BDTD - Biblioteca Digital de Teses e Dissertações
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Master Thesis Concordância entre procedimentos de triagem auditiva e o teste de dígitos no ruído (TDR) em estudantes(Universidade Federal do Rio Grande do Norte, 2025-12-01) Oliveira, Ranielly Nóbrega de; Balen, Sheila Andreoli; Araújo, Aryelly Dayane da Silva Nunes; https://orcid.org/0000-0002-3814-2675; http://lattes.cnpq.br/3932225932295114; http://lattes.cnpq.br/3487546022829633; http://lattes.cnpq.br/5116738594130098; Cavalcanti, Hannalice Gottschalck; https://orcid.org/0000-0003-2327-8040; http://lattes.cnpq.br/6975482659120440; Comerlatto Júnior, Ademir Antonio; https://orcid.org/0000-0003-2746-0851; http://lattes.cnpq.br/6132323467519862Introduction: Identifying hearing loss in students is essential to ensure adequate educational and social development. Objective: To assess the agreement between auditory screening procedures and the Hearing-in-Noise Test (HINT) adapted as the Digits-in-Noise Test (DIN) in students. Method: This was a cross-sectional study conducted with 83 students from the Federal Institute of Rio Grande do Norte – Parnamirim Campus (52.2% female; 15 to 45 years old; mean age = 19.79 years), who underwent audiometric screening, transient-evoked otoacoustic emissions (TEOAE) screening, distortion product otoacoustic emissions (DPOAE) screening, tympanometric screening, and the Digits-in-Noise Test (DIN) in diotic and antiphasic modes. The DIN was administered via an online link on a smartphone using headphones, following an automated adaptive procedure, with cut-off points of –6.7 dB SNR (diotic) and –11 dB SNR (antiphasic). Agreement between procedures was analyzed using Fleiss’ Kappa and Cohen’s Kappa indices. Results: The diotic DIN showed the highest pass rate (98.80%), followed by the antiphasic DIN and DPOAEs (91.57%). The highest failure rate occurred in the TEOAEs (42.17%). Overall agreement between procedures was low (Fleiss’ kappa = –0.20), and pairwise agreement ranged from slight to regular agreement among tests, with the highest agreement observed between tympanometry and DPOAEs. Conclusion: The DIN, particularly in the antiphasic mode, shows greater agreement with otoacoustic emissions in failure outcomes. Nevertheless, the sample size and differences in the distribution of outcomes may have limited the results. The DIN is a functional and promising tool for identifying hearing difficulties related to speech-in-noise recognition, although it does not replace traditional methods. The combination of different procedures contributes to a more sensitive hearing screening process among students.Master Thesis Codificação neural de sons de fala em lactentes com citomegalovírus congênito e adultos normo-ouvintes(Universidade Federal do Rio Grande do Norte, 2025-09-23) Câmara, Lara Louise Pinto; Balen, Sheila Andreoli; http://lattes.cnpq.br/3487546022829633; https://orcid.org/0000-0002-2716-7906; http://lattes.cnpq.br/2717831726629612; Carnaúba, Aline Tenório Lins; https://orcid.org/0000-0003-4100-6866; http://lattes.cnpq.br/5017815237151501; Sanfins, Milaine Dominici; https://orcid.org/0000-0002-3647-3999; http://lattes.cnpq.br/5730428419438808Master Thesis Disfunção vestibular e alterações posturais na população pediátrica com citomegalovírus congênito: uma revisão sistemática(Universidade Federal do Rio Grande do Norte, 2025-06-17) Calheiros, Karine Christine Gusmão de Freitas; Mantello, Erika Barioni; Taveira, Karinna Verissimo Meira; http://lattes.cnpq.br/0851971851975853; https://orcid.org/0000-0003-3200-5474; http://lattes.cnpq.br/9843066941267902; http://lattes.cnpq.br/3984816240846247; Anastasio, Adriana Ribeiro Tavares; Balen, Sheila Andreoli; http://lattes.cnpq.br/3487546022829633Congenital cytomegalovirus (CMV) is considered the most common etiology of congenital infection and its main sequela is sensorineural hearing loss. Considering the prevalence of sensorineural hearing loss in this population and the anatomical proximity of the cochlear and vestibular organs in the inner ear, vestibular disorders may also occur in children affected by congenital CMV infection. This study aimed to verify the presence of vestibular alterations and postural balance disorders in the pediatric population with congenital CMV infection. This is a systematic review conducted and reported according to PRISMA and registered in the International prospective register of systematic reviews- PROSPERO, under registration CRD42024549387. Five electronic databases (Embase, LILACS, PubMed/MEDLINE, Scopus and Web of Science) were searched, in addition to the gray literature (Google Scholar and ProQuest Dissertations and Theses). The following inclusion criteria were used: studies conducted in children aged 0 to 12 years, diagnosed with congenital CMV infection, performed through urine or saliva samples in the first 21 days of life, neonatal blood samples, serological tests or molecular tests; articles that addressed the assessment of vestibular function and body balance, and that compared symptomatic groups with asymptomatic groups and/or with healthy children. A metaanalysis was performed to estimate the association between vestibular alterations and cytomegalovirus, as well as the combined proportion of these alterations. A randomeffects model was used and subgroup analyses were performed according to the presence of symptoms. