Oxidative stress is a major cause of auditory hair cell degeneration and hearing impairment.Reducing intracellular reactive oxygen species (ROS) levels may help preserve auditory hair cell function. In this study, we explored the otoprotective properties of mangiferin, a xanthonoid extracted from mango leaves, bark, and fruit peels. Our findings indicate that mangiferin protects HEI-OC1 cells against oxidative stress induced by H2O2 through modulation of autophagic mechanisms and elimination of ROS. The modulation of proteins linked to autophagy and apoptosis, such as LC3 conversion and SQSTM1 degradation, confirmed this protective effect. Furthermore, auditory brainstem response test and scanning electron microscopy findings indicated that mangiferin effectively mitigates hair cell degeneration in the organ of Corti in guinea pigs subjected to ototoxicity induced by kanamycin and furosemide. Immunohistochemical analysis also provided insights into the effects of mangiferin on ribbon synapses within the cochlea of rats. Both in vitro and in vivo studies demonstrated that mangiferin exerts protective effect against ototoxicity by inducing autophagy.

Objectives: Hearing difficulty is prevalent in older adulthood and projected to increase via global aging, particularly among men. Currently, there is limited research on how this gender disparity might vary by country. Methods: Using 2018 data (n = 29,480) from the Health and Retirement Study (HRS) international family of studies, we investigate gender disparities in hearing difficulty among respondents ages 55-89 from the United States (n = 12,566), Mexico (n = 10,762), and Korea (n = 6152) with country-specific ordinal logistic regression models that progressively adjust for demographic, social, and health indicators. Results: In the United States, men's hearing difficulty disadvantage was consistently observed. In Mexico, men's hearing difficulty disadvantage was explained by the interactive effect of gender and age group but resurfaced after adjusting for comorbidities. In Korea, there was consistently no gender difference in hearing difficulty. Discussion: Our results highlight the heterogeneity in older men's hearing difficulty disadvantage among a diverse group of aging countries.

Sudden sensorineural hearing loss (SSNHL) is a medical emergency characterized by unexplained hearing loss, usually one-sided, of at least 30 dB across three or more contiguous frequencies within 72 h. This condition significantly impairs daily communication and has serious consequences for mental health, social relationships, and the overall quality of life. Hyperbaric oxygen therapy (HBOT) is being investigated as a potential adjuvant treatment for SSNHL alongside systemic steroids.

This systematic review and meta-analysis aimed to evaluate the efficacy of HBOT combined with systemic corticosteroids compared with corticosteroids alone in patients with SSNHL.

We searched PubMed, Cochrane, Scopus, Web of Science, and Google Scholar to identify 14 studies that matched our inclusion criteria of randomized controlled trials (RCTs) published in English, which evaluated HBOT alone or with corticosteroids in adults (≥ 18 years) diagnosed with SSNHL based on the AAO-HNS criteria, reporting pure-tone audiometry (PTA)-based outcomes. The analysis included 794 participants and evaluated outcomes such as improvements in Pure Tone Audiometry (PTA) thresholds, rates of hearing recovery, and adverse events.

Results indicated that the combined therapy of HBOT and systemic corticosteroids significantly improved low-frequency hearing thresholds (SMD: 0.83, 95% CI: 0.66-1.00, p < 0.0001) and increased the odds of complete recovery (OR: 2.05, 95% CI: 1.41-2.98, p = 0.0002). However, significant heterogeneity (I² = 96.7%) and variations in the treatment protocols were observed. Adverse events, including vertigo, have been reported but are generally mild.

This meta-analysis suggests that combining systemic corticosteroids with HBOT may improve hearing recovery in ISSNHL, particularly at lower frequencies within the first three months. However, high heterogeneity and the lack of statistical significance in the random-effects model call for cautious interpretation. Well-designed RCTs with standardized protocols and clear patient selection criteria are needed to confirm these findings. Future research should focus on identifying subgroups most likely to benefit and optimizing treatment protocols.

The purpose of this systematic review was to identify and synthesise the literature regarding barriers and enablers affecting general practitioner (GP) referral to hearing care for their older patients (50 years and over).

A search of peer-reviewed articles reporting primary empirical studies was conducted across CINAHL, Ovid Medline and Scopus, with search terms relating to the search domains "General Practitioner", "Referral", "Hearing loss", and "adults aged 50 and older". Qualitative and quantitative studies were included if they reported barriers or enablers to referral. A mixed-methods approach was used to synthesise the findings of the included studies, firstly into the Theoretical Domains Framework of behaviour change, and then into more granular sub-themes.

The initial search yielded 859 unique studies. Title and abstract screening identified 21 studies of possible relevance, and full text review identified seven studies for inclusion in this review. A total of 19 unique themes were identified and coded to 10 of the 14 domains of the Theoretical Domains Framework; however thematic overlap between studies was low and fewer than half of these themes were consistently identified as either a barrier or enabler. Four main barriers to referral to hearing care were identified: Lack of time, lack of familiarity with diagnostic criteria and tools, lack of knowledge of treatments and higher relative importance of other health conditions.

The minimal overlap of themes and low agreement on which of these constitute barriers and enablers for referral indicates a need for further research to provide greater clarity in this area and explain the heterogeneity of these results.

In order to explore the clinical effect of preimplantation genetic testing (PGT) in hereditary hearing loss (HHL), we explore the related factors affecting the pregnancy outcome of PGT of hereditary hearing loss and provide more evidence for clinical work.

From January 2015 to April 2024, we select 288 couples of child-bearing age who are at risk of conceiving children with HHL from 1444 pedigrees in Chinese Deafness Genome Project (CDGP). After genetic counseling, 19 couples elected to undergo PGT. The embryo genotypes were diagnosed by low-coverage sequencing combined with SNP linkage analysis, and followed up during pregnancy and after delivery.

The 19 couples include variants of autosomal recessive hearing loss gene GJB2, SLC26A4, USH2A, CDH23, and autosomal dominant hearing loss gene MITF, WFS1, and GSDME. The 135 embryos from the 19 couples were cultured in vitro, 93.33% (126/135) embryos got reliable genetic diagnosis, and nine embryos (6.67%) had no diagnosis. The depth of embryonic 2-3 × WGS of 205 human hearing loss genes are sufficient. Eleven women got pregnancy, and eight newborns with normal hearing have been delivered through assisted reproduction; clinical pregnancy rate was 57.89% (11/19). Pregnancy outcome is associated with the female age (P = 0.037), male age (P = 0.015), and number of transferable blastocysts obtained (P = 0.000) in per ART cycle.

PGT based on low-coverage next-generation sequencing with linkage analyses can block the transmission of deafness-related mutations to offspring. 2-3 × depth of embryo sequencing data enabled a credible testing of 205 deafness-related mutations loci. Couple age and number of retrieved oocytes are related to pregnancy outcome and can be considered prognostic indicators of PGT of HHL.

