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Monday, August 23, 2021

Occupational settings can involve exposure to loud noise, a known and preventable contributor to hearing loss. Hearing conservation programs and policies aim to protect workers from noise-induced hearing loss, but it remains unclear whether stress reactions caused by noise exposure might also lead to other negative health outcomes -- possibly at sound levels below those associated with hearing impairment.

In The Journal of the Acoustical Society of America, published by the Acoustical Society of America through AIP Publishing, researchers from the Canadian Federal Department of Health describe how data from the Canadian Health Measures Survey do not support an association between loud noise exposure and changes in biomarkers for cardiovascular disease or outcomes, such as hypertension, myocardial infarction, or stroke.

This very large cross-sectional study reproduced expected results for hearing loss but did not support the underlying theory that noise is a serious contributor to cardiovascular disease.

"Noise is definitely capable of acting as a stressor and causing reactions in the body, and there is a large science base showing the links between stress and cardiovascular disease," said co-author David Michaud. "But the question remains: Is occupational noise sufficient to cause stress-related illness when exposure is at levels below those known to impair hearing?"

There were associations found between noise and several biomarkers and cardiovascular outcomes in the data. However, none of these remained statistically significant after adjusting for important variables such as age, sex, and socioeconomic status.

Since many of these variables themselves are linked to cardiovascular disease and related biomarkers, the relationship between noise and adverse outcomes is complicated, and it remains difficult to assess the degree to which noise may contribute to impaired cardiovascular health.

Hearing loss induced by noise, often characterized by high-frequency hearing loss, was present in audiometry data for this study and correlated with noise exposure. While this was expected, it also indicates that self-reported loud noise exposure, defined as having to raise your voice to speak to someone at arm's length, was likely an accurate indication of one's exposure to loud noise.

"Our main interest was related to hearing among Canadians, not specifically to investigate whether noise exposure may contribute to cardiovascular disease," said Michaud. "We realized we had the data to look at the relationship between noise and cardiovascular outcomes on a national level."

While this study was not designed to look at either cardiovascular disease outcomes or classic stress biomarkers in specific settings, historical studies designed specifically to evaluate this link show mixed results. Some researchers contest there is adequate evidence for causal connections.

Editor's note: The original material was provided by The Journal of the Acoustical Society of America. The accuracy of information in this press release is the responsibility of the source, and opinions expressed are not necessarily the views of The Hearing Journal. Read more at bit.ly/Hjbreakingnews.

Tuesday, August 17, 2021

With an expected FDA ruling creating a new category of over-the-counter (OTC) hearing aids, treatment may become significantly more affordable for many. Auditory Insight's market analysis shows that stigma may be among the greatest barriers to overcome regarding consumer hearing aid adoption, currently at 15%.

Auditory Insight Stigma Banner.jpg“Fifty years ago, almost half of adults regularly smoked cigarettes. Today, society stigmatizes hearing aid use with the same potency that it once glamorized smoking," observes Nancy M. Williams, president of Auditory Insight. "By implementing proven strategies from anti-smoking public health campaigns, the hearing healthcare industry should be able to transform the discourse surrounding stigma with hearing aid use."

Applying Auditory Insight's proprietary framework to analyze MarkeTrak data enables pinpointing the top reasons why individuals avoid using hearing aids. The main categories of consumers' reasons when the survey was fielded in 2018 were:

• Price (33%)

• Denial (30%)

• Stigma (21%)

• Other (17%)

Note that responses in the “denial" category may be fueled by stigma, since some surveyed may feel uncomfortable admitting to concerns about appearance and/or stigma.

Since that survey was conducted, Costco, consumer electronics, and telehealth companies have introduced hearing devices for mild to moderate hearing loss that retail for significantly less than those sold through an audiologist or ENT clinic. Additionally, the FDA's finalized rule will create a new category of OTC hearing aids that companies could potentially retail for around $500 a pair, 10% of the price currently charged by the average clinic.

To address stigma, the hearing healthcare industry would benefit from anti-smoking campaigns' techniques. Auditory Insight's analysis of those campaigns has identified three proven strategies to change consumer behavior:

1. Deploy Shock Factor. Disturbing images and stories from former smokers who endured painful health conditions.

2. Create Empowerment. Information, reinforcement, and support programs to help people create a sense of agency.

3. Encourage Counter-Narratives. Alternative viewpoints to oppose stereotypes promoted by tobacco industry.

“Each of these three strategies may be applied to reduce hearing aid stigma," advises Williams. "For example, older adults may be encouraged to maintain their performance in the workplace by embracing hearing aids, empowering them to take action and preserve their effectiveness."

