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INTRODUCTION: In the Israeli Air Force (IAF) both aircrew and ground crew are exposed to harmful noise during their work. By law, the employer is obligated to instruct and train employees on the proper use of hearing protection. The most common hearing protection is earplugs made of sponge. The objectives of this study were to evaluate the effectiveness of the use of sponge earplugs among IAF members in relation to previous instruction. METHODS: Data was collected from subjects who had been routinely evaluated at the Israeli Aeromedical Center between March 2020 and May 2021. Using the 3M E-A-Rfit Dual-Ear Validation System, noise reduction achieved with earplugs was measured. Participants who did not achieve at least 20dB (out of the maximum 29dB declared by the manufacturer) noise reduction were instructed on proper earplug use by the examiner and were reexamined. This study was approved by the Institutional Review Board. RESULTS: A total of 133 IAF members were examined with an average age of 24.6±6.7 years. There was a male and ground crew predominance (90% and 67%, respectively). Less than 50% of study participants had been previously instructed on proper earplug use, and less than 40% properly used the earplugs. Participants who had not been previously instructed achieved statistically significant lower attenuation value (16.2dB) compared to those who had been previously instructed (18.98dB, p=0.011). Participants who did not achieve the required attenuation value and were instructed on proper earplug use by the examiner significantly improved their attenuation values by an average of 8.5dB (p<0.001). DISCUSSION: Hearing impairment is a major health concern for military personnel. There are various hearing protection measures. Earplugs are low cost and commonly available and offer a 29dB noise reduction. However, proper use is not intuitive and straightforward as one may think, as less than 40% of our cohort was found to have used earplugs correctly. On the other hand, concise instruction on the use of earplugs greatly improved the attenuation. Learning Objectives 1. Implementing periodic instruction on the proper use of earplugs may help reduce noise induced hearing loss. 2. Concise instruction on the use of earplugs greatly improved the attenuation values by an average of 8.5dB. [ABSTRACT FROM AUTHOR]

BACKGROUND: The acoustic environment in space flight vehicles and habitats remains a major operational concern. Risks associated with noise, radiation, and ototoxin exposure include reduced speech intelligibility and permanent shifts in hearing thresholds. This presentation assesses key elements of the NASA Hearing Conservation Program (HCP), reviews data availability in critical areas, and provides a prioritized list of recommendations for future study. OVERVIEW: Data collected in terrestrial environments primarily inform auditory damage risk criteria and recommendations on the use of hearing protective devices. A comprehensive understanding of short- and long-term changes in hearing sensitivity in spacecraft environments is required to mitigate unique habitability concerns and safety risks. Noise level monitoring and periodic audiometric testing are critical components of the HCP, but whether existing approaches can sufficiently characterize changes in hearing sensitivity and its impact on communication must be rigorously evaluated. This presentation discusses 1) the extent to which pure-tone audiometry can detect changes in hearing sensitivity affecting speech discrimination; 2) the limitations of existing retrospective studies investigating transient and permanent shifts in hearing thresholds; and 3) NASA Johnson Space Center (JSC) data availability and reporting. A workshop composed of relevant specialties across military and civilian spheres assembled primary peer-reviewed papers and JSC data in the following areas: pre- and post- flight audiograms, On-Orbit Hearing Assessments, Sound Level Meter measurements, and Acoustic Dosimeter measurements. Data quality and accessibility were evaluated, and reviewers generated a prioritized list of recommendations for further research. DISCUSSION: NASA's Hearing Conservation Program and effective programs in other professional disciplines use accurate, scientifically-based standards and countermeasures. Increasing interest in commercial and long-term space flight expands the variety of astronaut medical and physical conditions requiring accommodation, establishing the need to rigorously characterize the impact of the acoustic environment on auditory health and safety. This work is of broad interest to professionals who may be in a position to contribute to the scientific knowledge base, increase data accessibility, or implement additional testing and countermeasures in this area. Learning Objectives 1. Recognize the impact of acoustic conditions in space flight vehicles on auditory health and communication and review current approaches to hearing conservation. 2. Understand current methodologies and data utilized in monitoring auditory health in space environments, recognizing areas of potential improvement and further research needs. [ABSTRACT FROM AUTHOR]

Objectives This study: (i) assessed the relationship between noise exposure and injury risk, comprehensively adjusting for individual factors, psychosocial stressors, and organizational influences; (ii) determined the relative importance of noise on injuries; (iii) estimated the lowest observed adverse effect level (LOAEL) of noise on injury risk to determine the threshold of noise considered hazardous to injuries; and (iv) quantified the fraction of injuries that could be attributed to hazardous noise exposure. Methods In this cross-sectional study at 10 US surface mine sites, traditional mixed effects, Poisson regression, and boosted regression tree (BRT) models were run on the number of reported work-related injuries in the last year. The LOAEL of noise on injuries was identified by estimating the percent increase in work-related injuries at different thresholds of noise exposure using a counterfactual estimator through the BRT model. A population attributable fraction (PAF) was quantified with this counterfactual estimator to predict reductions in injuries at the LOAEL. Results Among 18 predictors of work-related injuries, mine site, perceived job safety, age, and sleepiness were the most important predictors. Occupational noise exposure was the seventh most important predictor. The LOAEL of noise for work-related injuries was a full-shift exposure of 88 dBA. Exposure ≥88 dBA was attributed to 20.3% (95% CI: 11.2%, 29.3%) of reported work-related injuries in the last year among the participants. Conclusions This study further supports hypotheses of a dose–response relationship between occupational noise exposure and work-related injuries, and suggests that exposures ≥88 dBA may increase injury risk in mining. [ABSTRACT FROM AUTHOR]