Research suggests that early detection of hearing loss, coupled with prompt and appropriate treatment, can significantly alleviate its negative impacts. Routinely collected real-world data, such as those from electronic health records data, provide an opportunity to enhance our understanding of the management of hearing loss. This project aims to create the HEaring Impairment Data Infrastructure (HEIDI) data lake by assembling datasets from general practice (GP), audiology clinic registries, and cohort studies to investigate hearing-impaired patients' care pathways. This study seeks to answer key research questions such as "How do patients with hearing loss navigate the care pathway from general practice clinics to audiology clinics?".

The HEIDI data lake will be hosted in a secure research environment at Macquarie University, Sydney, Australia, that complies with Australian legal and ethical requirements to protect patient privacy. Afterwards, new integrated datasets will be built through data linkage of hearing and GP datasets. Finally, the HEIDI data warehouse will be developed and used as a stand-alone dataset for future research. Descriptive and predictive analytics will be undertaken to answer our research questions with the data warehouse. Descriptive analysis will include both conventional and advanced statistical techniques and visualisation that will help us understand the journey of patients with hearing loss. Machine learning strategies such as deep neural networks, support vector machines, and random forests for predictive analytics will also be employed to identify participants that could benefit from proactive management by their GP and determine the effect of interventions through the patient's journey (e.g., referrals to specialist) on outcomes (e.g., adherence to the intervention).

The findings will be disseminated widely through academic journals, conferences and other presentations.

Hearing loss is a widespread condition that impacts the quality of life, affecting communication, social interactions, and cognitive functions. This study aimed to evaluate the subjective benefit and satisfaction of using hearing aids among patients since the adoption rate of hearing aids remains low.

The study retrospectively analysed data from 133 patients with hearing aids, using the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Satisfaction with Amplification in Daily Life (SADL) questionnaires. Patients were divided into two groups based on this median age and sex for comparative analysis. The Mann Whitney test was applied with references to numerical parameters (APHAB and SADL) to assess differences between male vs female subjects and adults vs elderly. The Spearman correlation test was applied to assess the possible correlation between APHAB and SADL. A p-value lower than 0.05 was considered statistically significant.

Results indicated no significant gender differences in most APHAB and SADL subscales, except for the SADL "personal image" subscale, which showed lower scores for women (p =  0.023). Age-based comparison revealed no significant differences in APHAB scores; the SADL scores showed significant differences in the "positive effect" (p = 0.013), "negative features" (p = 0.005), and overall scores (p = 0.039), with lower satisfaction in older patients. Correlation analysis identified a positive relationship between the SADL "negative features" and APHAB "aversiveness" subscales (p = 0.042, correlation coefficient ρ = 0.176).

The study highlights the importance of addressing subjective perceptions and aesthetic concerns in hearing aid adoption, emphasizing the need for personalized rehabilitation strategies to improve patient outcomes and satisfaction.

Level 3.

Early Hearing Detection and Intervention (EHDI) is essential for minimising the negative impact of childhood hearing loss on speech, language, and cognitive development. However, in low- and middle-income countries such as South Africa, various challenges hinder the implementation of EHDI services, leading to delayed diagnosis and intervention.

This study explores caregivers' experiences with EHDI services, identifying key challenges and facilitators affecting access and timely intervention.

A narrative inquiry approach was used as part of a broader research initiative on family-centred EHDI. Nine caregivers of children who are deaf or hard of hearing (DHH) were purposively sampled, and data were collected through semi-structured interviews.

Thematic analysis revealed systemic and structural challenges, logistical and financial constraints, and caregiver-related factors that hindered access to EHDI services. Key facilitators included caregiver knowledge and advocacy, family support services such as counselling and South African Sign Language training, and high-quality audiological and educational services.

Findings emphasise the need for policy-driven reforms, including expanding newborn hearing screening programmes, improving financial assistance mechanisms, and increasing public awareness. Addressing these challenges and leveraging facilitators can help South Africa align with global EHDI benchmarks and improve outcomes for DHH children.

Sensorineural hearing deficiency caused by hair cell damage represents a prevalent sensory deficit disorder. In mammals, age-related reduction in plasticity of inner ear supporting cells (recognized as hair cell precursors) compromises their trans-differentiation capacity, resulting in impaired spontaneous hair cell regeneration post-injury. Therapeutic reprogramming of supporting cells to functionally replace damaged hair cells has emerged as a promising strategy for sensorineural hearing loss treatment. In this study, we demonstrate that the secretory protein Sparcl1 enhances supporting cell reprogramming and hair cell regeneration in both in vitro and in vivo models. Through the adeno-associated virus (AAV)-mediated overexpression system, we successfully achieved in vivo expansion of inner ear organoids accompanied by hair cell differentiation. RNA-seq analysis revealed that Sparcl1 overexpression stimulates supporting cell proliferation via follistatin (Fst) activation and extracellular matrix (ECM) remodeling. Notably, both AAV-ie-Sparcl1 delivery and recombinant Sparcl1 protein administration effectively induced supporting cell differentiation into hair cells in vivo. Collectively, our findings establish Sparcl1 as a potent positive regulator of hair cell regeneration and elucidate mechanisms by which secretory proteins regulate supporting cell plasticity.

Globally, hearing loss affects around 1.5 billion people, while tinnitus is estimated to impact around 740 million. More research is urgently needed to address the challenges presented by hearing loss, tinnitus, and other hearing-related conditions. Our plans for a Nottingham Hearing BioResource, providing research-willing volunteers and comprehensive tests of hearing and ear health repeated over time, has the potential to accelerate the field. The protocol described here is a feasibility study for this BioResource, specifically addressing questions of recruitment from the general population (i.e., outside of clinical audiology services or pathways). Participants with or without known hearing problems will be recruited for data collection. This study will quantify how feasible it will be to recruit and retain a large sample of the general population, and will suggest the demographic, and hearing condition status, distributions we could achieve for the BioResource. Data collection will involve a health and lifestyle questionnaire; cognitive assessment; five questionnaires about hearing loss, tinnitus, and hyperacusis; an estimation of lifetime noise exposure; a suite of in-depth audiological tests; and taking a hair sample. The same measurements will be taken on two separate occasions in person, and a third set of overlapping measurements will be taken remotely. Repeating the data collection will allow us to evaluate participant retention rates and establish the reliability of the measures. The findings from this feasibility study will allow us to assess which channels work well to recruit a diverse pool of participants, which, when used in conjunction with recruitment from clinic, will provide the basis for a recruitment strategy for our BioResource. In addition, we will gain useful insight into whether specific tests or questionnaires used in the feasibility study are suitable for inclusion in a deep phenotyping protocol.

