objectively evaluate
the residual hearing abilities of patients with hearing abilities of patients considered for partial deafness treatment (PDT). Such
an evaluation might allow a wider range of PD candidates to benefit from cochlear implantation (CI). Although existing studies suggest that functional magnetic resonance (fMRI) may help predict the benefits of CI for hearing-impaired patients, little is known about the activity of the primary auditory cortex in patients with partial deafness. This study is the first to apply
fMRI to examine BOLD signal changes in the auditory cortex induced by chirp stimulation in patients with partial deafness

Material and Method

Ten patients considered for partial deafness treatment with electro-acoustic stimulation (PDT-EAS)
and 10 patients considered for electrical complement treatment (PDT-EC) according to Skarżyński’s categorization of partial
deafness treatment (PDT) participated in the study. fMRI measurements were performed in a 3T Siemens Magnetom Trio
scanner at the Bioimaging Research Center (BRC) of the Institute of Physiology and Pathology of Hearing in Kajetany, Poland.
During the fMRI study, subjects were presented with a chirp of two different bandwidths: 50–950 Hz (middle frequency 500 Hz)
and 3000–5000 Hz (middle frequency 4000 Hz) at 90 dB(C) via MRI-compatible earphones. A sparse paradigm was used and
the data was analyzed using the SPM8 package (Statistical Parametric Mapping, http://www.fil.ion.ucl.ac.uk/spm/). Standard
preprocessing was followed by a second-level analysis for contrast of low and high frequencies.

Results

As expected, bilateral activation in the auditory cortex was observed in response to stimulation by 500 Hz chirps in
PDT-EAS and PDT-EC candidates. Activation in response to 4000 Hz chirps were found only in the PDT-EAS group but less
strongly than for 500 Hz chirps.

Conclusions

fMRI can be used as an objective way of assessing residual hearing in the auditory cortex of patients with partial deafness.
THE TELEFITTING METHOD USED IN THE NATIONAL
NETWORK OF TELEAUDIOLOGY: ASSESSMENT OF QUALITY
AND COST EFFECTIVENESS
Authors: Wasowski Arkadiusz , Skarzynski Henryk , Lorens Artur , Obrycka Anita , Walkowiak Adam , Walkowiak Adam , Skarzynski Piotr , Wlodarczyk Andrzej , Bruski Lukasz
Published: May 2021

Background

To obtain the best hearing benefits after cochlear implantation, the speech processor must be optimally fitted.
The majority of patients have to undertake a long trip to the cochlear implant (CI) clinic, and this incurs high cost, time, and
travel weariness. To overcome this problem, ‘telefitting’ has been proposed. The aim of this paper is to present the results of a
large-scale introduction of telefitting into clinical practice.

Material and Methods

Material of this study consisted of 94 cochlear implant users scheduled for telefitting between March
and May 2011 in one of 8 centers selected for this study. For cost assessment a group of 195 patients was surveyed. Each patient underwent a teleconsultation procedure. After telefitting the patient was presented with a questionnaire consisting of questions relating to the quality and time effectiveness of telefitting and the preparation process, assessment of the ease
of contact with the audiologist, the sense of security and calm during the session, and an overall assessment of its usefulness
as an alternative to different kinds of standard visits.

Results and Conclusions

The Nationwide Network of Teleaudiology proved to be a reliable platform for telefitting. The method and a proposed model of postoperative care for implanted patients using telemedicine seems to be a reliable alternative to
standard model. It improves the quality of service provided to patients and saves substantial time and money
GAIN AND MAXIMUM OUTPUT OF IMPLANTABLE HEARING DEVICES IN PATIENTS WITH MODERATE TO SEVERE SENSORINEURAL HEARING LOSS
Authors: Zwartenkot Joost , Snik Ad , Kompis Martin , Stieger Christof
Published: May 2021

Background

To determine the dynamic range and the maximum output of three current middle ear implants and to discuss optimal candidacy for middle ear implantation.

