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Purpose: Tinnitus is a condition that causes people to hear sounds without an external source. One significant issue arising from this condition is the difficulty in communicating, especially in the presence of noisy backgrounds. The process of understanding speech in challenging situations requires both cognitive and auditory abilities. Since tinnitus presents unique challenges, it is important to investigate how it affects speech perception in noise., Method: In this review, 32 articles were investigated to determine the effect of tinnitus on the effect of speech in noise perception performance. Based on the meta-analysis performed using a random-effects model, meta-regression was used to explore the moderating effects of age and hearing acuity., Results: A total of 32 studies were reviewed, and the results of the meta-analysis revealed that tinnitus significantly impacts speech in terms of noise perception performance. Additionally, the regression analysis revealed that age and hearing acuity are not significant predictors of speech in noise perception., Conclusion: Our findings suggest that tinnitus affects speech perception in noisy environments due to cognitive impairments and central auditory processing deficits. Hearing loss and aging also contribute to reduced speech in noise performance. Interventions and further research are necessary to address individual challenges associated with continuous subjective tinnitus., Competing Interests: Declarations Conflict of interest The authors declare no conflict of interest., (© 2024. The Author(s).)

Parental and caregiver support is crucial for addressing childhood hearing loss in low and middle-income countries, where a significant burden of disabling hearing loss exists among children. This study aimed to assess the knowledge and attitudes of parents and caregivers regarding childhood hearing loss and available hearing services in both urban and rural settings in Delhi, India. A total of 314 participants were recruited and interviewed using a culturally adapted questionnaire consisting of 26 items, covering topics like biomedical and non-biomedical beliefs, knowledge of otitis media-related hearing loss, identification, and intervention. Statistical analysis of data was performed using  Mann Whitney U tests and categorical principal component analysis (PCA). The study found that parents generally had a higher percentage of correct responses compared to caregivers in both urban and rural areas. Categorical PCA revealed variations in responses between fathers, mothers, and caregivers. In the urban group, mothers exhibited higher knowledge and more positive attitudes, while fathers showed lower involvement. In the rural group, while mothers demonstrated relatively higher awareness on all categories compared to fathers, these differences were highly relevant on questions concerning noise exposure, maternal medicine during pregnancy, and communication milestones. The findings emphasize the importance of considering regional and cultural factors when designing programs. Additionally, involving fathers in awareness campaigns and support networks is crucial to achieve comprehensive coverage in addressing childhood hearing loss. In conclusion, this study contributes valuable insights into the preparedness of parents and caregivers for audiology services and the need for contextually appropriate strategies to enhance childhood hearing health services in India., Competing Interests: Conflict of interestThe authors declare no conflict of interest. The authors have no relevant financial or non-financial interests to disclose., (© Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: Misophonia, a condition characterized by heightened sensitivity and strong emotional reactions to specific sounds, has sparked considerable interest and debate regarding its underlying auditory mechanisms. The study aimed to understand the auditory underpinnings of two such potential inner ear systems, non-linear and linear outer hair cell functioning along with auditory efferent functioning in individuals with misophonia., Methods: 40 ears with misophonia (20 participants) and 37 ears without misophonia (20 participants), both having normal hearing sensitivity were included in this study. Transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) were obtained in two conditions (with and without contralateral noise)., Results: Results of independent-samples t-test showed no statistically significant difference (p > 0.05) in the absolute amplitudes of both TEOAEs and DPOAEs between the individuals with and without misophonia. There was no statistically significant difference (p > 0.05) observed in the magnitude of suppression amplitude between the two groups for in both TEOAEs and DPOAEs between individuals with and without misophonia., Conclusion: These results suggest that the cochlear and efferent auditory underpinnings examined in this study may not be major contributors to the development or manifestation of misophonia., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: Numerous patient-reported outcome measures (PROMs) are available to measure hearing aid benefit and satisfaction. It is unclear to what extent currently available PROMs on hearing aid outcomes, often developed decades ago, meet current guidelines for good content validity and readability. This study evaluated the content validity and readability of PROMs that focus on perceived hearing aid benefit and/or satisfaction., Method: A literature review was conducted to identify eligible instruments. Content validity evaluation included mapping extracted questionnaire items to the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework. In addition, study design in content validity methodology was evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments study design checklist for PROM instruments. Readability was estimated using the Simple Measure of Gobbledygook measure., Results: Thirteen questionnaires were identified and evaluated. Item content focused primarily on the components of environmental factors as well as activity limitations and participation restrictions with less emphasis on body functions and personal factors. The content validity methodology analysis revealed an underuse or lack of reporting of a qualitative methodology in assessing patient and professional perspectives. All the included questionnaires exceeded the recommended sixth-grade reading level., Conclusions: The categories covered by hearing aid PROMs vary considerably, with no single instrument comprehensively covering all the key ICF components. Future development of hearing aid outcome measures should consider a mixed methodology approach for improved content validity and ensure an appropriate reading level.

