Directionality in BiCROS hearing aids: an investigation of objective and subjective outcomes.

OBJECTIVES: To assess the effect of forward and omnidirectional microphone configurations in BiCROS versus monaural hearing aids on objective and subjective outcomes in different noise conditions. DESIGN: After fitting and a 4-week acclimatisation period, speech recognition and sound quality were measured using forward directional, omnidirectional, and unaided settings. Two noise configurations were used, surrounding noise and noise presented from the aided (better) ear. Subjective outcomes were assessed using the SSQ-b and BBSS questionnaires and participant interviews. STUDY SAMPLE: Eighteen adult participants (mean: 74.6 y; range: 61-94 y; ten males, eight females) with mild to moderately severe SNHL in their better ear (PTA0.5-4khz > 20 dB HL) and limited usable hearing in their poorer ear (average PTA0.5-4khz > 100 dB HL). RESULTS: Significant improvement in speech recognition and sound quality for BiCROS and monaural directional settings over omnidirectional and unaided, in both noise configurations. There were no significant differences observed between monoaural and BiCROS directional settings. CONCLUSION: Speech in noise recognition and sound quality scores demonstrated a significant directional benefit for both BiCROS and monaural directional fitting settings over omnidirectional and unaided conditions. Unique BiCROS-specific experiences were identified in a patient-oriented approach. These can inform the development of BiCROS-tailored tools.

A Rare Case of Sigmoid Colon Perforation in a Patient With Severe Acute Pancreatitis.

Severe acute pancreatitis can cause systemic inflammation and multiorgan failure. We present the case of a 60-year-old woman who presented with necrotizing pancreatitis and subsequently developed a sigmoid colon perforation. The perforation presumably occurred because of extravasation of pancreatic enzymes into the abdominal cavity, resulting in colonic wall injury. Our case highlights the rare colonic complications of severe acute pancreatitis.

Acute esophageal stricture after bone marrow transplant.

Esophageal stricture after bone marrow transplantation (BMT) is exceptionally rare, with only a few cases reported in the literature. We present an interesting case of a 58-year-old male with refractory multiple myeloma who developed dysphagia five days following his second bone marrow transplantation. He was found to have a severe esophageal stricture. The patient was treated with multiple esophageal dilations and triamcinolone injections in the following weeks to months, resulting in an improvement in symptoms. Although the exact underlying mechanism remains unknown, high-dose chemotherapy conditioning with melphalan prior to BMT likely contributed to the stricture. Our case highlights the importance of heightened post-bone marrow transplantation management for rare complications, such as an esophageal stricture.

PERMA well-being and innovative work behaviour : A systematic literature review.

Background: The purpose of this research is to examine at how the literature measures the relationship between PERMA (positive emotion, engagement, relationships, meaning, and accomplishments) well-being and innovative work behaviour (IWB). Methods: This systematic literature review examines peer-reviewed English research papers published in 2012 that investigate the relationship between PERMA well-being and IWB. A total of 37 publications were discovered in 32 journals. Results: A total of 220 articles were initially retrieved from the database. 37 studies out of 220 satisfied the inclusion criteria and were thoroughly examined. Our findings present a comprehensive overview of the types of PERMA well-being related to IWB in different countries and industries. Literature-based research approaches are also discussed. Research methods from the previous literature are also discussed. Conclusions: This study is one of the first to conduct a systematic literature review (PRISMA) method on the relationship between PERMA well-being and IWB. This review suggests constructive future research directions.

Development and initial evaluation of the Hearing Aid Attribute and Feature Importance Evaluation (HAFIE) questionnaire.

OBJECTIVES: To develop and validate a novel questionnaire aimed at providing a structured, evidence-based methodology for hearing aid recommendation and selection using self-reported importance ratings for different modern hearing aid features. DESIGN: The initial questionnaire items were created through a concept mapping approach that involved input from hearing aid users. Hearing care professional focus groups (n = 10) were conducted to assess questionnaire content and design, and to guide modifications. Validation of this initial 34-item version of the questionnaire was conducted using an anonymous online survey tool (Qualtrics). Exploratory factor analysis was used to assess the factor structure of the dataset, using principal axis factoring. Questionnaire reliability and inter-item correlation were assessed. Items with low factor loading and high cross-loading were removed. STUDY SAMPLE: Two hundred and eighteen adult participants with a self-reported hearing loss (median age = 48 years, range = 18-95 years) completed the questionnaire. RESULTS: Analysis and item removal resulted in a 28-item questionnaire. Three factors were identified, dividing the hearing aid features into the subscales: "Advanced connectivity & streaming", "Physical attributes & usability", and "Sound quality & intelligibility". CONCLUSION: This study has resulted in a patient-oriented questionnaire that allows clinicians to gather patient input in a structured manner.