Study Design

Clinical study

Material and Methods

Gain and output measurements were compared for three types of middle ear implants: the Otologics middle ear transducer (MET), the Vibrant Soundbridge (VSB), and the Direct Acoustic Cochlear Stimulator (DACS). The performance of these selected implants in users with severe, predominantly sensorineural, hearing loss (50–65 dB HL) was studied. Patients with chronic external otitis and sensorineural hearing loss used either a MET (n=9) or a VSB (n=9) implant. Patients with a predominantly sensorineural hearing loss after surgically treated otosclerosis used a DACS (n=4). Patients were selected from two different implant teams but evaluated with the same protocol. The relative gain at threshold level was determined, viz. the bone-conduction threshold minus the aided soundfield threshold, divided by the bone-conduction threshold. Input–output measurements were performed with the devices in linear amplification mode and with unlimited output. In this latter data set, the maximum output and the input dynamic range of the devices were determined.

Results

The relative gain for each of the three implants was comparable; however, the values were slightly lower than the generally accepted target values. The input dynamic range of the devices varied, with the widest range for the DACS and Otologics devices.

Conclusion

The results from this study indicate that the first generation DACS device is a good option for patients with moderate/severe sensorineural hearing loss and surgically treated otosclerosis who require a hearing implant.
AUDITORY BEHAVIOURAL AND ELECTROPHYSIOLOGICAL RESPONSES IN ADULTS: EVALUATING CENTRAL AUDITORY PROCESSING
Authors: Raumane Diana , Kise Ligija , Logina Inara
Published: May 2021

Background

In addition to well known declines in the peripheral auditory system successful perception of speech is dependent on behavioural factors, as well as sound processing at subcortical and cortical levels. We hypothesized that cause and hence localization of impairment in the brain may be diverse in young and elderly people with hearing impairment, accordingly not always related with aging. The aim of the study is to determine the hallmarks of auditory behaviour and auditory cortical evoked responses that could be used in audiology clinics to help explain deficits in speech recognition in young and elderly listeners and recognize the most indicative effects of cortical auditory evoked potentials associated with difficulties of speech intelligibility.

Material and Methods

Three groups of adults participated: young normal hearing, young and elderly subjects with difficulty to understand speech especially in complex listening environments despite normal pure tone thresholds. We supposed that differences could be found between young and elderly subjects. Procedure involved behavioural hearing tests, dichotic word tests and sentence recognition test in quiet and noise, and electrophysiological measures as cortical auditory evoked potential components P1, N1, P2, P3 in quiet and noise.

Results

Significant correlation was found between hearing behavioural tests and auditory cortical evoked potentials. This dichotic study demonstrated differences in cortical processing in people with good hearing, young and elderly listeners with speech recognition difficulties. Results provide information about central tests showing significant decrease of perception in young and elderly participants with hearing impairment and it is most strongly associated with event related potential response P3. Sensitivity to signal intensity level significantly changes in the group of young and elderly subjects with hearing impairment for responses P1, N1, P2(p<0.5).

Conclusions

Despite of resembling results from behaviour tests outcomes of auditory evoked potentials mark less influence of signal intensity level latencies in young then in older subject group. They could be useful in audiology practice for clinical diagnostics and evaluation of hearing rehabilitation.
UTILITY OF VESTIBULAR EVOKED MYOGENIC POTENTIALS
IN THE DIAGNOSIS OF MENIERE’S DISEASE: A REVIEW
Authors: Saravanan P. , Sinha Sujeet
Published: May 2021

Meniere’s disease is an inner ear disorder characterized by aural fullness, spontaneous attacks of vertigo, fluctuating low-frequency sensorineural hearing loss and tinnitus. There are various tests such as puretone audiometry, electrocochleography,
glycerol test, Caloric test, Cochlear hydrops analysis masking which have been utilised in diagnosing the Meniere’s disease. Recently cervical vestibular evoked myogenic potentials and ocular vestibular myogenic potentials have been utilised to measure
the functioning of the sacculocollic and otolith ocular pathway respectively. The objective of the present study is to provide an
overview of the cervical and ocular vestibular evoked myogenic potentials tests findings in individuals with Meniere’s disease.
MANAGED ESTIMATION OF PSYCHOPHYSICAL THRESHOLDS
Authors: Vaerenberg Bart , Heeren Willemijn , Govaerts Paul
Published: May 2021

Objective

The estimation of perceptive thresholds is a basic element of psychoacoustics. One of the drawbacks of commonly used adaptive algorithms is the lack of reliability when the behavioral response is not robust. To address this issue an adaptive algorithm, TEMA (Threshold Estimation by Managed Algorithm), has been developed.

