Balance Deficits Research Articles

Efeito agudo da terapia por ondas de choque na pressão plantar e equilíbrio de indivíduos hemiparéticos

Abstract Introduction: Cerebral vascular accident (CVA) is the second leading cause of death and is one of the diseases that most generate disability Hemiparesis is the most common motor deficit, and one of its characteristics is asymmetry in weight bearing and in the plantar sup-port area, leading to balance deficits. extracorporeal shock-wave therapy (ESWT) has been shown to be effective in reducing post-stroke spasticity. Objective: To evaluate the effect of a ESWT session on the distribution of plantar pressure and on the static and dynamic balance of hemiparetic individuals after stroke. Methods: Twelve individuals with hemiparesis as a result of stroke in the chronic stage participated in the study. Data collection was divided into two days. On the first day, anamnesis and tests were performed: timed up and go (TUG), four square step test (FSST), and short physical performance battery (SPPB). After carrying out the tests, the distribution of plantar pressure was evaluated using baropodometry. Also on the first day, participants received ESWT in the muscle belly of the gastrocnemius muscle on the hemiparetic side. At the end of the ESWT session and after 7 days, the individuals were reassessed. Results: The results referring to the static and dynamic balance and baropodometry evaluations performed before, immediately after and one week after the application of ESWT did not show a significant difference between the three evaluations in any of the tests and in any of the moments performed. Conclusion: One ESWT session did not affect plantar pressure distribution and static and dynamic balance of hemiparetic individuals after stroke.

Use of Reactive Balance Assessments With Clinical Baseline Concussion Assessments in Collegiate Athletes.

Current clinical concussion evaluations assess balance deficits using static or dynamic balance tasks while largely ignoring reactive balance. Including a reactive balance assessment might provide a more comprehensive concussion evaluation. To identify redundancy in current clinical baseline assessments of concussion and determine whether reactive balance adds unique information to these evaluations. Cross-sectional study. Clinical assessment. A total of 279 healthy National Collegiate Athletic Association Division I athletes. Two cohorts of data were collected at the beginning of the athletic season. For cohort 1 (n = 191), the Immediate Post-Concussion Assessment and Cognitive Tool, instrumented modified push and release (I-mP&R), and Balance Error Scoring System (BESS) were administered. For cohort 2 (n = 88), the I-mP&R, BESS, timed tandem gait, walking with eyes closed, and clinical reaction time were administered. The strengths of the relationships between the Immediate Post-Concussion Assessment and Cognitive Tool cognitive indices, mP&R clinical score, instrumented measures (BESS sway; I-mP&R time to stability, latency, and step length), BESS score, timed tandem gait, walking time to completion, and clinical reaction time were characterized. The strongest interinstrument correlation value was between single-task time to stability from the I-mP&R and clinical reaction time but was considered weak (r = 0.35, P = .001). The mP&R and I-mP&R clinical scores were weakly associated with the other assessments. Weak correlations between interassessment variables indicated that little redundancy was present in the current clinical evaluations. Furthermore, reactive balance represents a unique domain of function that may improve the comprehensiveness of clinical assessments.

Establishing the Normative Reference Values of Timed Up and Go Test among Normal Weight and Overweight Schoolage Children: A Study Protocol

Introduction: The dynamics of body posture to avoid falling are generally referred to as balance. It has been shown that child developmental skills are influenced by their body compositions. When compared to their peers who are at a healthy weight, children who are overweight or obese frequently show poorer levels of motor proficiency including balance, mobility and related features. Need of the study: The protocol will determine the typical TUG test results in children relative to their body composition, enabling clinicians to effectively screen for balance deficits in children and will enable timely interventions to prevent falls, accidents, and sports injuries in children. Aim: To find the reference values of Timed Up and Go (TUG) test in normal weight and overweight children and compare the values between them. Materials and Methods: A study protocol on school-going children aged 5 to 15 years will be recruited using convenience sampling and divided into two groups based on their Body Mass Index (BMI): normal weight and overweight. The procedure for performing TUG test will be taught to the children, and the time taken for completion will be recorded using a stopwatch. To check the normality, Kolmogorov test will be applied as sample size estimated is above 50. Parametric or non parametric tests will be used for between group analyses.