Background and Objectives: Traditional sound field localization setups in a free-field environment closely represent real-world situations. However, they are costly and sophisticated, and it is difficult to replicate similar setups in every clinic. Hence, a cost-effective, portable, and less sophisticated virtual setup will be more feasible for assessing spatial acuity in the clinical setting. The virtual auditory space identification (VASI) test was developed to assess spatial acuity using virtual sources in a closed field. The present study compares the legitimacy of these two methods., Subjects and Methods: Fifty-five individuals with normal hearing (mean age±SD: 21± 3.26 years) underwent spatial acuity assessment using two paradigms: 1) the sound field paradigm (localization test) and 2) the virtual paradigm (VASI test). Location-specific and overall accuracy scores and error rates were calculated using confusion matrices for each participant in both paradigms., Results: The results of Wilcoxon signed-rank tests showed that the locationspecific and overall accuracy scores for both paradigms were not significantly different. Further, both paradigms did not yield significantly different localization error rates like right and left intra-hemifield errors, inter-hemifield errors, and front-back errors. Spearman's correlation analysis showed that all the measures of the two paradigms had mild to moderate correlation., Conclusions: These results demonstrate that both VASI and the sound field paradigm localization test performed equally well in assessing spatial acuity.

Background: Musical perception requires a host of skills. Instrumental musicians place greater emphasis on motor coordination, whereas vocal musicians rehearse vocal sounds. The study explored the differential advantages of musical background on binaural integration and interaction in musicians (instrumentalists, vocalists) and compared them with age-matched non-musicians., Methods: Eight six participants aged 20-40 y with normal hearing sensitivity were subjected to binaural tests using a standard group comparison research design. The participants were segregated into three groups - Group 1 included instrumentalists (n = 26, mean age: 17.73 ± 2.83 y), while Group 2 and Group 3 consisted of vocalists (n = 30, mean age: 19.30 ± 2.47 y) and non-musicians (n = 30, mean age: 18.20 ± 3.02 y) respectively. The binaural processes namely integration (Dichotic syllable test, DST; and virtual acoustic space identification - VASI) and interaction (Interaural difference thresholds for time and level: ITD & ILD), were administered on all the participants., Results: Statistical analyses showed the main effect of musicianship. Bonferroni pair-wise test revealed that the musicians (instrumentalists and vocalists) outperformed ( p  < 0.05) non-musicians in all the tests. The differential advantage of the musical background was seen on the binaural integration test with instrumentalists performing better in the VASI test compared to vocalists, and vice-versa for DST. No difference was observed in interaction tasks (ITD & ILD) between vocalists and instrumentalists ( p  > 0.05)., Conclusion: Musical background-induced differential advantages can be reasonably noted in the binaural skills of instrumentalists and vocalists (compared to non-musicians)., Competing Interests: There is no conflict of interest to disclose. This is a non-funded research., (© 2023 PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd.)