Objective: This study explored the effects of hearing protection devices (HPDs) and head protection on the ability of normal-hearing individuals to localize reverse alarms in background noise. Background: Among factors potentially contributing to accidents involving heavy vehicles, reverse alarms can be difficult to localize in space, leading to errors in identifying the source of danger. Previous studies have shown that traditional tonal alarms are more difficult to localize than broadband alarms. In addition, HPDs and safety helmets may further impair localization. Method: Standing in the middle of an array of eight loudspeakers, participants with and without HPDs (passive and level-dependent) had to identify the loudspeaker emitting a single cycle of the alarm while performing a task on a tablet computer. Results: The broadband alarm was easier to localize than the tonal alarm. Passive HPDs had a significant impact on sound localization (earmuffs generally more so than earplugs), particularly double hearing protection, and level-dependent HPDs did not fully restore sound localization abilities. The safety helmet had a much lesser impact on performance than HPDs. Conclusion: Where good sound localization abilities are essential in noisy workplaces, the broadband alarm should be used, double hearing protection should be avoided, and earplug-style passive or level-dependent devices may be a better choice than earmuff-style devices. Construction safety helmets, however, seem to have only a minimal effect on sound localization. Application: Results of this study will help stakeholders make decisions that are more informed in promoting safer workplaces. [ABSTRACT FROM AUTHOR]

Backround: Noise is one of the most important occupational and environmental health hazards. Exposure to loud noise can cause irrevocable hearing damage and loss of hearing. The aim of this study was to determine the efficiency of two samples of earmuff and earplug in low frequency noise reduction in comparison to subjective method. Methods: All the procedures of the work were done using the simulated human ear canal and the required microphone in the eardrum. At the octave frequencies, that is 31.5 and 63.5, 125, 250, 500, 1000, 2000, 4000, and 8000 Hz, and intensities of 85‑90 dB, one stage was done by using the individual’s subjective response relative to the received sound before and after using the ear protector. Results: The sound levels before and after the protection were significantly different in both the model and humans (P < 0.05). However, at 315 Hz frequency, the rate of attenuation is increased by 4 dB after placing the earplug and 14 dB after placing the earmuff, showing a reduction of 18 dB. Conclusions: This study verifies the increasing protection by simultaneous application of earplugs and earmuffs. Because of the laboratory evaluation of ear protectors, it is possible not to justify the proficiency of ear protectors in a subjective method. [ABSTRACT FROM AUTHOR]

Borderline personality disorder has been identified as a risk factor for polydrug use. Despite this, there remains a lack of understanding of which characteristics of the disorder provide the mechanisms for this relationship. This study examined a set of constructs as mechanisms explaining the borderline personality disorder-polydrug use relationship that are divided into affective and cognitive categories. The Pathways to Desistance data were used in analyses. Generalized structural equation modeling was used to examine the direct relationship between borderline personality disorder and test for attenuation of this direct effect. A bootstrap resampling process was used to estimate standard errors utilized to specify specific and total indirect effects of mechanism variables and their significance level. Results indicated that greater symptom severity of borderline personality disorder predicted increased drug use variety. This relationship was attenuated by 70% when hypothesized mechanisms were included and became nonsignificant. It appeared that this attenuation was mainly due to sensation-seeking. Findings indicate that interventions for individuals suffering from borderline personality disorder with polydrug use issues may find utility in structuring programming around mitigating sensation-seeking. [ABSTRACT FROM AUTHOR]

Applied ergonomics in the pharmaceutical industry, involves the design and adaptation of work spaces from the production area, equipment and tasks for operator safety, noise level and lighting, being the factors that create real discomfort. The noise is present in all machines in this industry, the noise level being the one that requires additional protection measures for some machines. In the following, the analysis of the data collected from the occupational medicine and the measurements carried out, it was found that the wearing hearing protection equipment and optimization of lighting are mandatory at the level of departments production, especially hearing protection is mandatory at the level of tablet presses, because the noise level is the highest with these machines. [ABSTRACT FROM AUTHOR]

In order to diagnose an incipient fault in rotating machinery under complicated conditions, a fast sparse decomposition based on the Teager energy operator (TEO) is proposed in this paper. In this proposed method, firstly, the TEO is employed to enhance the envelope of the impulses, which is more sensitive to frequency and can eliminate the low-frequency harmonic component and noise; secondly, a smoothing filtering algorithm was adopted to suppress the noise in the TEO envelope; thirdly, the fault signal was reconstructed by multiplication of the filtered TEO envelope and the original fault signal; finally, sparse decomposition was used based on a generalized S-transform (GST) to obtain the sparse representation of the signal. The proposed preprocessing method using the filtered TEO can overcome the interference of high-frequency noise while maintaining the structure of fault impulses, which helps the processed signal perform better on sparse decomposition; sparse decomposition based on GST was used to represent the fault signal more quickly and more accurately. Simulation and application prove that the proposed method has good accuracy and efficiency, especially in conditions of very low SNR, such as impulses with anSNR of −8.75 dB that are submerged by noise of the same amplitude. [ABSTRACT FROM AUTHOR]

To undertake calibration and preliminary validation of a custom-designed computer-based screening audiometer connected to consumer insert phone-earmuff combination for adult pure tone audiometry. Part 1 involved electroacoustic measurement and biological calibration of a laptop-earphone pair used for the computer-based audiometry (CBA). Part 2 compared CBA thresholds obtained without a sound booth with those measured using the gold-standard clinical audiometry. 17 young normal-hearing volunteers (Part 1) and 43 normal and hearing loss subjects (Part 2) recruited from an audiology clinic via convenience sampling. The transducer-device combination produced outputs suitable for measuring thresholds down to 0 dB HL. Threshold pairs obtained from the CBA and clinical audiometry were highly correlated (Spearman's correlation coefficient, ρ = 0.92, p < 0.0001) and had a good degree of agreement (mean difference of −1.06 ± 7.63 dB). Also, the CBA showed about 90% sensitivity and 80% specificity for detecting hearing loss based on low (0.5, 1, 2 kHz) and high frequency (4, 8 kHz) pure tone averages of >25 dB HL. The use of a computer-based audiometer application with consumer insert phone-earmuff combination can offer a cost-effective solution for boothless screening audiometry. [ABSTRACT FROM AUTHOR]