Background/Objectives: Sensorineural hearing loss (HL) is a highly prevalent chronic health condition. It can be managed through hearing care, including the use of hearing aids (HAs). Still, a majority of individuals with HL remain undiagnosed or untreated. Virtual care delivery may support uptake and adherence to interventions. In blended care, individuals can choose interchangeably between in-person and virtual services. This study aimed to investigate how real-world individuals accessed blended hearing care (through in-person, virtual, or hybrid services), the amount of support they received, and their satisfaction with services and products. Methods: An exploratory, retrospective analysis was performed on longitudinal observational data collected through Australia's longest-running blended hearing care model. A total of 25,058 appointment records were available, matched to HA purchase records and clinical notes where possible, as well as 916 satisfaction ratings. Results: The majority of individuals attended in-person appointments (75%); 25% were virtual or hybrid appointments. The number of appointments attended depended on how HAs were purchased (in-person, virtually, or hybrid), but all modalities were complemented by ample unscheduled email and telephone support. Of those who purchased HAs repeatedly, 49% changed preferred sales channel (in-person versus virtual) over time. Satisfaction ratings were highest for virtual services. Conclusions: This first report of real-world, longitudinal evidence on blended hearing care showed strong attendance of in-person appointments, while hybrid services-including informal; unscheduled support-may have responded to individuals' changing needs and preferences over time. The findings offer practice-based evidence for blended care models and recommendations for further research.

To investigate the current situation of hearing loss and the associations of occupational noise exposure with hearing loss in petrochemical enterprise workers. This was a cross-sectional study that employed cluster sampling methods, and 951 workers aged 20-59 years from a petrochemical enterprise were included between June and December 2022. The subjects underwent health status surveys and occupational health examinations. To assess the associations between noise level and hearing loss, a logistic regression model was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). A total of 951 participants (837 male and 114 female) were included in this study. And 68.3% of workers had a noise exposure level greater than ≥ 80 dB (A). The prevalence of speech frequency hearing loss, high-frequency hearing loss, and bilateral hearing loss among participants was 2.3% (22/951), 10.2% (97/951), and 10.3% (98/951), respectively. The prevalences of high-frequency hearing loss and binaural hearing loss were compared among subjects grouped by gender, age, family history of hyperlipidaemia, smoking status, systolic blood pressure, diastolic blood pressure, duration of noise exposure, and level of occupational noise exposure, and all differences were statistically significant (all P < 0.01). Compared with that of participants with noise levels < 80 dB(A), the risk of speech frequency hearing loss was significantly greater in the ≥ 90 dB(A) noise exposure group (OR: 5.33). The noise exposure level 80-89 dB(A) group (OR: 2.75) and the noise exposure level ≥ 90 dB(A) group (OR: 2.16) were both associated with a higher prevalence of high-frequency hearing loss. The noise hazards in petrochemical enterprises are severe. Long-term exposure to occupational noise environments significantly increases the risk of hearing loss among workers. Therefore, it is essential to strengthen noise control and enhance hearing protection efforts to effectively prevent excessive occupational noise exposure, thereby reducing the risk of hearing loss in workers.

Job security and performance are crucial needs for nurses, greatly influencing their motivation and commitment to work. This study seeks to examine Jordanian nurses' perceptions of job security and employee performance and to compare these factors between government and private hospitals.

A descriptive, comparative cross-sectional design was used for the study.

The study was conducted in two government and two private hospitals. A total of 156 nurses were conveniently sampled to participate. Data were collected using the Job Security Questionnaire and the Six-Dimension Scale of Nursing Performance.

The mean job security score was 3.26, indicating a moderate level of job security. The mean employee performance score was 2.68, reflecting a high level of job performance. Nurses in private hospitals had significantly higher scores in both job security (t =  -5.53, p <  0.001) and employee performance (M =  2.53, SD ±  0.53) compared to nurses in government hospitals.

Nurses with moderate job security levels achieved high job performance scores. Private hospitals demonstrated higher job security and employee performance levels than government hospitals. Future research could investigate specific aspects of the Jordanian nursing work environment that may contribute to the differences observed in job security and employee performance.

Our study tried to evaluate and compare the therapeutic efficacy of intratympanic injection of dexamethasone (DEX) at different concentrations for the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL).

A prospective randomized controlled study was conducted on 203 patients with unilateral ISSNHL. Patients were divided into four groups: the control group (n = 47, systemic treatment only), the high-concentration group (n = 51, intratympanic injection of DEX 20 mg/ml), the medium-concentration group (n = 55, 10 mg/ml), and the low-concentration group (n = 50, 5 mg/ml). Pure tone audiometry (PTA) thresholds were measured before treatment and on the 10th day post-treatment, with a follow-up period of 2 months. Hearing gains and efficacy rates were compared among the groups.

Significant differences were observed in PTA thresholds before and after treatment in all four groups (P < 0.05), indicating that both systemic therapy and intratympanic injection were effective. The overall efficacy rate and hearing gain were higher in the intratympanic injection groups compared to the control group, but the differences were not statistically significant. Specifically, the control group achieved an efficacy rate of 57.4 % with a hearing gain of 11.25 ± 10.00 dB HL. The intratympanic injection groups showed an overall efficacy rate of 67.3 % and a hearing gain of 12.50 ± 10.94 dB HL, with subgroup results as follows: low-concentration group (62.0 %, 12.50 ± 11.56 dB HL), medium-concentration group (69.1 %, 11.25 ± 13.75 dB HL), and high-concentration group (70.6 %, 12.50 ± 8.75 dB HL). Among patients with severe or profound hearing loss, the high-concentration group exhibited significantly greater hearing gains compared to the control group, while no significant differences were observed in efficacy rates.

Combined intratympanic injection of DEX with systemic treatment for SSNHL provides higher hearing gains and efficacy rates compared to systemic treatment alone, though the differences were not statistically significant. In patients with severe or profound hearing loss, intratympanic injection of high-concentration DEX resulted in significantly greater hearing improvement, suggesting a potential therapeutic advantage in this subgroup.

We aimed to investigate the correlation between prevalent risk factors for high-risk neonates in neonatal intensive care unit and their hearing loss, and to examine the audiological features and genetic profiles associated with different deafness mutations in our tertiary referral center. This research seeks to deepen our understanding of the etiology behind congenital hearing loss.

We conducted initial hearing screenings, including automated auditory brainstem response, distortion product otoacoustic emission, and acoustic immittance on 443 high-risk neonates within 7 days after birth and 42 days (if necessary) after birth. Neonates who failed initial screenings underwent further diagnostic tests at 3 months. The risk factors were analyzed retrospectively by Chi-Square test and stepwise logistic regression. Genetic analysis involved a deafness sequencing panel targeting 19 pathogenic variants across four genes (GJB2, GJB3, SLC26A4, and MT-RNR), applied to both the study cohort and a larger hearing screening cohort of 14863 neonates from our center and different medical centers in the same region.

Out of the 443 high-risk neonates, 222 failed their diagnostic hearing tests. Logistic regression identified preterm birth, neonatal hyperbilirubinemia and advanced maternal age (≧35 yr) as significant risk factors for hearing loss. Genetic screening of 33 neonates who failed the diagnostic tests revealed that 7 (21.21%) carried at least one pathogenic variant, with identified 1 homozygotes and 3 heterozygotes in the GJB2, 1 homozygotes and 1 heterozygotes in the SLC26A4 gene, and 1 homoplasmic variant in the MT-RNR (12SrRNA). In the larger hearing screening cohort, 497 (3.34%) were genetically positive for deafness mutations, among whom 29 had the diagnostic hearing tests and 7 eventually diagnosed with hearing loss. Of the rest 468 neonates who didn't have the diagnostic tests, 445 (95.09%) passed the hearing screening tests.