Purpose: The virtual acoustic space identification (VASI) test was designed to assess spatial-hearing acuity by simulating sound location perception in a closed field (under headphones). The utility of this tool in children can be asserted only if the test results are consistent across measurement sessions, which is evaluated in this study using test-retest reliability assessments., Method: The VASI test assessed the spatial abilities of 40 typically developing school-aged children aged 7-13 years ( M age = 10.47 ± 1.83 years, 22 boys, 18 girls). The test consisted of eight virtual location percepts (with 45° separation) produced under headphones (Sennheiser HD 569). Each spatial percept was presented randomly 7 times at 65 dB SPL. Each participant completed the assessment in three measurement sessions (baseline, intrasession, and intersession). The accuracy scores at each location and overall accuracy scores were compared across the sessions., Results: The Shapiro-Wilk test indicated that the VASI data were not normally distributed. Intraclass correlation coefficient analysis revealed excellent test-retest reliability of the overall accuracy scores and moderate-to-high reliability of location-specific scores. This was complimented by the low response variability of the overall and location-specific accuracy scores. The Bland-Altman analysis also indicated minimal bias in VASI accuracy scores across the three sessions., Conclusions: It can be concluded from the results that VASI is a reliable tool for assessing spatial-hearing acuity in school-aged children. The high test-retest reliability and ease of portability make the test highly relevant for classroom setups where early diagnosis and intervention of spatial deficits can play a critical role in determining the academic success of school-going children.

Objectives: Binaural hearing is the interplay of acoustic cues (interaural time differences: ITD, interaural level differences: ILD, and spectral cues) and cognitive abilities (e.g., working memory, attention). The current study investigated the effect of developmental age on auditory binaural resolution and working memory and the association between them (if any) in school-going children., Methods: Fifty-seven normal-hearing school-going children aged 6-15 y were recruited for the study. The participants were divided into three groups: Group 1 (n=17, M age  = 7.1y ± 0.72 y), Group 2 (n = 23; M age  = 10.2y ± 0.8 y), Group 3 (n = 17; M age : 14.1 y ±1.3 y). Group 4, with normal hearing young adults (n = 20; M age  = 21.1 y± 3.2 y), was included for comparing the maturational changes in former groups with adult values. Tests of binaural resolution (ITD and ILD thresholds) and auditory working memory (forward and backward digit span and 2n-back digit) were administered to all the participants., Results: Results indicated a main effect of age on spatial resolution and working memory, with the median of lower age groups (Group 1 & Group 2) being significantly poorer (p < 0.01) than the higher age groups (Group 3 & Group 4). Groups 2, 3, and 4 performed significantly better than Group 1 (p < 0.001) on the forward span and ILD task. Groups 3 and 4 had significantly better ITD (p = 0.04), backward span (p = 0.02), and 2n-back scores than Group 2. A significant correlation between scores on working memory tasks and spatial resolution thresholds was also found. On discriminant function analysis, backward span and ITD emerged as sensitive measures for segregating older groups (Group 3 & Group 4) from younger groups (Group 1 & Group 2)., Conclusions: The present study showed that the ILD thresholds and forward digit span mature by nine years. However, the backward digit span score continued to mature beyond 15 y. This finding can be attributed to the influence of auditory attention (a working memory process) on the binaural resolution, which is reported to mature till late adolescence., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Objective: The primary aim of the research was to document spatial acuity changes across the life span using a battery of psychoacoustical and perceptual tests. The secondary aim was to identify the optimal metric for measuring spatial processing changes across the life span (ages 10-70 years)., Design and Study Sample: A cross-sectional study comprising 115 participants with clinically normal hearing was conducted. Purposive sampling was adopted to recruit participants in the study, who were divided into six groups based on their chronological age., Method: Temporal, intensity, spectral, and composite correlates of spatial acuity were assessed using psychoacoustic measures and perceptual questionnaires. The temporal (interaural time difference [ITD]) and intensity correlates (interaural level difference [ILD]) of spatial perception were obtained using a MATLAB (v 2020a), whereas the composite correlate (virtual auditory space identification scores [VASIs]) and perceptual ratings of spatial processing were measured using Paradigm software and speech spatial and qualities in Kannada (SSQ-K)., Results: Results across all tests (multivariate analyses variance: 6 age groups × 4 tests, followed by post hoc tests) consistently demonstrate poor ITD and ILD thresholds and overall lower spatial accuracy (VASI, SSQ-K) with increasing age. Discriminant function analyses (DFAs) revealed that VASI had a higher predictive power in capturing age-related changes in auditory spatial processing. The group segregation on spatial performance in DFA became evident after 50 years., Conclusion: This study provides evidence of gradual change in all three correlates of spatial processing, with statistically demonstrable deficits appearing from fourth decade of life on VASI and fifth decade of life on binaural processing.

