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Ramkumar V, Krumm M. Tele-audiology diagnostic testing services for children with disabilities in a school setting: A pilot study. Int J Pediatr Otorhinolaryngol 2023; 165:111426. [PMID: 36587539 DOI: 10.1016/j.ijporl.2022.111426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 12/18/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Children with disabilities (CWDs) having comorbidities face challenges in accessing and completing diagnostic hearing evaluations. This study was conducted to determine whether a tele-audiology diagnostic test battery can be administered to school-aged CWDs having comorbidities in a school-setting. DESIGN A proof-of-concept pilot study using a cross-sectional design. STUDY SAMPLE Ten typically developing children between 3 years 9 months and 10 years 9 months of age; mean age of 8 years 3 months (pilot-norm group) and seven CWDs having comorbidities between 3 years and 8 years and 1 month of age; mean age of 5 years and 2 months (CWD group) participated in the study. A diagnostic test protocol delivered via tele-audiology was first administered to the pilot-norm group to ensure its efficiency and suitability for use in the CWD group. Following modifications, the diagnostic test protocol was delivered for CWDs. RESULTS We identified key aspects, including the role of the facilitator in conducting a diagnostic test battery using tele-audiology on CWDs, the usefulness of having co-facilitators to support child-friendly testing, as well as technology-related requirements. With respect to tele-audiology diagnostic testing, it was possible to quickly assess peripheral hearing using synchronous tele video-otoscopy, tympanometry, and DPOAEs. We identified limitations in conducting behavioral audiometry and completing tone-burst ABRs in CWDs. CONCLUSION Evidence was obtained from this exploratory pilot study that a tele-audiology diagnostic test battery can be administered in a school setting to school-aged CWDs having comorbidities. Tele-audiology can be considered to provide hearing healthcare services to school-aged CWDs who may otherwise not receive these services.
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Affiliation(s)
- Vidya Ramkumar
- Faculty of Audiology and Speech, Language Pathology, Sri Ramachandra Institute for Higher Education and Research, Chennai, India.
| | - Mark Krumm
- Department of Speech Pathology and Audiology, School of Health Sciences, Kent State University, Kent, OH, USA
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Robler SK, Coco L, Krumm M. Telehealth solutions for assessing auditory outcomes related to noise and ototoxic exposures in clinic and research. J Acoust Soc Am 2022; 152:1737. [PMID: 36182272 DOI: 10.1121/10.0013706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 08/04/2022] [Indexed: 06/16/2023]
Abstract
Nearly 1.5 billion people globally have some decline in hearing ability throughout their lifetime. Many causes for hearing loss are preventable, such as that from exposure to noise and chemicals. According to the World Health Organization, nearly 50% of individuals 12-25 years old are at risk of hearing loss due to recreational noise exposure. In the occupational setting, an estimated 16% of disabling hearing loss is related to occupational noise exposure, highest in developing countries. Ototoxicity is another cause of acquired hearing loss. Audiologic assessment is essential for monitoring hearing health and for the diagnosis and management of hearing loss and related disorders (e.g., tinnitus). However, 44% of the world's population is considered rural and, consequently, lacks access to quality hearing healthcare. Therefore, serving individuals living in rural and under-resourced areas requires creative solutions. Conducting hearing assessments via telehealth is one such solution. Telehealth can be used in a variety of contexts, including noise and ototoxic exposure monitoring, field testing in rural and low-resource settings, and evaluating auditory outcomes in large-scale clinical trials. This overview summarizes current telehealth applications and practices for the audiometric assessment, identification, and monitoring of hearing loss.