Effectiveness of a Virtual Reality-Based Rehabilitation Program versus Conventional Physical Therapy in Improving Motor Function and Balance in Stroke Survivors: A Randomized Controlled Trial.

Background: Stroke is a leading cause of mortality and functional impairment worldwide, often resulting in balance and motor function deficits. Conventional stroke therapy, primarily consisting of aerobic exercise and physical training, does not fully address neuroplasticity-related motor improvements in stroke survivors. Recent advancements in technology have enabled the development of virtual reality-based rehabilitation (VRBR), which offers immersive, intensive therapy that may be more effective than traditional methods. Objective: This study aims to evaluate the efficacy of VRBR compared to conventional physical therapy (CPT) in enhancing motor function and balance in individuals who have experienced a stroke. Methods: A randomized controlled trial was conducted at Johar Poly Clinic, Lahore, over a 9-month period, with 56 participants who had recent stroke diagnoses. Participants were randomly assigned to either the VRBR or CPT group. Balance was measured using the Berg Balance Scale, and functional abilities were assessed with the Barthel Index Scale. Statistical analysis included descriptive and inferential methods to identify within-group and between-group differences. Results: In the study, both the Virtual Reality-Based Rehabilitation (VRBR) and Conventional Physical Therapy (CPT) groups showed improvements, but the VRBR group exhibited statistically significant increases in both balance and functional abilities. Specifically, Berg Balance Scale scores improved more in the VRBR group (from 20 ± 3.5 at baseline to 30 ± 6 at 9 months) compared to the CPT group (from 19 ± 4 to 25 ± 5). Similarly, Barthel Index Scale scores, which measure functional abilities, increased substantially in the VRBR group (from 40 ± 6 to 55 ± 9), outperforming the CPT group (from 39 ± 5.5 to 48 ± 8) over the 9-month study period. These results indicate a potential advantage of VRBR in enhancing balance and functional independence among stroke survivors. Conclusion: Virtual Reality-Based Rehabilitation demonstrates significant potential in improving balance and functional abilities among stroke survivors compared to conventional physical therapy. The immersive nature and intensity of VRBR may contribute to its effectiveness, suggesting its incorporation into stroke rehabilitation protocols.

Is trunk training effective at improving ability in activities of daily living and function of people who have had a stroke? ACochrane Review summary with commentary.

Effective trunk control is an essential component of sitting and standing balance, and is a key requirement for movement of the head and limbs, and for carrying out functional tasks. A stroke can result in impaired trunk control, affected by stroke-related deficits in balance, muscle function, coordination and position sense. Recovery of trunk control is recognised as a key goal of stroke rehabilitation. To evaluate the effectiveness of trunk training interventions in people with stroke. A summary of the Cochrane Review by Thijs et al. (2023), with comments from a rehabilitation perspective. 68 studies (2585 participants) were included in the Cochrane review. Trunk training was not found to have any benefit on measures of ADL, when compared to other dose-matched therapies, but did improve trunk function and other outcomes. Trunk training was more beneficial than non-dose-matched therapies for measures of ADL, trunk function, and other outcomes. The certainty of these findings is very low. Evidence supports the use of trunk training as part of stroke rehabilitation. However certainty in these findings is very low due to volume, quality and heterogeneity of the evidence.

Effect of Public Debt on the twin deficits using a Threshold time series model: Case Study of Jordan 1980-2020

This study examines the Effect of Public Debt on the twin deficits using the threshold time series model of the Jordanian economy from 1980-2020. The independent variables were relied upon: private saving, production gap, economic growth, trade openness, and budget deficit. In addition to public debt as a threshold variable. The results indicated that the optimal number of model systems is six systems only, which means that there are only five thresholds. The results also showed that three threshold values are significant, but there are two values of the threshold which are not significant, but there are two values of the threshold which are not significant. The results support the Keynesian view of the strong and positive relationship between the current account balance deficit, saving, budget deficit, and trade openness in Jordan during the period 1980-2020. Work must be done to reduce the budget deficit or to enhance saving and investment, or both in Jordan, which may help reduce the current account deficit. However, it requires radical reforms in the trade and financial sectors to achieve efficient markets. To increase external competitiveness, it is necessary to put in place incentive policies for production to increase exports to take advantage of trade liberalization policies in the field of specialization in production.

