Applications of direct-to-consumer hearing devices for adults with hearing loss: a review

Background: This systematic literature review is aimed at investigating applications of direct-to-consumer hearing devices for adults with hearing loss. This review discusses three categories of direct-to-consumer hearing devices: 1) personal sound amplification products (PSAPs), 2) direct-mail hearing aids, and 3) over-the-counter (OTC) hearing aids. Method: A literature review was conducted using EBSCOhost and included the databases CINAHL, MEDLINE, and PsycINFO. After applying prior agreed inclusion and exclusion criteria, 13 reports were included in the review. Results: Included studies fell into three domains: 1) electroacoustic characteristics, 2) consumer surveys, and 3) outcome evaluations. Electroacoustic characteristics of these devices vary significantly with some meeting the stringent acoustic criteria used for hearing aids, while others producing dangerous output levels (ie, over 120-dB sound pressure level). Low-end (or low-cost) devices were typically poor in acoustic quality and did not meet gain levels necessary for most adult and elderly hearing loss patterns (eg, presbycusis), especially in high frequencies. Despite direct-mail hearing aids and PSAPs being associated with lower satisfaction when compared to hearing aids purchased through hearing health care professionals, consumer surveys suggest that 5%-19% of people with hearing loss purchase hearing aids through direct-mail or online. Studies on outcome evaluation suggest positive outcomes of OTC devices in the elderly population. Of note, OTC outcomes appear better when a hearing health care professional supports these users. Conclusion: While some direct-to-consumer hearing devices have the capability to produce adverse effects due to production of dangerously high sound levels and internal noise, the existing literature suggests that there are potential benefits of these devices. Research of direct-to-consumer hearing devices is limited, and current published studies are of weak quality. Much effort is needed to understand the benefits and limitations of such devices on people with hearing loss

Lack of ECG effects of BMS-986165, an oral, selective tyrosine kinase 2 (TYK2) inhibitor: results from a thorough QT study in healthy subjects

Abstract not available.</jats:p

6-Hydroxybuspirone Is a Major Active Metabolite of Buspirone: Assessment of Pharmacokinetics and 5-Hydroxytryptamine1A Receptor Occupancy in Rats

The pharmacokinetics and in vivo potency of 6-hydroxybuspirone (6-OH-buspirone), a major metabolite of buspirone, were investi-gated. The plasma clearance (47.3 3.5 ml/min/kg), volume of distribution (2.6 0.3 l/kg), and half-life (1.2 0.2 h) of 6-OH-buspirone in rats were similar to those for buspirone. Bioavailabil-ity was higher for 6-OH-buspirone (19%) compared with that for buspirone (1.4%). After intravenous infusions to steady-state levels in plasma, 6-OH-buspirone and buspirone increased 5-hydroxy-tryptamine (HT)1A receptor occupancy in a concentration-depen-dent manner with EC50 values of 1.0 0.3 and 0.38 0.06 M in the dorsal raphe and 4.0 0.6 and 1.5 0.3 M in the hippocampus, respectively. Both compounds appeared to be 4-fold more po-tent in occupying presynaptic 5-HT1A receptors in the dorsal raphe than the postsynaptic receptors in the hippocampus. Oral dosing of buspirone in rats resulted in exposures (area under the concen

Do corticotropin releasing factor-1 receptors influence colonic transit and bowel function in women with irritable bowel syndrome?

Corticotropin releasing factor (CRF), a mediator of stress response, alters gastrointestinal (GI) functions. Stress-related changes in colonic motility are blocked by selective CRF1 receptor antagonists. Our aim was to assess whether modulation of central and peripheral CRF1 receptors affects colonic transit and bowel function in female patients with diarrhea-predominant irritable bowel syndrome (D-IBS). This randomized, double-blind, placebo-controlled, 2-wk study evaluated the effects of oral pexacerfont (BMS-562086), a selective CRF1 receptor antagonist, 25 and 100 mg qd, on GI and colonic transit of solids [by validated scintigraphy with primary end point colonic geometric center (GC) at 24 h] and bowel function (by validated daily diaries) in 39 women with D-IBS. The 100-mg dose was comparable to a dose that inhibited colonic motility in stressed rats. Treatment effects were compared by analysis of covariance with baseline colonic transit as covariate. The study had 80% power (α = 0.05) to detect clinically meaningful (26%) differences in colonic transit. Thirty-nine of 55 patients fulfilled eligibility criteria (9 screen failures, 5 baseline GC24 outside prespecified range). At baseline, three treatment groups had comparable age, body mass index, and GC 24 h. Significant effects of pexacerfont relative to placebo were not detected on colonic GC24 (P = 0.53), gastric emptying, orocecal transit, ascending colon emptying half-time, and stool frequency, consistency, and ease of passage. No safety issues were identified. We conclude that in women with D-IBS, pexacerfont, 25 or 100 mg qd, does not significantly alter colonic or other regional transit or bowel function. The role of central and peripheral CRF1 receptors in bowel function in D-IBS requires further study

Behavioral variables affecting the development of amphetamine tolerance

The behavioral effects of chronic administration of d-amphetamine in rats at a dosage of 1 mg/kg were studied with baselines involving either food or shock reinforcement. Food reinforcement was assigned according to a fixed interval or on the basis of differential reinforcement of low rate in a multiple schedule of reinforcement. Behavioral tolerance was observed in response to chronic administration of d-amphetamine when the action of drug led to a decrease in frequency of food reinforcement regardless of the schedule of reinforcement. In the second experiment, a shock avoidance situation was employed in which each avoidance response postponed the onset of grid shock. An escape contingency was provided for occasions on which an avoidance response did not occur. The chronic administration of d-amphetamine led to a uniform increase in response rate throughout the drug regimen with the consequence of decreasing rate of shock reinforcement. An hypothesis was put forward on the basis of these results which considers the development of behavioral tolerance to amphetamine administration to be a function of the drug's action in relation to its effects on the organism's behaviour in meeting reinforcement requirements.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46441/1/213_2004_Article_BF00404721.pd