Repeated Measures Factor Research Articles

Effect of Ibuprofen and Exercise Training on Bone, Body Composition and Strength in Older Women

Chronic low-grade systemic inflammation occurs in part due to increased pro-inflammatory cytokines mediated via cyclooxygenase (COX) pathways and contributes to excessive loss of muscle and bone mass with age. Administration of ibuprofen, a non-steroidal anti-inflammatory drug (NSAID) with inhibitory effects on COX, after resistance training enhances muscle mass in older individuals (Trappe et al. 2011) and hip areal bone mineral density (aBMD) in young women (Kohrt et al. 2010). PURPOSE: To examine the effects of longer term (i.e. 9 months) exercise training with ibuprofen supplementation (given after exercise sessions) on bone and muscle in older women. METHODS: Participants (n = 60, 64.8 ± 4.4y) were randomly assigned (double blind) to supervised resistance training or stretching 3d/week, and ibuprofen (400mg, post-exercise) or placebo (i.e. 4 groups) for 9 months. Baseline and post-intervention testing included: a) dual energy x-ray absorptiometry (DXA) for total body, lumbar spine, and hip aBMD, and total body lean tissue and fat mass; b) predicted 1-repetition maximum (1-RM) testing (biceps curl, hack squat). Data was analyzed with SPSS using alpha value of 0.05 via 3-factor ANOVA with two between-groups factors (ibuprofen versus placebo, resistance versus stretching), and one repeated-measures factor (baseline versus 9 month post-testing) controlling for age as a covariate. RESULTS: There was no effect of the ibuprofen on any of the dependent variables. There was a significant exercise x time interaction for biceps curl strength (p<0.01; resistance training increased 23% versus 3% for stretching), hack squat strength (p<0.01; resistance training increased110% versus 15% for stretching), and total body fat mass (p=0.04; resistance training decreased 2% versus 2% increase with stretching). There were trends for exercise x time interactions for aBMD at the total body (p = 0.07; 0.3% increase for the resistance training versus stretching decrease of 0.5%), and lumbar spine (p = 0.11; 0.6% decrease in the resistance training group versus 0.8% decrease for stretching). CONCLUSIONS: Resistance exercise increased strength, decreased fat mass, and trended towards improving aBMD of the total body and lumbar spine. Ibuprofen supplementation following exercise showed no additional benefits. Supported by the Canadian Institutes of Health Research

The OSCE progress test – Measuring clinical skill development over residency training

Purpose: The purpose of this study was to explore the use of an objective structured clinical examination for Internal Medicine residents (IM-OSCE) as a progress test for clinical skills.Methods: Data from eight administrations of an IM-OSCE were analyzed retrospectively. Data were scaled to a mean of 500 and standard deviation (SD) of 100. A time-based comparison, treating post-graduate year (PGY) as a repeated-measures factor, was used to determine how residents’ performance progressed over time.Results: Residents’ total IM-OSCE scores (n = 244) increased over training from a mean of 445 (SD = 84) in PGY-1 to 534 (SD = 71) in PGY-3 (p < 0.001). In an analysis of sub-scores, including only those who participated in the IM OSCE for all three years of training (n = 46), mean structured oral scores increased from 464 (SD = 92) to 533 (SD = 83) (p < 0.001), physical examination scores increased from 464 (SD = 82) to 520 (SD = 75) (p < 0.001), and procedural skills increased from 495 (SD = 99) to 555 (SD = 67) (p = 0.033). There was no significant change in communication scores (p = 0.97).Conclusions: The IM-OSCE can be used to demonstrate progression of clinical skills throughout residency training. Although most of the clinical skills assessed improved as residents progressed through their training, communication skills did not appear to change.

