Horizontal Localization in Simulated Unilateral Hearing Loss

Anvarsamarein Parisa,Nazeri Ahmad Reza,Sameni Seyyed Jalal,Kamali Mohammad,Zarrin Koob Homa 대한청각학회 2018 Journal of Audiology & Otology Vol.22 No.1

Background and Objectives: The ability to localize a sound source is one of the binauralhearing benefits in a horizontal plane based on interaural time difference and interaural intensitydifference. Unilateral or bilateral asymmetric hearing loss will affect binaural hearing and leadto sound locating errors. In this cross sectional analytical descriptive study, the localization errorwas investigated when participants turned their heads to the sound source with closedeyes and after simulating unilateral hearing loss by placing earplugs inside the right ear canal. Subjects and Methods: This cross sectional analytical descriptive study was carried out on30 right-handed adults, 22 female and 8 male (average: 25 years, standard deviation: 3.16). They were selected with the available random access method. Horizontal localization wasevaluated with five speakers located at 0, ±30, and ±60 degree azimuths at a 1-meter distancefrom the examinee. Narrow-band noise signals were delivered at 35 dB SL in two “withoutearplug” and “with earplug” situations and the results were compared. The study was performedbetween September and December 2016 in Tehran, Iran. Results: Significantdifferences were observed in localization errors between the “with earplug” and “without earplug”situations. The localization differences were greater for left-side speakers (-30 and -60degrees) compared with right-side speakers (+30 and +60 degrees). The differences weremore apparent at 4,000 and 6,000 Hz, which confirmed the effect of unilateral simulatedhearing loss on interaural latency differences. Conclusions: Simulating hearing loss by usingan earplug in one ear (right) increased localization errors at all frequencies. The errorsincreased at higher frequencies.

An Efficient Modified Immigrant Population Search Algorithm for Optimization over Unconstrained Spaces

Hamid-Reza Kamali,Parisa Shahnazari-Shahrezaei 대한산업공학회 2019 Industrial Engineeering & Management Systems Vol.18 No.1

Immigrant Population Search Algorithm (IPSA) is a combinatorial optimization method that is based on the population of solutions. In this paper, the structure of this algorithm is explained for unconstrained optimization. The steps of the algorithm include initialization, new population group immigration, removal of undesirable population groups and local search. After presenting the steps of the algorithm, a comparison with other meta-heuristic algorithms and their performance is done based on a number of mathematical optimization functions. The result of the comparison and statistical analysis shows that the proposed algorithm has a better performance over other algorithms that have been studied.

National perioperative outcomes of flap coverage for pressure ulcers from 2005 to 2015 using American College of Surgeons National Surgical Quality Improvement Program

Bao Ngoc N. Tran,Austin D. Chen,Parisa Kamali,Dhruv Singhal,Bernard T. Lee,Eugene Y. Fukudome 대한성형외과학회 2018 Archives of Plastic Surgery Vol.45 No.5

Background Complication rates after flap coverage for pressure ulcers have been high historically. These patients have multiple risk factors associated with poor wound healing and complications including marginal nutritional status, prolonged immobilization, and a high comorbidities index. This study utilizes the National Surgical Quality Improvement Program (NSQIP) to examine perioperative outcomes of flap coverage for pressure ulcers. Methods Data from the NSQIP database (2005–2015) for patient undergoing flap coverage for pressure ulcers was identified. Demographic, perioperative information, and complications were reviewed. One-way analysis of variance and Pearson chi-square were used to assess differences for continuous variables and nominal variables, respectively. Multivariate logistic regression was performed to identify independent risk factors for complications. Results There were 755 cases identified: 365 (48.3%) sacral ulcers, 321 (42.5%) ischial ulcers, and 69 (9.1%) trochanteric ulcers. Most patients were older male, with some degree of dependency, neurosensory impairment, high functional comorbidities score, and American Society of Anesthesiologists class 3 or above. The sacral ulcer group had the highest incidence of septic shock and bleeding, while the trochanteric ulcer group had the highest incidence of superficial surgical site infection. There was an overall complication rate of 25% at 30-day followup. There was no statistical difference in overall complication among groups. Total operating time, diabetes, and non-elective case were independent risk factors for overall complications. Conclusions Despite patients with poor baseline functional status, flap coverage for pressure ulcer patients is safe with acceptable postoperative complications. This type of treatment should be considered for properly selected patients.

National perioperative outcomes of flap coverage for pressure ulcers from 2005 to 2015 using American College of Surgeons National Surgical Quality Improvement Program

Tran, Bao Ngoc N.,Chen, Austin D.,Kamali, Parisa,Singhal, Dhruv,Lee, Bernard T.,Fukudome, Eugene Y. Korean Society of Plastic and Reconstructive Surge 2018 Archives of Plastic Surgery Vol.45 No.5