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Affiliation(s)
- Samantha Kleindienst Robler
- Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA
| | - Laura Coco
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, California 92182, USA
| | - Mark Krumm
- Department of Hearing Sciences, Kent State University, Kent, Ohio 44240, USA
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Schober M, Hohe J, Richter F, Judt P, Sauerwein C, Krumm M, Schäuble R, Schlimper R, Strubel V. Werkstoffeffiziente Auslegung und Herstellung gewickelter Innendruck‐Komponenten am Beispiel von Wasserstoff‐Hochdruckspeichern. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- M. Schober
- Fraunhofer-Institut für Werkstoffmechanik IWM Wöhlerstraße 11 79108 Freiburg im Breisgau Deutschland
| | - J. Hohe
- Fraunhofer-Institut für Werkstoffmechanik IWM Wöhlerstraße 11 79108 Freiburg im Breisgau Deutschland
| | - F. Richter
- Hexagon Purus GmbH Otto-Hahn-Straße 5 34123 Kassel Deutschland
| | - P. Judt
- Hexagon Purus GmbH Otto-Hahn-Straße 5 34123 Kassel Deutschland
| | - C. Sauerwein
- RayScan Technologies GmbH Klingleweg 8 88709 Meersburg Deutschland
| | - M. Krumm
- RayScan Technologies GmbH Klingleweg 8 88709 Meersburg Deutschland
| | - R. Schäuble
- Fraunhofer-Institut für Mikrostruktur von Werkstoffen und Systemen IMWS Otto-Hahn-Straße 1 06120 Halle (Saale) Deutschland
| | - R. Schlimper
- Fraunhofer-Institut für Mikrostruktur von Werkstoffen und Systemen IMWS Otto-Hahn-Straße 1 06120 Halle (Saale) Deutschland
| | - V. Strubel
- InnovationGreen Junkerfeldele 13 79211 Denzlingen Deutschland
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Raman N, Nagarajan R, Venkatesh L, Monica DS, Ramkumar V, Krumm M. School-based language screening among primary school children using telepractice: A feasibility study from India. Int J Speech Lang Pathol 2019; 21:425-434. [PMID: 30175626 DOI: 10.1080/17549507.2018.1493142] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 06/10/2018] [Accepted: 06/20/2018] [Indexed: 06/08/2023]
Abstract
Purpose: This study explored the feasibility of conducting school-based language screening using telepractice to expand its scope for providing speech-language pathology services in India. Method: Thirty-two primary school children underwent language screenings through in-person and telemethods. Screening through telemethod was conducted by a Speech-Language Pathologist (SLP) using digitised picture stimuli presented through videoconferencing and remote computing with assistance of a facilitator at school site. Technology and child-related factors influencing screening were documented using an inventory. Result: Language outcomes through in-person and telemethods revealed no significant differences in both receptive and expressive domains, suggesting absence of bias due to testing method used. Use of multiple internet options at both sites helped overcome technical challenges related to connectivity during screening through telemethod. The trained facilitator played a crucial role in overcoming child related factors such as poor speech intelligibility, poor audibility of voice, motivation, interaction with SLP and need for frequent breaks. Conclusion: Feasibility of conducting school-based language screening using multiple internet options and help of a facilitator at school demonstrates promise for delivery of services by SLP in resource constrained contexts such as India.
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Affiliation(s)
- Nitya Raman
- Pediatric Neurodevelopmental Centre and Autism Intervention Centre, Lokmanya Tilak Municipal Medical College & Government Hospital (LTMMC & GH) , Mumbai , India
| | - Roopa Nagarajan
- Department of Speech, Language and Hearing Sciences, Sri Ramachandra University , Chennai , India
| | - Lakshmi Venkatesh
- Department of Speech, Language and Hearing Sciences, Sri Ramachandra University , Chennai , India
| | | | - Vidya Ramkumar
- Department of Speech, Language and Hearing Sciences, Sri Ramachandra University , Chennai , India
| | - Mark Krumm
- Department of Hearing Sciences, Kent State University , Kent , OH , USA
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Hensel M, Güldenpfennig T, Schmidt A, Krumm M, Kerner T, Kox WJ. Digital palpation of the pilot balloon vs. continuous manometry for controlling the intracuff pressure in laryngeal mask airways. Anaesthesia 2016; 71:1169-76. [PMID: 27501056 DOI: 10.1111/anae.13566] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2016] [Indexed: 11/29/2022]
Abstract
This study compared two methods of controlling the intracuff pressure in laryngeal mask airways. One hundred and eighty patients were randomly assigned into two groups. In the first group (n = 90), after training, the intracuff pressure was controlled using digital palpation of the pilot balloon. In the second group (n = 90), continuous manometry was used to control the intracuff pressure. An upper pressure limit of 60 cmH2 O was set. The median (IQR [range]) intracuff pressure in the palpation group was 130 (125-130 [120-130]) cmH2 O compared with 29 (20-39 [5-60]) cmH2 O in the manometry group (p < 0.001). In the palpation group, 37% of patients experienced pharyngolaryngeal complications vs. 12% in the manometry group (p < 0.001). We conclude that the digital palpation technique is not a suitable alternative to manometry in controlling the intracuff pressure in laryngeal mask airways.
