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Tinnitus is a heterogeneous hearing disorder with no cure at present, but some treatments, such as a combination of counselling and sound therapy, can alleviate the discomfort it causes. The sound therapy efficiency depends on both the type of sound stimulus and the time of exposure. This study describes the fundamentals of a personalized sound therapy that stimulates the auditory system with either continuous or sequential sounds whose spectra are adjusted to the hearing levels of the participants. This sound therapy is called Enriched Acoustic Environment and is assessed in a sample of 137 participants with tinnitus. Tinnitus-related distress relief was clinically relevant and statistically significant for 90% of these patients. This was quantified as a mean decrease of 24.3 points on the Tinnitus Handicap Inventory. 31% of participants were treated with sequential stimuli and ach- ieved greater relief of distress (29.4 points on their Tinnitus Handicap Inventory score) compared to those treated with continuous sound (69%). According to these results, sequential sound seems to be optimal compared to continuous sound.

Taking into account heterogeneity has been highly recommended in tinnitus studies both to disentangle all diverse factors that can contribute to their complexity and to design personalized treatments. To this aim, a heterogeneous sample of 270 tinnitus subjects is analyzed considering the gender (male/female), hearing condition (hearing-impaired/normal-hearing), and tinnitus severity (compensated/decompensated) subgroups. Two categorical variables (tinnitus laterality and tinnitus sound type) and four quantitative variables (average auditory threshold, age of tinnitus onset, tinnitus frequency, and tinnitus severity) are used. The percentages (for categorical variables) and mean values (for quantitative variables) of the whole sample are compared with these of each subgroup. Furthermore, correlational and hypothesis testing is applied to calculate the correlation coefficients and statistical significance, respectively. The results show that the male and female subgroups contrast in the sound type and frequency of their tinnitus, hearing-impaired and normal-hearing individuals differ, in addition, in their average auditory threshold, and the compensated/decompensated tinnitus subgroup provides significantly distinct values in tinnitus laterality and tinnitus sound.

This research was motivated by our acknowledgment of the lack of a cohesive structure in the so called ‘philosophical pessimism’. We observed that, though some ideas are generally considered pessimistic, there was not a systematization of those ideas nor a theoretical corpus of pessimism that allows us to make such a statement. The same goes for the authors considered by most contemporary philosophers to be pessimists: what appears to be some dim darkness in their intellectual approaches to existence automatically qualified them as pessimists, but we lacked a historical categorization of the differences between those authors, their philosophical systems, and, most of all, the possible connections and influences among them. That is why we considered necessary to carry out a review of philosophical pessimism in order to identify what constitutes that school of thought (or even if it can be seen as such), to propose a binary system that separates what, as far as we are concerned, are different types of pessimism that have become mutual antagonists, and finally, to systematize these a ideas in a progressive philosophical theory which could eventually culminate in a development and correction of those steps that, from our point of view, were mistaken. Our hypothesis, then, was the following: it is possible, and it should be done, to track down the pessimistic ideas of, at least, the last two centuries, in order to connect them, define a theoretical corpus and develop their components until what we consider to be their last consequences with the objective of creating an intrinsically new system of thought. We considered this hypothesis to be highly fruitful due to the small amounts of investigations regarding this topic. It is easy to imagine, as we have deeply discussed in the present essay, that philosophical pessimism is not a very esteemed subject of study, and it tends to be underrated or simply considered to be uninteresting in the modern world, where affirmative ph

Background: Tinnitus is an audiological disorder for which there are no objective measuring tools. Thus, many self-report questionnaires have been proposed to assess its severity. These questionnaires have been judged for their capacity to assess the tinnitus severity at baseline, their sensitivity to treatment-related changes (responsiveness), and their resolution. Methods: The most widely used questionnaires for clinical and research studies are the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI). While both questionnaires have been recognized as good evaluators of the baseline tinnitus severity, the latter is considered to be more responsive to changes following treatments. Objectives: The aim of this work is to provide a preliminary comparison of the performance of both questionnaires in the initial and final tinnitus severity assessment of a cohort of patients undergoing a four-month Enriched Acoustic Environment (EAE) therapy. Results: The EAE therapy provided a 30 and 26 point reduction in THI and TFI, respectively. A good correlation is obtained between the THI and TFI questionnaires at baseline and after the treatment. Conclusion: At baseline, the THI provided a higher score than the TFI for a higher degree of tinnitus but a lower score for lower tinnitus severity. Both THI and TFI were good questionnaires for baseline assessment and for treatment-related changes. The THI provided a slightly higher score drop than the TFI following the treatment, although the TFI had better resolution.