Editor's note: The original material was provided by Auditory Insight The accuracy of information in this press release is the responsibility of the source, and opinions expressed are not necessarily the views of The Hearing Journal. Read more at bit.ly/Hjbreakingnews.

Monday, August 9, 2021

At the Georgia and Alabama Combined Meeting for Hearing Professionals in Stone Mountain, attendees attended a presentation on how telecoils, hearing loops, and Bluetooth technology benefit consumers with hearing loss by Juliëtte Sterkens, an audiologist with the Hearing Loss Association of America.  Attendees who listened in the temporarily professionally installed hearing loop by loop-engineer Nick Hobbs from Active Life Hearing Loops in Georgia, participated in a raffle to win a portable PLA 90 Hearing Loop and desktop microphone, generously provided by Williams AV, Eden Prairie, MN. 

The Georgia and Alabama combined meeting was the result of months of preparation during a pandemic which made preparation even more crucial to the success of the conference.   Organized by the board of the Georgia Society of Hearing Professionals, the Summer Conference had 93  attendees from 4 states across the southeastern United States, and welcomed presenters from various niches of the professional hearing spectrum to further educate its members on best practices in hearing healthcare.  

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Georgia and Alabama have been combining for their summer meeting since 1996. This year's meeting, hosted by the GA group, was held at Evergreen Resort and Conference Center located inside Stone Mountain Park.  The meeting was attended by 95 attendees and 10 exhibitors.  Attendees had the opportunity to earn 11.5 units of Continuing Education on interesting topics.  Conference attendees shared positive feedback on their listening experience in the loop, including notes on its crisp and clear sound quality.

Katrina Husband, a 20-year veteran hearing care provider from Conyers, GA was the lucky winner. “Winning this gift from Williams AV will allow me to loop right in my front office! It is a way to differentiate from my competitors who don't discuss much less demo assistive devices that can make their lives even better.  I am super excited to add this to my toolbox to better serve my patients."

From left to right: Nick Hobbs with Active life Hearing Loops in GA, Katrina Husband, HIS and Juliëtte Sterkens, AuD with the Hearing Loss Association of America.



Editor's note: The original material was provided by Georgia and Alabama Combined Meeting for Hearing Professionals. The accuracy of information in this press release is the responsibility of the source, and opinions expressed are not necessarily the views of The Hearing Journal. Read more at bit.ly/Hjbreakingnews.

Wednesday, July 28, 2021

​A University of Alberta research lab has helped identify a genetic variant that increases the risk of hearing loss in children with cancer who are treated with the widely used drug cisplatin.

Amit Bhavsar, assistant professor in the Department of Medical Microbiology & Immunology and Canada Research Chair in Functional Genomic Medicine, led the U of A team that contributed to the international study, which was published in the journal Precision Oncology. Bhavsar's team confirmed the study's genomic findings with a biological investigation using cell-based models.

With significant advances in pediatric cancer care in recent decades, the five-year survival rate for childhood cancer is now almost 80 per cent. But many childhood cancer survivors suffer from serious health complications after chemotherapy. Permanent hearing loss is one of them.

Hearing loss affects half of young patients

Children with solid tumours in the brain, liver and bone are usually treated with cisplatin, a highly effective chemotherapy that has been in use since the 1960s. They are more vulnerable to chemotherapy toxicities than adults—half of children treated with cisplatin suffer irreversible hearing loss.

Hearing loss in young children can have a devastating effect on speech development, psychosocial skills and academic performance, said Bhavsar, and affects quality of life in children of all ages.

The international study began in 2015, spearheaded by the European organization PanCareLIFE. The collaborators looked at how the genetic variations in 770 pediatric patients in Europe and Canada influenced their response to cisplatin. Bhavsar said close to a million variants were examined.

In their first cohort study, the researchers identified a genetic variant in the TCERG1L gene, along with a few other variants, that appeared to increase the risk of cisplatin-induced hearing loss. Two further replication studies—including one involving young cancer patients in Canada—were done, looking at those specific variants. They confirmed the association between the TCERG1L variant and the hearing loss.

The Bhavsar lab joined the project in 2019. Its role was to replicate the statistical findings in a laboratory setting "to see if there was a biological rationale for what they had seen in the cohorts," he explained. The U of A team manipulated the TCERG1L gene in human cell lines to determine how that would affect the cells' response to cisplatin. 

Their laboratory findings corroborated the cohort research, concluding that children with the TCERG1L variant have three times the risk of hearing loss due to cisplatin treatment compared with those who don't have the variant. They are the first research group to make this connection.

Predicting who is at risk

Bhavsar said further research is needed. In the case of the TCERG1L gene, which is a transcription regulator, it would be important to investigate other genes regulated by TCERG1L to see what role they play in cisplatin-induced hearing loss. 