Preterm birth, neonatal hyperbilirubinemia and advanced maternal age are critical risk factors for hearing impairment in high-risk neonates. Mutations such as c.235delC in GJB2 and c.919-2A>G in SLC26A4 are the most common. Long-term follow-up of neonates carrying heterozygous variants, particularly in genes like GJB3, is necessary to understand their progression and hearing outcomes. This study highlights the importance of deafness gene screening in neonates to ensure accurate diagnosis and effective intervention.

Level 3.

Today, due to the increase in the incidence of heart problems in people, we see an increase in the number of heart surgeries worldwide. Hearing disorders in the form of hearing loss have been reported as one of the side effects of this kind of surgery in some studies. Considering the evidence of the effect of open-heart surgery on patients' hearing loss, this systematic review study was conducted to determine the frequency of hearing loss after open-heart surgery.

To carry out this systematic review, studies that investigated hearing loss after open-heart surgery in Iran and the rest of world, published in Persian or English, and various international electronic databases including PubMed®, Web of Science, Scopus®, and authentic Persian sources (e.g., Irandoc and Scientific Information Database) until the end of 2021 have been indexed.

In the initial review, 46 of the 2230 initially searched articles had the conditions for further review. After checking the articles' title and abstract and the working method of the studies and removing duplicates and incomplete articles, a total of 16 articles were included in the study. Then, their results were analyzed as the frequency of hearing loss after open-heart surgery by age and sex.

The review of various studies confirms the fact that after open-heart surgery, the existence of evidence of hearing changes is not far from expected.

Prior research has indicated a connection between rheumatoid arthritis (RA) and hearing impairment (HI), although there is disagreement among researchers. An extensive assessment of the causal relationship between RA and HI was the aim of this Mendelian randomization (MR) study. We examined summary-level data from RA and HL genome-wide association studies using inverse variance weighted (IVW) analysis. We further supplemented the results with weighted median (WM), MR-Egger, MR-RAPS, and maximum likelihood techniques. We used sensitivity analyses to check the accuracy of the MR analysis results. Genetically, higher RA substantially increases the likelihood of HI (IVW: P = 8.78 × 10-03, odds ratio (OR) = 1.014, 95% confidence interval (CI): 1.003-1.024). Sensitivity analysis reveals a consistent direction of the association using the following methods: Bayesian MR (P = 8.72 × 10-03, OR = 1.014, 95% CI: 1.004-1.025), MR robust adjustment profile score (P = 2.31 × 10-02, OR = 1.013, 95% CI: 1.002-1.024), maximum likelihood method (P = 2.70 × 10-02, OR = 1.014, 95% CI: 0.996-1.026), WM (P = 1.35 × 10-01, OR = 1.012, 95% CI: 0.996-1.029), and MR-Egger (P = 1.41 × 10-01, OR = 1.011, 95% CI: 0.996-1.027). Despite not achieving statistical significance, the WM and MR-Egger approaches offered reliable guidance. Moreover, we replicated our results on other datasets and obtained similar results (IVW: P = 8.71 × 10-03, OR = 1.016, 95% CI: 1.004-1.028), indicating the validity of our results. Our study provides evidence linking RA to a higher risk of HI. In order to gain more insight into treatments that change the disease or prevent hearing loss, audiological testing is necessary for the diagnosis and follow-up of individuals with RA.

Define the extent to which pathogenic GJB2 (gap junction beta-2) variants are responsible for non-syndromic hearing loss (NSHL) in the Asian population.

Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed. CINAHL, Embase, and PubMed's MEDLINE were accessed from 1997 to 2023 using permutations of the MeSH terms: "Asian," ''Southeast Asian,'' "South Asian," "East Asian," "Southeastern Asian," and "GJB2." Additionally, all countries within the Indian subcontinent, Far East, and Southeast Asia, were included as key terms. Exclusion criteria included non-English publications, a non-Asian study population (per US Office of Management and Budget), and literature not investigating GJB2. An allele frequency analysis of pathogenic GJB2 variants in the Asian population was performed and stratified by country of origin.

One thousand one hundred and forty-one unique studies were identified, of which 420 met our inclusion criteria during the abstract screen. One hundred and ninety-five studies were included in the systematic review after full-text screen. Over 45 pathogenic variants were identified across 11 countries within the Indian subcontinent, Far East, and Southeast Asia. A total of 4,220,591 people from over 30 ethnic groups were included with ages ranging from 0 to 97 years. Of those with reported demographic information, 50 % (221,336/445,813) were female and 50 % (224,477/445,813) were male. The prevalence of pathogenic GJB2 variants varied by country, with common variants including c.235del; p.Leu79Cysfs∗3, c.109G > A; p.Val37Ile, and c.299_300del; p.His100Argfs∗14.

Variation in the prevalence of pathogenic GJB2 variants is likely due to the wide diversity of ancestral contributions in the Asian population. There are limited studies on the prevalence of GJB2 variants particularly for countries within the Indian subcontinent and Southeast Asia. Additional studies on the prevalence of GJB2 variants in these countries as well as ethnic sub-groups may be helpful in the development of assays for high throughput diagnosis for patients with hereditary hearing loss.

This study compares delays in otolaryngologic care between patients in Mekelle, Ethiopia and Harare, Zimbabwe using the Three Delays model. Patient surveys conducted among 46 patients in Zimbabwe during October 2022 and 105 patients in Ethiopia during June 2023 revealed a significantly higher prevalence of delays in seeking and reaching care in Ethiopia. This was in the aftermath of the Tigray War, which damaged the region's health care infrastructure and diminished the trust of patients. In Zimbabwe, there was poor awareness among patients and nonotolaryngologist providers of otolaryngology disease and care capacity leading to delays in seeking and reaching care. Patients in both countries faced delays in receiving appropriate care due to resource limitations, with Ethiopia's constraints worsened by the recent war and Zimbabwe's by consistent health care underfunding. The longest delays were observed in head and neck oncology care. These findings provide a foundation for understanding otolaryngologic care delays in these low- and middle-income countries.

This nationwide retrospective cohort study examines the association between adults with hearing loss (HL) and subsequent injury risk. Utilizing data from the Taiwan National Health Insurance Research Database (2000-2017), the study included 19,480 patients with HL and 77,920 matched controls. Over an average follow-up of 9.08 years, 18.30% of the 97,400 subjects sustained subsequent all-cause injuries. The injury incidence was significantly higher in the HL group compared to the control group (24.04% vs. 16.86%, p < .001). After adjusting for demographics and comorbidities, the adjusted hazard ratio (aHR) for injury in the HL cohort was 2.35 (95% CI: 2.22-2.49). Kaplan-Meier analysis showed significant differences in injury-free survival between the HL and control groups (log-rank test, p < .001). The increased risk was consistent across age groups (18-64 and ≥65 years), with the HL group showing a higher risk of unintentional injuries (aHR: 2.62; 95% CI: 2.45-2.80), including falls (aHR: 2.83; 95% CI: 2.52-3.17) and traffic-related injuries (aHR: 2.38; 95% CI: 2.07-2.74). These findings highlight an independent association between HL and increased injury risk, underscoring the need for healthcare providers to counsel adult HL patients on preventive measures.