DFT Insights into MAX Phase Borides Hf2AB [A = S, Se, Te] in Comparison with MAX Phase Carbides Hf2AC [A = S, Se, Te].

In this work, density functional theory (DFT)-based calculations were performed to compute the physical properties (structural stability, mechanical behavior, and electronic, thermodynamic, and optical properties) of synthesized MAX phases Hf2SB, Hf2SC, Hf2SeB, Hf2SeC, and Hf2TeB and the as-yet-undiscovered MAX carbide phase Hf2TeC. Calculations of formation energy, phonon dispersion curves, and elastic constants confirmed the stability of the aforementioned compounds, including the predicted Hf2TeC. The obtained values of lattice parameters, elastic constants, and elastic moduli of Hf2SB, Hf2SC, Hf2SeB, Hf2SeC, and Hf2TeB showed fair agreement with earlier studies, whereas the values of the aforementioned parameters for the predicted Hf2TeC exhibit a good consequence of B replacement by C. The anisotropic mechanical properties are exhibited by the considered MAX phases. The metallic nature and its anisotropic behavior were revealed by the electronic band structure and density of states. The analysis of the thermal properties-Debye temperature, melting temperature, minimum thermal conductivity, and Grüneisen parameter-confirmed that the carbide phases were more suited than the boride phases considered herein. The MAX phase's response to incoming photons further demonstrated that they were metallic. Their suitability for use as coating materials to prevent solar heating was demonstrated by the reflectivity spectra. Additionally, this study demonstrated the impact of B replacing C in the MAX phases.

Optical Response, Lithium Doping, and Charge Transfer in Sn-Based 312 MAX Phases.

The optical response, lithium doping, and charge transfer in three Sn-based existing M3SnC2 MAX phases with electron localization function (ELF) were investigated using density functional theory (DFT). Optical calculations show a slight optical anisotropy in the spectra of different optical parameters in some energy ranges of the incident photons. The peak height is mostly slightly higher for the polarization ⟨001⟩. The highest peak shifts toward higher energy when the M-element Ti is replaced by Zr and then by Hf. Optical conductivity, refractive index, extinction coefficient, and dielectric functions reveal the metallic nature of Ti3SnC2, Zr3SnC2, and Hf3SnC2. The plasma frequencies of these materials are very similar for two different polarizations and are 12.97, 13.56, and 14.46 eV, respectively. The formation energies of Li-doped Zr3SnC2 and Hf3SnC2 are considerably lower than those of their Li-doped 211 MAX phase counterparts Zr2SnC and Hf2SnC. Consistently, the formation energy of Li-doped Ti3SnC2 is lower than that of the corresponding 2D MXene Ti3C2, which is a promising photothermal material. The Bader charge is higher in magnitude than the Mulliken and Hirschfeld charges. The highest charge transfer occurs in Zr3SnC2 and the lowest charge transfer occurs in Ti3SnC2. ELF reveals that the bonds between carbon and metal ions are strongly localized, whereas in the case of Sn and metal ions, there is less localization which is interpreted as a weak bond.

Severe Mpox Proctitis Complicated by Bowel Obstruction.

Mpox is a rare infection caused by the zoonotic orthopoxvirus. We present the case of a 44-year-old man with HIV and a history of kidney transplant who presented with mpox and developed proctitis-associated bowel obstruction, urinary retention, and eosinophilia. Our case highlights potential gastrointestinal manifestations of severe mpox infection.

Proposed dietary recommendations for iron overload: a guide for physician practice.