Purpose: The current study aims to evaluate gender variations in the efferent auditory system functioning in the ANSD population and compare them to normal hearing persons using contralateral suppression of spontaneous OAE (SOAEs)., Methods: For the current study, a total of 54 ears were considered prospectively. 27 ears with normal hearing (NH) sensitivity were in group I, while 27 ears with ANSD were in group II. All of the subjects had a regular audiological examination followed by synchronised SOAE recordings with and without broadband noise (in the contralateral ear) at 50 dB SPL and statistical analysis was carried out., Results: Wilcoxon signed rank test revealed a significant decrease in SOAE amplitude with contralateral noise stimulation in NH, while no such trend was observed in ANSD. However, contralateral SOAE stimulation resulted in significant high-frequency shifts for both the ANSD and NH groups in the noise condition. In the comparison of gender effects on SOAE amplitude and frequency shifts using Mann-Whitney, no significant gender differences were seen. The lack of gender differences in SOAE suppression is explained based on global standing wave theory and local oscillator theory., Conclusions: Contralateral effect of noise on SOAE shows frequency shifts, but not amplitude shifts both of which are not affected by gender effects., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: The present study aimed to quantify the effects of spatial training using virtual sources on a battery of spatial acuity measures in listeners with sensorineural hearing impairment (SNHI)., Methods: An intervention-based time-series comparison design involving 82 participants divided into three groups was adopted. Group I ( n = 27, SNHI-spatially trained) and group II ( n = 25, SNHI-untrained) consisted of SNHI listeners, while group III ( n = 30) had listeners with normal hearing (NH). The study was conducted in three phases. In the pre-training phase, all the participants underwent a comprehensive assessment of their spatial processing abilities using a battery of tests including spatial acuity in free-field and closed-field scenarios, tests for binaural processing abilities (interaural time threshold [ITD] and level difference threshold [ILD]), and subjective ratings. While spatial acuity in the free field was assessed using a loudspeaker-based localization test, the closed-field source identification test was performed using virtual stimuli delivered through headphones. The ITD and ILD thresholds were obtained using a MATLAB psychoacoustic toolbox, while the participant ratings on the spatial subsection of speech, spatial, and qualities questionnaire in Kannada were used for the subjective ratings. Group I listeners underwent virtual auditory spatial training (VAST), following pre-evaluation assessments. All tests were re-administered on the group I listeners halfway through training (mid-training evaluation phase) and after training completion (post-training evaluation phase), whereas group II underwent these tests without any training at the same time intervals., Results and Discussion: Statistical analysis showed the main effect of groups in all tests at the pre-training evaluation phase, with post hoc comparisons that revealed group equivalency in spatial performance of both SNHI groups (groups I and II). The effect of VAST in group I was evident on all the tests, with the localization test showing the highest predictive power for capturing VAST-related changes on Fischer discriminant analysis (FDA). In contrast, group II demonstrated no changes in spatial acuity across timelines of measurements. FDA revealed increased errors in the categorization of NH as SNHI-trained at post-training evaluation compared to pre-training evaluation, as the spatial performance of the latter improved with VAST in the post-training phase., Conclusion: The study demonstrated positive outcomes of spatial training using VAST in listeners with SNHI. The utility of this training program can be extended to other clinical population with spatial auditory processing deficits such as auditory neuropathy spectrum disorder, cochlear implants, central auditory processing disorders etc., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Nisha, Uppunda and Kumar.)

Background: Recent developments in virtual acoustic technology has levered promising applications in the field of auditory sciences, especially in spatial perception. While conventional auditory spatial assessment using loudspeakers, interaural differences and/or questionnaires are limited by the availability and cost of instruments, the use of virtual acoustic space identification (VASI) test has widespread applications in spatial test battery as it overcomes these constraints., Purpose: The lack of test-retest reliability data of VASI test narrows its direct application in auditory spatial assessment, which is explored in the present study., Methods: Data from 75 normal-hearing young adults (mean age: 25.11 y ± 4.65 SD) was collected in three sessions: baseline, within 15 min of baseline (intra-session), and one week after baseline session (inter-session). Test-retest reliability was assessed using the intra-class correlation coefficient (ICC), coefficient of variation (CV), and cluster plots., Results: The results showed excellent reliability for both accuracy and reaction time measures of VASI, with ICC values of 0.93 and 0.87, respectively. The CV values for overall VASI accuracy and reaction time 9.66% and 11.88%, respectively. This was also complemented by the cluster plot analyses, which showed 93.33% and 96.00% of temporal stability in the accuracy and reaction time measures, indicative of high test-retest reliability of VASI test in auditory spatial assessment., Conclusions: The high temporal stability (test-retest reliability) of VASI test validates its application in spatial hearing test battery., Competing Interests: There is no conflict of interest to disclose. This is a non-funded research., (© [copyright 2022] PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd.)