In this study a heart-beat-interval counterbased a low-power PPG microsystem is proposed for accurate assessment of the mental stress. The designed microsystem incorporates a new low power PPG sensing readout with a Time-to-digital converter for the long-time continuous heart-beat-interval estimation. Further the analog front-end circuit is implemented in the integrated chip having an area of 1.4 mm2 and fabricated using the TSMC 0.18 µm process. Measured linear sensing range of the designed readout is 20 nA to 110 µA. With the 1.8 V standard supply, measurement results show that the power consumption of the PPG readout circuit is 52.2 µW, while the total measured power consumption of the designed chip is 100.2 µW. To evaluate the performance of the proposed microsystem in mental stress assessment, the designed circuit is integrated with OLED-OPD sensor and then applied to the wrist of two healthy subjects under different stressors, (e.g., laughing, solving a mathematical problem, hearing loud audio/sound, and moving neck). The statistical analysis of the detected PPG signal and measured on-chip-heart rate interval in time domain shows that the mean value of peak-to-peak interval, entropy, and stress-induced vascular index increases during the stress. In addition, in the frequency domain analysis of the heart rate variability (HRV) shows that the ratio of the low frequency component to the high frequency component is increased during the stress. Thus, the indices of HRV measured directly from the designed readout system can serve effectively as indication of heart rate variability and mental stress. [ABSTRACT FROM AUTHOR]

This paper deals with the use of modern technology for security purposes, focusing on the situation in cities (urban noise and shooting) and in transport (passenger rail). The authors aimed to highlight the possibilities and capabilities of installation of technology in the field of applied physical acoustics (sensors, evaluation system with the possibility of setting sensitive sensing filters, end output) and the possibilities of monitoring, including the response of security forces or security measures to the detected danger. In the paper, the authors also include graphical representations of the energynormalized spectra of the different sound backgrounds and classification classes of acoustic events and types of acoustic events to clarify the differences of the selected monitored events. [ABSTRACT FROM AUTHOR]

Objective: Workers from various industries use personal protective equipment (PPE) including masks, respirators, and hearing protection to reduce their exposures to workplace hazards. Many studies have evaluated the physiological impacts of PPE use, but few have assessed the psychological impacts. The aim of the present study was to carry out a scoping review to compile existing evidence and determine the extent of knowledge on workplace mask, respirator or hearing protection use as a psychosocial hazard (stressor) that could result in a stress response and potentially lead to psychological injury. Methods: The scoping review followed recognized methods and was conducted using Ovid Emcare, PubMed, Sage Journals, ScienceDirect, Scopus, SpringerLink, Google Scholar and preprint databases (OSF Preprints and medRxiv). Articles on the stressors associated with the use of masks, respirators, and hearing protection were included. The extracted data included author(s) name, year of publication, title of article, study design, population data, stressors assessed, and key findings. Results: We retrieved 650 articles after removal of duplicates, of which 26 were deemed eligible for inclusion for review. Identified factors associated with PPE use that could potentially create a stress response were identified: communication impacts, physical impacts, psychological illness symptoms, cognitive impacts, and perceived PPE-related impacts. Evidence for respirators suggest that there may be psychological injury associated with their use. However, hearing protection appears to have a protective effect in reducing psychological symptoms such as anxiety, depression, and aggression. Conclusions: Mask or respirator use may lead to an increase in work-related stress. Whereas hearing protection may have protective effects against psychological symptoms and improves speech intelligibility. More research is needed to better understand potential psychosocial impacts of mask, respirator and/or hearing protection use. [ABSTRACT FROM AUTHOR]

The poxvirus lumpy skin disease virus (LSDV) is the causative agent of the vexatious lumpy skin disease, which predominantly affects cattle and water buffalo. It has been endemic to South Africa since the 1950s, and in 1960, a live attenuated vaccine was commercially released for use in the country to mitigate the spread of this transboundary disease. This vaccine (Neethling/vaccine/LW-1959) was generated from serial passages of the prototype lumpy skin disease virus strain Neethling-WC/RSA/1957, which was isolated in 1957 from an outbreak in the Western Cape province of South Africa and was subsequently used to prove the infectious nature of the virus and the resulting disease in cattle. In this study, we determined the complete genome sequence of the LSDV prototype strain Neethling-WC/RSA/1957, as well as three other LSDV isolates from the 1950s, one wild-type isolate from the 1970s, and a commercial vaccine produced in 1988 (LW-1959). Phylogenomic analysis showed that all six sequences were in cluster 1.1, along with previous sequences of the vaccine strain, the oldest known isolate (LSDV/Haden/RSA/1954), and virulent viruses isolated in the 1990s from South Africa. Seven single-nucleotide polymorphisms were identified between the Neethling-WC/RSA/1957 strain and the vaccine strain (LW-1959), providing new insights into virus attenuation and possible markers for DIVA assays. [ABSTRACT FROM AUTHOR]