PURPOSE OF REVIEW: Iron overload disorders such as hemochromatosis involve unregulated absorption of dietary iron, leading to excessive iron accumulation in multiple organs. Phlebotomy is the standard of care for removal of excess iron, but dietary modification is not standardized in practice. The purpose of this article is to help standardize hemochromatosis diet counseling based on commonly asked patient questions. RECENT FINDINGS: The clinical benefit regarding dietary modification in iron overload patients is limited due to lack of large clinical trials, but preliminary results are promising. Recent studies suggest diet modification could reduce iron burden in hemochromatosis patients resulting in less annual phlebotomy as supported through small patient studies, concepts of physiology, and animal studies. SUMMARY: This article is a guide for physicians to counsel hemochromatosis patients based on commonly asked questions such as foods to avoid, foods to consume, use of alcohol, and use of supplements. The goal of this guide is to help standardize hemochromatosis diet counseling to reduce phlebotomy amount in patients. Standardization of diet counseling could help facilitate future patient studies to analyze the clinical significance.

The Rise of 212 MAX Phase Borides: DFT Insights into the Physical Properties of Ti2PB2, Zr2PbB2, and Nb2AB2 [A = P, S] for Thermomechanical Applications.

In this article, ab initio calculations of unexplored Ti2PB2, Zr2PbB2, and Nb2AB2 [A = P, S] were performed wherein Ti2PB2 along with its 211 boride phase Ti2PB was predicted for the first time. The stability was confirmed by calculating the formation energy, phonon dispersion curve, and elastic stiffness constants. The obtained elastic constants, elastic moduli, and Vickers hardness values of Ti2PB2, Zr2PbB2, and Nb2AB2 [A = P, S] were found to be significantly larger than those of their counterparts 211 borides and carbides. The studied compounds are brittle, like most MAX and MAB phases. The electronic band structure and density of states revealed the metallic nature of the titled borides. Several thermal parameters were explored, certifying the suitability of Ti2PB2, Zr2PbB2, and Nb2AB2 [A = P, S] to be used as efficient thermal barrier coating materials. The response of Ti2PB2, Zr2PbB2, and Nb2AB2 [A = P, S] to the incident photon was studied by computing the dielectric constant (real and imaginary parts), refractive index, absorption coefficient, photoconductivity, reflectivity, and energy loss function. In this work, we have explored the physical basis of the improved thermomechanical properties of 212 MAX phase borides compared to their existing carbide and boride counterparts.

Premium versus entry-level hearing aids: using group concept mapping to investigate the drivers of preference.

OBJECTIVES: To investigate the difference in outcome measures and drivers of user preference between premium and entry-level hearing aids using group concept mapping. DESIGN: A single-blind crossover trial was conducted. Aided behavioural outcomes measured were loudness rating, speech/consonant recognition, and speech quality. Preference between hearing aids was measured with a 7-point Likert scale. Group concept mapping was utilised to investigate preference results. Participants generated statements based on what influenced their preferences. These were sorted into categories with underlying themes. Participants rated each statement on a 5-point Likert scale of importance. STUDY SAMPLE: Twenty-three adult participants (mean: 62.4 years; range: 24-78) with mild to moderately severe bilateral SNHL (PTA500-4000 Hz > 20 dB HL). RESULTS: A total of 83 unique statements and nine distinct clusters, with underlying themes driving preference, were generated. Clusters that differed significantly in importance between entry-level and premium hearing aid choosers were: Having access to smartphone application-based user-controlled settings, the ability to stream calls and music, and convenience features such as accessory compatibility. CONCLUSION: This study has identified non-signal-processing factors which significantly influenced preference for a premium hearing aid over an entry-level hearing aid, indicating the importance of these features as drivers of user preference.

Newly Synthesized Three-Dimensional Boron-Rich Chalcogenides B12X (X = S and Se): Theoretical Characterization of the Physical Properties for Optoelectronic and Mechanical Applications.