Reading Achievement of English Learners Who Participated in the Response to Intervention Model

The purpose of this study was to determine if English Learners (ELs) reading achievement scores could be related to the group’s participation in Response to Intervention (RTI). RTI addresses the challenges many public schools face as they seek the best methods for teaching reading and language while facing a nationally significant growth in the population of ELs students. This quantitative study utilized a repeated-measures design with English proficiency as the one between-groups factor and California Standardized Test (CST) as the one repeated-measures factor with two levels. The data were gathered from CSTs for the 2009-2010 and 2010-2011 school years. Each research question was answered with descriptive statistics gathered from a general linear model ANOVA to determine if there was a statistically significant relationship between participation in RTI and ELs reading achievement scores. As a result of the data analyzed for this study, students who are ELs and also participants in the RTI model demonstrated a relationship between their participation in RTI and reading achievement. To support effective implementation practices for RTI, school administrators can use the descriptive data found in this study to consider possible RTI implementation options. The results of this study indicated that RTI was a beneficial practice for ELs. Further study is needed to address the decline in test scores for both ELs and English Only (EO) students in grade 3. District administrators can use the results of the study to address curricular needs for ELs during the first year of schooling between the scaffolded grade 2 administration of the CST and the independently read grade 3 administration of the CST. The results of this study are significant for ELs and the schools that serve them. Schools similar to those that participated in this study can glean important information about RTI implementation and the effect it has on ELs and their reading achievement. Administrators and school leaders can consider the data presented in this study and the interpretation of the results and construct a similar RTI model or begin implementation of an RTI model that will ultimately be beneficial to the EL population in schools.

Speech intelligibility benefits of hearing AIDS at various input levels.

Although the benefits of hearing aids are generally recognized for soft- and conversational-level sounds, most studies have reported negative benefits (i.e., poorer aided than unaided performance) at high noise inputs. Advances in digital signal processing such as compression, noise reduction, and directional microphone could improve speech perception at high input levels. This could alter our view on the efficacy of hearing aids in loud, noisy situations. The current study compared the aided versus the unaided speech intelligibility performance of hearing-impaired (HI) listeners at various input levels (from 50-100 dB SPL) and signal-to-noise ratios (SNRs; quiet, +6, +3, and -3 dB) in order to document the benefits of modern hearing aids. In addition, subjective preference between aided and unaided sounds (speech and music) at various input levels was also compared. The experiment used a factorial repeated-measures design. A total of 10 HI adults with symmetrical moderate to severe hearing losses served as test participants. In addition, speech intelligibility scores of five normal-hearing (NH) listeners were also measured for comparison. Speech perception was studied at 50 and 65 dB SPL input levels in quiet and also in noise at levels of 65, 85, and 100 dB SPL with SNRs of +6, +3, and -3 dB. This was done for all participants (HI and NH). In addition, the HI participants compared subjective preference between the aided and unaided presentations of speech and music stimuli at 50, 65, 85, and 100 dB SPL in quiet. The data were analyzed with repeated-measures analysis of variance. The results showed a decrease in aided benefits as input levels increased. However, even at the two highest input levels (i.e., 85 and 100 dB SPL), aided speech scores were still higher than the unaided speech scores. Furthermore, NH listeners and HI listeners in the aided condition showed stable speech-in-noise performance between 65 and 100 dB SPL input levels, except that the absolute performance of the NH listeners was higher than that of the HI listeners. Subjective preference for the unaided sounds versus the aided sounds increased as input level increased, with a crossover intensity at approximately 75 dB SPL for speech and 80 dB SPL for music. The results supported the hypothesis that the study hearing aid can provide aided speech-in-noise benefit at very high noise inputs in a controlled environment.

Using Structural Priming to Study Scopal Representations and Operations

Using Structural Priming to Study Scopal Representations and Operations

Diabetes island: preliminary impact of a virtual world self-care educational intervention for african americans with type 2 diabetes.

