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3M on Trial for Failing to Protect SOLDIERS Hearing

3M on Trial for Failing to Protect Soldiers Hearing

Veterans claim that the 3M knowingly gave soldiers defective NOISE REDUCTION earplugs.

Julia Métraux

Health Writer

30 March 2021

1280px 3 M Building Maplewood Mn1

Image via Wikimedia Commons/Acroterion

The first trial began yesterday for multinational corporation 3M—for its defective military-issued earplugs. There are over 229,397 lawsuits from veterans and soldiers who claim that 3M knowingly gave defective earplugs to soldiers to use in combat. Two subsequent trials will take place in May and June.

“Combat Arms CAEv2” earplugs, sold by 3M-subsidiary Aearo Technologies, were designed for use by the US Military, and sold to the US government between 1999 and 2015. The Star Tribune reports that damages related to the faulty earplugs “could tally in the hundreds of millions of dollars, if not more, based on the outcome of other large mass tort cases in recent years.” The plaintiffs from the first trial are veterans, mostly between the ages of 30 and 49.

One plaintiff, U.S. combat veteran Dave Henderson, started to experience ringing in his ears and had trouble hearing people after using the Combat Arms earplugs in the field. Henderson told Reuters that “we had no choice but to use the 3M earplugs” because the soldiers “trusted that our equipment would work.” Henderson told Reuters that he has to sleep with a fan to help with the ringing in his ears, and sometimes cannot hear when his children are crying.

The plaintiffs claim that 3M knowingly hid product defects—namely that the CAEv2 earplug didn’t always fit properly—from the U.S. Department of Defense.  Aearo’s own laboratory tests, conducted in 2000, showed that the earplugs weren’t effective unless they were fitted “in a particular way.” According to Star Tribune, 3M claimed that it informed the military about “fitting issues”, but “in a 2018 report, the Army concluded that had the government known about tests […] it may not have purchased Combat Arms earplugs.” 3M also paid a $9.1 million penalty in a whistleblower settlement but did not admit liability. 3M also paid a $9.1 million penalty in a whistleblower settlement but did not admit liability.

Judge M. Casey Rodgers of U.S. District Court for northern Florida, who will hear all three consolidated claims, will not allow 3M to use the “government contractor defense”, which would potentially “offer protection from state law product liability actions arising out of a contractor’s compliance with a federal government contract,” according to the American Bar Association.

The key point in this trial is whether or not 3M knew that the Combat Arms earplugs were defective. Hearing loss is a major issue for veterans, and a costly service-connected injury for the VA. The U.S. Department of Veteran’s Affairs reported that  “more than 933,000 Veterans were receiving disability compensation for hearing loss, and nearly 1.3 million received compensation for tinnitus” at the end of the fiscal year of 2014.

Julia Métraux

Health Writer

Julia Métraux is a health and culture writer with hearing loss and a member of the Association of Health Care Journalists. Check out her portfolio.

Ear Buds to Hearing Aids

Samsung Galaxy Buds Pro are tested as a hearing aids — the results are here:

By James Archer 3 days ago

Study finds Samsung Galaxy Buds Pro can help with hearing loss

Samsung Galaxy Buds Pro

(Image credit: Samsung)

The Samsung Galaxy Buds Pro has an Ambient Sound mode that uses onboard microphones to pick up and amplify sounds that you’d otherwise struggle to hear with the headphones in. Conceptually it’s no different to the transparency modes on many other wireless earbuds, but a new study has suggested the feature could make the Samsung Galaxy Buds Pro an alternative to dedicated hearing aids.

The study, conducted by the Samsung Medical Center and published in the peer-reviewed Clinical and Experimental Otorhinolaryngology journal, involved 18 participants with mild or moderate hearing loss. Of these, 57.6% reported that using the Galaxy Buds Pro was beneficial to their hearing in quiet environments.

It’s important to note the limitations of such a small sample size, as well as the fact that conventional hearing aids outperformed the Galaxy Buds Pro — especially in noisy environments, where only 26.3% of participants reported a benefit from the Samsung earbuds.

But while Samsung isn’t advocating the Galaxy Buds Pro as a one-to-one replacement to hearing aids, the study does make a good point in suggesting headphones with ambient/transparency modes could be useful in low- and middle-income countries, where hearing aids are prohibitively expensive. RECOMMENDED VIDEOS FOR YOU…CLOSEVolume 0%PLAY SOUNDThis video file cannot be played.(Error Code: 203000)

The World Health Organization’s research on deafness and hearing loss, cited in the Samsung study, notes that 80% of people with disabling hearing loss live in these countries, and that only 17% of those who could benefit from a hearing loss actually wear one.

Hearing aids can be free at the point of use in some countries, like the U.K., though elsewhere the $199 Galaxy Buds Pro could feasibly be seen as a more attainable alternative to hearing aids that typically cost several times as much. Even if it’s not as effective, and has a battery life lasting a few hours (instead of several days like most hearing aids).

Samsung has focused on the therapeutic qualities of the Galaxy Buds Pro before. In January it released a software update that added the ability to adjust volume on the left and right Galaxy Buds Pro independently, potentially helping those with worse hearing in one ear than another.

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super hearing coming


Google’s Project Wolverine is a HEARING AID in the future


Google’s X division has been secretly working on a fascinating project it calls “Wolverine.” It has to do with technology that enhances augmented reality (AR) applications. Google’s X division focuses exclusively on “moonshot” projects.
Project Wolverine is all about supplying users with a wearable device that employs directional microphones to enable “super hearing.” It’s a reference to the X-Men character Wolverine. The technology is still being fleshed out. The idea is that these directional microphones will connect to ear pods and likely work in conjunction with both outward- and inward-facing cameras on a pair of glasses or some other wearable device. This will allow the sensor-packed hardware to know who we are focusing on in the noisy room. And then we can direct the microphones to zero in on what that person is saying. The mics will filter out the background noise so we can hear our target clearly. This technology is called speech segregation, and I think it is the future.

. Speech segregation solves the problem of hearing in a noisy environment. We can imagine using this device at events like restaurants or parties to focus in on the person we are speaking to. This cuts through all the chaos in common areas. Of course, the same dynamic is true for any other event or gathering. This tech would be useful even at our holiday dinners or cocktail parties. So I think that every company working on AR will ultimately adopt this technology. It just makes too much sense.
However, there are major privacy concerns with this. It’s easy to imagine how this tech could be used for nefarious purposes. Bad actors could eavesdrop on private conversations happening at coffee shops, restaurants, and town squares.

And then there’s Google… We already know that Google’s goal is to extract as much behavioral data from us as possible. The company packages this data into a detailed dossier that it sells to anyone willing to pay. In this way, the argument could be made that Google knows many of us better than we know ourselves. Now, imagine Google pairing facial recognition technology with speech segregation. Suddenly, Google can document exactly what we are talking about out in public. That gives it an even more invasive framework in which to build its profile on us. So this is incredibly useful technology that I believe will gain rapid adoption. But as with everything, we need to be diligent about how it is used. Let us hope that other Corporations will adopt this technology for the common good.

Many “DIRECTIONAL HEARING AIDS ” have been on the market beginning about 50 years ago with Maico Hearing aid Company. I introduced that hearing aid in the Los Angeles county on TV, radio and the Los Angeles Times 3/4 page advertisement. I formed an advertising group of Southern Calif. Specialists. I was the President of “The Guild of Hearing Aid Disp.”

The BTE Hearing aid had 2 mics (Knowles) in a behind ear hearing aid. The front facing mic amplified the full sound. The rear facing mic reduced the sound coming from the rear, about 40% . They provide a significant benefit. The idea has been copied by most every other company since.
But today, when these mics are coupled with more mics. and the advanced technology that is described above, we will see great advances of HEARING IN NOISY SITUATIONS..

hearing aid molds prices

Hearing aid molds prices range from $2 each to over $200 each.

HCPB DIY EAR MOLDS COST from $2 to #19 EACH

Provider/seller ear molds cost from $80 to $250 each, hat is, the person who sold you your hearing aid.