Design

TEMA seeks the 50% point on the psychometric curve based on an up-down staircase procedure. Internal controls
and stochastic processes aim at enhancing the reliability. The development of TEMA is described, together with its validations
with reference to common adaptive procedures. Both Monte Carlo simulations and real subject testing were performed to assess the psychoacoustic threshold in intonation perception tests and the number of stimulus presentations needed.

Study sample

A total of 29 adult listeners participated in the within-subjects comparison; 19 listeners had normal-hearing,
the other 10 were hearing impaired (5 aided, 5 unaided).

Results

The results show that TEMA outperformed commonly used algorithms in non-robust responders, with a minimal
cost in terms of test duration.

Conclusions

TEMA’s adaptive algorithm was shown to be significantly more resistant to gambling or cheating behavior and
threshold drift than traditional, reversal-based algorithms. TEMA increases the accuracy of threshold estimation and the test
reliability in non-robust responders. This makes TEMA applicable for automated threshold measurements in clinical settings.
TEMPORAL PROCESSING IN MUSICIANS
AND NON-MUSICIANS
Authors: Kumar Priyanka , Rana Baljeet , Krishna Rajalakshmi
Published: May 2021

Background

Temporal processing abilities are important for speech perception, and they are generally superior in musicians
than in non-musicians. Since there are many different training methods used to develop musical expertise (e.g. vocal or instrumental), these differences could lead to varying temporal processing abilities of acoustic signals. The current study aims
to see if there are any differences in temporal processing abilities between violinists and vocalists.

Material and Methods

Four different psychoacoustic tests – gap detection threshold (GDT), duration discrimination test
(DDT), duration pattern test (DPT), and the modulation detection threshold for sinusoidally amplitude-modulated noise
(SAM) at six different modulation frequencies – were used to assess differences in temporal processing abilities between 15
trained violinists and 15 trained vocalists. The results were compared with a group of 15 non-musicians.

Results

Musicians, both violinists and vocalists, always performed significantly better (p<0.01) than non-musicians in all 4
psychoacoustic tests. Vocalists performed equal to or slightly better than violinists in GDT and at 5/6 modulation frequencies
in modulation detection threshold for SAM noise test, although the differences were not statistically significant.

Conclusions

Although vocalists and instrumentalists undergo different forms of training in terms of the sound they produce and the sound qualities they need to perceive, the training does not lead to any major difference in their temporal processing abilities of acoustic signals.
THE EFFECT OF TINNITUS AND PRESBYCUSIS ON
CONTRALATERAL SUPPRESSION OF OTOACOUSTIC
EMISSIONS
Authors: Komis Agis , Maragkoudakis Pavlos , Gkoritsa Eleni , Kandiloros Dimitrios , Korres Stavros , Ferekidis Eleftherios , Nikolopoulos Thomas
Published: May 2021

Background

The medial olivocochlear system (MOCS), part of the efferent auditory pathway, causes an inhibitory effect on
the outer hair cells, thus protecting them against extreme noise exposure and improving speech discrimination in noisy environments. This study aims to assess the MOCS function and aging in tinnitus patients with the use of contralateral suppression (CS) of otoacoustic emissions (OAEs).

Material and Methods

136 subjects took part in this study, divided in 6 groups (control group, right-side tinnitus, left-side
tinnitus, bilateral tinnitus, presbycusis without tinnitus and presbycusis with tinnitus). CS of transiently- evoked (TEOAEs)
and distortion products OAEs (DPOAEs) was measured for each group and pair- wise comparisons between the groups were
performed.