We describe the development and validation of a self-administered online hearing test, which screens for hearing loss and provides an estimated audiogram. The hearing test computes test results from age, self-reported hearing abilities, and self-assessed pure-tone thresholds. It relies on regression, Bayesian and binary classification, leveraging probabilistic effects of age as well as interfrequency and interaural relationships in audiograms. The test was devised based on development data, collected prospectively in an online experiment from a purposive convenience sample of 251 adult American, Australian, Canadian, and Swiss participants, 58% of whom had hearing loss. Later, we externally validated the hearing test. Validation data were collected prospectively from a representative sample of 156 adult Belgian participants, 15% of whom had hearing loss. Participants completed the hearing test and audiometric assessments at home. The results for the primary screening outcome showed that the hearing test screened for mild hearing losses with a sensitivity of 0.83 [95%-confidence interval (CI): 0.65, 0.96], specificity of 0.94 [CI: 0.89, 0.98], positive predictive value of 0.70 [CI: 0.57, 0.87], and negative predictive value of 0.97 [CI: 0.94, 0.99]. Results for the secondary audiogram estimation outcome showed mean differences between estimated and gold standard hearing thresholds ranging from 2.1 to 12.4 dB, with an average standard deviation of the differences of 14.8 dB. In conclusion, the hearing test performed comparably to state-of-the-art hearing screeners. This test, therefore, is a validated alternative to existing screening tools, and, additionally, it provides an estimated audiogram.

Cisplatin is widely used in anti-tumor therapy, but the ototoxicity caused by high-dose cisplatin often limits its efficacy, and the specific mechanism of cisplatin-induced cochlear damage is still not perfect. The Wnt/β-catenin signaling pathway is closely related to aging, embryonic development, and apoptosis. Meanwhile, B lymphoma Moloney murine leukemia virus insertion region 1 (BMI1) plays a certain role in the evolution and development of the inner ear and the occurrence and development of inner ear-related diseases. Our study intends to explore the role and specific mechanism of the Wnt/β-catenin signaling pathway and BMI1 in improving cisplatin ototoxicity. The appropriate experimental concentrations for each drug were selected by CCK-8 cell proliferation assay and Western Blot to detect apoptosis. The lentivirus transfection of HEI-OC1 cochlear hair cells was used to overexpress BMI1. Western Blot, qPCR, and immunofluorescence detected the activation of each component of BMI1 and Wnt/β-catenin signaling pathway in each experimental model. Wnt/β-catenin signaling pathway and BMI1 are jointly involved in cisplatin-induced cell injury. Low lithium chloride (LiCl) concentrations activated the Wnt/β-catenin pathway, increased BMI1 expression, and reduced cisplatin-induced hair cell injury. In contrast, overexpression of BMI1 inhibited the Wnt/β-catenin pathway and reduced hair cell injury. Meanwhile, the increased cisplatin-induced damage to hair cells by inhibiting BMI1 could not be rescued by LiCl. In conclusion, LiCl can ameliorate cisplatin ototoxicity by elevating BMI1 expression through activation of the Wnt/β-catenin pathway. Overexpression of BMI1 inhibits the Wnt/β-catenin pathway and reduces cisplatin-induced hair cell damage.

To assess the awareness about hearing loss and ear health among adults in Jordan.

A cross-sectional study was conducted where a questionnaire was filled from the month of November to the month of December of the year 2023, to assess the level of awareness about hearing loss and ear health. The participants included were Jordanian adults (age ≥ 18 years) residing in the North, Middle and South of Jordan.

Data from 333 participants (54.1% men) were analyzed. Participants between 18 and 28 years of age comprised 29.7% of the sample population. More than half of the participants (52.6%) held a university degree. Overall percentage of correct responses was 83%. Women, postgraduate degree holders, and participants diagnosed with hearing loss had an average of 11.96±1.47, 12.65±1.59 and 11.70±1.69 correct answers, respectively. The highest correct response received (97.6%) was for: hearing aids need to fit accurately to provide the maximum benefit. Furthermore, 97% of the sample correctly acknowledged that sudden hearing loss is an emergency and requires an immediate audiological assessment. The main misconception was that a deaf-mute cannot speak because of defects in the vocal tract, with only 39.3% of the sample providing a correct response. The other two misconceptions were: cotton buds are necessary for ear cleaning and are the safest means, and that ear drops are sufficient to treat earache, with 78.1% correct responses for each statement. Participants with higher level of education had higher odds of answering the questions correctly, with limited role observed for gender, prior diagnosis of hearing loss and a family history of hearing loss.

Majority of the adults surveyed provided a correct answer to the hearing loss and ear health survey. While most of the sample population were aware that a sudden loss of hearing is considered an emergency, only one third knew that defects in vocal cords do not play a role in deafness/muteness. The study highlights the need of public education on causes of hearing loss and measures needed to prevent the onset of hearing loss, with emphasis on methods for caring of ear health.

Recent studies have identified hearing loss (HL) as a primary risk factor for Alzheimer's disease (AD) onset. However, the mechanisms linking HL to AD are not fully understood. This study explored the effects of drug-induced hearing loss (DIHL) on the expression of proteins associated with AD progression in mouse models.

DIHL was induced in 5xFAD and Tg2576 mice aged 3 to 3.5 weeks using kanamycin (700 mg/kg, subcutaneous) and furosemide (600 mg/kg, intraperitoneal). The accumulation and expression of beta-amyloid (Aβ), ionized calcium-binding adaptor molecule 1 (Iba1), and glial fibrillary acidic protein (GFAP) were measured through immunohistochemistry and immunoblotting. Additionally, the expression of proteins involved in the mammalian target of rapamycin (mTOR) pathway, including downstream effectors p70 ribosomal S6 kinase (p70S6K) and S6, as well as proinflammatory cytokines, was analyzed.

Compared to control conditions, HL led to a significant increase in the accumulation of Aβ in the hippocampus and cortex. Elevated levels of neuroinflammatory markers, including Iba1 and GFAP, as well as proinflammatory cytokines such as interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-alpha (TNF-α), were observed. Moreover, DIHL enhanced phosphorylation of mTOR, p70S6K, and S6, indicating activation of the mTOR pathway.

HL significantly increases Aβ accumulation in the brain. Furthermore, HL activates astrocytes and microglia, leading to increased neuroinflammation and thereby accelerating AD progression. These findings strongly suggest that HL contributes autonomously to neuroinflammation, highlighting the potential for early intervention in HL to reduce AD risk.