Purpose: Onset-based differences are understudied in Auditory Neuropathy Spectrum Disorder (ANSD) in dimensions such as voice, which is addressed in the study. The study aimed to profile and predict the best metrics of onset-related differences in acoustic vocal characteristics of early and late-onset ANSD patients., Methods: 31 participants (15 early and 16 late-onset) aged 15-30 years diagnosed with ANSD were included in the study. The sustained phonation of vowel /i/ recorded by the participants using android based smartphones of selected configuration was sent over email to the experimenter. Acoustic parameters (fundamental frequency, harmonic frequencies, jitter, shimmer, harmonic-to-noise ratio, cepstral peak prominence -CPP, and pitch sigma) were analysed using Praat software., Results: Results revealed significantly increased (p < 0.05) fundamental frequency along with decreased F2 and F3 of /i/ in the early-onset ANSD compared to the late-onset group, which can be explained based on differences in the pathophysiology of the disorder. Although not statistically significant, mean perturbations (jitter and shimmer), harmonic-to-noise ratio, cepstral peak prominence, and pitch sigma were more affected in the early-onset group, reflective of lowered auditory feedback and periodicity in their voice samples. Results of discriminant analysis marked the emergence of F2, F3, and CPP as the most sensitive metrics for onset-based group differences in voice characteristics., Conclusions: The findings from the study highlight the role of acoustical voice evaluation (especially CPP, F2 & F3) in verifying the onset of ANSD disorder. The insights from the onset-based differences seen in vocal characteristics can indirectly help audiologists in deciding the management options for ANSD., (© 2022 PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd.)

Introduction  The spatial auditory system, though developed at birth, attains functional maturity in the late childhood (12 years). Spatial changes during childhood affect navigation in the environment and source segregation. Accommodation of a new skill through learning, especially during childhood, can expedite this process. Objective  To explore the auditory spatial benefits of abacus training on psychoacoustic metrics in children. The study also aimed to identify the most sensitive metric to abacus training related changes in spatial processing, and utilize this metric for a detailed spatial error profiling. Methods  A standard group comparison analysis with 90 participants divided into three groups: I: children with abacus training (C-AT); II: children with no training (C-UT); III: adults with no training (A-UT). The groups underwent a series of psychoacoustic tests, such as interaural time difference (ITD), interaural level difference (ILD), and virtual auditory space identification (VASI), as well as perceptual tests such as the Kannada version of the speech, spatial, and quality questionnaire (K-SSQ). Results  Significant group differences were observed in the multivariate analysis of variance (MANOVA) and post-hoc tests, with the C-AT group showing significantly lower ILD scores ( p  = 0.01) and significantly higher VASI scores ( p <0.001) compared to the C-UT group, which is indicative of better spatial processing abilities in the former group. The discriminant function (DF) analyses showed that the VASI was the most sensitive metric for training-related changes, based on which elaborate error analyses were performed. Conclusions  Despite the physiological limits of the immature neural framework, the performance of the C-AT group was equivalent to that of untrained adults on psychoacoustic tests, which is reflective of the positive role of abacus training in expediting auditory spatial maturation., Competing Interests: Conflict of Interests The authors have no conflict of interests to declare., (Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Objective: This article aimed to assess the relationship between musical training and age-related changes in binaural, temporal, and spatial processing abilities., Design: A standard group comparison study was conducted involving both musicians and nonmusicians. The effect of musical training was assessed using a battery of psychoacoustical tests (interaural time and level difference thresholds: ITD & ILD, binaural gap detection threshold, and virtual auditory space identification test) and subjective ratings (Spatial-Hearing subsection of Speech, Spatial, and Quality of Hearing scale in Kannada)., Study Sample: A total of 60 participants, between 41 and 70 years, were divided into three groups of 20 each, based on their age (41-50, 51-60, and 61-70 years). Each of these three groups was subdivided into two, one comprising 10 musicians (vocalists practicing South-Indian classical music) and the other comprising 10 nonmusicians., Results: Multivariate analyses of variance revealed that musicians performed significantly better ( p < .001) than nonmusicians in all the tests. Analyses of variance showed that whereas age had no effect ( p > .05) on performance in any of the tests in musicians, age affected the performance of nonmusicians significantly in terms of ITD ( p = .02) and ILD ( p = .01) thresholds., Conclusion: Musical training appears to have the potential to slow down age-related decline in binaural, temporal, and spatial processing.