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Affiliation(s)
- M Hensel
- Department of Anaesthesiology and Intensive Care Medicine, Park-Klinik-Weissensee, Berlin, Germany.
| | - T Güldenpfennig
- Department of Anaesthesiology and Intensive Care Medicine, Park-Klinik-Weissensee, Berlin, Germany
| | - A Schmidt
- Department of Anaesthesiology and Intensive Care Medicine, Park-Klinik-Weissensee, Berlin, Germany
| | - M Krumm
- Department of Anaesthesiology and Intensive Care Medicine, Park-Klinik-Weissensee, Berlin, Germany
| | - T Kerner
- Department of Anaesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Asklepios Klinikum Harburg, Hamburg, Germany
| | - W J Kox
- Department of Anaesthesiology and Intensive Care Unit, Campus Charité Mitte, Charité-University Hospital, Berlin, Germany
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Abstract
We administered pure tone and otoacoustic emissions testing to subjects in a distant community using remote computing technology. Fifteen men and 15 women ranging in age from 18–30 years were tested. An audiometer was used to measure subject pure tone thresholds. In addition, distortion product otoacoustic emissions (DPOAEs) data were recorded using a portable system. Both systems were interfaced to a PC which was connected to the local area network at Minot State University (MSU). An examiner at Utah State University, 1100 km away, could control both the DPOAE and the audiometer equipment at MSU. Overall, the pure tone means for the face-to-face and telemedicine trials were equivalent at each frequency. Moreover, DPOAE recordings exhibited equivalent results at each frequency for telemedicine and face-to-face trials. These results support the use of remote computing as a telemedicine method for providing pure tone audiometry and DPOAE testing to distant communities.
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Affiliation(s)
- Mark Krumm
- School of Speech Pathology and Audiology, Kent State University, Kent, Ohio
| | - John Ribera
- Department of Communication Disorders and Sciences, Utah State University, Logan, Utah, USA
| | - Richard Klich
- School of Speech Pathology and Audiology, Kent State University, Kent, Ohio
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Hensel M, Güldenpfennig T, Schmidt A, Krumm M. [Continuous cuff pressure measurement during laryngeal mask anesthesia : An obligatory measure to avoid postoperative complications]. Anaesthesist 2016; 65:346-52. [PMID: 27072313 DOI: 10.1007/s00101-016-0160-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/01/2016] [Accepted: 02/26/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Inflation of laryngeal masks is often performed only with regard to the clinical impression and without any objective measurement of cuff pressure. As a result the use of laryngeal masks frequently leads to postoperative complications, such as sore throat, dysphonia, dysphagia and nerve palsy. In this study the influence of continuous measurement of cuff pressure on the incidence of postoperative sore throat was investigated in patients who underwent laryngeal mask anesthesia. PATIENTS/MATERIAL AND METHODS In the context of a retrospective audit all patients who underwent laryngeal mask anesthesia were asked to complete a questionnaire on anesthesia. The primary endpoint of the study was the postoperative occurrence of a sore throat. For analysis the patients were divided into two groups. In the first group the cuff pressure was controlled only by clinical means and in the second group the cuff pressure was controlled using continuous manometry. The study covered a 10-month period of observation for each group. RESULTS During the observation period laryngeal mask anesthesia was performed in 4169 patients. Of these 917 patients (manometry group n = 433 and control group n = 484) voluntarily completed the questionnaire. In the group without cuff pressure measurement 36 % of patients complained of sore throat postoperatively but only 12 % of the patients in the group with cuff pressure measurement (p < 0.001). Postoperative nausea and vomiting occurred in 16 % of the patients and 13 % complained of severe pain in the area of the operation. No differences between the two groups were found. While 97 % of patients in the group with continuous measurement of cuff pressure were satisfied with the anesthesia, this applied to only 79 % of patients in the control group (p = 0.006). CONCLUSION In terms of the results of this study and with respect to data from the literature, measurement of cuff pressure should be compulsory during laryngeal mask anesthesia.