Background/Objectives: The World Federation of the Deafblind Global Report 2023 reports that many countries do not have a comprehensive identification, assessment, and referral system for persons with deafblindness, a combination of hearing and vision loss, across all age groups and geographic regions. The scan seeks to inform researchers, policymakers, and community-based organizations about the status of and gaps in sensory healthcare initiatives in Canada, with the intent to raise awareness to enhance the integration and coordination of eye and ear care services. Methods: We conducted an environmental scan of Canada's healthcare system and current public health policies addressing vision and hearing care in Canada at the federal and provincial levels. The scan was conducted using published literature searches from five scientific databases-Embase, Medline, PsycINFO, PubMed, and CINAHL-in combination with the gray literature review of federal, provincial, and territorial governments and non-profit organizations' websites from April 2011-October 2022. Out of 1257 articles screened, 86 studies were included that met the inclusion/exclusion criteria. In total, 13 reports were included in the gray literature search, with 99 total articles used in the analysis. Results: The thematic findings indicate stigma and discrimination toward individuals with disabilities and marginalized communities (Indigenous people, rural communities, recent immigrants, people of older age, and people with disabilities), including hearing, vision, or dual sensory loss, persist. Barriers to vision and hearing healthcare access include inadequate policies, underinvestment in vision and/or hearing services, limited collaboration and coordinated services between hearing and vision services, discrepancies in insurance coverages, and lack of health system support. Conclusions: This scan demonstrates the persisting barriers to vision and/or hearing services present in Canada, stemming from inadequate policy and limited service coordination. Future work to address gaps, evaluate public education, and develop integrated sensory healthcare initiatives to enhance coordinated eye and ear care services, as recommended in the WHO Report on Hearing and Vision, is imperative.

Population-based evidence linking sleep characteristics with hearing is limited and how the associations change with age remains unknown. We aim to investigate cross-sectional associations between sleep characteristics and hearing by age in a nationally representative sample of U.S. adults.

We included 3,100 participants aged 40 years and older from the National Health and Nutrition Examination Survey 2015-18. Audiometric hearing thresholds at 0.5, 1, 2 and 4 kilohertz were averaged to calculate better-ear pure-tone average (PTA). Sleep questions were self-reported, including sleep duration on weekdays or workdays, snoring, snorting or stopping breathing, trouble sleeping, and daytime sleepiness. Multivariable-adjusted linear regression with an interaction term between sleep characteristic (categorical) and age (continuous in years) was used. Primary models adjusted for demographic and lifestyle factors with additional adjustment for cardiovascular factors in secondary models.

There was no association of reported sleep duration with PTA at age 50; however, compared to those reporting 7-8 h of sleep, there was a borderline-significant association at age 60 (<7 h: 1.72 dB, 95 % confidence interval [CI], -0.21, 3.66; >8 h: 1.25 dB, 95 % CI, -0.01, 2.51), and a significant association at age 70 (<7 h: 2.52 dB, 95 % CI, -0.27, 5.31; >8 h: 2.67 dB, 95 % CI, 0.56, 4.79). No consistent associations for other sleep characteristics were found.

Long sleep duration is associated with worse hearing among middle-aged and older adults and the association differs by age. Longitudinal evidence is needed to establish temporality and examine changes in hearing associated with sleep characteristics.

The Revised Hearing Handicap Inventory-Screening (RHHI-S) is a robust 10-item Patient-Reported Outcome Measure (PROM) that can quantify impacts of hearing loss (HL). Employing a cross-sectional study, the psychometric properties of a cross-culturally adapted Kurdish version of RHHI-S (RHHI-S-CK) were investigated. According to the degrees of HL, 168 enrollees (64.3% male; mean-age 63.1 ± 12.6 years) were divided into three subgroups; that is, mild (n = 56; 67.9% male; mean-age 60 ± 12.5 years), moderate (n = 64; 60.9% male; mean-age 64.6 ± 12.5), & moderately-severe (n = 48; 64.6% male; mean-age 63.1 ± 12.6). The internal cohesion among the items was confirmed by Cronbach's alpha (0.94). Confirmatory factor analysis recognised structural validity when a strong unidimensional factor was extracted. Convergent validity was verified (P-value < 0.001) via Spearman's correlation between the scale and a subjective correlator (visual analogue scale). A large effect size (0.88) from Kruskal-Wallis & Dunn-Bonferroni post-hoc tests established the discrimination between different degrees of HL. Lastly, intraclass correlation coefficient (ICC) proved the external reliability of the adapted version of the tool (Test-retest ICC = 0.95). RHHI-S-CK is a robust PROM that can measure the impacts of HL in adults across all age ranges. Accordingly, RHHI-S-CK augmented the clinical and academic practice of the Kurdish medical community.

Early Hearing Detection and Intervention (EHDI) programmes were established to reduce the impact of hearing loss on children. High-income countries (HICs) have resources and knowledge to execute these programmes. However, financial and other resource constraints limit the availability of these programmes to low-income and middle-income countries (LMICs). Yet, LMICs have explored strategies to implement EHDI programmes in their context; the outcomes are still largely unknown.The aim of this study is to identify the various models of the EHDI program implemented in non-Asian LMICs.

METHOD: Studies published between 2010 and 2023 reporting EHDI programmes in non-Asian LMICs for children were considered. The primary databases searched were PubMed, Scopus, Web of Science, EBSCOHost, EBSCO-CINAHL and ProQuest dissertations. The search results are summarised using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses chart. Quality appraisal and risk-of-bias assessment were assessed. Using the retrieved data, a narrative synthesis of the identified methods and forest plots for the prevalence estimate was created.

Fifty-six studies from 16 LMICs were included. They were grouped into 29 hearing screening programmes for neonates and infants and 26 programmes for older children. Predominantly hospital-based screening was employed for neonates and infants and school-based screening for older children. Two-stage otoacoustic emissions screening was employed for neonates and infants, while single-stage pure tone audiometry with otoscopy screening was used for older children. Predominantly, audiologists performed screening and diagnostics for neonates/infants while community health workers performed screening for the older children. Screening aspects were reported predominantly and not diagnostic evaluation/intervention outcomes. Overall, the economics of EHDI was reported only anecdotally in a few studies.

The screening strategies were not uniform among non-Asian LMICs. The protocols used were similar to HICs, yet few developed protocols adapting the Joint Committee of Infant Hearing. However, long-term outcomes such as rate of identification, suitable intervention and their outcomes are not known. EHDI programmes with successful outcomes of early intervention must be studied and reported with economic evaluations.

Observational studies suggest a potential association between sleep characteristics, sensorineural hearing loss (SNHL), and sudden SNHL (SSNHL), but causal evidence is scarce. We sought to clarify this issue using two-sample Mendelian randomization analysis.

The inverse-variance weighted (IVW) method was performed as primary analysis to assess bidirectional causal associations between sleep traits (chronotype, sleep duration, insomnia, daytime sleepiness, and snoring) and SNHL/SSNHL using publicly available Genome-Wide Association Studies summary data from two large consortia (UK Biobank and FinnGen). Sensitivity analyses, including Mendelian randomization (MR)-Egger, Mendelian randomization pleiotropy residual sum and outlier, weight median, Cochran's Q test, leave-one-out analysis, and potential pleiotropy analysis, were conducted to ensure robustness.