Background and Objectives: This study compared the effectiveness of two spatial training programs using real and virtual sound sources in refining spatial acuity skills in listeners with normal hearing., Subjects and Methods: The study was conducted on two groups of 10 participants each; groups I and II underwent spatial training using real and virtual sound sources, respectively. The study was conducted in three phases: pre-training, training, and post-training phases. At the pre- and post-training phases, the spatial acuity of the participants was measured using real sound sources through the localization test, and virtual sound sources through the virtual acoustic space identification (VASI) test. The thresholds of interaural time difference (ITD) and interaural level difference (ILD) were also measured. In the training phase, Group I participants underwent localization training using loudspeakers in free field, while participants in Group II were subjected to virtual acoustic space (VAS) training using virtual sound sources from headphones. Both the training methods consisted of 5-8 sessions (20 min each) of systematically presented stimuli graded according to duration and back attenuation (for real source training) or number of VAS locations (for virtual source training)., Results: Results of independent t-scores comparing the spatial learning scores (pre vs. post-training) for each measure showed differences in performance between the two groups. Group II performed better than Group I on the VASI test, while the Group I out-performed Group II on the ITD. Both groups improved equally on the localization test and ILD., Conclusions: Based on the present findings, we recommend the use of VAS training as it has practical implications due to its cost effectiveness, need for minimal equipment, and end user usefulness.

Background: Tinnitus is one of the most frequent chronic conditions in adults with wide range of consequences., Aims/objectives: The aim of the current study was to determine the problems and life effects reported by individuals with tinnitus using the International Classification of Functioning, Disability and Health (ICF) framework., Material and Methods: The study used a cross-sectional survey design. A total of 344 individuals with tinnitus completed a series of questionnaires. The responses to open-ended questions were linked to ICF categories., Results: Activity limitations and participation restrictions were most dominant consequence of tinnitus followed by effect on the body function with limited emphasis on the contextual factors. Frequently reported responses to body function involved emotional functions (b152), attention function (b140), and sleep functions (b134). Commonly reported responses to activity limitations and participation restrictions were recreation and leisure (d920), conversation (d350), communicating with-receiving-spoken messages (d310), listening (d115), and remunerative employment (d850). Sound intensity (e2500) and sound quality (e2501) were the frequently reported responses to environmental factors. Coping styles, past and present experiences, and lifestyle were the most frequently occurring personal factors., Conclusions and Significance: The study highlighted some key influencing factors of tinnitus in different ICF domains which can be helpful in rehabilitation planning.

Background and Objectives: The influence of musical aptitude on cognitive test performance in musicians is a long-debated research question. Evidence points to the low performance of nonmusicians in visual and auditory cognitive tasks (working memory and attention) compared with musicians. This cannot be generalized to all nonmusicians, as a sub-group in this population can have innate musical abilities even without any formal musical training. The present study aimed to study the effect of musical aptitude on the working memory and selective attention., Subjects and Purpose: Three groups of 20 individuals each (a total of 60 participants), including trained-musicians, nonmusicians with good musical aptitude, and nonmusicians with low musical aptitude, participated in the present study. Cognitive-based visual (Flanker's selective attention test) and auditory (working memory tests: backward digit span and operation span) tests were administered., Results: MANOVA (followed by ANOVA) revealed a benefit of musicianship and musical aptitude on backward digit span and Flanker's reaction time (p<0.05). Discriminant function analyses showed that the groups could be effectively (accuracy, 80%) segregated based on the backward digit span and Flanker's selective attention test. Trained musicians and nonmusicians with good musical aptitude were distinguished as one cluster and nonmusicians with low musical aptitude formed another cluster, hinting the role of musical aptitude in working memory and selective attention., Conclusions: Nonmusicians with good musical aptitude can have enhanced working memory and selective attention skills like musicians. Hence, caution is required when these individuals are included as controls in cognitive-based visual and auditory experiments.