 Some of  the popular Audiologist from Laboratory earmolds are at the left in the below photo. They cost from $80 to $250 EACH, DEPENDING ON YOUR HEARING AID PROVIDER’s FEE who sold and adjusted it.. 

Those above, on the left, are Lab molds, made of Lucite, acrylic and Urethane hard plastic and these particular molds are made for BTE, Behind The Ear Hearing aids. They require an impression of your ear be taken, mailed to a factory where the ear mold is made and mailed back to the seller. Upon receipt, the seller calls you for an appointment. This entire process typically takes from 9 to 21 days. You may also need to return to fix problems and make adjustments.

The remaining earmolds above on the right are made for BTE hearing Aids. Those in the center are for RIC and Open Fit hearing aids. They are  DIY from HCPB Ear mold Kits that are made from flexible Medical Grade Silicone rubber putty at a cost of $2 Each to $12 Each. They take only 10 minutes to make in your own home

You are in control HCPB rar molds for your satisfaction. They are available in 3 skin colors, Tan, Brown and Dark Brown. They work with ALL BRANDS and MODEL Hearing Aids and are shipped PRIORITY in 2 to 3 day USPS FREE.

For more information click here.

hearing loss and work, case study

By Sarah Ellsworth

Everyone has their own opinions about remote work, our “new normal” approach to office-based professions during the COVID-19 pandemic.

Some people still struggle with the lack of face-to-face interaction, while others became acclimated to their virtual environments instantly. Unlike many workers who commuted to a physical office each day prior to March 2020, my daily routine has not changed.

I have been working from home since 2014 for a company that provides remote accounting services to nonprofit organizations around the country. 

I know that I am lucky to have avoided a career disruption during this time. Still, I recognize that the transition from in-person to online work has been difficult for people like me. I have a hearing loss, and I can appreciate that visual cues are more likely to be missed when we can’t collaborate with coworkers in the same room. I don’t wear hearing aids, but rely on lipreading for communication. I was born with a genetic hearing loss, so it’s been part of my entire life.

Joining her current company as a remote employee was a dream come true for Sarah, who was born with a hearing loss. Technology helps Sarah to work with confidence. Image credit:    FreePik   .
Joining her current company as a remote employee was a dream come true for Sarah, who was born with a hearing loss. Technology helps Sarah to work with confidence. Image credit: FreePik.

As someone who’s only known a life with difficulty hearing, take it from me. I’m here to encourage folks with hearing loss that this new normal — my old normal — is actually something to embrace. I’ve had many different jobs in my life — outdoor recreation, retail sales, mail carrier, publicist, blogger — but I’ve always gravitated towards positions where I’m not working against my hearing loss. Joining my current company as a remote employee was a dream come true. 

If there was ever a time to live with hearing loss, it’s now. Technology has improved exponentially in recent years, and the internet has allowed people with hearing loss to participate in communities and real-time conversations in a way that used to be almost impossible. 

One significant recent technological development is the live captioning built into Google Meet video conferencing software. They’re surprisingly accurate! Many of the other tools that my colleagues and I use — email, instant messages, virtual project management systems — are also really helpful for people with hearing loss. 

Nothing is perfect, of course. While, like most Millennials, I do my best to avoid phone calls, automated phone menus are the bane of my existence. It can be especially tough for people with hearing loss to get through a phone tree or automated greeting when the robot on the other end doesn’t understand, “What? Could you repeat that please?” 

Sarah Ellsworth Headshot.jpg

Despite the challenges that remain, I’m excited to see what the future holds for those of us with hearing loss. From new advancements in technology to more flexible working environments, change can be a wonderful thing.

Sarah Ellsworth is Communications Director at Altruic Advisors, a virtual/remote accounting firm for nonprofit organizations. She lives in Colorado.

are on-line hearing tests reliable?

1. Know what online tests can and cannot reveal

Recognize that these assessments can be a first step in learning about hearing loss, but aren’t comparable to a highly accurate, in-depth evaluation by a trained professional.

“Online tests are intended to screen your hearing, but they are not audiogram tests,” said Sharron Nixon, hearing services manager. “They only indicate whether you may have loss. You still need a full test in a soundproof chamber with a professional.”

2. Look for tests with real-world scenarios

Auditory Insight president Nancy M. Williams was the lead author of a study that looked at how hearing tests can best engage users. “You want to interact with a test that will explain your hearing loss in real-world conditions, in real-world terms,” she said. In particular, she praised those by Miracle-Ear and Starkey for featuring relatable scenarios. For instance, Miracle-Ear’s test replicates being in a train station. “The announcement comes on and broadcasts the platform for your train,” Williams explained. “That’s a real stressor for people with hearing loss. The announcer is often speaking over a lot of background noise.”

In Starkey’s evaluation, users are in a café and need to tune into conversations over the hubbub around them. These tests can provide valuable intel on how the test-taker fares in these everyday situations.

3. Recognize that these tests offer privacy – which can be a relief

While hearing loss—especially the age-related kind—affects many people, shame surrounding this disability can hinder acceptance. “I think these tests are really important because a lot of people with hearing loss have a need for privacy,” Williams said. “Not everybody is ready to go to the audiologist and have their hearing loss announced to them.”

Dr. Archelle Georgiou, the Chief Health Officer of Starkey Hearing, previously told Hearing Tracker how an online hearing test helped her mother move forward and address her hearing loss. “It provided objective evidence that she did indeed have hearing loss, and I think that’s the moment she took it seriously,” Dr. Georgiou said.

4. Avoid the temptation to pump up the volume

Your computer’s volume setting may impact the results of an online test. ReSound’s hearing test, for example, tells users to make sure that “the volume is set at a comfortable level.” But a comfortable level could be much louder for someone with hearing loss than without—and it may also be higher than what an audiologist would use.

Amber Bright, who lives in Tennessee, took an online hearing test once and received different results than what her audiologist uncovered. “It’s not really comparable. It can be ‘cheated’ by adjusting the volume on the computer, and external equipment [like certain speakers] can also amplify sounds,” Bright said. So keep the volume at a moderate level, and consider your results directional but not definitive.

5. Go ahead and boost your product knowledge

If you have an appointment for a hearing test, the audiologist will likely suggest getting hearing aids if a loss is detected. Some online hearing tests also nudge this process along, according to Williams. “An example is getting a product recommendation based on the type of hearing loss detected,” she said. She highlighted Audicus as an example of this. This information about appropriate devices can help deepen your knowledge.

If an online hearing test does indicate deficits, you’ll be primed to make your next move: contacting an audiologist Hearing Aid Specialist, or ENT. They can then do a full-fledged assessment and recommend the right devices to support your hearing.

Opiods and hearing loss

Why Hearing Loss May Increase Your Risk of Opioid Addiction

Here’s a shocking statistic: Deaf and hard of hearing people are twice as likely to develop a prescription opioid-use disorder than their hearing counterparts. That finding was uncovered by Dr. Michael M. McKee, a family physician with hearing loss who leads the Deaf Health Clinic at Michigan Medicine.

Dr. McKee noticed that many of his new patients were taking controlled substances to address chronic pain. He began to wonder if hearing loss was a factor, and set out to formally explore the relationship between hearing loss and substance use. His findings were published the American Journal of Preventative Medicine.

Dr. McKee’s key finding was that adults (aged 18-49) with hearing loss were significantly more likely to develop an opioid use disorder when compared to their normal hearing peers, especially for those younger than 35. Older adults with hearing loss were no more vulnerable than their peers.

Understanding the hearing and pain connection

Dr. McKee became concerned that his patients’ high number of prescriptions might be due to communication issues. If information isn’t fully shared, it presents challenges to receiving optimal care. “Whether it’s back pain, fibromyalgia, [or both] of those conditions, chronic pain requires a lot of communication to address it,” Dr. McKee said. “Most doctors want to avoid controlled substances because of [the risk of] dependency. But when communication breaks down…these issues pop-up.”