IVW analysis found suggestive associations of morning chronotype (odds ratio [OR] = 1.08, 95% confidence interval [CI] = 1.01-1.16, p = 0.031) and daytime sleepiness (OR = 1.88, 95% CI = 1.24-2.87, p = 0.003) with SNHL onset. Additionally, morning chronotype was nominally associated with SSNHL onset using IVW method (OR = 1.37, 95% CI = 1.10-1.71, p = 0.006). However, there was no evidence for the causal effect of SNHL and SSNHL on different sleep traits (all p > 0.05). Sensitivity analysis showed that the results were stable.

Within the MR limitations, morning chronotype and daytime sleepiness were underlying causal contributors to the burden of SNHL, indicating that optimal sleep might facilitate the prevention and development of SNHL.

3 Laryngoscope, 134:4723-4729, 2024.

The aim of this project was to investigate the provision of counselling in adult audiological rehabilitation and to highlight training barriers and needs.

A service evaluation in which respondents completed a survey in which they rated their knowledge, confidence and competence in addressing the hearing, social and emotional needs of their patients. They were also asked to define counselling.

64 UK practising audiologists in adult audiological rehabilitation, aged 20->60 years (84% females, 16% males), with a range of years in clinical practice.

Counselling definitions fell into three main categories: the audiologist as the doer, the audiologist as the facilitator, and the audiologist and patient as partners. Respondents reported feeling more able to counsel the hearing related needs of their patients, than emotional or social needs. There were significant positive statistical associations between counselling training completed and self-rated counselling abilities for managing emotional needs. Clinical experience was not associated with self-rated counselling. Lack of supervision and training were identified as some of the main barriers to providing emotional support. Almost all respondents reported a desire for further training in delivering emotional support, with the belief that this would improve services and patient outcomes.

UK audiologists demonstrated person-centred thinking through their definitions of counselling. However, they reported significant barriers in being able to support the needs of adults with hearing loss. Training needs around emotional support in audiology counselling are not currently being met. It is important for clinical training programmes to address this gap by incorporating more counselling courses into their curricula.

To determine whether immigrant status is associated with likelihood of audiogram and hearing aid use among US adults with hearing loss.

Cross-sectional study.

Nationally representative data from 2009 to 2010, 2011 to 2012, 2015 to 2016, and 2017 to 2020 National Health and Nutrition Examination Survey (NHANES) cycles.

This cross-sectional study of 4 merged cycles of NHANES included 12,455 adults with subjective (self-reported) or objective (audiometric) hearing loss. Sequentially adjusted logistic regressions were used to assess the association of immigration status with likelihood of having undergone audiogram among those with objective and self-reported hearing loss, and with likelihood of hearing aid use among candidates with objective hearing loss.

Immigrants were less likely to have received an audiogram among subjects with subjective (odds ratio [OR]: 0.81, 95% confidence interval [CI]: 0.75-0.87), and objective (OR: 0.76, 95% CI: 0.72-0.81) hearing loss, compared to nonimmigrants. The association persisted for those with subjective (OR: 0.88, 95% CI: 0.81-0.96), and objective (OR: 0.87, 95% CI: 0.80-0.96) hearing loss after adjusting for sociodemographic factors, comorbidities, insurance, and hearing quality, but disappeared in both groups after adjusting for English proficiency. Immigrants were less likely to use hearing aids (OR: 0.90, 95% CI: 0.87-0.93). However, this association disappeared (OR: 0.98, 95% CI: 0.93-1.04) in the adjusted model.

Immigrant status is a significant barrier to hearing health care and is associated with lower rates of audiometric testing and hearing aid use among individuals with hearing loss.

Previous studies have suggested a possible link between hearing loss and the risk of depression. However, the strength of this association remains uncertain across varying follow-up periods, age groups, cohort studies, and longitudinal study designs.

We conducted an extensive literature search across PubMed, Embase, and the Cochrane Library databases to retrieve pertinent studies. The quality of observational studies was assessed using the Newcastle-Ottawa Scale. Synthesis and meta-analysis of odds ratios (ORs) along with corresponding 95% confidence intervals (CIs) were performed using Stata 14.0. Funnel plot analysis and Egger's regression test were utilized to assess potential publication bias.

This meta-analysis comprised 24 cohort studies conducted between 2007 and 2024, with sample sizes ranging from 548 to 254,466 participants. Among these participants, 24,304 had experienced depression events. The pooling analysis shows that hearing loss is associated with an increased risk of depression (OR = 1.35; 95%CI: 1.27-1.44). In the subgroup analysis, the retrospective cohort exhibited a slightly higher risk of depression compared to the prospective cohort (OR = 1.43; 95% CI: 1.30-1.58). There are differences in the risk of depression among young, middle-aged, and older individuals, with older adults facing a higher risk (OR = 1.33, 95% CI: 1.21-1.45). Additionally, the risk of depression was slightly higher in the sudden sensorineural hearing loss (SSNHL) group compared to the non-SSNHL group (OR = 1.62; 95% CI: 1.27-2.07). Furthermore, in cohorts with a follow-up time ≥ 5 years, the risk of depression was higher compared to those with <5 years of follow-up (OR = 1.39; 95% CI: 1.26-1.54).

Our meta-analysis shows that hearing loss increases the risk of depression. These findings provide evidence that hearing loss should be recognized as an independent risk factor for depression.

https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42024502043.

Noise-induced cochlear synaptopathy has recently emerged as a focus in hearing research.

This study aimed to examine the impact of repeated noise exposure on the quantification and mRNA expression levels of cochlear synapses.

Measurements were conducted at baseline, 1 day, and 14 days post-exposure to 88 or 97 dB SPL noise (2 h/day for 7 days, frequency range 2-20 kHz). Auditory brainstem responses (ABRs), immunofluorescence and quantitative real-time PCR (qRT-PCR) were used to examine the results.

1. Exposure to 88 dB SPL caused minimal changes in ABRs, ribbon morphology and medial olivocochlear (MOC) efferent synapses; elevation of synaptophysin(SYP) and α9α10 nAchR mRNA levels were observed. 2. Exposure to 97 dB SPL caused threshold shift and synaptopathy of ribbon and MOC; downregulation of α10nAchR, SYP and ctbp2 mRNA levels were observed.

Noise-induced cochlear synaptic degeneration involves both afferent and efferent synaptopathy.

Age-related hearing loss (ARHL) is a prevalent sensory organ disorder among elderly individuals that significantly impacts their cognitive function, psychological well-being, and ability to perform activities of daily living. As the population ages, the number of ARHL patients is increasing. However, the Audiological rehabilitation (AR) status of patients is not promising. In recent years, there has been an increasing focus on the health and rehabilitation of elderly individuals, and significant progress has been made in researching various age-related disorders. However, a unified definition of ARHL in terms of etiology and rehabilitation treatment is still lacking. This study aims to provide a reference for future research on ARHL and the development of AR strategies by reviewing the classification, etiology, and rehabilitation of ARHL.