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Affiliation(s)
- M Hensel
- Abteilung Anästhesiologie u. Intensivmedizin, Park-Klinik-Weissensee, Schönstr. 80, 13086, Berlin, Deutschland.
| | - T Güldenpfennig
- Abteilung Anästhesiologie u. Intensivmedizin, Park-Klinik-Weissensee, Schönstr. 80, 13086, Berlin, Deutschland
| | - A Schmidt
- Abteilung Anästhesiologie u. Intensivmedizin, Park-Klinik-Weissensee, Schönstr. 80, 13086, Berlin, Deutschland
| | - M Krumm
- Abteilung Anästhesiologie u. Intensivmedizin, Park-Klinik-Weissensee, Schönstr. 80, 13086, Berlin, Deutschland
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Abstract
The following paper is a review of relevant literature and models presently available in teleaudiology. An attempt was made to consolidate suggested models and programmatic guidelines into a teleaudiology model. This model includes consumer input, pilot testing, mode of teleaudiology applications, and recursive evaluation. The model also includes a traditional clinical visit component when teleaudiology is not practical or desired by the client.
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Affiliation(s)
- Mark Krumm
- School of Speech Pathology and Audiology, Kent State UniversityKent, OH
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Pressler A, Hanssen H, Dimitrova M, Krumm M, Halle M, Scherr J. Acute and chronic effects of marathon running on the retinal microcirculation. Atherosclerosis 2011; 219:864-8. [DOI: 10.1016/j.atherosclerosis.2011.08.052] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 08/29/2011] [Accepted: 08/31/2011] [Indexed: 10/17/2022]
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Ciccia AH, Whitford B, Krumm M, McNeal K. Improving the access of young urban children to speech, language and hearing screening via telehealth. J Telemed Telecare 2011; 17:240-4. [DOI: 10.1258/jtt.2011.100810] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We studied the feasibility of low-cost videoconferencing (using Skype) in urban community health clinics for speech, language and hearing screening of children up to six years of age. During a two-year study, screening services were provided via videoconferencing at two community clinics in an inner city area of Cleveland, Ohio. In total, 411 screenings were completed. Of these, 358 children (87%) received hearing screenings, 377 (92%) received tympanometry screening and 263 (64%) received speech and language screening only. A total of 151 children were aged three years or under (37%). The reliability of pure tone hearing screening ( n = 7), DPOAE screening ( n = 51) and speech-language screening ( n = 10) was 100%. Typanometry screenings ( n = 55) were 84% reliable. Families reported a high level of satisfaction with both the technology and with the videoconferencing. The results indicate that low-cost videoconferencing for screening of speech, language and hearing development in very young children in urban community health clinics is feasible, reliable and strongly supported by the community.
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Affiliation(s)
- Angela Hein Ciccia
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Mark Krumm
- Department of Speech Pathology and Audiology, Kent State University, Kent, USA
| | - Kay McNeal
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
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Steinhäuser-Andresen S, Detterbeck A, Funk C, Krumm M, Kasperl S, Holst A, Hirschfelder U. Pilot study on accuracy and dimensional stability of impression materials using industrial CT technology. J Orofac Orthop 2011; 72:111-24. [DOI: 10.1007/s00056-011-0015-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Swanepoel DW, Clark JL, Koekemoer D, Hall III JW, Krumm M, Ferrari DV, McPherson B, Olusanya BO, Mars M, Russo I, Barajas JJ. Telehealth in audiology: The need and potential to reach underserved communities. Int J Audiol 2010; 49:195-202. [DOI: 10.3109/14992020903470783] [Citation(s) in RCA: 139] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
Purpose
Telehealth (telepractice) is the provision of health care services using telecommunications. Telehealth technology typically has been employed to increase the level of health care access for consumers living in rural communities. In this way, audiologists can use telehealth to provide services in the rural school systems. This is important because school hearing screening programs are the foundation of educational audiology programs. Therefore, the goal of this study was to determine the feasibility of providing hearing screening services by telehealth technology to school-age children.