Boron-rich chalcogenides have been predicted to have excellent properties for optical and mechanical applications in recent times. In this regard, we report the electronic, optical, and mechanical properties of recently synthesized boron-rich chalcogenide compounds B12X (X = S and Se) using density functional theory for the first time. The effects of exchange and correlation functionals on these properties are also investigated. The consistency of the obtained crystal structure with the reported experimental results has been checked in terms of lattice parameters. The considered materials are mechanically stable, brittle, and elastically anisotropic. Furthermore, the elastic moduli and hardness parameters are calculated, which show that B12S can be treated as a prominent member of the hard materials family compared to B12Se. The origin of differences in hardness is explained on the basis of density of states near the Fermi level. Reasonably good values of fracture toughness and the machinability index for B12X (X = S and Se) are reported. The melting point, T m, for the B12S and B12Se compounds suggests that both solids are stable, at least up to 4208 and 3577 K, respectively. Indirect band gaps of B12S (2.27 eV) and B12Se (1.30 eV) are obtained using the HSE06 functional. The energy gaps using local density approximation (LDA) and generalized gradient approximation (GGA) are found to be significantly lower. The electrons of the B12Se compound show a lighter average effective mass than that of the B12S compound, which signifies a higher mobility of charge carriers in B12Se. The optical properties such as the dielectric function, refractive index, absorption coefficient, reflectivity, and loss function are characterized using GGA-PBE and HSE06 methods and discussed in detail. These compounds possess bulk optical anisotropy, and excellent absorption coefficients in the visible-light region along with very low static values of reflectivity spectra (range of 7.42-14.0% using both functionals) are noted. Such useful features of the compounds under investigation show promise for applications in optoelectronic and mechanical sectors.

Adaptation of the Connected Speech Test: Rerecording and Passage Equivalency.

Purpose The original Connected Speech Test (CST; Cox et al., 1987) is a well-regarded and often utilized speech perception test. The aim of this study was to develop a new version of the CST using a neutral North American accent and to assess the use of this updated CST on participants with normal hearing. Method A female English speaker was recruited to read the original CST passages, which were recorded as the new CST stimuli. A study was designed to assess the newly recorded CST passages' equivalence and conduct normalization. The study included 19 Western University students (11 females and eight males) with normal hearing and with English as a first language. Results Raw scores for the 48 tested passages were converted to rationalized arcsine units, and average passage scores more than 1 rationalized arcsine unit standard deviation from the mean were excluded. The internal reliability of the 32 remaining passages was assessed, and the two-way random effects intraclass correlation was .944. Conclusion The aim of our study was to create new CST stimuli with a more general North American accent in order to minimize accent effects on the speech perception scores. The study resulted in 32 passages of equivalent difficulty for listeners with normal hearing.

Skill Transference of a Probe-Tube Placement Training Simulator.

BACKGROUND: Probe-tube placement is a necessary step in hearing aid verification which needs ample hands-on experience and confidence before performing in clinic. To improve the methods of training in probe-tube placement, a manikin-based training simulator was developed consisting of a 3D-printed head, a flexible silicone ear, and a mounted optical tracking system. The system is designed to provide feedback to the user on the depth and orientation of the probe tube, and the time required to finish the task. Although a previous validation study was performed to determine its realism and teachability with experts, further validation is required before implementation into educational settings. PURPOSE: This study aimed to examine the skill transference of a newly updated probe-tube placement training simulator to determine if skills learned on this simulator successfully translate to clinical scenarios. RESEARCH DESIGN: All participants underwent a pretest in which they were evaluated while performing a probe-tube placement and real-ear-to-coupler difference (RECD) measurement on a volunteer. Participants were randomized into one of two groups: the simulator group or the control group. During a two-week training period, all participants practiced their probe-tube placement according to their randomly assigned group. After two weeks, each participant completed a probe-tube placement on the same volunteer as a posttest scenario. STUDY SAMPLE: Twenty-five novice graduate-level student clinicians. DATA COLLECTION AND ANALYSIS: Participants completed a self-efficacy questionnaire and an expert observer completed a questionnaire evaluating each participant's performance during the pre- and posttest sessions. RECD measurements were taken after placing the probe tube and foam tip in the volunteer's ear. Questionnaire results were analyzed through nonparametric t-tests and analysis of variance, whereas RECD results were analyzed using a nonlinear mixed model method. RESULTS: Results suggested students in the simulator group were less likely to contact the tympanic membrane when placing a probe tube, appeared more confident, and had better use of the occluding foam tip, resulting in more improved RECD measurements. CONCLUSIONS: The improved outcomes for trainees in the simulator group suggest that supplementing traditional training with the simulator provides useful benefits for the trainees, thereby encouraging its usage and implementation in educational settings.