BackgroundDiabetes is a serious worldwide public health challenge. The burden of diabetes, including prevalence and risk of complications, is greater for minorities, particularly African Americans. Internet-based immersive virtual worlds offer a unique opportunity to reach large and diverse populations with diabetes for self-management education and support.ObjectiveThe objective of the study was to examine the acceptability, usage, and preliminary outcome of a virtual world intervention, Diabetes Island, in low-income African Americans with type 2 diabetes. The main hypotheses were that the intervention would: (1) be perceived as acceptable and useful; and (2) improve diabetes self-care (eg, behaviors and barriers) and self-care related outcomes, including glycemic control (A1C), body mass index (BMI), and psychosocial factors (ie, empowerment and distress) over six months.MethodsThe evaluation of the intervention impact used a single-group repeated measures design, including three assessment time points: (1) baseline, (2) 3 month (mid intervention), and (3) 6 month (immediate post intervention). Participants were recruited from a university primary care clinic. A total of 41 participants enrolled in the 6 month intervention study. The intervention components included: (1) a study website for communication, feedback, and tracking; and (2) access to an immersive virtual world (Diabetes Island) through Second Life, where a variety of diabetes self-care education activities and resources were available. Outcome measures included A1C, BMI, self-care behaviors, barriers to adherence, eating habits, empowerment, and distress. In addition, acceptability and usage were examined. A series of mixed-effects analyses, with time as a single repeated measures factor, were performed to examine preliminary outcomes.ResultsThe intervention study sample (N=41) characteristics were: (1) mean age of 55 years, (2) 71% (29/41) female, (3) 100% (41/41) African American, and (4) 76% (31/41) reported annual incomes below US $20,000. Significant changes over time in the expected direction were observed for BMI (P<.02); diabetes-related distress (P<.02); global (P<.01) and dietary (P<.01) environmental barriers to self-care; one physical activity subscale (P<.04); and one dietary intake (P<.01) subscale. The participant feedback regarding the intervention (eg, ease of use, interest, and perceived impact) was consistently positive. The usage patterns showed that the majority of participants logged in regularly during the first two months, and around half logged in each week on average across the six month period.ConclusionsThis study demonstrated promising initial results of an immersive virtual world approach to reaching underserved individuals with diabetes to deliver diabetes self-management education. This intervention model and method show promise and could be tailored for other populations. A large scale controlled trial is needed to further examine efficacy.

Amplification for listeners with a moderately severe high-frequency hearing loss.

Some evidence exists to support the use of an extended bandwidth (EBW) for those with a relatively mild to moderate degree of hearing loss. The use of frequency lowering is suggested for those with a severe/profound degree of hearing loss. The amplification option for those with a moderately severe hearing loss in the high frequencies is less clear. This study compared three amplification options for listeners with a moderately severe hearing loss in the high frequencies. The efficacy of three amplification options-limited bandwidth to 4000 Hz, EBW, and frequency transposition-were evaluated for listeners with a moderately severe, high-frequency hearing loss. The experiment used a factorial repeated-measures design. A total of 13 adults with bilateral hearing loss of 50-70 dB HL at 4000 Hz served as test participants. The participants rated the sound quality of birdsongs and music when aided with the amplification options. Speech perception in quiet was measured at 50 dB SPL and 68 dB SPL input levels. The participants also completed a questionnaire on the best amplification option to use in different real-life environments during a 2 wk, take-home trial. The data were analyzed with repeated-measures analysis of variance. The findings showed that more listeners preferred the EBW for home use but that the frequency transposition was the least preferred. In addition, the performance of the EBW was better than that of the limited bandwidth in speech recognition but similar to that of the frequency transposition. The results supported the fitting of an EBW as the better choice for this group of listeners.

DRD2 genotype predicts prefrontal activity during working memory after stimulation of D2 receptors with bromocriptine