During the current COVID-19 pandemic, communication barriers have intensified. Masks block lipreading; a dearth of interpreters at some in-person appointments due to social distancing requirements may also make matters more difficult. If deaf or hard-of-hearing patients cannot understand their doctors, “they are not being taken care of properly,” said Gregory Shuler, RN. BC. MSN., of Worcester Recovery Center and visiting instructor at Worcester State University, when talking with Hearing Tracker.

Why aren’t older Americans with hearing loss at risk?

Interestingly, the occurrence of opioid use disorder among older patients (50+) was the same regardless of whether they had hearing loss or normal hearing. Dr. McKee attributes this to doctors being more aware that older patients may experience age-related hearing loss, leading to improved communication about pain management with older adults with hearing loss.

Advocating for better care and communication

Dr. McKee finds it essential to empower patients to get their needs met but knows this isn’t always easy. Some are simply not comfortable discussing how their hearing loss affects them. “They get to a point where they give up because the barriers are huge. There’s stigma,” Dr. McKee says. “On top of that, some people are not comfortable saying ‘I can’t hear.’”

Dr. McKee cites the Hearing Loss Association of America’s Communication Access Plan as a way that those with hearing loss can address the situation with their doctors. It all boils down to “explaining what is the way to best communicate with me,” he said, “trying to be more proactive instead of reactive on how we address communication needs or combinations needed.” Having this alignment between patient and healthcare professional can improve how well symptoms and sentiments are shared, leading to better care.

How healthcare professionals can help

The medical community can also play an important role in diminishing opioid-use disorder. Previously the charge nurse at the deaf unit for psychiatric adult and adolescent patients at Worcester State Hospital, Shuler—along with other health professionals—outlined how providers could improve communication with deaf patients in Nursing. These steps could also apply to interacting with those who are hard of hearing, too.

  1. Ask the patient what you can do to help improve the communication process.
  2. Don’t assume the patient can hear and understand what you’re saying just because they are wearing a hearing aid.
  3. Ask the patient what communication tools (such as a whiteboard, computer, or tablet) work best for them
  4. Only one person should talk at a time in a group situation.

Shuler also advocates for professional sign-language interpreters in medical settings instead of relying on the patient’s family or friends, who may have their own biases when signing. “You need someone who is following a specific code of ethics, is a neutral party, and is trained to interact between the deaf person and the hearing person,” Shuler said. Patients may want to request an interpreter prior to their appointments as well.

Overcoming the opioid issue

To address the heightened risk of substance-use issues in deaf and hard of hearing patients, Dr. McKee says that doctors could benefit from communication training, starting in medical school. He says doctors must learn to take a step back and recognize risks that hard of hearing people face.

“These people often have higher rates of mental-health issues, which can go hand in hand with opioid-use disorders,” Dr. McKee said. “Many deaf and hard-of-hearing individuals have depression, anxiety, interpersonal violence, abuse from past, and they may struggle with lower socio-economic statuses.”

As the healthcare community recognizes this issue—and as patients demand appropriate communication—the link between hearing issues and prescription opioid-use disorder will hopefully be unraveled and eliminated.

How we hear science

Hearing Acrobatics

Dynamic, delicate grip between protein filaments enables hearing

By KEVIN JIANG February 8, 2021 Research

hair cells

A scanning electron microscope image of a hair bundle protruding from a sensory cell in the inner ear. Image: David Furness/Wellcome Collection (CC-BY-NC 4.0)

The sense of hearing is, quite literally, a molecular tightrope act. Turns out, it involves acrobatics as well.

In a paper published in Nature Communications on Feb 8, researchers at Harvard Medical School and Boston Children’s Hospital show that a dynamic and delicate connection between two pairs of diminutive protein filaments plays a central role in hearing.

The tension held by these filaments, together called a tip link, is essential for the activation of sensory cells in the inner ear. The team’s analyses reveal that the filaments, which are joined end-to-end, work together like trapeze artists holding hands. Their grasp on each other can be disrupted, by a loud noise, for example. But with a two-handed grip, they can quickly reconnect when one hand slips.

Get more HMS news here

The findings present a new understanding of the molecular underpinnings of hearing, as well as the sense of balance, which arises from similar processes in the inner ear. Disorders of deafness and balance have been linked to mutations in tip links, and the study results could lead to new therapeutic strategies for such disorders, according to the authors.

“This tiny apparatus, made of less than a dozen proteins, is what helps change sound from a mechanical stimulus into an electrical signal that the brain can decipher,” said co-corresponding author David Corey, the Bertarelli Professor of Translational Medical Science at HMS. “Understanding how these proteins work provides insights into the secrets of the sensation of sound.”

The dynamic connection between the filaments may also function as a circuit breaker that protects other cellular components, according to the researchers.

“I think our study gives us a sense of awe for how perfectly engineered this system in the ear is,” said co-corresponding author Wesley Wong, HMS associate professor of biological chemistry and molecular pharmacology at Boston Children’s. “It maintains a delicate balance between being just strong enough to carry out its function but weak enough to break to potentially preserve the function of other elements that can’t be as easily reformed.”

Decoding a handshake

For hearing to occur, cells must detect and translate pressure waves in the air into bioelectrical signals. This task falls upon hair cells, the sensory cells of the inner ear. Protruding from these cells are bundles of hair-like structures, which bend back and forth as pressure waves move through the inner ear.

tip links
A close up of tip links connecting the stereocilia of a hair cell. Image: David Furness/Wellcome Collection (CC-BY-NC 4.0)

Tip link filaments physically connect each hair to another and are anchored onto specialized ion channels. As the bundle moves, the tension of the tip links changes, opening and closing the channels like a gate to allow electric current to enter the cell. In this way, tip links initiate the bioelectrical signals that the brain ultimately processes as sound.

In previous studies, Corey and colleagues explored the composition of tip links and identified the precise atomic structure of the bond between the two protein filaments. Intriguingly, this bond was evocative of a molecular handshake, according to the authors.

In the current study, CoreyWong, and the team set out to understand the nature of this handshake. To do so, they applied single-molecule force spectroscopy, a technique that often uses optical tweezers—highly focused laser beams that can hold extremely small objects and move them by distances as short as a billionth of a meter.

The researchers, led by study first authors Eric Mulhall and Andrew Ward, both research fellows in neurobiology in the Blavatnik Institute at HMS, coated microscopic glass beads with strands of either protocadherin-15 or cadherin-23, the two proteins that make up the tip link. Using optical tweezers, they moved beads close to each other until the protein strands stuck together end to end and then measured the forces needed to pull the bonds apart.

Stronger than the sum

Each tip link is made up of two strands of both proteins. The team found that the strength of this double-stranded bond far surpassed the strength of the bond between individual strands of either protein. Under low tension, a double-stranded bond lasted ten times longer than a single-stranded bond before breaking.

This increased strength appears to be due to the dynamic nature of the connection, according to the authors. Rather than acting as a simple static rope, the filaments detach and reattach to each other within tenths of a second. A force may break one pair of strands apart, but the other pair can remain connected long enough for the broken pair to rejoin.

acrobats
The bond between tip link filaments resembles an acrobatic “two-handed grip.” Image: David Corey
Trapeze artists
 Christina Saran and Daniel Simard. Image: Feld Entertainment

At extremely high forces, however, the double-stranded bond breaks rapidly. This feature may help to prevent catastrophic damage to other components of the hair cell, the authors said.

“If the tip link were super strong, then when exposed to a very loud sound it might rip the whole complex out of the cell membrane, which would be hard to recover from,” said Wong, who is also an associate faculty member at the Wyss Institute for Biologically Inspired Engineering at Harvard.

“The ability to break with loud sounds is analogous to a mechanical circuit breaker,” he added. “This use of multiple weak bonds to form a tunable biological circuit breaker could potentially be very interesting for synthetically engineered systems.”

Surprisingly, the team found that under resting tension, each tip link lasts only around eight seconds before it breaks. Their analyses, coupled with evidence from other studies, suggest that new tip links can form rapidly from other strands of protein nearby. Together, the results support a new paradigm of highly dynamic tip link formation and rupture that both enables and protects hearing.