Results

CS was less frequent and the mean values of CS were significantly lower in the tinnitus ears than normal ones. The
mean values of CS of ears with presbycusis were in some cases higher than ears with presbycusis and tinnitus and also than
ears with tinnitus and normal hearing. Not particular statistical differences were found between the method used (TEOAEs
or DPOAEs) and the comparisons between the groups.

Conclusions

The absence and lower values of CS in tinnitus ears imply a MOCS dysfunction as a main factor of tinnitus generation. Tinnitus seems to have a more detrimental effect to the MOCS function than presbycusis. CS of TEOAEs and DPOAEs
are equally sensitive methods in detecting MOCS dysfunction in patients with tinnitus.
BALANCE PROBLEMS IN DOWN SYNDROME CHILDREN: VARIOUS SENSORY ELEMENTS AND CONTRIBUTION TO MIDDLE EAR PROBLEMS
Authors: El Shennawy Amira
Published: May 2021

Background

Down syndrome (DS) is one of the commonest causes of developmental delay in children, with equilibrium problems being an integral part of the syndrome. This leads to further impairment of cognitive and concentration abilities.

Material and Methods

In our study, 30 DS children were categorized into 3 groups: bilateral normal middle ear pressure, bilateral abnormal middle ear pressure, and unilateral abnormal middle ear pressure. Sensory components of balance (somatosensory, visual, and vestibular) were assessed using computerized dynamic posturography

Results

Results showed a statistically significant decrease in composite score, visual ratio, and vestibular ratio among DS children compared to normal children. No significant differences in sensory parameters between the various DS groups (with various tympanogram types) were encountered.

Conclusions

This might lead one to suspect central and proprioceptive causes behind balance problems in DS, but further extended studies are needed to confirm this. Bedside screening tests for visual and vestibular functioning of balance are recommended, e.g. past pointing and Fukuda for early detection and intervention.
DEVELOPMENT OF PHONEMICALLY BALANCED WORD LISTS
FOR ADULTS IN THE KANNADA LANGUAGE
Authors: Manjula Puttabasappa , Antony Jawahar , Kumar Keelara , Geetha Chinnaraj
Published: May 2021

Background

Standard word lists are required to assess an individual’s level of speech understanding. The material should comprise a number of lists and has to be in the listener’s native language. The aim of the present study was to develop and standardize a set of phonemically balanced word lists for adults in the Kannada language.

Material and Methods

Exactly 1200 bisyllabic Kannada words were collected from various sources and evaluated for familiarity. The words that were familiar (820 of them) were assessed for equivalency at –3 dB signal-to-noise ratio (SNR) to make
sure that the words in the lists were of equal difficulty. Equivalency across the word lists were assessed, in quiet at four sensation levels, on 65 participants with normal hearing. Equivalency was also assessed on 100 participants with normal hearing in noise at –3 dB SNR.

Results

The assessment of word equivalency revealed that 769 words had a score of around 50% identification at –3 dB SNR.
These words were then used to construct 25 test lists each containing 25 words. Except for List 5, all other word lists were
equivalent in quiet. The performance intensity function for phonemically balanced words in quiet was derived at 4 SLs for all
the other 24 lists. Assessment of list equivalency in noise revealed that Lists 1, 4, 5, and 12 were significantly different from
the other lists. After removing these four lists, the mean word recognition score was 46.04% (raw score) at –3 dB SNR in 100
individuals with normal hearing sensitivity.

Conclusions

The standardized 24 word lists in quiet and 21 word lists in noise can be used for adults in routine speech identification testing, assessment of hearing aid benefits, and for research that requires multiple word lists.
HEARING LOSS AND VERY LOW BIRTHWEIGHT
Authors: Barreiro Silvia , Gonzalez Juan , Acosta Angel , Macias Angel
Published: May 2021

Background

Regardless of gestational age, any newborn (NB) with a weight at birth of <1500 g is considered to be of very
low birth weight (VLBW). The incidence of hearing loss in this population group is 5–6% but the frequency of moderate or
severe hearing loss in children of VLBW is 2%.