Background: Tinnitus is a rather heterogeneous chronic condition/disorder which is difficult to treat. Some tinnitus treatments combine sound therapy with counselling. The main goal of this study is to report the efficacy of a customized sound therapy combined with counselling on a cohort of 83 tinnitus patients. Methods: 119 tinnitus subjects, recruited between January 2018 and June 2021, were subjected to a treatment consisting of a combination of an initial counselling session and four-month sound therapy. The sound stimulus was a personalized broadband noise colored by the audiometry of the subjects. These stimuli were given to the patients in mp3 format to be heard 1 h per day over 4 months. The tinnitus severity of the patients was evaluated monthly through the validated Spanish version of the Tinnitus Handicap Inventory. Results: Of the patients, 30% (36 of 119) withdrew from the treatment before finishing, and 96% (80 of 83) of the subjects completing the therapy attained some relief after 4 months. The overall average THI decrease of these 80 participants was 23. However, when the THI was analyzed by severity scales, it was found that patients with initial mild, moderate, severe and catastrophic handicap had an average THI decrease of 14, 20, 31 and 42 points, respectively. Thus, the average THI decrease depended on the baseline severity scale of patients. Conclusions: Consequently, the proposed treatment was demonstrated to be effective in providing clinically relevant relief in tinnitus distress patients in just 4 months.

The articles collected in this Special Issue address new approaches to the pathophysiology of tinnitus, so as to understand where and how tinnitus is generated; to the diagnosis of tinnitus, with both objective and subjective techniques; and to the performance innovative treatments that could contribute to alleviate the most severe effects in patients

The aim of this article is to describe the fundamentals of a sound therapy, named Enriched Acoustic Environment, for the selective stimulation of tinnitus patients. The sound stimulus consists of three types of tones (pip, burst, and gamma) of random frequency, within the audible frequency band, each one with amplitude proportional to the hearing loss value at that frequency. The tone pip and tone burst already demonstrated their efficacy in the restoration of the cortical tonotopic map of cats previously exposed to a traumatizing noise, and the restoration of the hypersensibility of a human group of hyperacusis patients, respectively. The gamma tones sequence, which acoustical fundamentals are described in the article, are an original proposal. The resulting tone sequence stimulates selectively the auditory system of the subject by compensating its hearing loss, which is a possible trigger of tinnitus., El objetivo de este artículo es describir los fundamentos de una terapia sonora, el Ambiente Acústico Enriquecido (EAE), para la estimulación selectiva de pacientes con acúfenos. El estímulo sonoro consiste en una secuencia de tres tipos de tonos (pip, burst y gamma) de frecuencia aleatoria, dentro de la banda de frecuencias audibles, cada uno de ellos con una amplitud directamente proporcional a la pérdida de audición del sujeto a esa frecuencia. Las secuencias de tonos pip y tonos burst ya han demostrado su eficacia en la restauración del mapa tonotópico de animales expuestos previamente a un ruido traumatizante, y  en el restablecimiento la hipersensibilidad de un grupo de pacientes con hiperacusia, respectivamente. Las secuencias de tonos gamma, cuyos fundamentos se describen en este artículo, constituyen una propuesta original. La sucesión de tonos resultante estimula secuencialmente el sistema auditivo del sujeto compensando su pérdida de audición, que es una de las causas que disparan el acúfeno.

Background: Tinnitus is a rather prevalent, quite heterogeneous, and difficult to treat auditory disorder. The aim of this article is to provide the design and results of a cross-sectional study related to audiological and tinnitus features in a group of 170 Spanish patients. Methods: Audiometric characteristics were assessed on the basis of the pure-tone audiometry of both ears in 170 tinnitus patients and 85 control subjects. The audiometric status of each tinnitus participant was assessed on the basis of the average auditory threshold (AAT) in the whole frequency range (from 125 Hz to 8 kHz), and low (from 125 Hz to 2 kHz) and high (from 3 kHz to 8 kHz)-frequency intervals. Tinnitus features were evaluated through personal interview with patients and included tinnitus duration, laterality, pitch, sound, and distress (Tinnitus Handicap Inventory, THI). Correlational analysis was carried out between audiological (AAT) and tinnitus (THI) variables. Results: A very weak Spearman rank correlation factor is found between both variables. Conclusions: The subjective outcome of tinnitus distress (THI) was not correlated with the objective measure of hearing loss (AAT) in our cohort.

Sound absorbing materials are used in buildings to dissipate sound energy into heat using viscous and thermal processes. Sound absorbers increase the transmission loss of walls, decrease the reverberation time of rooms, and attenuate the noise generated by internal sound sources. Porous absorbers (fibrous, cellular, or granular) are the most used materials in noise control applications because of their high performance-to-cost ratio in the frequency band of interest. However, when cleaning conditions and health reasons are of concern, microperforated panel (MPP) absorbers may be the preferred choice. MPPs, consisting of many minute (sub-millimetric) holes in a panel, are tunable absorbers in a prescribed frequency band, whose main shortcomings are high manufacturing cost and limited absorption frequency band. Currently, the production cost of MPPs can be drastically reduced by means of modern techniques. The absorption frequency band can be considerably enlarged by designing multiple-layer MPPs (ML-MPPs). The aim of this article is to review the high potential of ML-MPPs as a modern, clean, and healthy alternative to porous materials for sound absorption.