The team also looked at mutations to protocadherin-15 that are linked to Usher syndrome, a rare hereditary disorder of deafness and blindness. Their experiments suggest that some of these mutations can greatly weaken the bond between the tip link filaments. This may be why the disorder leads to deafness, and further mechanistic understanding of this process could lead to new therapeutic approaches, the authors said.

“It’s hard to fix something if you don’t really know what’s broken, and we are optimistic that a better understanding can help lead to new solutions,” Corey said.

In addition, the new findings may help inform study in other areas of the body. 

“We have many different mechanical senses besides hearing, such as touch, the sensation of blood pressure, and certain types of pain,” Corey added. “We understand hearing in more molecular detail than any of the others—knowledge that can help us probe the workings of other mechanical senses.”

Additional authors on the study include Darren Yang and Mounir Koussa.

The work was supported by the National Institutes of Health (grants F31 DC016199, R01 DC000304, R01 DC002281, and R35 GM119537).

HEARING EXPLAINED by new science

How we hear Hear

Dynamic, delicate grip between protein filaments enables hearing

By KEVIN JIANG February 8, 2021 Research

hair cells

A scanning electron microscope image of a hair bundle protruding from a sensory cell in the inner ear. Image: David Furness/Wellcome Collection (CC-BY-NC 4.0)

The sense of hearing is, quite literally, a molecular tightrope act. Turns out, it involves acrobatics as well.

In a paper published in Nature Communications on Feb 8, researchers at Harvard Medical School and Boston Children’s Hospital show that a dynamic and delicate connection between two pairs of diminutive protein filaments plays a central role in hearing.

The tension held by these filaments, together called a tip link, is essential for the activation of sensory cells in the inner ear. The team’s analyses reveal that the filaments, which are joined end-to-end, work together like trapeze artists holding hands. Their grasp on each other can be disrupted, by a loud noise, for example. But with a two-handed grip, they can quickly reconnect when one hand slips.

Get more HMS news here

The findings present a new understanding of the molecular underpinnings of hearing, as well as the sense of balance, which arises from similar processes in the inner ear. Disorders of deafness and balance have been linked to mutations in tip links, and the study results could lead to new therapeutic strategies for such disorders, according to the authors.

“This tiny apparatus, made of less than a dozen proteins, is what helps change sound from a mechanical stimulus into an electrical signal that the brain can decipher,” said co-corresponding author David Corey, the Bertarelli Professor of Translational Medical Science at HMS. “Understanding how these proteins work provides insights into the secrets of the sensation of sound.”

The dynamic connection between the filaments may also function as a circuit breaker that protects other cellular components, according to the researchers.

“I think our study gives us a sense of awe for how perfectly engineered this system in the ear is,” said co-corresponding author Wesley Wong, HMS associate professor of biological chemistry and molecular pharmacology at Boston Children’s. “It maintains a delicate balance between being just strong enough to carry out its function but weak enough to break to potentially preserve the function of other elements that can’t be as easily reformed.”

Decoding a handshake

For hearing to occur, cells must detect and translate pressure waves in the air into bioelectrical signals. This task falls upon hair cells, the sensory cells of the inner ear. Protruding from these cells are bundles of hair-like structures, which bend back and forth as pressure waves move through the inner ear.

tip links
A close up of tip links connecting the stereocilia of a hair cell. Image: David Furness/Wellcome Collection (CC-BY-NC 4.0)

Tip link filaments physically connect each hair to another and are anchored onto specialized ion channels. As the bundle moves, the tension of the tip links changes, opening and closing the channels like a gate to allow electric current to enter the cell. In this way, tip links initiate the bioelectrical signals that the brain ultimately processes as sound.

In previous studies, Corey and colleagues explored the composition of tip links and identified the precise atomic structure of the bond between the two protein filaments. Intriguingly, this bond was evocative of a molecular handshake, according to the authors.

In the current study, CoreyWong, and the team set out to understand the nature of this handshake. To do so, they applied single-molecule force spectroscopy, a technique that often uses optical tweezers—highly focused laser beams that can hold extremely small objects and move them by distances as short as a billionth of a meter.

The researchers, led by study first authors Eric Mulhall and Andrew Ward, both research fellows in neurobiology in the Blavatnik Institute at HMS, coated microscopic glass beads with strands of either protocadherin-15 or cadherin-23, the two proteins that make up the tip link. Using optical tweezers, they moved beads close to each other until the protein strands stuck together end to end and then measured the forces needed to pull the bonds apart.

Stronger than the sum

Each tip link is made up of two strands of both proteins. The team found that the strength of this double-stranded bond far surpassed the strength of the bond between individual strands of either protein. Under low tension, a double-stranded bond lasted ten times longer than a single-stranded bond before breaking.

This increased strength appears to be due to the dynamic nature of the connection, according to the authors. Rather than acting as a simple static rope, the filaments detach and reattach to each other within tenths of a second. A force may break one pair of strands apart, but the other pair can remain connected long enough for the broken pair to rejoin.

acrobats
The bond between tip link filaments resembles an acrobatic “two-handed grip.” Image: David Corey
Trapeze artists
 Christina Saran and Daniel Simard. Image: Feld Entertainment

At extremely high forces, however, the double-stranded bond breaks rapidly. This feature may help to prevent catastrophic damage to other components of the hair cell, the authors said.

“If the tip link were super strong, then when exposed to a very loud sound it might rip the whole complex out of the cell membrane, which would be hard to recover from,” said Wong, who is also an associate faculty member at the Wyss Institute for Biologically Inspired Engineering at Harvard.

“The ability to break with loud sounds is analogous to a mechanical circuit breaker,” he added. “This use of multiple weak bonds to form a tunable biological circuit breaker could potentially be very interesting for synthetically engineered systems.”

Surprisingly, the team found that under resting tension, each tip link lasts only around eight seconds before it breaks. Their analyses, coupled with evidence from other studies, suggest that new tip links can form rapidly from other strands of protein nearby. Together, the results support a new paradigm of highly dynamic tip link formation and rupture that both enables and protects hearing.

The team also looked at mutations to protocadherin-15 that are linked to Usher syndrome, a rare hereditary disorder of deafness and blindness. Their experiments suggest that some of these mutations can greatly weaken the bond between the tip link filaments. This may be why the disorder leads to deafness, and further mechanistic understanding of this process could lead to new therapeutic approaches, the authors said.

“It’s hard to fix something if you don’t really know what’s broken, and we are optimistic that a better understanding can help lead to new solutions,” Corey said.

In addition, the new findings may help inform study in other areas of the body. 

“We have many different mechanical senses besides hearing, such as touch, the sensation of blood pressure, and certain types of pain,” Corey added. “We understand hearing in more molecular detail than any of the others—knowledge that can help us probe the workings of other mechanical senses.”

Additional authors on the study include Darren Yang and Mounir Koussa.

The work was supported by the National Institutes of Health (grants F31 DC016199, R01 DC000304, R01 DC002281, and R35 GM119537).

What Dome size is best

Joe B.

I have a couple of questions before I make my first ear mold with the kit I received yesterday.   I found the videos on you tube but they are not specific as to what type of dome gives the best results.

  1.   I have Siemens Pure S receivers that I currently use with tulip (semi closed) click domes.  I have a number of other styles and sizes that I have used and have spares of.  What is the best style to use to ensure proper fit and ability to clean the click dome and remove it to replace the wax guard on the receiver?  It seems that it would be better to use a smaller diameter click dome.  I have some 4mm that are the smallest made as well as 8 mm.  Does it make any difference to use a closed vs open click dome?  It would seem that it would no longer make a difference except for keeping the material from being  forced past the end of the receiver.
  2. I currently use concha locks to help keep the receivers in my ears.  Should I remove the concha lock or just leave it in place.  It seems like it should no longer be required
  3. Is the wire on the receiver strong enough to pull out the finished ear mold or should I add a piece of nylon fishing line to the mold material to prevent strain on the wire when pulling it out like a click mold has?
  4. I also have an open fit BTE with thin tubes that I use from time to time as a backup.  The same questions apply from above.  Will an open vs closed dome make any difference or is a dome even required as the tube has ridges for the mold material to adhere to?  Should I clip off the concha lock?