Pharmacological stimulation of D2 receptors modulates prefrontal neural activity associated with working memory (WM) processing. The T allele of a functional single-nucleotide polymorphism (SNP) within DRD2 (rs1076560 G > T) predicts reduced relative expression of the D2S receptor isoform and less efficient neural cortical responses during WM tasks. We used functional MRI to test the hypothesis that DRD2 rs1076560 genotype interacts with pharmacological stimulation of D2 receptors with bromocriptine on prefrontal responses during different loads of a spatial WM task (N-Back). Fifty-three healthy subjects (38 GG and 15 GT) underwent two 3-T functional MRI scans while performing the 1-, 2- and 3-Back versions of the N-Back WM task. Before the imaging sessions, either bromocriptine or placebo was administered to all subjects in a counterbalanced order. A factorial repeated-measures ANOVA within SPM8 (p < 0.05, family-wise error corrected) was used. On bromocriptine, GG subjects had reduced prefrontal activity at 3-Back together with a significant decrement in performance, compared with placebo. On the other hand, GT subjects had lower activity for the same level of performance at 1-Back but a trend for reduced behavioral performance in the face of unchanged activity at 2-Back. These results indicate that bromocriptine stimulation modulates prefrontal activity in terms of disengagement or of efficiency depending on DRD2 genotype and working memory load.

Neurological Injury After Transcatheter Aortic Valve Implantation

Subcortical ischemic damage occurs in 62% to 82% of patients who undergo transcatheter aortic valve implantation (TAVI), leaving clinicians and researchers with the difficult task of understanding the functional consequences of these often silent strokes.1 Furthermore, the patients for whom TAVI is the best option typically have additional age-associated systemic health complications, making it more difficult to determine the impact of such an injury on short- and long-term recovery. Repeat neurological examination, diffusion-weighted magnetic resonance imaging (DW-MRI), and neuropsychological assessment, as performed by Ghanem et al,2 in this issue of Circulation: Cardiovascular Interventions are certainly helpful. In 111 patients with TAVI, they report cerebral embolization in 64% of the imaged subjects but early cognitive decline was diagnosed in only 5.4%, and late cognitive decline occurred at an even lower rate. However, in considering these silent infarcts, we start by asking whether it is appropriate to prioritize overall cognition (the forest) over individual cognitive domains (the trees) when assessing the effects of DW-MRI–detected embolization, a phenomenon that is usually random throughout the subcortex, neurologically subclinical, and often complicated by many perisurgical and postsurgical factors. Article see p 615 In most studies on the perioperative neurological impact of TAVI, the strokes are small, randomly scattered, and generally supratentorial, lesion characteristics that are less likely to produce observable change on standard neurological examination.1 Neuropsychological assessment improves detection of subtle postoperative cognitive decline (POCD) but is constrained by the relative sensitivity of available behavioral and self-report measures to capture clinically meaningful pos tinterventional differences associated with TAVI embolization. Nevertheless, this intersection between measurement selection and sensitivity and the relatively random neuroanatomical pattern of TAVI embolization may help to clarify whether we should target the forest or the trees of post-TAVI cognitive and functional outcomes. Ghanem et al2 treated cognition as …

Metacognitive monitoring of attention performance and its influencing factors

Metacognitive monitoring is a central element of metacognitive processing exerting widespread influences on information processing. Albeit being subject to numerous empirical investigations referring to memory performance, there is little research investigating metacognitive monitoring in other cognitive domains. The present study investigated in 45 healthy students whether factors that are known to influence monitoring of memory performance, i.e., task difficulty, time of assessment, and practice, also exhibit a significant impact on monitoring of attention performance. A multivariate analysis of variance with three within-subject repeated measures factors on two dependent variables (monitoring of (a) time, and (b) errors in an attention task) was conducted. Results showed that monitoring ability significantly decreased with increasing task difficulty, was significantly better for post than for pre-assessment, and significantly increased with practice. Therefore, results suggest that the examined factors influenced monitoring of attention performance equivalent to the influence of these factors found in metamemory research.

The Effects of Group Leader Learning Style on Student Knowledge Gain in a Leadership Camp Setting: A Repeated-Measures Experiment

Many state FFA associations conduct summer camps focusing on leadership and personal development for FFA members. Interestingly, little research has been conducted on the impact or outcomes of these common activities. The purpose of this split-plot factorial repeated-measures experiment was to assess the level of campers’ learning of the curriculum taught during small group breakout sessions and to study the effects of the learning style of camp Small Group Leaders on student knowledge gain of camp curriculum measured by pre-test and post-test scores. Analysis of variance was utilized to test null hypotheses using an F-ratio to determine the significance (α = .05). Although there was a significant difference between pre-test and post-test scores, the interaction of test scores and SGL learning style failed to produce a statistically significant interaction; therefore, there was no significant treatment effect by SGL learning style. Recommendations for camp leaders in response to study results include regular summative assessments of the camp experience, annual evaluations of Small Group Leaders and campers, and the formation of instructional standards and learning goals. Further research was recommended in the impact of teacher learning styles on student academic performance in informal educational settings.