Background: The current study attempted to assess efferent auditory system functioning in individuals with auditory neuropathy spectrum disorder (ANSD) using a new approach, contralateral suppression of SOAE, which has not yet been extensively researched., Methods: Spontaneous otoacoustic emissions (SOAEs) were recorded in a total of 62 ears, divided into 2 groups. Group I comprised of 31 ears with normal hearing (NH), while group II consisted of 31 ears with ANSD. All the participants considered for the study were in the age range of 18-45 years. Synchronized SOAE were recorded using the ILO V6 OAE instrument with and without noise (broadband noise, 50 dB SPL) in the contralateral ear. The frequency and amplitude shifts secondary to the introduction of contralateral noise were analyzed., Results: The results of the study showed a statistically significant high-frequency shift of SOAE with contralateral noise for the NH and ANSD groups. In addition, the NH group also exhibited a statistically significant reduction in SOAE amplitude in contralateral noise conditions. Such a reduction in SOAE amplitude was not observed in individuals with ANSD., Conclusion: The absence of suppression of SOAE amplitude suggests efferent damage in individuals with ANSD. The shift in SOAE frequency toward higher frequency in the ANSD group, which is similar to NH group, is suggestive of differential allotment of medial olivocochlear (MOC) mechanism in individuals with ANSD, which codes for contralateral frequency changes and not for amplitude changes.

Objectives: The present study explored the auditory benefits of abacus-training using a battery of tests (auditory acuity, clarity, and cognition). The study also aimed to identify the relative contributions of auditory processing tests that are most sensitive to the effects of abacus-training., Materials and Methods: The study was conducted on 60 children aged between 9 - 14 years. These participants were divided into two groups (abacus trained and untrained) of 30 each, who underwent a series of auditory functioning tests. The battery of tests included: auditory acuity (frequency, intensity, temporal, binaural and spatial resolution), auditory clarity (speech perception in noise), and auditory cognition (working digit and syllable memory)., Results: Statistically (t-test and Mann Whitney U test), significant changes were observed in the spatial resolution, auditory clarity, and cognition tests, suggestive of positive outcomes of abacus training at the higher-order auditory processing. This finding was complemented by the discriminant function (DF) analyses, which showed that clarity and cognitive measures helped for effective group segregation (abacustrained and untrained). These measures had significantly higher contributions to the DF., Conclusions: The findings of the study provide evidence of the multi-component benefits of abacus training in children and the transferability of learning effects to the auditory modality., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Purpose This study was carried out to understand the neural intricacies of auditory spatial processing in listeners with sensorineural hearing impairment (SNHI) and compare it with normal hearing (NH) listeners using both local and global measures of waveform analyses. Method A standard group comparison research design was adopted in this study. Participants were assigned to 2 groups. Group I consisted of 13 participants with mild-moderate flat or sloping SNHI, while Group II consisted of 13 participants with NH sensitivity. Electroencephalographic data using virtual acoustic stimuli (spatially loaded stimuli played in center, right, and left hemifields) were recorded from 64 electrode sites in passive oddball paradigm. Both local (electrode-wise waveform analysis) and global (dissimilarity index, electric field strength, and topographic pattern analyses) measures were performed on the electroencephalographic data. Results Results of local waveform analyses marked the appearance of mismatch negativity in an earlier time window, relative to those reported conventionally in both the groups. The global measures of electric field strength and topographic modulations (dissimilarity index) revealed differences between the 2 groups in different time periods, indicating multiphases (integration and consolidation) of spatial processing. Further, the topographic pattern analysis showed the emergence of different scalp maps for SNHI and NH in the time window corresponding to mismatch negativity (78-150 ms), suggestive of differential spatial processing between the groups at the cortical level. Conclusions The findings of this study highlights the differential allotment of neural generators, denoting variations in spatial processing between SNHI and NH individuals.