Farming ranks among the top occupations for which workers are at risk for noise-induced hearing loss (NIHL), an irreversible yet preventable condition. Hearing Protection Devices (HPDs) (i.e., earmuffs and ear plugs) are effective at preventing exposure to noise; however, few farmers report consistent use. The purpose of this study was to test an intervention based on Social Cognitive Theory with interactive smartphone technology to increase the use of HPDs among swine facility workers. A pilot, quasi-experimental study was implemented among 72 younger adult swine workers. Participants were randomly assigned to one of three groups. Group 1 received HPDs (e.g., earmuffs and ear plugs). Group 2 received the same HPDs as Group 1 and was also instructed to use a smartphone application to track their use of hearing protection for 60 days. Group 3 received the HPDs and instructions on using a smartphone app for tracking the use of hearing protection and setting daily goals for hearing protection use. Use of hearing protection was assessed via an online survey prior to the intervention (i.e., "baseline"), immediately after the post-intervention, and at a 3-month follow-up. Compared to baseline use, all three groups reported increased use of hearing protection immediately post-intervention. However, this increase was not maintained at a 3-month follow-up for two of the study groups. Group 3 (HPD, tracking, and goal-setting app) showed the greatest increase in the use of HPDs from baseline to immediate post-intervention; however, Group 1 (HPD only) showed the greatest sustained increase from baseline to the 3-month follow-up. Modifying the environment by supplying HPDs was effective in increasing HPD use among swine facility workers. Improving access to hearing protection devices alone may lead to sustained changes in behavior. [ABSTRACT FROM AUTHOR]

Background: Workers in production agriculture are frequently exposed to high noise levels and face unique barriers to implementing hearing protection, leading to occupational hearing loss. Motivational interviewing is a promising approach to assist workers in preserving their hearing. Methods: This pilot study used a mixed-method approach to evaluate the feasibility of an innovative motivational interviewing intervention for agricultural producers from February to May 2021. Qualitative data included coaches' and participants' comments and were coded using a structural coding approach. Quantitative data included Likert-type-style responses given by participants in a post-intervention survey. Data types were then integrated. Results: Sixteen participants were recruited during the 4-month pilot. Participants' satisfaction scores averaged above six on a 7-point scale for all satisfaction questions. Implementation factors included the intervention's flexibility, services provided by the coaches beyond motivational interviewing, and difficulties with recruitment. Conclusions/Applications to Practice: This motivational interviewing intervention was highly acceptable to participants, but factors affecting implementation may challenge scalability. [ABSTRACT FROM AUTHOR]

Seismic-hazard analysis is based on the knowledge of the factors that configure the wave attenuation properties due to the loss of energy radiated away from the source (geometrical spreading and anelastic attenuation) and the site amplification due to surface geological conditions (the so-called site effects). Both factors can be separately investigated based on Generalized Inversion Techniques (GIT), through spectral decomposition of earthquake recordings in terms of Fourier Amplitude Spectra (FAS). In this study a parametric GIT algorithm, was applied in western Greece, allowing a simultaneous spectral decomposition of S-wave records in order to estimate parameters controlling seismic motion. The analyses provided a regional variation of the quality factor, Qs between 23—91, with a geometric mean value of 45, a distance dependent geometrical spreading attenuation factor gamma, γ, smoothly decreased between 12 and 200 km, from 0.98 to 0.77, as well as Site Amplification Factors for both horizontal and vertical components of 24 sites located in the study area. Moment Magnitudes, Mw and corner frequencies, fc, were computed for the examined earthquakes, indicating an increasing trend of stress drop, Δσ from ~ 6 to ~ 55 bar for Mw = 2.5 to 5.2. The estimated values of these parameters, are in good agreement with the corresponding ones based on other methodologies, concluding to the relevant low average logarithmic misfit (~ 0.17) between observed and synthetic FAS. Consequently, attenuation and site amplification factors computed in this study, can provide rational input parameters for stochastic S-wave simulations, improving thus deterministic seismic hazard assessment. [ABSTRACT FROM AUTHOR]

As a type of earth observation technology, interferometric synthetic aperture radar (InSAR) is increasingly widely used in the field of geological disaster detection. However, the application of InSAR in low-coherence areas, such as alpine canyon areas and vegetation coverage areas, is subject to considerable limitations. How to accurately identify landslides from InSAR measurement data in these areas remains the subject of several challenges and shortcomings. Based on statistical analysis and spatial cluster analysis, in this paper, we propose an automatic landslide identification and gradation method suitable for low-coherence areas. The proposed method combines the small baseline subset InSAR (SBAS-InSAR) method and the interferogram stacking (stacking-InSAR) method to obtain a deformation map in the study area, using statistical analysis and spatial cluster analysis to extract deformation regions and landslide polygons to propose a landslide screening model (LSM) based on multivariate features to screen landslides and reduce the interference of noise in landslide identification, in addition to proposing a landslide gradation model (LGM) based on signum function to grade the identified landslides and provide support to distinguish landslides with different deformation degrees. The method was applied to landslide identification in the upper section of the Jinsha River basin, and 47 potential landslides were identified, including 15 high-risk landslides and 13 landslides endangering villages. The experimental results show that the proposed method can identify landslides accurately and hierarchically in low-coherence areas, providing support for geological hazard investigation agencies and local departments. [ABSTRACT FROM AUTHOR]

Introduction: Satisfaction with telemedicine is generally high; however, it can lead to communication problems for people with hearing loss (HL), especially when encounters are conducted by telephone, because of the inability to see the face and lips on which many people with HL rely. Despite acknowledgement that HL might affect telemedicine outcomes, no studies have directly examined this. The primary aims of this study were to determine whether and how HL impacts patient satisfaction and willingness to use telemedicine. Methods: Opinions about telemedicine were assessed in a survey of 383 members of the general public. Data regarding reported hearing ability, use of hearing assistive technology, and preferred form of communication (oral/aural vs. sign language) were also collected; people with HL were intentionally oversampled. Survey items included closed set and open-ended responses. Results: People with HL declined the offer of telemedicine appointments, rated telemedicine outcomes significantly less positively, and had stronger preferences for in person care than did people without HL. Explanations provided for this were directly associated with hearing-related difficulties or the indirect consequences of those difficulties. HL resulted in concerns about communication during the appointment, a lack of privacy when an intermediary helped with communication during the appointment, worries that critical information has been misheard/missed, and anxiety/stress. Conclusions: The needs of people with HL during telemedicine encounters must be addressed to ensure equitable access. Health care providers should take responsibility to communicate clearly with people with HL and individuals with HL should be willing to advocate for their needs and use special access tools during telemedicine appointments. [ABSTRACT FROM AUTHOR]