Dual-Coded Advisory Turn Indicators for GPS Navigational Guidance of Surface Vehicles

The aim of the study was to compare the decision times for left-right decisions for a dual-coded advisory turn indicator and a typical spatial-only turn indicator in a GPS navigational map display. Track-up maps are useful for turn decision making but do not facilitate configural knowledge acquisition of an area. North-up maps present a stable orientation for this type of learning, but typical implementations of north-up map displays lead to misaligned and confusing turn information. We compared a typical spatial-only indicator with a dual-coded spatial-plus-verbal indicator, systematically manipulating vehicle heading and measuring reaction time. The new display, the Dual-Coded Advisory Turn Indicator for Maps (DATIM), was based on an assumption of the advantages of concurrent verbal and spatial processing of advisory turn indicators in map displays. The experimental design was a 2 x 2 x 24 mixed design with indicator type as a between-subjects factor and turn direction (left, right) and 24 heading angles (15 degrees intervals) as repeated-measures factors. Participants made turn decisions while viewing static displays of intersections at variably rotated headings. Reaction time for the DATIM display was consistently faster than the typical spatial-only indicator at all heading angles but especially at heading angles beyond +/- 45 degrees (520-ms difference at 180 degrees). The DATIM display produced faster turn decisions at all heading angles. DATIM displays could allow north-up maps to be used for turn-by-turn decision making in GPS navigational systems. Drivers could have the advantages of both the stable orientation to facilitate planning and the easy turn-by-turn guidance. Limitations are discussed.

Reversal of Peripheral Nerve Injury-induced Hypersensitivity in the Postpartum Period

Physical injury, including surgery, can result in chronic pain; yet chronic pain following childbirth, including cesarean delivery in women, is rare. The mechanisms involved in this protection by pregnancy or delivery have not been explored. We examined the effect of pregnancy and delivery on hypersensitivity to mechanical stimuli of the rat hindpaw induced by peripheral nerve injury (spinal nerve ligation) and after intrathecal oxytocin, atosiban, and naloxone. Additionally, oxytocin concentration in lumbar spinal cerebrospinal fluid was determined. Spinal nerve ligation performed at mid-pregnancy resulted in similar hypersensitivity to nonpregnant controls, but hypersensitivity partially resolved beginning after delivery. Removal of pups after delivery prevented this partial resolution. Cerebrospinal fluid concentrations of oxytocin were greater in normal postpartum rats prior to weaning. To examine the effect of injury at the time of delivery rather than during pregnancy, spinal nerve ligation was performed within 24 h of delivery. This resulted in acute hypersensitivity that partially resolved over the next 2-3 weeks. Weaning of pups resulted only in a temporary return of hypersensitivity. Intrathecal oxytocin effectively reversed the hypersensitivity following separation of the pups. Postpartum resolution of hypersensitivity was transiently abolished by intrathecal injection of the oxytocin receptor antagonist, atosiban. These results suggest that the postpartum period rather than pregnancy protects against chronic hypersensitivity from peripheral nerve injury and that this protection may reflect sustained oxytocin signaling in the central nervous system during this period.