The hope is that research like this international study will lead to predictive tests that will allow doctors to determine which patients are at higher risk of hearing loss during or after cisplatin treatment. This might change treatment or dose decisions and would at least allow patients and families to be informed in advance of the risks, Bhavsar noted.

Editor's note: The original material was provided by University of Alberta Faculty of Medicine & DentistryThe accuracy of information in this press release is the responsibility of the source, and opinions expressed are not necessarily the views of The Hearing Journal. Read more at bit.ly/Hjbreakingnews.

Wednesday, July 28, 2021

Researchers at the University of Maryland School of Medicine (UMSOM) launched a new online tool that could more quickly advance medical discoveries to reverse progressive hearing loss. The tool enables easy access to genetic and other molecular data from hundreds of technical research studies involving hearing function and the ear. The research portal called gene Expression Analysis Resource (gEAR) was unveiled in a study last month in Nature Methods. It is operated by a group of physician-scientists at the UMSOM Institute for Genome Sciences (IGS) in collaboration with their colleagues at other institutions.

The portal allows researchers to rapidly access data and provides easily interpreted visualizations of datasets. Scientists can also input their own data and compare it to other datasets to help determine the significance of their new finding.

"It saves scientists a huge amount of time," said study corresponding author Ronna Hertzano, MD, PhD, Associate Professor of Otorhinolaryngology-Head & Neck Surgery at UMSOM and founder of the gEAR. "Instead of relying only on identifying mutations in genes for hearing loss, researchers can easily identify which cells express any gene in the ear, and how this expression changes, for example, as a result of noise exposure or in processes of regeneration in other species."

Dr. Hertzano and her team recently added data from the BRAIN initiative to a specialized domain of the gEAR portal to provide access to those performing neuroscience studies to better understand brain function and neurodegenerative diseases like Alzheimer's. The portal is free and available to any researcher seeking access.

Users of the portal can do a variety of applications depending on their needs. They can access the dataset uploader and add their dataset into gEAR to view their data in a private setting. This enables them to see their findings in the context of other public data before posting their results online or submitting their paper for publication. Once a manuscript is published, a permalink can be included in the manuscript which links readers directly to a curated view of that dataset.

"The gEAR portal currently includes over 800 datasets, which we carefully reviewed before inputting," said Dr. Hertzano. "We currently have more than 1,200 registered users and over 80 citations in research studies. We are expecting a large increase now that our methods paper is published." She and her colleagues did a soft launch of the portal a few years earlier and publicized its existence via discussions with colleagues and user workshops at scientific meetings.

The Hearing Restoration Project, a non-profit research consortium funded by the Hearing Health Foundation, provided initial support of gEAR in an effort to better understand the mystery of hair cell regeneration - why hair cells in the ear regenerate in certain animals but not in humans. Our hair cells do not naturally regenerate when they die off due to aging, excess noise, or exposure to certain potent medications like chemotherapy drugs for cancer. For this reason, hearing loss is usually permanent and cannot be reversed. The consortium uses genomic analyses to compare molecular processes in species that do not regenerate hair cells. "The gEAR team closely interacts with the consortium researchers who also serve as our focus group, providing priceless feedback and suggestions," Dr. Hertzano said.

Understanding how the expression of certain genes plays a role in hair cell regeneration - and how enzymes and other proteins mediate that process - could lead to new treatments to reverse hearing loss by triggering a regeneration of these cells.

"By enabling rapid access to enormous datasets, the gEAR portal can serve as a valuable hub for community building around common research areas," said Claire M. Fraser, PhD, the Dean's Endowed Professor of Medicine, Microbiology and Immunology, and Director of IGS. "Having access to data in large repositories is not enough. What's essential is that gEAR curates and organizes the data into an accessible format so it can be used to address important scientific questions."

Study lead author Joshua Orvis, Lead Bioinformatics Software Engineer at IGS and study co-author Yang Song, PhD, Bioinformatics Analyst II at IGS, were instrumental in the development of gEAR. Researchers from the University of Maryland, College Park, National Institute on Deafness and Other Communication Disorders, University of Iowa, Johns Hopkins University School of Medicine, and Bar-Ilan University in Israel also contributed to this study.

"The gEAR portal is a beautiful example of the value of close collaboration of clinicians, biologists, and engineers to bridge the gap in technology and make the critically important 'omic' data generated across the world immediately accessible to biologists in a meaningful format," said E. Albert Reece, MD, PhD, MBA, Executive Vice President for Medical Affairs, UM Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor, and Dean, University of Maryland School of Medicine.

Editor's note: The original material was provided by University of Maryland School of Medicine. The accuracy of information in this press release is the responsibility of the source, and opinions expressed are not necessarily the views of The Hearing Journal. Read more at bit.ly/Hjbreakingnews.