Background Complication rates after flap coverage for pressure ulcers have been high historically. These patients have multiple risk factors associated with poor wound healing and complications including marginal nutritional status, prolonged immobilization, and a high comorbidities index. This study utilizes the National Surgical Quality Improvement Program (NSQIP) to examine perioperative outcomes of flap coverage for pressure ulcers. Methods Data from the NSQIP database (2005-2015) for patient undergoing flap coverage for pressure ulcers was identified. Demographic, perioperative information, and complications were reviewed. One-way analysis of variance and Pearson chi-square were used to assess differences for continuous variables and nominal variables, respectively. Multivariate logistic regression was performed to identify independent risk factors for complications. Results There were 755 cases identified: 365 (48.3%) sacral ulcers, 321 (42.5%) ischial ulcers, and 69 (9.1%) trochanteric ulcers. Most patients were older male, with some degree of dependency, neurosensory impairment, high functional comorbidities score, and American Society of Anesthesiologists class 3 or above. The sacral ulcer group had the highest incidence of septic shock and bleeding, while the trochanteric ulcer group had the highest incidence of superficial surgical site infection. There was an overall complication rate of 25% at 30-day follow-up. There was no statistical difference in overall complication among groups. Total operating time, diabetes, and non-elective case were independent risk factors for overall complications. Conclusions Despite patients with poor baseline functional status, flap coverage for pressure ulcer patients is safe with acceptable postoperative complications. This type of treatment should be considered for properly selected patients.

Surgical outcomes of sternal rigid plate fixation from 2005 to 2016 using the American College of Surgeons-National Surgical Quality Improvement Program database

Bao Ngoc N. Tran,Austin D. Chen,Melisa D. Granoff,Anna Rose Johnson,Parisa Kamali,Dhruv Singhal,Bernard T. Lee,Eugene Y. Fukudome 대한성형외과학회 2019 Archives of Plastic Surgery Vol.46 No.4

Background Sternal rigid plate fixation (RPF) has been adopted in recent years in high-risk cases to reduce complications associated with steel wire cerclage, the traditional approach to sternal closure. While sternal RPF has been associated with lower complication rates than wire cerclage, it has its own complication profile that requires evaluation, necessitating a critical examination from a national perspective. This study will report the outcomes and associated risk factors of sternal RPF using a national database. Methods Patients undergoing sternal RPF from 2005 to 2016 in the American College of Surgeons-National Surgical Quality Improvement Program were identified. Demographics, perioperative information, and complication rates were reviewed. Logistic regression analysis was performed to identify risk factors for postoperative complications. Results There were 381 patient cases of RPF identified. The most common complications included bleeding (28.9%), mechanical ventilation >48 hours (16.5%), and reoperation/readmission (15.2%). Top risk factors for complications included dyspnea (odds ratio [OR], 2.672; P<0.001), nonelective procedure (OR, 2.164; P=0.010), congestive heart failure (OR, 2.152; P=0.048), open wound (OR, 1.977; P=0.024), and operating time (OR, 1.005; P<0.001). Conclusions Sternal RPF is associated with increased rates of three primary complications: blood loss requiring transfusion, ventilation >48 hours, and reoperation/readmission, each of which affected over 15% of the study population. Smokers remain at an increased risk for surgical site infection and sternal dehiscence despite RPF’s purported benefit to minimize these outcomes. Complications of primary versus delayed sternal RPF are roughly equivalent, but individual patients may perform better with one versus the other based on identified risk factors.

Surgical outcomes of sternal rigid plate fixation from 2005 to 2016 using the American College of Surgeons-National Surgical Quality Improvement Program database

Tran, Bao Ngoc N.,Chen, Austin D.,Granoff, Melisa D.,Johnson, Anna Rose,Kamali, Parisa,Singhal, Dhruv,Lee, Bernard T.,Fukudome, Eugene Y. Korean Society of Plastic and Reconstructive Surge 2019 Archives of Plastic Surgery Vol.46 No.4

Background Sternal rigid plate fixation (RPF) has been adopted in recent years in high-risk cases to reduce complications associated with steel wire cerclage, the traditional approach to sternal closure. While sternal RPF has been associated with lower complication rates than wire cerclage, it has its own complication profile that requires evaluation, necessitating a critical examination from a national perspective. This study will report the outcomes and associated risk factors of sternal RPF using a national database. Methods Patients undergoing sternal RPF from 2005 to 2016 in the American College of Surgeons-National Surgical Quality Improvement Program were identified. Demographics, perioperative information, and complication rates were reviewed. Logistic regression analysis was performed to identify risk factors for postoperative complications. Results There were 381 patient cases of RPF identified. The most common complications included bleeding (28.9%), mechanical ventilation >48 hours (16.5%), and reoperation/readmission (15.2%). Top risk factors for complications included dyspnea (odds ratio [OR], 2.672; P<0.001), nonelective procedure (OR, 2.164; P=0.010), congestive heart failure (OR, 2.152; P=0.048), open wound (OR, 1.977; P=0.024), and operating time (OR, 1.005; P<0.001). Conclusions Sternal RPF is associated with increased rates of three primary complications: blood loss requiring transfusion, ventilation >48 hours, and reoperation/readmission, each of which affected over 15% of the study population. Smokers remain at an increased risk for surgical site infection and sternal dehiscence despite RPF's purported benefit to minimize these outcomes. Complications of primary versus delayed sternal RPF are roughly equivalent, but individual patients may perform better with one versus the other based on identified risk factors.