Introduction: The emergence of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli has become an important challenge among pediatric patients with community-acquired urinary tract infection (UTI)., Objectives: The aim of this study was to assess the antimicrobial susceptibility patterns, associated risk factors and to survey the frequency of bla cefotaximase (CTX-M), bla temoneira (TEM), and bla sulfhydryl variable (SHV) genotypes in ESBL-producing E. coli isolated from children with community-acquired UTI., Methods: This was a prospective study conducted from November 2012 to March 2016 in a tertiary care center. E. coli isolated in urine cultures from children aged ≤18 years was identified and confirmed for ESBL production. ESBL-positive strains were screened for ESBL encoding genes. Chi-square test and Fisher's exact test were used to compare the difference in antibiotic susceptibility with respect to ESBL positive and negative, and binary logistic regression was used to identify the risk factors associated with ESBL production., Results: Among 523 E. coli isolates, 196 (37.5%) were ESBL positive, >90% were resistant to cephalosporins, and 56% were resistant to fluoroquinolones. Least resistance was observed for imipenem, netilmicin, and nitrofurantoin (2%, 8.6%, 15.3%). Association between ESBL production and drug resistance was significant for ceftazidime ( P < 0.001), cefixime ( P < 0.001), cefotaxime ( P = 0.010), ceftazidime-clavulanic acid ( P < 0.001), levofloxacin ( P = 0.037), and gentamicin ( P = 0.047) compared to non-ESBL E. coli . CTX-M gene was the most prevalent (87.5%), followed by TEM (68.4%) and SHV (3.1%). Previous history of UTI and intake of antibiotics were the common risk factors., Conclusion: ESBL-producing E. coli from community-acquired pediatric UTI carries more than one type of beta-lactamase coding genes correlating their increased antibiotic resistance. Aggressive infection control policy, routine screening for detecting ESBL isolates in clinical samples, and antimicrobial stewardship are the keys to prevent their dissemination in community settings., Competing Interests: There are no conflicts of interest.

Objective: Localization involves processing of subtle yet highly enriched monaural and binaural spatial cues. Remediation programs aimed at resolving spatial deficits are surprisingly scanty in literature. The present study is designed to explore the changes that occur in the spatial performance of normal-hearing listeners before and after subjecting them to virtual acoustic space (VAS) training paradigm using behavioral and electrophysiological measures., Materials and Methods: Ten normal-hearing listeners participated in the study, which was conducted in three phases, including a pre-training, training, and post-training phase. At the pre- and post-training phases both behavioral measures of spatial acuity and electrophysiological P300 were administered. The spatial acuity of the participants in the free field and closed field were measured apart from quantifying their binaural processing abilities. The training phase consisted of 5-8 sessions (20 min each) carried out using a hierarchy of graded VAS stimuli., Results: The results obtained from descriptive statistics were indicative of an improvement in all the spatial acuity measures in the post-training phase. Statistically, significant changes were noted in interaural time difference (ITD) and virtual acoustic space identification scores measured in the post-training phase. Effect sizes (r) for all of these measures were substantially large, indicating the clinical relevance of these measures in documenting the impact of training. However, the same was not reflected in P300., Conclusion: The training protocol used in the present study on a preliminary basis proves to be effective in normal-hearing listeners, and its implications can be extended to other clinical population as well.

Bottled water is generally accepted as safe for consumption. However, its potability is uncertain. Ninety samples of Six national and 3 local brands marketed in Mangalore City were studied. Seven of these were ISI certified. Bacteriological analysis of these samples were carried out for viable count, presumtive coliform count by multiple tube method, confirmed Esch. coli count by Eijkman test and specific intestinal pathogens, such as Salmonella, Shigella and Vibrios. Thirty out of 90 samples though free from coliforms, had viable count much higher than specified by Bureau of Indian Standard. Three samples of one of the brands which is ISI not certified had Esch. coli with most probable number 18/100 ml and Salmonella typhimurium. It is concluded that bottled water can not be taken for granted to be safe.