Nearly 1.5 billion people globally have some decline in hearing ability throughout their lifetime. Many causes for hearing loss are preventable, such as that from exposure to noise and chemicals. According to the World Health Organization, nearly 50% of individuals 12–25 years old are at risk of hearing loss due to recreational noise exposure. In the occupational setting, an estimated 16% of disabling hearing loss is related to occupational noise exposure, highest in developing countries. Ototoxicity is another cause of acquired hearing loss. Audiologic assessment is essential for monitoring hearing health and for the diagnosis and management of hearing loss and related disorders (e.g., tinnitus). However, 44% of the world's population is considered rural and, consequently, lacks access to quality hearing healthcare. Therefore, serving individuals living in rural and under-resourced areas requires creative solutions. Conducting hearing assessments via telehealth is one such solution. Telehealth can be used in a variety of contexts, including noise and ototoxic exposure monitoring, field testing in rural and low-resource settings, and evaluating auditory outcomes in large-scale clinical trials. This overview summarizes current telehealth applications and practices for the audiometric assessment, identification, and monitoring of hearing loss. [ABSTRACT FROM AUTHOR]

Speech production while wearing hearing protectors poses significant challenges due to their occlusion effect and disruption of the Lombard effect. An experiment was conducted with 24 individuals as they read a list of 12 sentences in open ears and while wearing an earmuff in quiet and in four different noises [pink, International Female Fluctuating Masker (IFFM), speech-spectrum noise (SSnoise), and helicopter] at two levels (70 and 85 dBA). An acoustic manikin, fitted or not with an identical protector, served as the target listener. In noise, speech levels decreased when the talkers wore the earmuff but increased when the target listener was fitted with the earmuff. When the earmuff was used by both the talkers and target listener, speech levels were lower by 3–6 dB at the higher noise level compared to when they were both open ears. Speech levels were typically lower, but extended speech intelligibility index estimates were consistently higher, in fluctuating (IFFM, helicopter) than in continuous noises (pink, SSnoise). Talkers' pitch frequency and voice spectrum measurements followed very closely the changes in speech levels, showing no evidence of compensatory voice modifications. Implications of the lower talker speech levels when wearing hearing protectors are discussed in terms of protector selection, training, and individuals with hearing loss. [ABSTRACT FROM AUTHOR]

Incense-cedar (Calocedrus decurrens (Torr.) Florin) is a drought-resistant conifer species native to the western United States that is host to few lethal pests and pathogens. Quantifying its survival and growth after planting is important for defining its potential place within future silvicultural prescriptions. Our objectives are to understand the impact of (1) spacing and herbivore protectors on seedling survival, (2) spacing on growing space occupancy after 19 years, and (3) spacing on individual tree and stand characteristics. The use of herbivory protection had a positive influence on seedling survival (96% survival with protection; 92% survival without protection). After 19 years, including drought conditions, 89% of planting spots were occupied by a live tree. Mean live crown ratios occurred across a narrow range, from 89.4 to 97.8, indicating a lack of differentiation at this phase of stand development. Wider spacing treatments resulted in the expected trade-off of larger individual tree sizes but lower stand-level volume. Because of persistent live crowns, thinning and pruning are potential strategies not only to reduce fire risk but also to improve timber quality. Our results also support the contention that incense-cedar is a species well-adapted to the anticipated future climate. [ABSTRACT FROM AUTHOR]

Many workers are exposed to noise levels that can cause hearing problems. Earplugs remain a common form of protection for workers exposed to hazardous levels. Their comfort directly affects the effective protection by influencing their consistent and correct use. In order to assess comfort, the COPROD questionnaire was previously developed on the basis of four comfort dimensions: acoustic, physical, functional and psychological. During this field survey, nine earplug models were evaluated by 118 participants over a 6-week period. This paper presents analyses of the collected data and compares three families of earplugs: roll-down foam, premolded and custom moulded. Analyses have shown a better rating of custom moulded earplugs in terms of overall comfort and for all dimensions of comfort. Although premolded earplugs are generally preferred to roll-down foam earplugs, from a statistical point of view, the evaluations of these two families are not significantly different for numerous characteristics. Practitioner Summary: Earplugs comfort conditions the hearing protection of the users. The COPROD questionnaire was developed to jointly evaluate all dimensions of comfort. Nine earplugs models were evaluated by 118 participants during 6 weeks. This paper presents analyses of the collected data. [ABSTRACT FROM AUTHOR]

Objectives: Dentists are constantly exposed to high-frequency noise at their workplace that increases the risk of occupational noise-induced hearing loss (ONIHL). Even though dentists acknowledge about the noisy dental workplace, hearing protection devices or ear protection devices (EPD) are not commonly used by dentists. No study has yet provided any evidence on how effective EPDs can be in reducing the temporary threshold shift and damage to the outer, middle and inner ears. The aim of this article is to evaluate and compare the changes in the hearing acuity and temporary threshold shift (TTS) in dentists who wear EPDs when compared with those who do not use EPDs. Materials and Methods: Sixty-four dental clinicians were randomly divided into two groups: Group 1 (performed ultrasonic scaling without EPDs) and Group 2 (performed ultrasonic scaling with EPDs). Their hearing threshold was checked by using pure tone audiometry, stapedial acoustic reflexes, and otoacoustic emission (OAE) before and after 45 mins of ultrasonic scaling. The intergroup and intragroup comparison was done. All the outcome measures from pre- and post-scaling across the ears, groups, and frequencies among groups were done using mixed-effects analysis of variance. A P-value of less than 0.05 was considered to be statistically significant. Results: EPDs were effective in reducing the immediate TTSs. Immediately upon exposure to high-frequency noise, the alterations in the hearing threshold and stapedial reflex OAE were less in the group that used EPDs. Conclusion: EPDs should be mandatorily worn by dentists to prevent accumulation of temporary shifts in the hearing acuity, which in long-term can lead to permanent hearing loss. [ABSTRACT FROM AUTHOR]

