Patient and Device Factors Contributing to Electrically Evoked Stapedial Reflex Thresholds in Cochlear Implanted Adults.

INTRODUCTION: Optimal cochlear implant (CI) outcomes are due to, at least in part, appropriate device programming. Objective measures, such as electrically evoked stapedial reflex thresholds (ESRTs), can be used to more accurately set programming levels. However, underlying factors that contribute to ESRT levels are not well understood. The objective of the current study was to analyze how demographic variables of patient sex and age, along with CI electrode location, influence ESRTs in adult CI recipients. METHODS: A single institution retrospective review was performed. Electronic medical records, CI programming records, and clinic database of postoperative computerized tomography were reviewed to gather information regarding patient demographics, ESRTs, and electrode array metrics including medial-lateral distance and scalar location. Linear mixed models were constructed to determine how demographic variables and electrode position influence ESRTs recorded in 138 adult CI recipients. RESULTS: ESRTs were significantly affected by recipient age, with older listeners demonstrating higher ESRT levels. On average, males had higher ESRT levels when compared to females. In a subset of the study sample, ESRT levels increased with increasing medial-lateral distance; however, there was not a statistically significant effect of electrode type (lateral/straight arrays compared to perimodiolar arrays). ESRTs were not affected by scalar location. DISCUSSION/CONCLUSIONS: The results suggest that key demographic and electrode position characteristics influence the level of ESRTs in adult CI recipients. While ESRTs are widely used to assist with CI programming, underlying factors are not well understood. The significant factors of aging and sex could be due to middle ear mechanics or neural health differences. However, further data are needed to better understand these associations.

A Fullerton Functional Fitness Test-based exercise intervention for older adults yields quick physical and psychological benefits.

OBJECTIVES: Functional fitness is essential for healthy living in older adults. Specially targeted fitness programs might be the most beneficial. This intervention study aimed to assess the efficacy of a specific 16-week exercise program in improving functions as measured by the Fullerton Functional Fitness Test (FFFT), also known as the Senior Test, in older adults. PARTICIPANTS: Thirty-eight participants (66 % women, Mage = 80.15, SD = 7.21) were randomized into an exercise group (n = 24) and a waiting list control group (n = 14). The exercise group trained three times a week for 1 h. METHODS: Objective tests (FFFT and handgrip power) and subjective psychological measures (life satisfaction, resilience, happiness, perceived stress, and well-being) were obtained at baseline, after eight weeks, and after 16 weeks. The data were analyzed using mixed-effect regression models. RESULTS: The results yielded statistically significant group-by-time interactions in all models, indicating improvements in physical and psychological measures over time in the treatment group compared to the control group. Significant differences between the groups in the estimated marginal means (with adjusted 95 % confidence intervals) emerged after 16 weeks in happiness (-3.5 [-6.5, -0.4]), resilience (-5.5 [-9.9, -1.2]), perceived stress (2.2 [0.2, 4.2]), well-being (-5.8 [-7.9, -3.6]), upper limb strength (-5.7 [-9.0, -2.4]), upper body flexibility (-8.7 [-16.4, -1.0]), and agility and balance (4.6 [1.2, 8.1]). Except for happiness and resilience, these differences surfaced already after eight weeks. CONCLUSION: The here-employed 16-week exercise program, targeting the test elements of the FFFT, efficiently induced physical and mental improvements in older adults.

Objective preclinical measures for bone conduction implants.

The study evaluates the accuracy of predicting intracochlear pressure during bone conduction stimulation using promontory velocity and ear canal pressure, as less invasive alternatives to intracochlear pressure. Stimulating with a percutaneous bone conduction device implanted in six human cadaveric ears, measurements were taken across various intensities, frequencies, and stimulation positions. Results indicate that intracochlear pressure linearly correlates with ear canal pressure (R2 = 0.43, RMSE = 6.85 dB), and promontory velocity (R2 = 0.47, RMSE = 6.60 dB). Normalizing data to mitigate the influence of stimulation position leads to a substantial improvement in these correlations. R2 values increased substantially to 0.93 for both the ear canal pressure and the promontory velocity, with RMSE reduced considerably to 2.02 (for ear canal pressure) and 1.94 dB (for promontory velocity). Conclusively, both ear canal pressure and promontory velocity showed potential in predicting intracochlear pressure and the prediction accuracy notably enhanced when accounting for stimulation position. Ultimately, these findings advocate for the continued use of intracochlear pressure measurements to evaluate future bone conduction devices and illuminate the role of stimulation position in influencing the dynamics of bone conduction pathways.

The Relation Between Subjective and Objective Measures of Visual Awareness: Current Evidence, Attempt of a Synthesis and Future Research Directions.

Within the realm of consciousness research, different methods of measuring the content of visual awareness are used: On the one hand, subjective measures require a report of sensory experiences related to a stimulus. On the other hand, objective measures rely on the observer's performance to accurately detect or discriminate the stimulus. The most appropriate measure of awareness is currently debated. To contribute to this debate, we review findings on the relation between subjective and objective measures of awareness. Although subjective measures sometimes lag behind objective measures, a substantial number of studies demonstrates a convergence of measures. Based on the reviewed studies, we identify five aspects relevant for achieving a convergence of measures. Future research could then identify and empirically test the boundary conditions, under which a convergence or divergence of subjective and measures of awareness is observed.

Social mobile sensing and problematic alcohol consumption: Insights from smartphone metadata.