I am looking forward to do it right the first time and not risk ruining a receiver in the process.
Thanks,

Joe Blazenski

~~~~~~~~~~~~

Hi Joe, 2/2/21

 thanks for your questions. It was very thorough but did not mention your hearing loss. Read the printed instructions that refers briefly to hearing loss considerations. I suspect that you have a severe loss from your comments..
 The concha lock is no longer needed. Keep the putty off the wax block so you can access it for replacement. You don’t need a large, tight dome. An Open Dome can lock the putty in the holes for a secure retention.
The click mold plastic pull is a good idea. Though I don’t use it. When I remove the earmold and hearing aid, I pull on the Pinna (Ear flap) which straightens the canal, making it easy to remove the earmold. 

~~~~~~~~~~~

Don, 2/3/21
  I am very pleased with the results.  I have not had earmolds before and they are a world of difference from the open fit domes.  No more feedback next to a cupboard door and no more fiddling to reset the receivers into my ears and soft sounds are easier to hear.

  FYI my hearing loss is ski slope with moderately severe at the high end – 70db @ 6000 on both ears.  The left low end is normal and the right low end mild to moderate from an ear infection decades ago.

THANKS for a great product.

Joe

Alerting devices for hearing impaired

alarm-clock

Alerting Devices for People with Hearing Loss

January 12, 2021 Shari Eberts14 CommentsAdvertisements

The fire alarm goes off or the doorbell rings, but you cannot hear it. Maybe the baby is crying or the phone is ringing, but you cannot tell. For most people, an auditory alert is all that is needed for them to take action or seek safety based on the sound, but for people with hearing loss, this is often not possible. Additional alerting methods are required. Luckily, many options exist and new ones are being developed all the time.

alarm-clock

Make the Alert Louder

If you can’t hear an alert, one option is to make it louder. The most common products with adjustable volume alerts are telephones, doorbells, and alarm clocks. These amplified alerts can be very loud — up to 100 decibels or more when activated. Several brands of landline telephones including Panasonic and AT&T offer this type of product. Extra loud ringtones are also available for most smartphones.

While loud tone alerts can be effective for people with hearing loss, they can also be dangerous. Depending on the volume, loud sound alerts can damage residual hearing, particularly for people close to the alert speaker. According to the NIDCD, two minutes of exposure to sounds at 110 dBs or more can cause permanent hearing loss.

Make the Alert Visual

A better option may be using visual alerts where the alert sound at normal volume triggers a secondary alert of a flashing or strobe light. This method works well for doorbells, telephone ringers, and baby monitors, as well as already loud alerts like fire alarms and other emergency notifications. Some auditory alert systems have a visual alert option built in so both are activated simultaneously. Others are separate units you place next to the speaker of the audible alert. When a tone is detected, a separate visual signal is activated. Depending on the size of your home, multiple receivers may be needed so the flash is visible from every room.

Visual alerts also work on some smartphones for calls and text messages. For iPhone, look in the Audio/Visual Hearing category under Accessibility to turn on LED flash for alerts. Visual alerts are available on some Android phones, but not on others. Check the Notifications settings before purchasing if this is a critical feature for you.

Make the Alert Tactile

Tactile alerts are great for alarm clocks, baby alarms as well as emergency situations where you might otherwise sleep through an auditory or visual alert. Place a vibrating pad under your mattress or pillow to be shaken awake when a designated alert sounds. You can also set up tactile alerts from your smartphone via a smartwatch or exercise tracker. Link the two, and you can feel your phone ringing or a text message coming in right on your wrist.

Let Your Smartphone Alert You

Smartphones are getting smarter every day and soon will be able to alert you to ambient sounds like doorbells, smoke alarms and the like. Apple’s new iOS includes sound recognition alerts where your iPhone will notify you whenever it detects one of the sounds you select for monitoring. Choices include a variety of alarms (fire, siren, smoke), household sounds (doorbells, door knocking, water running) as well as animal sounds and people sounds like a baby crying. Android phones can accomplish similar functions via apps or through a new Sound Notifications feature.

Alerting devices that provide loud tone, visual or tactile cues provide better safety, increased independence and a more inclusive lifestyle for people with hearing loss. Ask your audiologist which ones they recommend for your specific hearing challenges.

Readers, what alerting devices do you find helpful?

A version of this article was originally published in The Hearing Journal. Reproduced with their permission. 

New OTC hearing aids 2- $129

Adjust to your hearing loss with APP

Anker unveils $129 Soundcore Liberty Air 2 Pro wireless earbuds with ANC (noise cancelling)

And they’re available now:  Jan 12, 2021, 1:00pm EST

They include battery charger case.

The Soundcore Liberty Air 2 earbuds are one of our best options in the budget category, and now the Anker brand has returned with a more advanced model. The Liberty Air 2 Pro buds are focused on sound quality and active noise cancellation (ANC), and like the larger Liberty 2 Pro feature 11mm drivers.

The new model has improved ANC with modes designed to fit various situations — the transport mode blocks out lower frequencies, for example, while the indoor mode is better at reducing mid-range sounds like voices in an office. There’s also a transparency mode with two levels of ambient sound enhancement, and Anker is touting “premium call quality” thanks to six-mic noise reduction tech.

Anker says the Liberty Air 2 Pro should get seven hours of battery life with ANC off, or six with it on. With the case fully charged, Anker is quoting 26 total hours of endurance with ANC off and 21 with it on, so you’re probably looking at getting three to four full recharges from the case depending on your usage. The case can be charged over USB-C or wirelessly with Qi.

The Liberty Air 2 Pro will be available in four colors (black, white, blue, and pink) and will go on sale today for $129.99.

    Soundcore App

Use the app to enhance your listening experience—choose from 22 EQ settings, use HearID to create your own personalized sound profile, or totally customize the EQ. Other functions include adjusting on-ear controls and easy firmware updates.

Anker factory link:

                          https://www.anker.com/store/liberty-2-pro/A3909011

Clear face mask update

In 2017 — long before COVID-19 wreaked havoc on the world — the Baltimore-based company ClearMask launched a line of transparent surgical masks to improve communication between people who are deaf or hard of hearing and their medical providers.

“Now, with universal mask wearing during a pandemic, more and more people have started to realize the importance of seeing facial expressions, visual cues and lip-reading, and how much we all subconsciously rely on visual communication,” said Allysa Dittmar, the company’s co-founder and president.

The company started after Dittmar, who is deaf, had an adverse experience in a 2015 surgery when her sign language interpreter never showed due to a scheduling error, she recalled.

“Because there were no transparent masks on the market, I was unable to communicate effectively with my surgery team,” Dittmar said. “Traditional masks blocked everyone’s faces and impeded communication.”

Dittmar, who was dismayed after discovering the lack of transparent surgical masks on the market, teamed with Aaron Hsu to start the business. Hsu eventually would became the CEO.

The two met in class while studying at Johns Hopkins School of Medicine. They later pitched their idea of developing a fully transparent mask in October 2016 during a Medical Entrepreneurship class. The class provided the pair with mentoring, which allowed them to develop a business plan. They were able to raise $125,000 through a number of grants and awards to launch the company.

This month, the Wall Street Journal released a report showing the Remington-based company, which now has a staff of 250 employees, sold 12 million transparent masks in a seven-month period in 2020.

The company has been able to avoid many of the pitfalls other companies have experienced — especially when it comes to shipment delays from oversees manufacturers — because it produced their clear plastic, anti-fogging masks locally.

ClearMask worked with Columbia-based TEDCO, the state-backed Maryland Technology Development Corp., which connected it with critical partners, including manufacturer Xometry, based in Gaithersburg, and Baltimore-based Shapiro, a logistics partner that helped with domestic and international shipping, ocean freights and customs, according to Hsu.

“In addition to our unique and hardworking team, our networks and mentors gained from the accelerators and programs that ClearMask participated in over the years [that] helped make the company a success,” Hsu said.

And while the company was launched to better serve the deaf and hard of hearing community, the company’s biggest customers — 80% — have been front-line employees such as health care and hospital workers and government employees, Dittmar said.