Background and Aim: Exposure to impact noise (short-term, high intensity) higher than permitted levels results in injury to the auditory system. Armed forces are one of the occupational groups exposed to these types of noises resulting from gunshots. In this study, relevant articles and research on the adverse effects of impact noise, hearing loss, and tinnitus in armed forces and effective control methods are reviewed. Methods: In this review study, the databases of Web of Science, Scopus, PubMed, Science Information Database (SID), Islamic World Science Citation Center (ISC), and Science Direct were searched with the keywords including noise-induced hearing loss, armed forces, impact noise, control and exposure in armed forces and shooting range. Through determining entrance and exit indicators and consultations among writers, from 68 evaluated articles, 42 entered the study, and 26 were removed. Results: Several studies measured the gunshot noise level and found that exposure to this noise resulted in different auditory complications depending on the frequency and intensity of exposure. Baseline characteristics and lifestyle are parameters involved in developing noise-induced hearing loss. Active and passive noise control methods and the use of hearing protection devices are among the measures adopted to reduce the intensity of exposure and decrease the detrimental effects of noise on the auditory system. Conclusion: The use of hearing protection with an active noise cancellation has been developing during the past years, however, it is recommended to use both noise control engineering and hearing protection to reduce the highest level of harmful noise possible when firing a weapon. It should be noted that to prevent hearing loss in the military staff, it is necessary to build medical records upon recruitment for hearing monitoring and conduct periodic examinations. [ABSTRACT FROM AUTHOR]

ObjectiveIdentify contemporary noise exposures and hearing protection use among adults.Study designCross-sectional analysis of national health survey.MethodsAdult respondents in the 2014 National Health Interview Series hearing survey module were analyzed. Potentially harmful exposures to occupational and recreational noises in the past 12 months were extracted and quantified. Patterns of hearing protection use also were analyzed.ResultsAmong 239.7 million adults, "loud" and "very loud" occupational noise exposures were reported by 5.3% and 21.7%, respectively. Of those exposed to "loud" or "very loud" sounds at work, only 18.7% and 43.6%, respectively, always used hearing protection. A total of 38.2% (1.9 million) of those with "very loud" occupational exposures never used hearing protection. Frequent (> 10/year) "loud" and "very loud" recreational noise exposures were reported by 13.9% and 21.1%, respectively, most commonly to lawn mowers (72.6% and 55.2%, respectively). When exposed to recreational "loud/very loud" noise, only 11.4% always used hearing protection, whereas 62.3% (6.3 million) never used any protection. Lifetime exposure to firearm noise was reported by 36.6% of adults, 11.5% of whom had used firearms in the prior 12 months. Of those, only 58.5% always used hearing protection, whereas 21.4% (7.4 million) never used hearing protection.ConclusionSubstantial noise exposures with potentially serious long-term hearing health consequences frequently are occurring in occupational and recreational settings, and with the use of firearms. Only a minority of those exposed consistently are using hearing protection. Healthcare providers should actively identify and encourage the use of hearing protection with those patients at risk.Level of evidence4. Laryngoscope, 127:E340-E346, 2017.

Yuyu Huang,1,2,&ast; Haoran Yu,3,&ast; Min Liang,1,2 Shule Hou,1,2 Junmin Chen,1,2 Fan Zhang,1,2 Xiayu Sun,1,2 Huan Jia,2,4,5 Jun Yang1,2,5 1Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, People’s Republic of China; 2Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (14DZ2260300), Shanghai, 200125, People’s Republic of China; 3ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, People’s Republic of China; 4Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People’s Republic of China; 5Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, 200031, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jun YangENT Ward of Xinhua Hospital, Floor 18, Building 8, 1665 Kongjiang Road, Yangpu District, Shanghai, 200092, People’s Republic of ChinaTel +86 13764981808Email yangjun@xinhuamed.com.cnHuan JiaENT Ward of Ninth People’s Hospital, Floor 2, Building 1, 639 Zhizaoju Road, Huangpu District, Shanghai, 200011, People’s Republic of ChinaTel +86 13601797481Email huan_jia_orl@163.comObjective: To investigate the hearing protection outcomes of different drug-eluting analog electrode arrays implanted into guinea pig cochleae.Methods: Sixty guinea pigs were randomly divided into a negative control group and five experimental groups implanted separately with blank (drug carrier), dexamethasone (DXM), aracytine (Ara-C), Ara-C+DXM, and nicotinamide adenine dinucleotide (NAD+) eluting analog electrode arrays. Micro CT was used to supervise the surgical procedure. Auditory brainstem response (ABR) thresholds of the guinea pigs were measured and analyzed.Results and Conclusions: Compared with the negative control, all other groups showed a significant increase in ABR threshold (p< 0.001) after surgery. Among them, there was no obvious difference between the blank (0 vs 90 days: 59.70± 10.57 vs 64.60± 9.47 dB SPL) and the NAD+ group (0 vs 90 days: 59.90± 9.87 vs 64.70± 8.65 dB SPL). On the other hand, the ABR thresholds in the DXM (0 days: 58.10± 10.73 dB SPL; 90 days: 51.70± 9.07 dB SPL) and the Ara-C group (0 days: 59.00± 10.05 dB SPL; 90 days: 51.60± 8.48 dB SPL) decreased significantly compared with the former two groups (p< 0.001). However, the Ara-C+DXM group showed no further benefit (p> 0.05). In addition, a significantly higher survival rate of spiral ganglion neurons in cochleae was observed in the Ara-C and/or DXM groups.Keywords: guinea pig, cochlear implant, drug-eluting electrode, hearing protection