PREDICTING FALLS IN OLDER ADULTS

Abstract Falls are detrimental to older adults causing injury and mortality. Although clinical assessments of balance deficits exist, it is not well understood how well they predict falls. Longitudinal analysis utilized data from 688 men and women aged 60-97 enrolled in the Baltimore Longitudinal Study of Aging with index and subsequent visits approximately 1.7 years apart. Inclusion criteria included objective balance assessment at index visit and answering the question “Have you fallen in the past 12 months?” at both visits. Predictors of interest included thigh muscle strength, progressive static balance test performance, narrow walk, and sway reference with eyes closed/feet together. Tests were parameterized using validated methods. Adjusted logistic regression was modeled to estimate the association between objective measures of balance and fall risk. Adjustment variables included age, sex, race, height, and weight. Results reported those who failed the eyes closed/feet together position had 3.6 (95% CI 1.03, 12.81) times the odds of future falls compared with those who passed. Those who failed the semi-tandem, tandem, and single leg stance, had respectively 3.1 (1.44, 6.75), 3.6 (1.59, 8.06) and 4.8 (1.93, 12.09) times greater odds of history of falls compared with those who did not fail. Progressive standing balance performance did not predict future falls. The eyes closed/feet together test is easily administered, requires no equipment, and takes less than 30 seconds to complete. Failure of eyes closed/feet together may predict future falls, which is clinically relevant as this may suggest shifting the momentum towards proactively preventing an initial fall.

The Impact of Macroeconomic Factors on Current Account Deficit in ASEAN Countries

In most ASEAN nations, a deficit in the current account balance began in 2018, sparking concerns among these countries. The deficit in the current account has led to various disadvantages in ASEAN countries, harming the nation’s economic health. Therefore, this paper analyzes the macroeconomic factors influencing the current account deficit in selected ASEAN countries. Data from eight ASEAN countries were analyzed using a panel static approach. Findings reveal that exchange rate (ER), Term of trade (TOT) and interest rate (IR) are the main factors that influence the deterioration of current account balances. Meanwhile, money supply (MS), and oil price (OILP) showed insignificant relationships towards current account balances. As ER, IR and TOT influence the current account significantly, it is suggested that the authorities in ASEAN countries have policy reforms and macroeconomic adjustments accordingly to improve the current account deterioration.

Smartphone-based evaluation of static balance and mobility in long-lasting COVID-19 patients.

SARS-CoV-2 infection can lead to a variety of persistent sequelae, collectively known as long COVID-19. Deficits in postural balance have been reported in patients several months after COVID-19 infection. The purpose of this study was to evaluate the static balance and balance of individuals with long COVID-19 using inertial sensors in smartphones. A total of 73 participants were included in this study, of which 41 had long COVID-19 and 32 served as controls. All participants in the long COVID-19 group reported physical complaints for at least 7 months after SARS-CoV-2 infection. Participants were evaluated using a built-in inertial sensor of a smartphone attached to the low back, which recorded inertial signals during a static balance and mobility task (timed up and go test). The parameters of static balance and mobility obtained from both groups were compared. The groups were matched for age and BMI. Of the 41 participants in the long COVID-19 group, 22 reported balance impairment and 33 had impaired balance in the Sharpened Romberg test. Static balance assessment revealed that the long COVID-19 group had greater postural instability with both eyes open and closed than the control group. In the TUG test, the long COVID-19 group showed greater acceleration during the sit-to-stand transition compared to the control group. The smartphone was feasible to identify losses in the balance motor control and mobility of patients with long-lasting symptomatic COVID-19 even after several months or years. Attention to the balance impairment experienced by these patients could help prevent falls and improve their quality of life, and the use of the smartphone can expand this monitoring for a broader population.