Patient-Reported Treatment Satisfaction with Oral Rivaroxaban Versus Standard Therapy in the Treatment of Acute Symptomatic Pulmonary Embolism

AbstractAbstract 1163 Background:Rivaroxaban treatment for symptomatic venous thromboembolism does not require routine laboratory monitoring, dose adjustments, or bridging with a parenteral anticoagulant and thus has the potential to reduce patient treatment burden compared with standard of care. It is becoming increasingly important to consider the views of patients in treatment decisions to improve adherence and, consequently, health outcomes. We investigated patient-reported outcomes in the EINSTEIN PE study, a large, open-label, randomized trial of patients with acute symptomatic pulmonary embolism with or without symptomatic deep vein thrombosis. This trial compared oral rivaroxaban with dose-adjusted enoxaparin overlapping with, and followed by, vitamin K antagonist (VKA) treatment. Methods:As part of the EINSTEIN PE study, 2397 patients from 7 countries (Canada, France, Germany, Italy, Netherlands, UK, and USA) were requested to complete a newly developed and validated measure of anticoagulation treatment satisfaction – the Anti-Clot Treatment Scale (ACTS) – at scheduled visits during treatment: Day 15, then at Months 1, 2, 3, 6, and 12. The ACTS consists of 2 scales: ACTS Burdens (12 items, scored on a 12–60 scale) and ACTS Benefits (3 items, scored on a 3–15 scale). The ACTS Burdens scale captures the negative aspects of patients’ anticoagulation experience (e.g. hassle/inconvenience, worry/frustration, and activity limitations), whereas the ACTS Benefits scale records the positive aspects (e.g. confidence, reassurance, and satisfaction). For each scale, higher total scores indicate better acceptance. In addition, patients completed the Treatment Satisfaction Questionnaire for Medication version II (TSQM II) at Months 1, 3, 6, and 12, primarily as a validation benchmark for the ACTS scale. There are 4 TSQM II subscales (Effectiveness, Side-Effects, Convenience, and Global Satisfaction), all of which are scored on a 0–100 scale. A pre-specified repeated measures analysis, stratified by intended treatment duration, with time (visit) as the repeated measure factor, was used to compare ACTS Burdens and ACTS Benefits scores between treatment groups in the intention-to-treat population; the analysis was repeated for the 4 TSQM II subscales. Results:Patients reported a lower burden and a higher perceived benefit in the rivaroxaban with higher mean ACTS scores across visits (Table). Mean ACTS Burdens scores were 55.4 versus 51.9 for rivaroxaban and enoxaparin/VKA, respectively (p<0.0001), and mean ACTS Benefits scores were 11.9 versus 11.4, respectively (p<0.001), in favorof rivaroxaban. The ACTS Burdens scores had a consistent treatment effect over time, but the difference in ACTS Benefits scores between the groups was not constant over time and showed a greater difference at Month 2 and later time points. The TSQM II scores confirmed the greater patient-reported treatment satisfaction, with higher scores shown in patients treated with rivaroxaban in all 4 subscales; the Convenience subscale had the largest difference.TableEINSTEIN PE: patient-reported treatment satisfaction scores (least-squares means from pre-specified repeated measures analysis)ScaleRivaroxabanEnoxaparin/VKAp-valueScorenScorenACTS Burdens55.4114951.91134<0.0001ACTS Benefits11.911.4<0.0001TSQM Effectiveness73.3112569.61107<0.0001TSQM Side-Effects86.681682.3809<0.0001TSQM Convenience81.6112971.81111<0.0001TSQM Global Satisfaction80.7112673.01109<0.0001 Conclusions:Patients with acute symptomatic pulmonary embolism reported a lower burden, higher perceived benefits, and improved treatment satisfaction with rivaroxaban compared with enoxaparin/VKA. The improved convenience of treatment, as perceived by patients, may contribute to increased patient acceptance of and adherence to anticoagulant treatment, with consequently improved health outcomes. Disclosures:Prins:Bayer Healthcare: Consultancy, Honoraria. Bamber:Bayer Healthcare: Employment. Cano:Bayer Healthcare: Research Funding. Wang:Bayer Healthcare: Employment. Lensing:Bayer Healthcare: Employment.