Material and Methods

Retrospective study of 364 NBs with birth weight <1500 g. Two levels of TEOAE screening were conducted, followed by an ABR test if the initial testing was inconclusive. The SPSS statistical software package, version 20.0 for
Windows, was used for statistical processing of data. Fisher’s Exact Test was used to study possible associations among categorical variables

Results

From 1 January 2007 to 31 December 2010, a total of 26,708 subjects were included in the hearing screening program.
Out of these, 364 were NBs of VLBW. Out of 112 NBs with VLBW, 76 (67.8%) had an ABR test done. Of these, 22 showed
signs of hearing loss. Eight of them (36.4%) were diagnosed with sensorioneural hearing loss (SNHL), and out of these, 2 infants had bilateral profound SNHL. The risk factor for hearing loss most frequently associated with VLBW was the use of ototoxic medications.

Conclusions

Hearing loss diagnosis among VLBW NBs is higher than the percentage in the general population. All subjects diagnosed with hearing loss were very premature infants and had one or two other auditory risk factors associated
with their VLBW.
APPLICATION OF THE IQIPP-AH STUDENT GUIDE
IN AUDIOLOGY CLINICAL EDUCATION
Authors: Driscoll Carlie , Sowden Hayley , Boundy Kate
Published: May 2021

Background

Using reflection tools benefits the ongoing development of clinicians. However, there is a paucity of instruments
appropriate for reflection in audiology clinical education, despite the availability of such tools in other disciplines. This paper describes a tool – Improving Quality in Practice Placements - Allied Health (iQIPP-AH) Student Guide – for promoting
self-reflection.

Material and Methods

A prospective, cohort study in Master of Audiology Studies students (n=23). The tool was applied as
an assessment task within a clinical placement course, followed by descriptive analysis of quantitative responses and thematic treatment of qualitative responses.

Results

Less than 75% of the cohort reported completing tasks associated with: (i) pre-reading in preparation for clinical
placement; (ii) participation in team activities during placement; and (iii) provision of feedback to practice educators and universities post-placement. Major qualitative themes included lack of established learning goals, willingness to seek educator
feedback, willingness to network and engage with other staff, desire to strive for independence, need for resumé writing, improvement in clinical skills, and the intention to continue with reflection and proactivity. Up to 52% of students intended to
take further action in relation to the tool’s Quality Indicators.

Conclusions

The iQIPP-AH Student Guide has the potential to be a useful reflective tool for students in audiology
A REVIEW OF CONTEMPORARY TELE-AUDIOLOGY
LITERATURE
Authors: Krumm Mark
Published: May 2021

Tele-audiology has grown considerably since Swanepoel and Hall’s literature review in 2010. Numerous new works on telehealth have appeared in areas of diagnosis, pediatric audiology, rehabilitation, cochlear implants, screening, web portals, and
hearing aids. Asynchronous solutions are now more common for screening and diagnostic purposes. In addition, self-assessment and m-health systems are available which offer accessible and valid paradigms. In general, tele-audiology appears to be
an increasingly useful method for providing hearing healthcare access to consumers anytime and anywhere.
IPSILATERAL SUPPRESSION OF TRANSIENT EVOKED
OTOACOUSTIC EMISSIONS IN ADULTS
Authors: Kei Joseph , Fullerton Amanda , Smith Beatrice , Henderson Lisa , Collins Alison , Smith Joanna , Wilson Wayne
Published: May 2021

Background

Measurement of the medial olivocochlear (MOC) reflex provides useful clinical information for understanding
the function of the auditory system. Although transient evoked otoacoustic emission (TEOAE) suppression has been demonstrated to be an indicator of MOC activity, its full role and fine details of TEOAE suppression spectra are still not clear. The
aim of this study was to investigate details of ipsilateral suppression of TEOAEs in normally hearing adults.

Material and Methods

Exactly 29 adults (13 males, 16 females, mean age 26.5 years, range 18–42 years), who passed a battery of tests including otoscopy, pure tone audiometry, immittance, and TEOAE tests, participated in the study. Suppression
was evaluated by comparing TEOAEs obtained with and without an ipsilateral suppressor in a forward-masking paradigm.