Immediate effects of local muscle vibration on static and dynamic balance control in individuals with chronic ankle instability

ObjectivesTo investigate the immediate effects of local muscle vibration (LMV) on static and dynamic balance control in individuals with and without chronic ankle instability (CAI). DesignQuasi-experimental study. SettingResearch laboratory. ParticipantsTwenty-six individuals with CAI and 26 healthy controls. Main outcome measuresCenter of pressure variables (mean total velocity and displacement in anteroposterior (AP) and mediolateral (ML) directions) during single-leg standing with eyes open and eyes closed and also reach distances in anterior (ANT), posteromedial (PM), and posterolateral (PL) directions of the modified star excursion balance test (MSEBT) were assessed before and after LMV. ResultsStatistical analyses showed a significant decrease in mean total velocity and displacement in AP direction from before to after LMV in eyes open condition for both individuals with CAI (p = 0.025, p = 0.041, respectively) and healthy controls (p = 0.001, p = 0.003, respectively). Similar results were observed in eyes closed condition for both individuals with CAI (p < 0.001, p < 0.001, respectively) and healthy controls (p = 0.040, p = 0.014, respectively). The results also showed increased reach distances in ANT (p < 0.001), PM (p < 0.001), and PL directions (p < 0.001) in all participants after LMV. ConclusionOur results suggest that LMV may be a useful tool in rehabilitation of static and dynamic balance deficits in individuals with CAI.

Antiretroviral drug use and the risk of falls in people living with HIV: a systematic review and meta-analysis

Objective: The risk of falls in people living with HIV (PLHIVs) on antiretroviral therapy (ART) has received little attention in the literature. The aim of the meta-analysis is to quantify the association between fall risk and various categories of drugs used in ART. Material and Methods: PubMed, Google Scholar, Embase, and the Cochrane Central Register of Controlled Trials were systematically searched from inception to January 2023. Any observational study or controlled trial that reported on the relationship of at least one antiretroviral drug with falls in PLHIVs was included. Data on the frequency of single fallers, multiple fallers (≥2 falls), and non-fallers were extracted and studied for each drug and drug category. The pooled results were reported as an odds ratio (OR) with a 95% confidence interval (CI). Results: A total of five observational studies (51 675 participants) were included out of 414 articles obtained through a literature review. Stavudine use was found to be associated with an increased risk of single falls in PLHIVs (OR: 1.69, 95% CI: 1.08–2.66, P=0.02). However, efavirenz (OR: 0.82, 95% CI=0.76–0.89, P&lt;0.001) and zidovudine (OR: 0.82, 95% CI=0.77–0.92, P&lt;0.001) were found protective against the single falls. Didanosine had no significant association with fall risk (OR: 1.23, 95% CI: 0.78–1.93, P=0.37). Likewise, protease inhibitors, integrase inhibitors, nucleoside reverse transcriptase inhibitors, and non-nucleoside reverse transcriptase inhibitors were discovered to have no significant association with fall risk. Conclusion: Most drug categories of ART have no significant association with the risk of falls in PLHIVs. However, certain drugs, such as didanosine and stavudine, which have the inherent effect of causing balance deficits and neuropathy, should be used cautiously.

PENGARUH EKSPOR, IMPOR KOPI DAN PERTUMBUHAN EKONOMI TERHADAP NERACA PERDAGANGAN INDONESIA TAHUN 2003-2018

This research analyzes the impact of coffee exports, imports, and economic growth on Indonesia's trade balance in 2003-2018. The multiple linear regression analysis method tests the relationship between these variables. Data obtained from Indonesian Plantation Statistics for Coffee Commodities (2019). The research results show that coffee exports significantly negatively impact the trade balance, which means that an increase in coffee exports can cause a decline in the trade balance. On the other hand, coffee imports have a significant negative impact, indicating that increasing coffee imports can contribute to the trade balance deficit. The importance of policies that support increasing the competitiveness of coffee exports, controlling imports, and sustainable economic development to achieve a better trade balance. Further research can explore in-depth micro and macroeconomic aspects to produce more specific policy recommendations.