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist, and the certainty of the evidence was assessed using the GRADE tool. Only articles from randomized clinical trials and observational studies were selected. The search in the databases resulted in the identification of 2,840 studies and, subsequently, eight observational articles were considered eligible for qualitative synthesis. All included articles reported vestibular and/or body balance alterations in the group with congenital CMV infection. The meta-analysis indicated an approximately ten-fold higher risk of manifestation of vestibular alterations in this group compared to the control group (95% CI: 2.42–40.29). The analysis of the risk of bias identified that most of the studies were of moderate/high quality. The certainty of the evidence was considered very low according to the GRADE tool. In addition, there was a higher frequency of alterations in children with symptomatic than asymptomatic congenital CMV infection. Among the included studies, 50% were cohort studies and 50% were case-control studies; 100% were published in English; the sample size ranged from 24 to 185 children with congenital CMV infection, aged between zero and 11 years. The most commonly used tests were VEMP and vHIT. It is concluded that there is an approximately ten-fold higher risk of children with congenital CMV infection presenting vestibular alterations, compared to the control group. Furthermore, the estimate of the combined proportion of vestibular alterations was higher in symptomatic individuals. Similarly, children with symptomatic congenital CMV infection showed higher rates of alteration in postural balance tasks, compared to the groups with asymptomatic congenital CMV infection and the control group, in the included studies.Master Thesis Instrumentos de avaliação de leitura de palavras e pseudopalavras: revisão e aplicabilidade(Universidade Federal do Rio Grande do Norte, 2025-03-10) Lima, João Victor Silva de Barros; Azoni, Cintia Alves Salgado; Navas, Ana Luiza Gomes Pinto; http://lattes.cnpq.br/0754347427711718; https://orcid.org/0000-0003-2175-9676; http://lattes.cnpq.br/4935645902363577; https://orcid.org/0000-0002-5071-3645; http://lattes.cnpq.br/5385599236907304; Alves, Luciana Mendonça; https://orcid.org/0000-0002-6403-4117; http://lattes.cnpq.br/6377992247953380; Mousinho, RenataObjective: To analyze the psycholinguistic variables of stimuli derived from a database of words and pseudowords, and to support the validation and development of screening tools and assessment instruments for reading. Method: Study 1 consisted of a scoping review following PRISMA-ScR guidelines, using the PCC (Population, Concept, and Context) strategy. Relevant studies were identified in six international databases. Studies that employed oral reading assessment instruments for schoolchildren aged 6 to 14 years and 11 months were included. Study 2 involved 262 first-, second-, and third-grade elementary school children, individually assessed using the Fluency IDB Portuguese application, which presents stimuli controlled by syllabic complexity. Results: Study 1 analyzed 16 studies and identified 11 assessment instruments with variations in syllabic complexity, regularity, and frequency of words and pseudowords, but found a lack of validation descriptions. Study 2 showed that reading performance was influenced by school year, stimulus type, and syllabic complexity, demonstrating that simpler structures were read more easily. Conclusion: Study 1 highlighted that the lack of validation information on assessment instruments may compromise the accuracy of reading evaluations. Study 2 reinforced the impact of syllabic complexity on reading fluency and emphasized the importance of validated instruments for effective assessment of reading difficulties, enabling more precise interventions in both clinical and educational contexts.Master Thesis Sinaptopatia coclear relacionada à idade em ratos: o uso do potencial evocado auditivo de tronco encefálico(Universidade Federal do Rio Grande do Norte, 2025-03-06) Silva, Maria Gabriela Paz da; Araújo, Eliene Silva; https://orcid.org/0000-0002-3675-4651; http://lattes.cnpq.br/5637269791915082; https://orcid.org/0000-0003-4938-3949; http://lattes.cnpq.br/1738023168769094; Andrade, Kelly Cristina Lira de; Alvarenga, Kátia de FreitasIn the natural aging process, there is a reduction in synapses between the inner hair cells of the organ of Corti and the neurons of the spiral ganglion in the auditory nerve, a phenomenon known as cochlear synaptopathy (CS). Studies suggest that shortlatency auditory evoked potentials (AEPs) can identify CS, but there are still gaps in the protocols and parameters used for its identification in clinical settings. Objective: To evaluate the use of short-latency AEPs in identifying age-related CS in rodents. Method: Two studies were conducted. The first was a systematic review with a metaanalysis, registered in PROSPERO (CRD42025615318), aiming to synthesize data on the accuracy of short-latency AEPs in identifying CS in aging rodents. The review followed the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) guidelines, searching the PUBMED/MEDLINE, Cochrane Library, Scopus, Embase, Web of Science, Scielo, LILACS databases, and gray literature. Article selection was performed independently and blindly by two reviewers, using the Rayyan and EndNote tools. No restrictions were applied regarding publication period or language. The second study was a crosssectional observational study, approved by the Animal Use Ethics Committee (2024- 02-ISD). Ten healthy Wistar rats of both sexes, with no prior noise exposure, were divided into age groups: G1 (3–4 months), G2 (10 months), G3 (14–15 months), and G4 (24 months). The animals underwent Auditory Brainstem Response (ABR) recording with click stimuli, alternating polarity at 90, 85, and 80 dBnHL, and stimulation rates of 33.1, 15.1, and 7.1 clicks/s. The amplitudes of waves I and IV were blindly analyzed by two specialists. Data were subjected to descriptive and inferential statistical analysis using IBM Statistical Package for the Social Sciences (SPSS), with a significance level of p<0.05. Results: In Study 1, 2,821 articles were identified, of which 15 were included in the systematic review, and seven were suitable for metaanalysis. All studies used the ABR to identify CS, with wave I amplitude being the most frequently reported biomarker. In Study 2, inter-examiner agreement was excellent (>90%). The mean amplitude was 1.33±0.69μV for wave I and 0.75±0.62μV for wave IV. There was an influence of sex, age, and stimulation rate, with wave I showing greater amplitude at 7.1 clicks/s compared to 33.1 clicks/s. Conclusion: The ABR demonstrated diagnostic performance in identifying SC in rodents, with the amplitude of wave I as a relevant biomarker and a clear effect of the stimulation rate. The findings reinforce the use of click-evoked ABR in SC investigation and provide support for future studies.