Results

In general, suppression was small – less than 1.4 dB at all frequencies studied. The spectrum of mean TEOAE suppression showed suppression was greatest between 586 and 3711 Hz (0.6–1.4 dB) but less than 0.6 dB between 3906 and 4883 Hz.
Mean suppression increased with post-stimulus time from 0.1 dB in the 2–4 ms time window to a maximum of 2.26 dB in
the 16–18 ms window; the mean suppression between 8 and 18 ms after noise stimulation was 1.32 dB (range=0.22–3.23 dB).
There were no significant gender or ear-laterality effects. Noise levels as measured in the ear canal were found to have a significant effect on calculated suppression at some frequencies.

Conclusions

The present study provides evidence of small ipsilateral TEOAE suppression by forward-masking noise in normally hearing adults. However, care is needed in interpreting the findings as noise in the ear canal can be a confounding factor during measurement of TEOAE suppression.
CAVERNOUS HEMANGIOMA OF THE EARDRUM
AND EXTERNAL AUDITORY CANAL: CASE PRESENTATION
AND REVIEW OF LITERATURE
Authors: Dimitriou Anastasia , Chrysovergis Aristeidis , Giannopoulos Dimitrios , Bibas Athanasios
Published: May 2021

Background

An external auditory canal cavernous hemangioma, with or without involvement of the eardrum and middle
ear (ME), is rare; only 23 cases have been described so far.

Case report

We present a patient with cavernous hemangioma of the external auditory canal, which extended to the tympanic cavity and presented with intermittent episodes of bleeding. Total excision was curative with no recurrence at 9-month
follow up. In addition, the literature is reviewed with respect to epidemiology, presentation, evaluation and treatment options
for hemangiomas arising from the external ear canal.

Conclusions

Treatment is achieved by excising the entire lesion, using a transcanal, endaural, or postauricural approach. For
hemangiomas extending to the medial aspect of the external auditory canal or the tympanic membrane, a retroauricular approach is favoured.
AUDIOMETRIC THRESHOLD MEASUREMENT
IN CHILDREN WITH INTELLECTUAL DISABILITY:
PREFERRED RESPONSE MODE
Authors: Ansari Mohammad
Published: May 2021

Background

The accuracy of pure tone audiometry is important for the success of auditory assessments and in monitoring rehabilitation
programs for auditory disorders. Studies have reported that pushing a button as a response mode has a significant effect on pure tone thresholds in subjects with normal and impaired hearing. We therefore assumed that a push-button response mode may negatively impact pure
tone threshold measurement in subjects with intellectual disability (ID) owing to their impaired cognition and poor motor coordination. The
current study compares in persons with ID the number of presentations, number of false alarms, test duration, and participant preference
across three response modes during audiometry.

Material and Methods

Air-conduction thresholds were measured for each response mode – push button, hand raise, and verbal – at octave intervals between 500 and 2000 Hz in the right ear of 14 children with intellectual disability. The order of the response mode was randomly assigned to three subgroups.

Results

The results indicated that among ID subjects a verbal response yielded a threshold in significantly less time. There was a significant
preference for using the verbal response. Children who were assigned a push button or hand raise also responded with a verbal response. For
push button participants, this occurred before the button was pushed and for the hand raising participants, a verbal response occurred before the button push.

Conclusions

The study finds verbal responses more beneficial in measuring auditory thresholds in children with ID.
TINNITUS SEVERITY IN PATIENTS WITH
COCHLEAR IMPLANTS
Authors: Skarzynski Piotr , Swierniak Weronika , Rajchel Joanna , Dziendziel Beata , Raj-Koziak Danuta , Skarzynski Henryk
Published: May 2021

Introduction

Cochlear implantation is the most effective method of hearing rehabilitation in a group method in group of patients with severe and profound sensorineural hearing loss. Furthermore, tinnitus is a frequent symptom related to hearing impairment. The aim of this
study was to assess severity of tinnitus before and after cochlear implantation.