Modeling the distribution of headwater streams using topoclimatic indices, remote sensing and machine learning.

Headwater streams (HWS) are ecologically important components of montane ecosystems. However, they are difficult to map and may not be accurately represented in existing spatial datasets. We used topographically resolved climatic water balance data and satellite indices retrieved from Google Earth Engine to model the occurrence (presence or absence) of HWS across Northwest Montana. A multi-scale feature selection (MSFS) procedure and boosted regression tree models/machine learning algorithms were used to identify variables associated with HWS occurrence. In final model evaluation, models that included climatic water balance deficit were more accurate (83.5% ranging from 82.9% to 83.7%) than using only terrain indices (81.1% ranging from 80.7% to 81.4%) and improved upon estimates of stream extent represented by the National Hydrography Dataset Plus High Resolution (NHDPlus HR) (82.7% ranging from 82.5% to 83.1%). Including topoclimate captured the varying effect of upslope accumulated area across a strong moisture gradient. Multi-scale cross-validation, coupled with a MSFS algorithm allowed us to find a parsimonious model that was not immediately evident using standard cross-validation procedures. More accurate spatial model predictions of HWS have potential for immediate application in land and water resource management, where significant field time can be spent identifying potential stream impacts prior to contracting and planning.

Interference of Seizure Disorders on Motor Functions, Coordination and Balance in Wistar Rats

Chronic recurrent seizures is a characteristic feature of epilepsy. It is a chronic neurological condition, usually resulting in unpredictable, unprovoked recurrent seizures that affect a variety of mental and physical functions. Some motor functions appear vulnerable to these seizure disorders. This study investigated the neurobehavioural analysis of pentylenetetrazole (PTZ) induced seizure on motor balance, coordination in Wistar rats. The study was done in two phases: acute (14days) and chronic (28days). A total of twenty adult Wistar rats weighing between 90-120g were used for each phase of study. The rats were divided into four (4) groups (1-4, n=5). PTZ was administered intraperitoneally to the PTZ treated groups one (1) week before the neurobehavioral experiments commenced. Group 1 (control) received distilled water; groups 2, 3 and 4 were administered with subconvulsive doses of PTZ (25mg/kg, 30mg/kg and 35mg/kg) respectively at alternate days (48 hourly) until kindling was achieved. The study evaluated neurobehavioural parameters using Rotarod test (RT) and Handgrip test (HT). In both tests, the time latencies were significantly (P&lt;0.05) reduced and worsened with time, when test groups were compared to control either in acute or chronic phase study. The results from the current study on the effects of the chemoculvosant seizures on motor functions, coordination and balance shows that severity and chronicity of seizures caused a deficit in motor coordination and balance. In conclusion, seizure disorder disrupts motor activities.

Supplementation with Manihot esculenta Crantz (Cassava) leaves’ extract prevents recognition memory deficits and hippocampal antioxidant dysfunction induced by Amyloid-β

ABSTRACT Objective: The Manihot esculenta Crantz (Cassava) is a typical South American plant rich in nutrients and energetic compounds. Lately, our group has shown that non-pharmacological interventions with natural antioxidants present different neuroprotective effects on oxidative balance and memory deficits in AD-like animal models. Here, our objective was to evaluate the neuroprotective effects of Cassava leaves’ extract (CAS) in an AD-like model induced by amyloid-beta (Aβ) 25–35 peptide. Methods: Male Wistar rats (n = 40; 60 days old) were subjected to 10 days of CAS supplementation; then, we injected 2 μL Aβ 25–35 in the hippocampus by stereotaxic surgery. Ten days later, we evaluated object recognition (OR) memory. Cassavas’ total polyphenols, flavonoids, and condensed tannins content were measured, as well as hippocampal lipid peroxidation and total antioxidant capacity. Results: CAS protected against Aβ-induced OR memory deficits. In addition, Aβ promoted antioxidant capacity decrease, while CAS was able to prevent it, in addition to diminishing lipoperoxidation compared to Aβ. Discussion: We show that treatment with Cassava leaves’ extract before AD induction prevents recognition memory deficits related to Aβ hippocampal injection. At least part of these effects can be related to the Cassava leaves’ extract supplementation effects on diminishing lipid peroxidation and preventing a decrease in the hippocampal total antioxidant capacity in the hippocampus of AD-like animals without adverse effects. Once cassavais a plant of warm and dry ground that can adapt to growon various soil types and seems to resist several insects, our results enable Cassava to be considered asa potential preventive intervention to avoid or minimizeAD-induced memory deficits worldwide.