BACKGROUND: Alcohol is often consumed in a social context. We aim to investigate whether social mobile sensing is associated with real-world social interactions and alcohol consumption. In addition, we investigate how social restriction policies implemented during the COVID-19 pandemic have influenced these associations. METHODS: We conducted a smartphone-based ecological momentary assessment (EMA) study for 7 days over a 213-day period from 8 August 2020 to 9 March 2021 in Germany, including both no-lockdown and lockdown stages. Participants used a smartphone application which passively collects data on social behavior (e.g., app usage, phone calls, SMS). Moreover, we assessed real-world social interactions and alcohol consumption via daily questionnaires. RESULTS: We found that each one-hour increase in social media usage was associated with a 40.2% decrease in the average number of drinks consumed. Mediation analysis suggested that social media usage decreases alcohol intake through decreased real-world social interactions. Notably, we did not find that any significant influence of the lockdown stage on the association between social mobile sensing and alcohol intake. CONCLUSIONS: Our study suggests that people who use more social media drink less, likely due to reduced face-to-face social interactions. This highlights the potential of social mobile sensing as an objective measure of social activity and its implications for understanding alcohol consumption behavior.

Association between objective measures of oral health and salivary gland irradiation with patient-reported outcomes following head and neck radiation therapy.

PURPOSE: To determine whether objective measures of oral health and salivary gland irradiation correlates with subjective measures of eating, drinking, and salivation in patients following head and neck radiation therapy (HNRT). METHODS: This cross-sectional study included 112 patients following HNRT with a completed patient-reported outcome (PRO) scale. Objective measures at post-HNRT visit included decayed-missing-filled teeth (DMFT) scores, periodontal disease condition, oral hygiene status, dental prosthesis use, and prescribed radiation dose to salivary glands. Data were collected and statistical analysis was performed. RESULTS: There was no significant association between PRO scales and dental prosthesis use, periodontal disease, and oral hygiene. Although some significant findings were seen with DMFT and prescribed radiation dose to salivary glands, this explained only very small amounts of the variation in eating, drinking, and salivation measures in these patients. CONCLUSION: PRO measures should be integrated in the routine care of patients with head and neck cancer.

Utilidad de mediciones objetivas para la programación en implantes cocleares / Use of objective measures for cochlear implant programming

RESUMEN Introducción: La programación adecuada de los implantes cocleares permiten lograr niveles de estimulación auditivos óptimos. Se realiza de forma individualizada, siendo la detección del umbral de confort ideal un desafío. Se ha descrito la utilidad de los potenciales auditivos del tronco encefálico eléctrico (ePEATC) y el reflejo eléctrico estapedial (eREE) para este propósito. Objetivo: Determinar la posibilidad de realizar ePEATC y eREE en pacientes adultos y pediátricos con implantes cocleares, y evaluar cambios en la programación de los implantes cocleares luego de las mediciones objetivas. Material y método: Se realizó un estudio prospectivo, descriptivo, de pacientes con implante coclear marca MED-EL®, separando los pacientes en dos grupos: el grupo adulto (n =5) y el grupo pediátrico (n =5). Todos los pacientes incluidos presentaron más de 6 meses de encendido del implante. Se evaluaron variables epidemiológicas y tiempo de encendido del implante. Se realizó una otoscopía, prueba básica de funcionamiento del implante, y las mediciones objetivas eléctricas (ePEATC, eREE). Con estos resultados se ajustó el umbral de confort. Resultados: El tiempo promedio de encendido del implante en el grupo adulto fue de 27 meses, y 30 meses en el grupo pediátrico. El ePEATC requiere más tiempo y cooperación al compararlo con eREE. Luego de estas evaluaciones objetivas, fue necesario el ajuste del umbral de confort en tres pacientes adultos, y en dos pacientes pediátricos. Fue necesario realizar una audiometría de campo libre para estimar el umbral de confort en dos pacientes pediátricos que no presentaron respuesta en eREE. Conclusión: Fue posible realizar estas mediciones objetivas en pacientes adultos y pediátricos, siendo mejor tolerado y requiriendo menos tiempo, el eREE.

ABSTRACT Introduction: Mapping a cochlear implant allows for adjusting ideal electrical stimulation limits. It is an individualized process and detecting the most comfortable loudness level can be challenging. The use of electrically evoked auditory brainstem response (ePEATC) and electrically evoked stapedius reflex thresholds (eREE) have been considered for this purpose. Aim: To determine the feasibility of performing ePEATC and eREE on adult and pediatric patients with a cochlear implant, and to evaluate changes in programming following these objective measures. Material and method: A prospective, descriptive study was completed, of patients with MED-EL® cochlear implants, separating patients into two groups: adults (n=5) and children (n=5). All of the patients included had their implants activated for 6 months or longer. Epidemiological variables and duration of implant activation were evaluated. Otoscopy, a basic implant functioning evaluation, and objective measures (ePEATC, eREE) were performed. With these results, comfortable loudness levels were adjusted. Results: Average duration of implant activation was 27 months and 30 months, for adults and children respectively. Performing ePEATC required more time and cooperation as compared to eREE. Following the objective measures, adjustment of the comfortable loudness levels was required for three adult and two pediatric patients. Sound field audiometry was necessary for two pediatric patients in order to estimate the comfortable loudness levels because the eREE responses were absent. Conclusions: It is feasible to perform these objective measures for both adult and pediatric patients, with eREE requiring less time and being better tolerated by patients.