“It’s been neat to see a growing, widespread recognition of how regular traditional masks impede natural communication, and our growing and diverse customer base as a testament to how universal visual communication is,” Dittmar said.

In addition to selling millions of the masks, the company also has donated thousands of masks. They said they plan to donate 38,480 masks to nonprofits across the country by the end of 2020.

Humanim, a nonprofit that oversees 35 human services, youth services, workforce development and social enterprise programs throughout Maryland and Delaware, received more than 4,000 of the masks from ClearMask.

“We are really, really grateful,” said Diana Ellis, vice president of strategic partnerships and development at Humanim. “As a nonprofit, times are tough. To receive this donation is a blessing. It is helping us divert funds to other areas. It’s really going to help in all of our programs.”

Dittmar believes that her company has a bright future even beyond COVID-19.

“Having a clear mask available on my medical team’s faces would have helped me better communicate with everyone — even the most basic gestures such as a smile goes a long way,” Dittmar said. “Just imagine — being unable to hear anything and being unable to see even a smile for reassurance. It’s truly scary and dehumanizing. I believe this is also why the ClearMask has been successful with other patient groups, especially children, senior citizens, and behavioral health — where anxiety and confusion is high.”

This article is part of our Newsmaker series that profiles notable people in the Baltimore region who are having an impact in our diverse communities. If you’d like to suggest someone who should be profiled, please send their name and a short description of what they are doing to make a difference to: Diversity, Equity, and Inclusion Editor, Sundra Hominik at shominik@baltsun.com.

ohn-John Williams IVCONTACT  


John-John Williams IV has worked for The Baltimore Sun since 2005. He joined the paper as an education reporter covering Howard County, then Baltimore City and state and national education stories. He joined the features staff as the fashion reporter in 2011. His role in features has expanded to covering home, food, travel and popular culture.

hearing loss = dementia update

One critical study was published in February of 2019 by University of California San Diego researchers; it reviewed the presence of hearing impairment and cognitive decline in 1,164 people for at least 20 years. Adult subjects who did not wear hearing aids were first assessed between 1992 and 1996 for their cognitive function and hearing; they were evaluated up to five more times over the years. At the end of the study, 49.8 percent had mild hearing loss and 16.8 percent had moderate to severe hearing loss.

Participants with age-related hearing loss experienced cognitive decline at a faster rate – up to around seven years sooner – than those with normal hearing, says co-author Dr. Linda McEvoy, professor at UC San Diego’s Center for Life Course and Vulnerable Population Research. “People with mild hearing loss were showing a steeper decline [than those without hearing loss], and those with more severe hearing loss were showing [a] more severe decline,” she told Hearing Tracker. “Having a deficit of seven years would mean that someone at age 80 was performing as if they were 87 years old.”

Dr. McEvoy’s study is not the only one to reveal that age-related hearing loss is a risk factor for dementia. For example, a recent report in the Lancet Commission, an international science journal, corroborated this learning. It showed “the largest attributable risk for dementia is hearing loss, and that makes it the largest modifiable risk factor of any others,” explains Dr. Nicholas Reed, assistant professor in the Departments of Epidemiology at the Johns Hopkins University Bloomberg School of Public Health and Otolaryngology-Head and Neck Surgery at the university’s School of Medicine. To show the full extent of this impact, he adds, “If you eliminated all hearing loss in the world, you would eliminate eight percent of dementia in the world.”

Broadening Our View of Dementia

While hearing loss is considered a risk factor for dementia, researchers are also hunting to see what other forces might increase a hearing-impaired person’s chance of developing this kind of cognitive decline. For instance, the interplay of age-related hearing loss, depression and dementia was the focus ofstudy published in September 2020 and led by Dr. Katharine Brewster, Late-Life Neuropsychiatry T32 Research Fellow at New York’s Columbia University College of Physicians and Surgeons.

“We think the combination of hearing loss and depression puts you at an even higher risk of developing cognitive decline,” Dr. Brewster told Hearing Tracker. She and her team uncovered one especially unexpected finding: Treated, rather than untreated, hearing loss was associated with increased risk for depression and dementia. According to Dr. Brewster, this surprising news show the importance of continued research to understand the connection between hearing loss and cognitive decline.

Another correlation to note: People with dual sensory loss may be at a still higher risk of developing dementia. “Older adults with both hearing and visual impairments have a higher risk of dementia than those with either impairment or no sensory impairments at all,” was a key finding in aJuly 2020 study led by Phillip Hwang, a University of Washington doctoral candidate in epidemiology. Like with Dr. McEvoy’s findings of the relationship between the level of hearing loss and cognitive decline, Hwang found that “those with a greater severity of hearing and vision impairments were associated with increased risk of severity” of dementia.

Answering the “But Why?” Questions

While there are no hard answers about the connection between hearing loss and dementia, there are hypotheses. Hearing loss could lead to loss of brain cells, specifically neurons, said Dr. Frank Lin, the Director of the Cochlear Center for Hearing and Public Health at Johns Hopkins Medicine, in a JHM article. “Brain scans show us that hearing loss may contribute to a faster rate of atrophy in the brain,” Lin explained. “Hearing loss also contributes to social isolation. You may not want to be with people as much, and when you are you may not engage in conversation as much. These factors may contribute to dementia.”

The Importance of Intervention

While it is unclear whether age-related hearing loss actually causes dementia, early intervention plays a role in optimizing the patient’s life. According to the Center for Disease Control, wearing hearing aids can help manage and slow hearing loss down – a sentiment that all the experts who talked to Hearing Tracker echoed.

We’ve seen that even after only six months to a year of hearing aid use, some of these changes in your brain associated with hearing loss can be mitigated and erased,” Dr. Brewster explained.

If research does later indicate that hearing loss contributes to dementia, Hwang said that taking action will be even more crucial. “Early intervention and management of these conditions,” he’s said, “can potentially have an important impact on reducing the risk of dementia in older adults.”

Julia Métraux

Health Writer

Julia Métraux is a health and culture writer with hearing loss whose work has appeared in Narratively, The Tempest, BUST, and Poynter. Check out her portfo

hOW HEARING LOSS EFFECTS OUR WELL BEING

Hearing is essential, for communicating with others and connecting to them. Hearing is also an emotional sense, and hearing loss can change how we enjoy social gatherings, theater, music and how we perceive emotions. Plus, hearing loss can affect the ability to monitor changes in the sounds in our environment,and potentially impacting a sense of safety or security.

If our hearing loss is not assisted with hearing aids, our well being is negatively effected in most situations because of the tension and strain of trying to hear.

untreated hearing loss = dementia update

Untreated hearing loss in midlife remains the largest modifiable risk factor.

The study is an update to The Lancet Commission’s original 2017 report on dementia prevention, intervention, and care, and adds head injury and harmful alcohol drinking in midlife, and air pollution exposure in later life, to the list of preventable causes of dementia but Untreated hearing loss in midlife remains the largest modifiable risk factor.

RELATED ARTICLE: Nine Risk Factors Associated with Dementia, by Dennis Hampton, PhD

Combined, the three new risk factors are associated with 6% of all dementia cases—with an estimated 3% of cases attributable to head injuries in midlife, 1% of cases to excessive alcohol consumption (of more than 21 units per week) in midlife, and 2% to exposure to air pollution in later life. The remaining risk factors are associated with 34% of all dementia cases. The factors associated with the greatest proportion of dementia cases in the population are less education in early life, hearing loss in midlife, and smoking in later life (7%, 8%, and 5%, respectively).

Led by 28 world-leading dementia experts, the report builds on the nine risk factors identified in the 2017 Lancet Commission*, and provides an up-to-date analysis of the best evidence on the prevention of dementia. The new report calls for nations and individuals to be ambitious about preventing dementia and lays out a set of policies and lifestyle changes to help prevent dementia. The report was presented July 30, 2020 at the Alzheimer’s Association International Conference (AAIC 2020).