Effects of the Russian–Ukrainian war on the value of imports and the food trade balance in Saudi Arabia

PurposeThis study aimed to measure the effects of the Russian–Ukrainian war on the value of imports and the food trade balance in Saudi Arabia.Design/methodology/approachEstimating the suggested model using econometric analysis for the years 1990–2021.FindingsThe amount of deficit increased in the food trade balance from 11.58 billion riyals in 1990 to 72.98 billion riyals in 2021. As for the increase in the index of food production by 10%, it leads to a decrease in the value of food imports for Saudi Arabia by 1.88%. Also, the value of the deficit in Saudi Arabia's food trade balance decreases by 5.24% as a result of a 10% rise in food exports to the country.Originality/valueIn light of the increase in the food price index to 145.8, the value of food imports and the deficit in the food trade balance exceed their counterparts in the current situation for the year 2021, at a rate of 37.1% and 44.5% for each respectively. In view of achieving huge financial surpluses as a result of the rise in oil prices, the Saudi Arabia is able to bear the high import bill and the amount of food trade balance deficit. Finally, the Russian–Ukrainian war leads to an increase in the cost of obtaining food commodities and their unavailability in the markets and thus affects the food security environment. Therefore, this study recommends the necessity of conducting more studies on the impact of the war on the food security of the Kingdom of Saudi Arabia.

Third-generation lentiviral gene therapy rescues function in a mouse model of Usher 1B

Usher syndrome 1B (USH1B) is a devastating genetic disorder with congenital deafness, loss of balance, and blindness caused by mutations in the myosin-VIIa (MYO7A) gene, for which there is currently no cure. We developed a gene therapy approach addressing the vestibulo-cochlear deficits of USH1B using a third-generation, high-capacity lentiviral vector system capable of delivering the large 6,645-bp MYO7A cDNA. Lentivirally delivered MYO7A and co-encoded dTomato were successfully expressed in the cochlear cell line HEI-OC1. In normal-hearing mice, both cochlea and the vestibular organ were efficiently transduced, and ectopic MYO7A overexpression did not show any adverse effects. In Shaker-1 mice, an USH1B disease model based on Myo7a mutation, cochlear and vestibular hair cells, the main inner ear cell types affected in USH1B, were successfully transduced. In homozygous mutant mice, delivery of MYO7A at postnatal day 16 resulted in a trend for partial recovery of auditory function and in strongly reduced balance deficits. Heterozygous mutant mice were found to develop severe hearing loss at 6months of age without balance deficits, and lentiviral MYO7A gene therapy completely rescued hearing to wild-type hearing thresholds. In summary, this study demonstrates improved hearing and balance function through lentiviral gene therapy in the inner ear.

Intermediate gray matter interneurons in the lumbar spinal cord play a critical and necessary role in coordinated locomotion.