The Alcohol Mixed with Energy Drink Debate: Masking the Facts! A Commentary on “Mixing an Energy Drink with an Alcoholic Beverage Increases Motivation for More Alcohol in College Students” by Marczinski and Colleagues (in press)

The Alcohol Mixed with Energy Drink Debate: Masking the Facts! A Commentary on “Mixing an Energy Drink with an Alcoholic Beverage Increases Motivation for More Alcohol in College Students” by Marczinski and Colleagues (in press)

Unmedicated, remitted patients with major depression have decreased serum immunoglobulin A

Patents with major depression have evidence of a proinflammatory state with consistent elevations in acute phase proteins and in the levels of inflammatory mediators such as interleukin-6 and tumor necrosis factor-α. We report here a study of the serum levels of immunoglobulin A (IgA) in medication-free patients with major depression in the remitted state (ruMDD). Selective IgA deficiency is the most common form of immunoglobulin abnormality, and is often associated with a higher than expected incidence of proinflammatory and autoimmune phenomena. We measured serum IgG, IgM, and IgA in 28 ruMDD patients and 27 healthy subjects (Ctrl) at 0 (pretreatment), 7, and 24h following sham depletion and tryptophan (TrpD) depletion conducted at least 8 days apart under balanced, randomized, blinded conditions. Immunoglobulins were measured by automated immunonephelometry. Data were analyzed by repeated measures ANOVA with diagnosis as a fixed effect and drug (TrpD vs. sham), and time as repeated measures factors. Serum IgA was consistently lower in ruMDD patients vs. Ctrl at all time points examined (p<0.04 for main effect of diagnosis). Serum IgG and IgM levels did not show significant differences by diagnosis. Medication-free patients with major depression in the remitted state have a significant reduction in serum IgA levels measured on multiple occasions. In the light of the fact that IgA serves many immunomodulatory, anti-inflammatory roles, this finding supports the concept that major depressive illness represents a proinflammatory state.

Efficacy of a Reverse Cardioid Directional Microphone

Directional microphones have been shown to improve a listener's ability to communicate in noise by improving the signal to noise ratio. However, their efficacy may be questioned in situations where the listener needs to understand speech originating from the back. The goal of the study was to examine the performance of a directional microphone mode that has an automatic reverse cardioid polar pattern. A single-blinded, factorial repeated-measures design was used to study the effect of microphone modes (reverse cardioid, omnidirectional, and front hypercardioid) and stimulus azimuths (front and back) on three outcome variables (aided thresholds, nonsense syllable identification in quiet, and sentence recognition in noise). Twenty adults with a mild-to-severe bilaterally symmetrical (±5 dB) sensorineural hearing loss participated. Audibility in quiet was evaluated by obtaining aided sound field thresholds and speech identification at an input level of 50 dB SPL presented at 0 and 180° azimuths. In addition, speech understanding in noise was also assessed with the Hearing In Noise Test (HINT) sentences presented at both azimuths (0 and 180°) with a diffuse noise. Repeated-measures analyses of variance (ANOVAs) were conducted to examine the effects of microphone mode (omnidirectional, front hypercardioid, reverse cardioid) and stimulus azimuth (0°, 180°) on aided thresholds, nonsense syllable identification, and HINT performance. Results with the reverse cardioid directional microphone in both quiet conditions were similar to the omnidirectional microphone. The results of the reverse cardioid microphone in noise were significantly better than the omnidirectional microphone and front hypercardioid microphone when speech was presented from the back (p < 0.001). These results support the possible benefits of a reverse cardioid directional microphone when used in specific listening situations.

Abdominal muscle response to a simulated weight-bearing task by elite Australian Rules football players

The aim of this study was to examine the automatic recruitment of the deep abdominal muscles during a unilateral simulated weight-bearing task by elite Australian Rules football (AFL) players with and without low back pain (LBP). An observational cross-sectional study was conducted using ultrasound imaging to measure the thickness of the internal oblique (IO) and transversus abdominis (TrA) muscles. Thirty-seven elite male AFL players participated. Repeated measures factors included ‘force level’ (rest, 25% and 45% of body weight), ‘leg’ (dominant or non-dominant kicking leg) and ‘side’ (ultrasound side ipsilateral or contralateral to the leg used for the weight-bearing task). The dependent variables were thickness of the IO and TrA muscles. The results of this study showed that thickness of the IO (p<.0001) and TrA (p<.0001) muscles increased in response to ‘force level’. During the task, the thickness of the IO muscle on the contralateral side of the trunk relative to the leg being tested, increased more in participants with current LBP (p=.034). This pattern was more distinct on the non-dominant kicking leg. Altered abdominal muscle recruitment in elite athletes with low back pain may be an attempt by the central nervous system (CNS) to compensate for inadequate lumbo-pelvic stability.