Lead author Professor Gill Livingston (UCL Psychiatry and Camden & Islington NHS Foundation Trust) said: “Our report shows that it is within the power of policymakers and individuals to prevent and delay a significant proportion of dementia, with opportunities to make an impact at each stage of a person’s life.

“Interventions are likely to have the biggest impact on those who are disproportionately affected by dementia risk factors, like those in low- and middle-income countries and vulnerable populations, including Black, Asian, and minority ethnic communities.

“As societies, we need to think beyond promoting good health to prevent dementia, and begin tackling inequalities to improve the circumstances in which people live their lives. We can reduce risks by creating active and healthy environments for communities, where physical activity is the norm, better diet is accessible for all, and exposure to excessive alcohol is minimized.”

Worldwide, around 50 million people live with dementia, and this number is projected to increase to 152 million by 2050. Dementia affects individuals, their families, and the economy, with global costs estimated at about US$1 trillion annually.

In certain countries, however, the proportion of older people with dementia has fallen, probably due to improvements in education, nutrition, healthcare, and lifestyle changes, demonstrating the possibility of reducing dementia through preventative measures.

To address dementia risk, the authors call for nine ambitious recommendations to be undertaken by policymakers and by individuals:

  • Aim to maintain systolic blood pressure of 130 mm Hg or less in midlife from around age 40 years.
  • Encourage use of hearing aids for hearing loss and reduce hearing loss by protecting ears from high noise levels.
  • Reduce exposure to air pollution and secondhand tobacco smoke.
  • Prevent head injury (particularly by targeting high-risk occupations and transport).
  • Prevent alcohol misuse and limit drinking to less than 21 units per week.
  • Stop smoking uptake and support individuals to stop smoking (which the authors stress is beneficial at any age).
  • Provide all children with primary and secondary education.
  • Lead an active life into mid, and possibly, later life.
  • Reduce obesity and diabetes.

These actions are especially important in low- and middle-income countries where dementia rates are rising more rapidly than in high-income countries, and around two-thirds of people with dementia live. This is a result of increasing life expectancy, and a higher frequency of certain dementia risk factors—such as lower rates of education; high rates of hypertension, obesity, and hearing loss, and rapidly growing rates of diabetes.

Study co-author Dr Naaheed Mukadam (UCL Psychiatry and Camden & Islington NHS Foundation Trust) said: “Based on our modeling, we expect that even more cases of dementia could be prevented in low- and middle-income countries, compared to wealthier countries, due to the higher prevalence of the risk factors we have identified. We had previously estimated that nine factors contribute to 35% of dementia cases worldwide, but that figure rises to 40% in China, 41% in India, and 56% in Latin America.”

The authors warn that estimates could be even higher, as they used conservative estimates for the prevalence of risk factors, and because they do not account for the three new risk factors.

Co-author Dr Jonathan Huntley (UCL Psychiatry and Camden & Islington NHS Foundation Trust) added: “Nearly all of the available evidence on dementia is from high-income countries, so there is an urgent need for more studies to be conducted in the rest of the world, to understand if risks differ elsewhere and if our solutions might need to be tailored to different cultures and environments.”

The authors note that the modeling for their prevention estimates assumes that there is a causal relationship between risk factors and dementia, but were careful to only include risk factors with strong evidence for a causal link.

In the final section of the report, the authors advocate for holistic and individualized evidence-based care that addresses physical and mental health, social care, and support that can accommodate complex needs.

Study co-author Dr Andrew Sommerlad (UCL Psychiatry and Camden & Islington NHS Foundation Trust) said: “Supporting the physical health of people with dementia is important for their cognition, but also because they may struggle to manage other illnesses, which can lead to preventable and potentially harmful hospitalizations.”

They note that people with dementia are particularly at risk from COVID-19 (due to age and having pre-existing illnesses, such as hypertension), and that physical distancing measures can be challenging for dementia patients, who may find it difficult to adhere to the guidelines or distressing to be unable to have contact with carers and family.

The authors call for people with unknown COVID-19 status to not be admitted to care homes to protect the existing residents, regular testing of staff and asymptomatic as well as symptomatic residents when there is exposure, not moving staff or residents between homes, and more research into how to protect dementia patients during the current pandemic and future public health emergencies.

The study was conducted by researchers in the UCL faculties of Brain Sciences and Population Health Sciences, alongside colleagues at other institutions in the UK, Nigeria, Australia, Israel, India, United States, France, Canada, and Norway. Lead partners with the Lancet were UCL, the Alzheimer’s Society, the Economic and Social Research Council, and Alzheimer’s Research UK.

Read the full report

Original Paper: Livingston G, Huntley J, Sommerlad A. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet. July 30, 2020. DOI: https://doi.org/10.1016/S0140-6736(20)30367-6.

Source: BAA, The Lancet

how to Restore hearing loss studies

UM SOM Study Announces Breakthrough in Understanding Hearing Loss

NewsArchive Pages2017 ArchiveUM SOM Study Announces Breakthrough in Understanding Hearing Loss

August 03, 2017 | Larry Roberts

Zubair Ahmed, PhD

Study Pinpoints a Mechanism Behind Some Deafness

Researchers at the University of Maryland School of Medicine (UM SOM) today announced a breakthrough discovery that could eventually help scientists repair hearing problems or protect those at risk for hearing loss – a condition that affects some 40 million Americans.

In particular, with 74,000 children currently affected by profound, early-onset deafness, scientists have been trying to solve the mystery of what causes hearing disorders, especially those that may have genetic causes.

Now, the new UM SOM study, has identified a crucial protein in the process that turns sound waves into brain signals. The new understanding could eventually help repair or prevent hearing problems for those with the highest risk.

The findings were published recently in the Nature Communications. The study is the first to illuminate in detail how the protein, known as CIB2, enables hearing.

“We are very excited by these results”, said the senior author of the study, Zubair Ahmed, PhD, Professor in the Department of Otorhinolaryngology-Head and Neck Surgery at UM SOM. “This tells us something new about the fundamental biology of how hearing works on a molecular level.”

CIB2, which is short for calcium and integrin-binding protein 2, is essential for the structure of stereocilia, the structures at the top of the sensory hair cells in the inner ear. Stereocilia are extremely small, less than a half a micrometer in diameter, which is about the wavelength of a visible light. Each ear contains 18,000 hair cells that do not divide or regenerate.

Saima Riazuddin, PhD, MPH, MBA

Dr. Ahmed and his colleague Saima Riazuddin, PhDProfessor in the Department of Otorhinolaryngology-Head and Neck Surgery at UM SOM, along with their collaborators, discovered five years ago that CIB2 was involved in hearing. Since then, they have studied the protein in flies, mice, zebrafish and humans. The new study is the first to explain the mechanism behind CIB2 in hearing.

In this study, they genetically engineered mice without CIB2, as well as mice in which a human CIB2 gene mutation had been inserted. The researchers found that the human mutation affects the ability of the CIB2 protein to interact with two other proteins, TMC1 and TMC2, which are crucial for converting sound to electrical signals, a process known as mechanotransduction.

People with this mutation cannot turn soundwaves into signals the brain can interpret, and so are deaf. When the researchers inserted the human CIB2 mutation into the mouse, they found that the mice were deaf.

“This is a big step in determining the identity of key components of the molecular machinery that converts sound waves into electrical signals in the inner ear,”said the study’s co-senior author, Gregory Frolenkov, PhD, of the Department of Physiology at the University of Kentucky.

Dr. Ahmed and his colleagues are now looking for other molecules beyond CIB2 that play a key role in hearing. In addition, they are exploring potential therapies for CIB2-related hearing problems. In mice, they are using the gene editing tool CRISPR to modify dysfunctional CIB2 genes. They suspect that if this modification occurs in the first few weeks after birth, these mice, which are born deaf, will be able to hear. The scientists are also experimenting with gene therapy, using a harmless virus to deliver a copy of the normal CIB2 gene to baby mice that have the mutated version. Dr. Ahmed says the early results of these experiments are intriguing.