The letter to the editor discusses the caution needed when relying on self-reported occupational noise exposures to determine hearing loss risk. While a study found a positive association between self-reported noise exposure and hearing loss, concerns were raised about the accuracy of these self-reports, especially in high-noise industries like mining. The author suggests that more research is needed in this area to better understand the impact of noise misperceptions on occupational health. [Extracted from the article]

Epidemiological data on depression and anxiety in Guatemala is lacking. Using 2016 National Disability Survey data, we explored the sociodemographics of people with anxiety and/or depression and its heightened burden on access to key services. The survey (n = 13,073) used the Washington Group Extended Set to estimate disability prevalence, including anxiety and/or depression. A nested case-control study was included to explore the impact of disability on key life areas. Cases (indicating 'A lot of difficulty' or 'Cannot do' in one or more functional domain) and age-/sex-matched controls were administered a structured questionnaire. Multivariable logistic regression and heightened-burden analysis were conducted. Higher odds of anxiety and/or depression were found in participants who were 50+ (aOR 2.3, 1.8–3.1), female (aOR 1.8, 1.4–2.2), urban (aOR 1.5, 1.2–1.9), divorced/separated (aOR 2.0, 1.3–3.0), and widowed (aOR 1.6, 1.0–2.4), as well as those with impaired communication or cognition (aOR 17.6, 13.0–23.8), self-care (aOR 13.2, 8.5–20.5), walking (aOR 13.3, 9.7–18.3), hearing (aOR 8.5, 5.6–13.1), and vision (aOR 8.5, 6.1–11.8). Lower odds of anxiety and/or depression were found in participants with a university education (aOR 0.2, 0.5–0.9), and those living in the southeast (aOR 0.2, 0.1–0.3) or northeast (aOR 0.3, 0.2–0.4). Compared to people with impairments that were not depression and/or anxiety, people with depression and/or anxiety were less likely to receive a retirement pension (aOR 0.4, 0.2–0.8), and more likely to receive medication for depression/anxiety (aOR 4.1, 1.9–9.1), report a serious health problem (aOR 1.8, 1.3–2.5), and seek advice/treatment with a government health worker/health post (aOR 6.3, 1.0–39.2). [ABSTRACT FROM AUTHOR]

National and international regulatory and consensus standards setting bodies have previously proposed derating hearing protector ratings to provide a better match between ratings determined in a laboratory and the real-world measurements of attenuation for workers. The National Institute for Occupational Safety and Health has proposed a derating scheme that depends upon the type of protector. This paper examines four real-world studies where personal attenuation ratings (PARs) were measured at least twice, before and after an intervention in earplug fitting techniques. Results from these studies indicate that individualized earplug fitting training dramatically improves a worker's achieved PAR value. Additionally, derating schemes fail to accurately predict the majority of achieved PARs. Because hearing protector fit testing systems are now readily available for use in the workplace, personal attenuation ratings provide a better estimate of worker noise exposures and are able to identify those persons who need additional instruction in fitting hearing protection devices. [ABSTRACT FROM AUTHOR]

Wind turbines (WT) can produce large amounts of energy and thus help economies make an important step towards a sustainable energy future. However, residents living near wind farms ascribe to wind turbine noise (WTN) a multitude of adverse health impacts and use them as an argument against wind farms. This paper reviews the relevant literature on the effects of wind turbine noise in order to help address the controversy that surrounds the safety of wind turbines and, in this way, to enhance community acceptance of wind farms. The objectives are to compare the findings of quantitative, experimental and longitudinal research on these effects and to detect whether findings are consistent. The analysis showed that while quantitative research recorded adverse health effects, experimental and longitudinal research provided no supporting evidence. However, findings from these different research types were consistent in indicating a risk for sleep posed by WTN. In addition, quantitative and experimental research converges that annoyance to WTN is affected by the visual impact of wind turbines on the landscape as well as attitudes to wind energy in general. Moreover, experimental work has shown that exposure to information on the Internet that accentuates negative health effects due to WTN can account for residents' complaints about adverse health effects. Finally, it is necessary to perform more longitudinal research on the health of residents in relation to WTN as well as more quantitative research on quality of life of individuals residing near wind farms. • Convergent quantitative, longitudinal and experimental findings show risk for sleep. • Wind energy attitudes and the visual impact of wind turbines affect noise annoyance. • Objective information can prevent the ascription of health effects to noise. • More longitudinal research on the health effects of wind turbine noise is needed. • Quality of life of residents exposed to wind turbine noise is understudied. [ABSTRACT FROM AUTHOR]

Introduction: Noise-induced hearing loss can be avoided by taking preventive measures. Objective: To assess the effectiveness of the Brazilian version of the Dangerous DecibelsR program for noise-exposed workers, using the ecological model as an educational intervention plan. Method: Non-randomized interventional study with a quantitative, experimental trial design, conducted at a meatpacking company. The participants were divided into two groups--the first one (n D 132, divided into 6 subgroups) received the Dangerous DecibelsR Brazil educational intervention (DDBEI) adapted to workers while the second group (n D 138, divided into 5 subgroups) received a conventional educational intervention (CEI). The interventions lasted 50 min. The Hearing Protection Assessment Questionnaire (HPA-5) was administered before and after the interventions. The five dimensions (attitude, behavior, knowledge, supports, and barriers) were compared using the Student's t-test for paired data (<0.05). Results: After both the DDBEI and CEI training, workers improved significantly in barriers, supports, knowledge, attitudes, and behavior around noise. By chance, the CEI group scored lower in all measures than the DDBEI group before training, and though both groups improved, the difference was maintained after training. Conclusion: The Brazilian version of the Dangerous DecibelsR program for noise-exposed workers was effective, influencing positively the factors at different levels of the ecological model. Though the DDBEI was no more effective than the CEI, the CEI participants began at much lower levels, so the effectiveness of the DDBEI may have been underestimated. [ABSTRACT FROM AUTHOR]