Introduction  Universal newborn hearing screening (UNHS) has been widely and strongly advocated as an early detection strategy for hearing loss in children. This intervention aims to prevent delays in speech and language development, which, in turn, has long-term beneficial effects on the social and emotional development and quality of life of individuals. However, the implementation of UNHS programs is circumstantial in different settings, for different reasons. Objectives  The present systematic review aimed to identify whether the implementation of UNHS programs are cost-effective, as well as their variations by localities. Data Synthesis  A search was conducted in seven databases: PubMed (Medline), Scopus, Web of Science, Embase, CINAHL, Lilacs, and Cochrane Library. Studies that included a cost analysis of UNHS programs were eligible for inclusion. Studies on evaluations of preschool or school-based programs only were excluded, among others. A total of 1,291 records were found. Of these, 23 articles were analyzed in full. All articles identified the cost-effectiveness of the UNHS programs implemented. Regarding the UNHS protocols, a wide variation was observed in all aspects: tests used, period established between tests and retests, professionals responsible for screening, environment, and criteria for defining hearing loss, limiting the generalization of this information. All studies presented values related to the expenses with the program, but none of them showed statistical elements for the described analyzes or any theoretical basis for such. Conclusion  It is necessary to estimate local specific issues, as well as the accuracy of the chosen tests and the NHS protocols used, so that more accurate analyzes on cost-effectiveness are possible.

Several health institutions developed strategies to improve health content on Wikimedia platforms given their unparalleled reach. The objective of this study was to compare an online volunteer-based Wikimedia outreach campaign with university course Wikipedia assignments (both focused on improving hearing health content in Wikimedia's public digital knowledge archives), in terms of the reach of the contributions and the extent of the participants' input. A secondary objective was to examine the feasibility and the implementation of the different strategies.

The research team partnered for the (1) coordination of improvements in hearing and healthcare content through educational programs using Wikimedia platforms, (2) participation in the global campaign Wiki4WorldHearingDay2023 and (3) evaluation of the proposed strategies. Metrics used in the comparison of the two strategies included the number of articles edited, number of views of the edited articles (as reach) and the extent of edits, captured as the number of words. The feasibility evaluation included assessing recruitment success and the implementation of the proposed plan among faculty, students from various university programs, and volunteers representing different constituencies.

The effort increased the availability of quality plain language information on hearing conditions and hearing care. Both strategies demonstrated to be feasible by their success in recruiting participants who contributed to the effort and by measurable outputs as edits. The contribution of content to Wikimedia platforms as part of education activities provided a more robust result. Wiki4WorldHearingDay2023 145 participants (78 from educational programs) contributed 167,000 words, 258 + references and 140 images to 322 Wikipedia articles (283 existing and 39 new ones), which were viewed 16.5 million times. Contributions occurred in six languages. Edits in Portuguese, mainly by those involved in educational programs, led the number of articles (226 or 70.2%) that were expanded or created during the 5-month tracking period.

The elements that contributed to the success of the studied strategies include an impact topic, coordination with educational programs, international multidisciplinary collaborations, the dissemination of the initiative in several platforms, connection with a robust local Wikimedia affiliate, and the use of a technical infrastructure that provides metrics and coordination mechanisms.

Hearing loss can impact an individual's mental, emotional, physical, and spiritual well-being. This review identifies existing research on client-centered interventions for Deaf and Hard of Hearing (DHH) clients which occupational therapy practitioners should understand. Databases searched included CINAHL, JSTOR, ERIC, PsychINFO, and Google Scholar. Full-text articles published in English from December 2013 to December 2023 were reviewed. After data extraction and analysis, 77 articles were synthesized, and interventions were categorized by type, occupation, relevant age group, theme, and professional performing the intervention. Understanding these interventions will help occupational therapy practitioners support DHH clients across the lifespan.

Untreated hearing loss is reported to negatively impact on an individual's quality of life, affecting their psychological and physical health and placing them at greater risk of developing dementia. Despite this, hearing loss management is often delayed by up to a decade. This is likely due to difficulties in navigating the hearing care pathway, and the absence of a central, unbiased reference point for consumer-friendly hearing health information and resources. We intend to co-design an online support service for adults with hearing loss with the following aims: 1) to understand unmet needs and consumer barriers to accessing hearing health information, 2) to identify solutions to these unmet needs that can be developed into prototype ideas, 3) to incrementally build on iterations of a prototype until a usable online support service is developed and ready for real-life testing with end-users, and 4) to test and evaluate the usability, accessibility, and effectiveness of the prototype from the consumer's perspective, so that the prototype can be refined into the final product.

This will be a mixed method study. Consumers will be involved in all stages of the design of the project following the Hasso Plattner model of design thinking. The qualitative component will involve sprints and semi-structured interviews to access the consumer perspective and understand unmet needs and challenges regarding the access of online hearing health information. For the quantitative component, an online survey will be administered prior to prototype testing as part of the remote usability study to collect self-efficacy and eHealth literacy outcome measures via validated questionnaires. Data collection will also be performed post-prototype testing for evaluation purposes. Finally, heuristic evaluation of the prototype will be conducted by an eLearning expert to help refine the prototype into the final product.

Audiological services are underused, possibly because patients need to drive long distances to see a provider. In this study, we measured the association of drive times to the nearest audiologist with population density, income, ethnicity, race, and distance to the nearest audiology graduate program.

Drive times for each census block group to the nearest audiologist were measured using census data, the National Provider Identifier Registry, and a geographic analyzing tool called ArcGIS for all block groups within the United States. The association between drive times and population density, income, ethnicity, race, and audiology program distance was evaluated with a population density-matched case-control study and multiple linear regression analyses.

Approximately 5.29 million Americans need to drive at least 1 hr to visit their closest audiologist. The 10% most rural-dwelling Americans drive an average of 33.8 min. The population density-matched case-control study demonstrated that percent below poverty, percent identifying as Hispanic, and travel times to the nearest audiology program were all significantly higher in census block groups with high drive times to the nearest audiologist. An average of 7.96% of individuals in census block groups with low drive times identified as Hispanic, but 18.8% identified as Hispanic in high drive time groups. The multiple linear regression showed that the effect of demographics and distance to the nearest audiology program was highest in rural areas. In both analyses, adjusting for poverty did not drastically change the effect of percent identifying as Hispanic on drive times.

Long drive times restrict access to audiological care for those who live in rural areas. This restriction disproportionately affects those in rural areas who identify as Hispanic or have low income.

Hearing loss is a significant disability that often goes under recognised, largely due to poor identification, prevention, and treatment. Steps are being made to amend these pitfalls in the investigation of hearing loss, however, the development of a cure to reverse advanced forms remains distant. This review details some current advances in the treatment of hearing loss, with a particular focus on genetic-based nanotechnology and how it may provide a useful avenue for further research. This review presents a broad background on the pathophysiology of hearing loss and some current interventions. We also highlight some potential genes that may be useful in the amelioration of hearing loss. Pathways of cellular differentiation from stem or supporting cell to functional hair cell are covered in detail, as this mechanism represents a key means of regenerating these cell types. Overall, we believe that polymer-based nanotechnology coupled with novel excipients represents a useful area of further research in the treatment of hearing loss, although further studies in this area are required.