Locomotion is a complex task involving excitatory and inhibitory circuitry in spinal gray matter. While genetic knockouts examine the function of individual spinal interneuron (SpIN) subtypes, the phenotype of combined SpIN loss remains to be explored. We modified a kainic acid lesion to damage intermediate gray matter (laminae V-VIII) in the lumbar spinal enlargement (spinal L2-L4) in female rats. A thorough, tailored behavioral evaluation revealed deficits in gross hindlimb function, skilled walking, coordination, balance and gait two weeks post-injury. Using a Random Forest algorithm, we combined these behavioral assessments into a highly predictive binary classification system that strongly correlated with structural deficits in the rostro-caudal axis. Machine-learning quantification confirmed interneuronal damage to laminae V-VIII in spinal L2-L4 correlates with hindlimb dysfunction. White matter alterations and lower motoneuron loss were not observed with this KA lesion. Animals did not regain lost sensorimotor function three months after injury, indicating that natural recovery mechanisms of the spinal cord cannot compensate for loss of laminae V-VIII neurons. As gray matter damage accounts for neurological/walking dysfunction in instances of spinal cord injury affecting the cervical or lumbar enlargement, this research lays the groundwork for new neuroregenerative therapies to replace these lost neuronal pools vital to sensorimotor function.

Identification of vestibular loss in children with sensorineural hearing loss using the balance subset of the BOT-2 test

BackgroundVestibular loss in children with sensorineural hearing loss (SNHL) is quite high. Despite the high prevalence of vestibular loss and balance impairment in children with SNHL, they are rarely assessed by clinicians and therefore are commonly undiagnosed. The purpose of the study was to evaluate the balance subset of the Bruininks-Oseretsky Test (BOT-2) as a tool to identify vestibular loss in children with SNHL and to determine its predictive values for vestibular loss.MethodsThe study included 210 children allocated into 4 groups: group 1 (control healthy children), group II (children with SNHL but without vestibular loss), group III (children with SNHL and unilateral vestibular loss), and group IV (children with SNHL and bilateral vestibular loss). Caloric test, video head impulse test (vHIT), and cervical vestibular evoked myogenic potential (c-VEMP) test were used for vestibular assessment in children with SNHL and to allocate them accordingly into one of the aforementioned groups. Scores of the balance subset of the BOT-2 were compared among the three groups and compared to the control healthy children.Results21.4% of children with SNHL but without vestibular loss have balance deficit revealed by the balance subset of the BOT-2, reflecting its better sensitivity for detecting balance deficit than the physiologic vestibular tests. Children with unilateral or bilateral vestibular loss (groups III and IV) showed a more significant balance deficit than children without vestibular loss (group II). The worst balance score was found in children with bilateral vestibular loss. The positive predictive value of the BOT-2 for peripheral vestibular loss in children with SNHL was 88%.ConclusionThe balance subset of the BOT-2 has particularly good predictive values for vestibular loss in children with SNHL. The test is a simple, easy, fast office test which does not require any costly equipment.

BİYOKAPASİTE VERİMLİLİĞİ VE EKONOMİK BÜYÜME ARASINDAKİ İLİŞKİ: AVRUPA İÇİN SUR MODEL ANALİZİ

To investigate the relationship between biocapacity efficiency and economic growth, data from Austria, Belgium, Germany, Spain, the United Kingdom, Greece, Italy, and the Netherlands were used, which are the European countries with the largest deficits in the biocapacity-ecological footprint balance between 1970 and 2014. Biocapacity measures the biosphere's ability to renew itself and supply the resources and services required to sustain life. It expresses overall human demand for natural resources, waste management, and fertile land for urban activities. The phrase "ecological footprint" refers to the quantity of biologically productive land and water that a population must utilize to maintain the urban infrastructure that it inhabits, create all the resources that it consumes, and remove all the garbage that it generates. An ecological deficit exists when a country's ecological footprint exceeds its biocapacity as measured by its population. An ecological deficit suggests that a country's ecosystems are unable to absorb extra carbon dioxide discharged into the atmosphere. When calculating national biocapacity productivity, the relative productivity of an average hectare of a specific land-use type is considered. The biocapacity efficiency factor was used as the dependent variable in this study, which evaluated the eight European nations with the greatest ecological deficit. GDP, the fraction of the total population residing in urban agglomerations with populations greater than one million, and electric energy consumption were the independent variables. Seemingly Unrelated Regression (SUR) model's overall findings reveal that the biocapacity productivity factor and GDP are adversely connected. The biocapacity productivity factor decreased by 0.75% for every 1% rise in GDP. Austria and Belgium had the highest influence on the biocapacity productivity factor, according to country-specific information.