Professional musicians are often exposed to high noise levels and thus face the risk of noise-induced hearing loss. Yet, adoption rates for hearing protection among musicians are low. Previous surveys indicate that the chief concern is the effect of hearing protection use on performance. However, few studies have investigated actual changes in performance when wearing hearing protection. We report an experiment investigating differences in pianists’ performance and experience with and without hearing protection. We compare the effect of foam earplugs and musician earplugs, designed to preserve sound quality with a flat frequency response. The analysis revealed that participants performed overall more loudly with the foam earplugs than with the musician earplugs, and in turn performances with the musician earplugs were louder than the open condition, indicating a compensatory effect. However, this effect was stronger for novel excerpts than for familiar excerpts. No effect was observed on dynamic range. Furthermore, we observed an acclimatization effect, whereby the effect of hearing protection use, observed on the first performance, decreased on the second performance. In terms of experience, participants reported changes in coloration, difficulties gauging dynamics and articulation, and increased effort required when performing with hearing protection. These effects were more pronounced when wearing the foam earplugs, and the participants reported finding the musician earplugs more comfortable to wear and play with. In conclusion, hearing protection use affects pianists’ performance particularly in terms of dynamics and their experience more so in terms of coloration. But the effects are less marked for familiar pieces and after repetition, suggesting that pianists can quickly adjust their playing when playing familiar pieces with hearing protection. [ABSTRACT FROM AUTHOR]

Background: Environmental factors such as loud sounds and bright lights in intensive care units can cause sleep disorders and delirium. Aim: The present study aims to investigate the effects of the overnight use of earplugs and eye masks by intensive care patients on their sleep quality and the degree of delirium. Study Design: This randomized controlled experimental study was conducted on the patients admitted to a coronary intensive care unit. Methods: The patients in the experimental group used earplugs and eye masks during the night, while those in the control group received only routine care. Data were collected using an information form, the Richards‐Campbell sleep questionnaire (RCSQ), and the intensive care delirium screening checklist (ICDSC). Results: The study included a total of 84 patients, 42 in the experimental group and 42 in the control group. The baseline average score of the patients in the experiment group on the RCSQ was 40.11 ± 16.55, with a Time 1 average score of 64.09 ± 14.07 and a Time 2 average score of 72.07 ± 11.75; their baseline average score on the ICDSC was 0.47 ± 0.50, with a Time 1 average score of 0.33 ± 065 and a Time 2 average score of 0.19 ± 039. The baseline average score of the patients in the control group on the RCSQ was 44.07 ± 7.30, with a Time 1 average score of 46.97 ± 9.22 and a Time 2 average score of 47.04 ± 11.53; the baseline average score of the control group on the ICDSC was 0.42 ± 0.50, with a Time 1 average score of 0.50 ± 0.70 and a Time 2 average score of 0.57 ± 0.66. A statistically significant difference was found between the Time 1 and Time 2 average scores of the experimental and control groups on the RCSQ and between the Time 2 average scores of the experimental and control groups on the ICDSC (U = 198.00, P <.001; U = 70.000, P <.001; U = 614.000, P = ·004 respectively). Conclusions: The earplugs and eye masks used by the intensive care patients overnight were associated with an increase in sleep quality and a decrease in the degree of delirium. Relevance to Clinical Practice: The use of earplugs and eye masks is recommended for intensive care units in supporting sleep quality and preventing delirium. [ABSTRACT FROM AUTHOR]

Noise-induced hearing loss (NIHL) is the largest cause of action for indemnity in North American industries despite the widespread implementation of hearing conservation programs. Possible causes behind the onset of NIHL are the intervals between hearing tests which are generally too long and the tests are insufficiently sensitive to detect temporary hearing changes to act and prevent permanent hearing damage. Moreover, current noise regulations might be too lenient as to the permissible maximum noise levels. Short-interval hearing assessment could help to observe temporary changes in hearing health and prevent permanent damage. This study investigates the short-term effects of noise exposure characteristics using repeated measurements of otoacoustic emission (OAE) growth functions and presents the most significant predictors of hearing health changes as observed in sixteen individuals equipped with OAE earpieces. The experimental results of this study show that the impulsiveness and frequency spectrum of the noise level could be a possible cause of the decline in OAE levels. As a consequence, hearing conservation programs should consider taking these noise metrics into account for proper NIHL risk assessment. Such noise exposure and hearing health monitoring could greatly improve hearing conservation practices in the workplace by acting faster and eventually mitigate occupational hearing loss. [ABSTRACT FROM AUTHOR]

Background: Severe pain is the most prevalent complication after Coronary Artery Bypass Grafting (CABG). The aim of this study is to compare the impact of two methods using ear protective devices on pain intensity in patients undergoing CABG. Materials and Methods: The present randomized clinical trial was conducted between October 2019 and February 2020. The participants included 84 patients undergoing CABG, who were randomly divided into two intervention groups (A, B) and a control group. On the first night after the heart surgery, ear protective devices were used for the patients in group A during the evening and night sleep, while they were used in group B only during the night sleep. A demographic questionnaire and Visual Analog Scale (VAS) were the data collection tools used in this study. Data were analyzed using Chi-square test, paired t-test, and one-way Analysis of Variance (ANOVA) in Statistical Package for the Social Sciences (SPSS) software. Results: Before the intervention, the mean (SD) of pain intensity in the two intervention groups (A, B) and the control group was 6.46 (1.71), 6.32 (1.36), and 6.54 (1.45), respectively, and there was no significant difference between the groups (F2,81 = 0.14; p = 0.86). However, after the intervention, the mean (SD) of pain intensity in the two intervention groups (A, B) and the control group was 3.39 (1.87), 4.46 (1.55), and 6.39 (1.54), respectively, which showed a significant difference (F2,81 = 23.37; p < 0.001). Conclusions: The use of ear protective device is recommended as a non-invasive and accessible way of reducing pain intensity in patients after CABG. [ABSTRACT FROM AUTHOR]