Method
Hearing screening services—including otoscopy, pure-tone, and immittance audiometry—were conducted on 32 children in 3rd grade attending an elementary school in rural Utah. Each child received 1 screening on-site and another through telehealth procedures.
Results
Immittance and otoscopy results were identical for on-site and telehealth screening protocols. Five children responded differently to pure-tone stimuli presented by the telehealth protocol than by the on-site protocol. However, no statistically significant difference was found for pure-tone screening results obtained by telehealth or on-site screening procedures (binomial test,
p
= .37). Likewise, overall screening results obtained by traditional and telehealth procedures were not statistically significant (binomial test,
p
= .37).
Conclusion
The results of this study suggest that school hearing screenings may be provided using telehealth technology. This study did find that 5 students performed differently to pure-tone screenings administered by the telehealth protocol in contrast to on-site hearing screening services. Further research is necessary to identify factors leading to false responses to pure-tone hearing screening when telehealth technology is used. In addition, telehealth hearing screening protocols should be conducted with participants of different age groups and experiencing a wide range of hearing loss to further clarify the value of telehealth technology.
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Abstract
Distortion product otoacoustic emissions (DPOAE) and automated auditory brainstem response (AABR) screening were conducted in infants at a distant hospital using remote computing. Eighteen males and twelve females ranging in age from 11-45 days were tested. Both DPOAE and AABR data were recorded using an integrated test system which was connected to the computer network at the Utah Valley Regional Medical Center. Using a broadband Internet connection, an examiner at Utah State University, 200 km away, could control the DPOAE and the ABR equipment. Identical hearing screening results were obtained for face-to-face and telemedicine trials with all infants. The DPOAE means for face-to-face and telemedicine trials were not significantly different at any frequency. In an analysis of variance, there was no significant difference for the test method (F = 0.8, P > 0.05). These results indicate that remote computing is a feasible telemedicine method for providing DPOAE and ABR hearing screening services to infants in rural communities.
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Affiliation(s)
- Mark Krumm
- School of Speech Pathology and Audiology, Kent State University, Ohio 44242, USA.
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Abstract
Various real-time telemedicine applications have been investigated in audiology, including pure tone audiometry, otoacoustic emission testing, auditory brainstem response recordings, hearing aid fitting and video-otoscopy. Store-and-forward applications have usually been used to transmit basic patient data including case history information and hearing screening results, although both video-nystagmography and video-otoscopy have been piloted. Remote access to computerized equipment is relevant to audiology telemedicine, although there have been few reports of the use of application sharing using computerized audiology equipment. In a pilot trial of real-time telemedicine, both pure tone and speech audiometry measures were provided remotely through application sharing. Audiology telemedicine appears promising, but it is at an early stage of development and many areas such as its cost effectiveness, patient acceptance and test efficacy require systematic investigation.
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Affiliation(s)
- Mark Krumm
- School of Speech Pathology and Audiology, Kent State University, Ohio, USA.
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Towers AD, Pisa J, Froelich TM, Krumm M. The Reliability of Click-Evoked and Frequency-Specific Auditory Brainstem Response Testing Using Telehealth Technology. Semin Hear 2005. [DOI: 10.1055/s-2005-863792] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Krumm M, Ribera J, Schmiedge J. Using a Telehealth Medium for Objective Hearing Testing: Implications for Supporting Rural Universal Newborn Hearing Screening Programs. Semin Hear 2005. [DOI: 10.1055/s-2005-863789] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Krizanovic O, Beyerle-Pfnür R, Krumm M, Lippert B, Sabat M, Randaccio L, Zangrando E. Trans-a2Pt(II) nucleobase chemistry: Metal-modified base pairs and heteronuclear derivatives. J Inorg Biochem 1991. [DOI: 10.1016/0162-0134(91)84566-r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Stamm E, Wilms H, Krumm M. [Comparative study of the mercury content in the air during the use of mercury seed disinfectants and in the urine of exposed workers]. Z Arztl Fortbild (Jena) 1976; 70:530-2. [PMID: 952014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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