OPTN/SRTR 2022 Annual Data Report: Kidney.

The year 2022 had continued successes and challenges for the field of kidney transplantation, as the community adapted to ongoing surges of the COVID-19 pandemic and broader geographic organ distribution. The total number of kidney transplants in the United States reached a record count of 26,309, driven by continued growth in deceased donor kidney transplants (DDKTs). The total number of candidates listed for DDKT rose slightly in 2022 but remained below 2019 listing levels, with 12.4% of candidates having been waiting 5 years or longer. Following the height of the COVID-19 pandemic, pretransplant mortality in 2022 declined across age, race and ethnicity, sex, and blood type groups. Pretransplant mortality continued to vary substantially by donation service area. The proportion of deceased donor kidneys recovered but not used for transplant (nonuse rate) rose to a high of 26.7% overall, with greater nonuse of biopsied kidneys (39.8%), kidneys from donors aged 55 years or older (54.7%), and kidneys with a kidney donor profile index (KDPI) of 85% or greater (71.3%). Nonuse of kidneys from donors who are hepatitis C virus (HCV) antibody positive rose to 30.2% but only slightly exceeded that of HCV antibody-negative donors. Disparities in access to living donor kidney transplant (LDKT) persist, especially for non-White and publicly insured patients. Delayed graft function continues an upward trend and occurred in 26.3% of adult kidney transplants in 2022. Five-year graft survival after LDKT compared with DDKT was 90.0% versus 81.4% for recipients aged 18-34 years and 80.8% versus 67.8% for recipients aged 65 years or older, respectively. The total number of pediatric kidney transplants performed in 2022 decreased to 705, its lowest point in the past decade; 502 (71.2%) were DDKTs and 203 (28.8%) were LDKTs. Among pediatric recipients, LDKT remains low, with continued racial disparities. The rate of DDKT among pediatric candidates has decreased by almost 25% since 2011. Congenital anomalies of the kidney and urinary tract remain the leading primary kidney disease diagnosis among pediatric candidates with a reported diagnosis. Most pediatric deceased donor recipients received a kidney from a donor with a KDPI of less than 35%. The rate of delayed graft function was 5.8% in 2022 and has been stable over the past decade. Long-term graft survival continues to improve, with superior outcomes for living donor transplant recipients.

Amplified earmuffs: impact on speech intelligibility in industrial noise for listeners with hearing loss.

PURPOSE: To determine how amplified earmuffs affect the intelligibility of speech in noise for people with hearing loss, and to determine how various brands of amplified earmuffs compare in terms of speech intelligibility and electroacoustic response. METHOD: The Hearing in Noise Test (HINT) was used to measure the intelligibility of speech for 10 participants with hearing loss when they listened in a background of recorded industrial noise at 85 dBA. Participants listened with 3 different sets of amplified earmuffs (Peltor Tactical 7-S, Elvex COM 55, and Bilsom 707 Impact II), with a set of passive earmuffs (E-A-R Ultra 9000), and with ears unoccluded. Two measurements of sentence threshold were obtained under each of the 5 listening conditions. Gain was measured electroacoustically across a range of input levels and frequencies for each amplified earmuff. RESULTS: Electroacoustic measurements indicated that each electronic earmuff amplified at low input levels and attenuated at high input levels. However, gain characteristics varied greatly across devices. HINT sentence thresholds were not significantly different across the 5 listening conditions or across the 2 trials. CONCLUSION: Results suggest that each type of earmuff can be used to reduce the noise exposure of people with hearing loss without compromising their ability to understand speech.

Audibility of train horns in passenger vehicles.

Studies of accident rates associated with train horn bans indicate that motorists rely on horns to warn them of approaching trains. However, researchers have not yet established the levels of horn sounds necessary for detection at railroad crossings. The purpose of this study was to obtain baseline measures of the auditory component of the motorist's detection task. Horn sounds recorded in three test vehicles were presented to 20 normal-hearing listeners in quiet and in four types of vehicle interior noise: engine idling, ventilation fan off; engine idling, fan on; vehicle moving at 30 miles/hr (mph), fan off; and vehicle moving at 30 mph, fan on. Thresholds of the horn sounds were determined by an adaptive procedure. Mean thresholds were lowest in quiet (1.8-4.4 dBA) and highest for the 30-mph, fan-on condition (49.7-58.4 dBA). Mean horn thresholds for all 12 noise conditions were more than 10 dB below the overall level of the vehicle interior noise. Our data are compared with those of previous studies and their implications are discussed. Actual or potential applications of this research include the establishment of a lower limit of signal-to-noise ratios required for the detection of horn sounds at highway-rail crossings.