It is not clear how common CIB2 mutations are in the US population, or how large a role these mutations play in deafness in humans worldwide. In his research on a group of families in Pakistan that have a higher risk of deafness, Dr. Ahmed has found that about 8 to 9 percent seem to have mutations in CIB2. Overall, he says, the gene could play a role in tens of thousands of cases of deafness, and perhaps many more than that. He is also studying CIB2 among the general population. It may be that some versions of the gene also play a role in deafness caused by environmental conditions, creating a predisposition to hearing loss.

Arnaud Giese, PhD, a Post-Doctoral Fellow at UM SOM, and Yi-Quan Tang, PhD, from Cambridge University in England, are co-authors of this study. Other significant contributors include Dr. Riazuddin, William Schafer, PhD, from Cambridge University, Steve S.D. Brown, PhD, from the MRC Harwell Institute, UK, and Robert Fettiplace, PhD, from the University of Wisconsin.

“Hearing loss and deafness remain major physiological and sociological problems, with enormous economic and emotional costs,” said UM SOM Dean E. Albert Reece, MD, PhD, MBA, who is also the vice president for Medical Affairs, University of Maryland, and the John Z. and Akiko K. Bowers Distinguished Professor. “This innovative work by Dr. Ahmed and his colleagues opens a key molecular window that could lead to the development of cutting-edge translational treatments in the future.”

About the University of Maryland School of Medicine

Commemorating its 210th Anniversary, the University of Maryland School of Medicine was chartered in 1807 as the first public medical school in the United States. It continues today as one of the fastest growing, top-tier biomedical research enterprises in the world — with 43 academic departments, centers, institutes, and programs; and a faculty of more than 3,000 physicians, scientists, and allied health professionals, including members of the National Academy of Sciences, and a distinguished recipient of the Albert E. Lasker Award in Medical Research.  With an operating budget of more than $1 billion, the School of Medicine works closely in partnership with the University of Maryland Medical Center and Medical System to provide research-intensive, academic and clinically-based care for more than 1.2 million patients each year. The School has over 2,500 students, residents, and fellows, and nearly $450 million in extramural funding, with more than half of its academic departments ranked in the top 20 among all public medical schools in the nation in research funding. As one of the seven professional schools that make up the University of Maryland, Baltimore campus, the School of Medicine has a total workforce of nearly 7,000 individuals. The combined School and Medical System (“University of Maryland Medicine”) has a total budget of $5 billion and an economic impact of nearly $15 billion on the state and local community. The School of Medicine faculty, which ranks as the 8th-highest public medical school in research productivity, is an innovator in translational medicine with 600 active patents and 24 start-up companies. The School works locally, nationally, and globally, with research and treatment facilities in 36 countries around the world. Visit medschool.umaryland.edu

LEARN MORE

• UM SOM Department of Otorhinolaryngology-Head and Neck Surgery

CONTACT

Department of Anesthesiology
(410) 328-6120 (phone)
(410) 328-5531 (fax)
newsletter@som.umaryland.edu

University of Maryland School of Medicine
Larry Roberts
Web Communications
410-706-4939

chemo patients get hearing loss 80% of time

IU cancer center researcher awarded $5.7 million to study chemo-induced hearing loss, toxicities

IU School of Medicine Sep 02, 2020

Lois Travis, MD, IU Simon Cancer Center, oncology

INDIANAPOLIS—A researcher at the Indiana University Melvin and Bren Simon Comprehensive Cancer Center has been awarded a five-year, $5.7 million National Cancer Institute grant to evaluate long-term health outcomes for cancer patients who receive platinum-based chemotherapies. 

An internationally recognized expert on cancer survivorship, Lois B. Travis, MD, ScD, leads the ongoing study that could lessen cancer treatment side effects for millions of patients. 

Nearly 6 million patients globally are diagnosed with a cancer each year in which first-line therapy potentially includes highly toxic, platinum-based chemotherapies. While the treatment may lead to hearing loss, ringing in the ears, numbness in hands and feet and other side effects, it is the only proven cure for the vast majority of testicular cancer patients. 

When IU’s Lawrence Einhorn, MD, developed a revolutionary therapy for testicular cancer in the 1970s, he flipped the 95 percent mortality rate for the disease to a 95 percent survival rate. His regimen of platinum-based cisplatin and two other drugs continues to be the standard care for testicular cancer. Einhorn is the Livestrong Foundation Professor of Oncology at IU School of Medicine and a physician scientist at the IU Simon Comprehensive Cancer Center.

Now Travis, Einhorn and a team of researchers from other top cancer centers are following more than 2,000 testicular cancer survivors who are part of the largest clinical cohort of germ cell cancer survivors worldwide. The alliance of researchers leads The Platinum Study, which was established through a previous NCI grant awarded to Travis in 2012. 

“We have shown with audiometric examination that 80 percent of the patients had hearing loss with one in five classified as severe to profound, levels at which hearing aids are recommended,” Travis, the Lawrence H. Einhorn Professor of Cancer Research at IU School of Medicine, said. Additionally, researchers found that 56 percent of patients had nerve damage called neuropathy and 40 percent had tinnitus or permanent ringing in their ears.

With this grant, researchers will tap into the existing cohort of patients who are part of the Platinum Study. The median age at diagnosis for testicular patients is 30, and the cohort’s median age now is 37. As patients age, researchers will continue to follow health changes, including if they are more susceptible to age-related hearing loss.

“We will examine the role of genetic variants in the platinum toxicities to try to identify high-risk subgroups,” Travis said.

The team of investigators wants to understand better which patients are at higher risk for these adverse outcomes and the daily effects of the toxicities. 

Collaborators of the Platinum Study gathered in Indianapolis in 2015.
Collaborators of the Platinum Study gathered in Indianapolis in 2015.

“The goal is to follow this cohort for many decades to characterize the longitudinal trajectory of toxicities related to platinum-based chemotherapy,” she said. “For the first time, we will evaluate the impact and severity of the hearing loss and tinnitus on the patients’ physical, emotional and social functioning.”

Patients will complete questionnaires to track the different facets of their lives that are affected by hearing loss, or pain and numbness associated with neuropathy, as well as other toxicities. Researchers will also investigate the social and emotional consequences of the constant ringing in the ears, such as difficulty sleeping or concentrating.
Additionally, researchers will continue to analyze previously collected patient blood samples to track platinum levels, which can remain in the body for decades after chemotherapy is completed.

“Platinum is not completely excreted and is believed to be held in several body reservoirs. As tissue is remodeled with age, platinum regains access to the circulation,” Travis explained. “We will continue to measure the residual serum platinum levels.”

While cisplatin is used for many cancers, Travis notes that the testicular cancer patient cohort offers researchers a unique opportunity to study the toxicities.

“If we want to improve our understanding of long-term cisplatin-related toxicities, this is an ideal population,” she said. “When doing genetic studies, we know that all patients received about the same cumulative dose of cisplatin. We can then consider: who developed hearing loss and who didn’t, and what genetic and other factors are associated with this outcome?”

Ultimately, Travis hopes this research can determine which patients are most likely to experience adverse effects from cisplatin and then provide guidelines that could decrease damaging side effects, such as duration of treatments or improved symptom management.

“This is a critical part of my life’s mission: to decrease the cost of the cure for cancer survivors,” Travis said.

Collaborators include researchers from Memorial Sloan Kettering Cancer Center (Darren Feldman, MD), Dana-Farber Cancer Institute (Neil Martin, MD), University of Pennsylvania (David Vaughn, MD), University of South Florida (Robert Frisina, PhD), Vanderbilt University (Nancy Cox, PhD), University of Chicago (Eileen Dolan, PhD), Princess Margaret Hospital (Robert Hamilton, MD), the Royal Marsden Hospital (Robert Huddart, PhD), University of Rochester (Chunkit Fung, MD), Loyola University (Heather Wheeler, PhD), Harvard School of Public Health (Howard Sesso, ScD), and the British Columbia Cancer Agency (Christian Kollmannsberger, MD).

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IU School of Medicine is the largest medical school in the U.S. and is annually ranked among the top medical schools in the nation by U.S. News & World Report. The school offers high-quality medical education, access to leading medical research and rich campus life in nine Indiana cities, including rural and urban locations consistently recognized for livability.