Material and Methods

This study included 70 patients (35 women and 35 men), who were implanted. Tinnitus severity was evaluated three
times: preoperatively, at activation and one month after implantation. Tinnitus and Hearing Survey (THS), Tinnitus Handicap Inventory (THI)
and Tinnitus Functional Index (TFI) were used to assess tinnitus severity. THS and THI adaptation were conducted in the World Hearing
Center of the Institute of Physiology and Pathology of Hearing.

Results

The results showed that tinnitus was experienced in 65.7% of patients who were qualified to cochlear implantation. One-sided tinnitus (in the operated ear) was experienced in 54.4% cases and bilateral tinnitus in 45.6%. Hearing impairment was the primary complaint
of 93.5% cases. Preoperatively, severity of tinnitus was assessed as moderate (THI M=39.9; SD=23.4; TFI M=38.4; SD=21). Results after one
monthly observation suggested mild tinnitus severity (M=25.6; SD=21.9; TFI M=29.2; SD=20.6).

Conclusions

Monthly observation showed that severity of tinnitus after cochlear implantation decreased
BENIGN PAROXYSMAL POSITIONAL VERTIGO
(BPPV): CASE REPORT WITH EPLEY MANOEUVER
Authors: Silva Ana , Tome David , Olsen Unn
Published: May 2021

Background

Benign paroxysmal positional vertigo (BPPV) is a peripheral vestibular dysfunction which represents about 70% of vestibular
pathology presented at ENT clinics. However, a variety of first treatment approaches are reported among clinicians.

Case report

We present the case of a 39-year-old woman who presented vertigo which worsened with head movement to the left. The
patient reported dizziness and migraine over the previous three days. Audiological testing revealed normal hearing, but under postural examination the Dix-Hallpike manoeuver was positive to BPPV of the left posterior canal. The patient was treated with a single Epley
manoeuver.

Conclusions

After the Epley manoeuver the patient had no further symptoms of vertigo or dizziness. The Dix-Hallpike manoeuver was effective as a differential diagnosis. The Epley manoeuver was successful in a case in which canalithiasis was believed to be the cause of the vertigo.
BENEFIT FROM AN AUDIO PROCESSOR UPGRADE
IN EXPERIENCED USERS OF AN ACTIVE MIDDLE
EAR IMPLANT: SPEECH UNDERSTANDING IN
NOISE AND SUBJECTIVE ASSESSMENT
Authors: Mühlmeier Guido , Aigner Eberhard , Brumma Iris , Schlegel Alexander , Tisch Matthias
Published: May 2021

Background

Microphone directionality plays an important role in speech understanding in challenging acoustic environments. A new audio
processor (AP) from Med-El, known as Samba, automatically detects and selects optimal settings depending on the listening situation. This clinical investigation evaluated speech understanding in noise and subjective benefit of an AP upgrade from the prior Amadé to the new Samba.

Material and Methods

Fourteen Vibrant Soundbridge users with at least 3 months experience with the Amadé AP received the new Samba AP.
Speech recognition in quiet was measured using the Freiburger monosyllable test. Speech understanding in noise was assessed using the Oldenburger sentence test. Subjective benefit was determined with the Hearing Device Satisfaction Scale and the Abbreviated Profile of Hearing Aid Benefit.

Results

No differences were detected in pure tone audiometry or speech recognition in quiet between the two audio processors. However, the
new Samba AP performed significantly better in challenging noise situations: when speech came from the front and noise from the back, the
signal-to-noise ratio (SNR) improved by 3.4 dB with the automatic mode of the Samba AP compared to the Amadé AP. When the sources of
speech and noise were switched, a significant improvement of 1.8 dB SNR was observed. Based on the two questionnaires, subjective benefit
in daily life and device satisfaction were comparable for the two APs.

Conclusions

Due to its new features, the Samba AP gave significantly better results in challenging acoustical test situations. Even when the direction of background noise changed, the Samba AP performed better due to the new built-in adaptive directional microphones.