Effect of Maximum Power Output and Noise Reduction on Speech Recognition in Noise

The maximum power output (MPO) of a hearing aid was typically discussed in the context of avoiding loudness discomfort. However, an MPO that is too low, as in the cases to avoid discomfort for people with a severe loudness tolerance problem and hearing losses that exceed the fitting range of the hearing aids, could negatively affect sound quality and speech intelligibility in noise. The current study was designed to demonstrate the degradation in speech intelligibility in noise on the HINT (Hearing in Noise Test) when the MPO of the wearers' hearing aids was lowered by 10 dB from the default. The interactions with noise reduction (NR) algorithms (classic [NR-classic] and Speech Enhancer [NR-SE]) were also examined. A single-blinded, factorial repeated-measures design was used to study the effect of noise input level (68 dBC, 75 dBC), MPO setting (default and default-10), and NR algorithm (off, classic, SE) on HINT performance. Eleven adults with a severe sensorineural hearing loss participated. Participants were fit with the Widex m4-19 behind-the-ear hearing aids binaurally in the default frequency response and MPO settings. The hearing aids were adjusted to six MPO (default, default-10) by NR (off, classic, SE conditions). Testing was completed within one 2 hr session. The RTS (reception threshold for speech) for 50% correct on the HINT was measured in each of the six hearing aid conditions at two input levels (68 and 75 dBC) with speech and noise stimuli presented from the front. Repeated-measures ANOVAs were conducted using SPSS software to examine significant differences. A repeated-measures ANOVA showed that noise level was not significant while NR algorithm and MPO were significant. The interaction between noise level and NR algorithm was also significant. Post hoc analysis with Bonferroni adjustment for the effect of NR algorithm showed that performance with NR-off was significantly poorer than performance with NR-classic and NR-SE (p < 0.05). However, NR-classic and NR-SE were not significantly different from each other (p > 0.05). An MPO that was 10 dB lower than the default could negatively affect the signal-to-noise ratio (SNR) of the listening environment. However, NR could compensate for the degradation in SNR.

3-D high-frequency endovaginal ultrasound of female urethral complex and assessment of inter-observer reliability

Assessment of the urethral complex and defining its morphological characteristics with 3-dimensional endovaginal ultrasonography with the use of high frequency rotational 360° transducer. Defining inter-observer reliability of the performed measurements. Twenty-four asymptomatic, nulliparous females (aged 18-55, mean 32 years) underwent high-frequency (12MHz) endovaginal ultrasound with rotational 360° and automated 3D data acquisition (type 2050, B-K Medical, Herlev, Denmark). Measurements of the urethral thickness, width and length, bladder neck-symphysis distance, intramural part of the urethra as well as rhabdosphincter thickness, width and length were taken by three investigators. Descriptive statistics for continuous data was performed. The results were given as mean values with standard deviation. The relationships among different variables were assessed with ANOVA for repeated measures factors, as well as T-test for dependent samples. Intraclass correlation (ICC) was calculated for each parameter. Intra- and interobserver reliability was assessed. Statistical significance was assigned to a P value of <0.05 (two-tailed). Excellent reliability was observed for urethral measurements (length, width, thickness and volume) (ICC>0.8) and good reliability for rhabdosphincter measurements (ICC>0.6) between all three investigators. Advanced EVUS provides detailed information on anatomy and morphology of the female urethral complex. Our results show that 360° rotational transducer with automated 3D acquisition, currently routinely used for proctological scanning is suitable for the reliable assessment of the urethral complex and can be applied in a routine diagnostics of pelvic floor disturbances in females.