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{"title"=>"Relation between speech-in-noise threshold, hearing loss and cognition from 40-69 years of age", "type"=>"journal", "authors"=>[{"first_name"=>"David R.", "last_name"=>"Moore", "scopus_author_id"=>"35580993300"}, {"first_name"=>"Mark", "last_name"=>"Edmondson-Jones", "scopus_author_id"=>"37079042000"}, {"first_name"=>"Piers", "last_name"=>"Dawes", "scopus_author_id"=>"36848089600"}, {"first_name"=>"Heather", "last_name"=>"Fortnum", "scopus_author_id"=>"6603678232"}, {"first_name"=>"Abby", "last_name"=>"McCormack", "scopus_author_id"=>"55307776100"}, {"first_name"=>"Robert H.", "last_name"=>"Pierzycki", "scopus_author_id"=>"54889378300"}, {"first_name"=>"Kevin J.", "last_name"=>"Munro", "scopus_author_id"=>"56066373500"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"sgr"=>"84907221226", "doi"=>"10.1371/journal.pone.0107720", "pui"=>"600046349", "pmid"=>"25229622", "scopus"=>"2-s2.0-84907221226", "issn"=>"19326203", "isbn"=>"1932-6203"}, "id"=>"a8d94b26-cb5c-38e6-875c-04295232b499", "abstract"=>"BACKGROUND Healthy hearing depends on sensitive ears and adequate brain processing. Essential aspects of both hearing and cognition decline with advancing age, but it is largely unknown how one influences the other. The current standard measure of hearing, the pure-tone audiogram is not very cognitively demanding and does not predict well the most important yet challenging use of hearing, listening to speech in noisy environments. We analysed data from UK Biobank that asked 40-69 year olds about their hearing, and assessed their ability on tests of speech-in-noise hearing and cognition. METHODS AND FINDINGS About half a million volunteers were recruited through NHS registers. Respondents completed 'whole-body' testing in purpose-designed, community-based test centres across the UK. Objective hearing (spoken digit recognition in noise) and cognitive (reasoning, memory, processing speed) data were analysed using logistic and multiple regression methods. Speech hearing in noise declined exponentially with age for both sexes from about 50 years, differing from previous audiogram data that showed a more linear decline from <40 years for men, and consistently less hearing loss for women. The decline in speech-in-noise hearing was especially dramatic among those with lower cognitive scores. Decreasing cognitive ability and increasing age were both independently associated with decreasing ability to hear speech-in-noise (0.70 and 0.89 dB, respectively) among the population studied. Men subjectively reported up to 60% higher rates of difficulty hearing than women. Workplace noise history associated with difficulty in both subjective hearing and objective speech hearing in noise. Leisure noise history was associated with subjective, but not with objective difficulty hearing. CONCLUSIONS Older people have declining cognitive processing ability associated with reduced ability to hear speech in noise, measured by recognition of recorded spoken digits. Subjective reports of hearing difficulty generally show a higher prevalence than objective measures, suggesting that current objective methods could be extended further.", "link"=>"http://www.mendeley.com/research/relation-between-speechinnoise-threshold-hearing-loss-cognition-4069-years-age", "reader_count"=>82, "reader_count_by_academic_status"=>{"Unspecified"=>3, "Professor > Associate Professor"=>3, "Librarian"=>3, "Researcher"=>14, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>23, "Student > Postgraduate"=>4, "Student > Master"=>11, "Other"=>6, "Student > Bachelor"=>7, "Lecturer > Senior Lecturer"=>2, "Professor"=>3}, "reader_count_by_user_role"=>{"Unspecified"=>3, "Professor > Associate Professor"=>3, "Librarian"=>3, "Researcher"=>14, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>23, "Student > Postgraduate"=>4, "Student > Master"=>11, "Other"=>6, "Student > Bachelor"=>7, "Lecturer > Senior Lecturer"=>2, "Professor"=>3}, "reader_count_by_subject_area"=>{"Unspecified"=>10, "Agricultural and Biological Sciences"=>15, "Arts and Humanities"=>1, "Computer Science"=>1, "Engineering"=>4, "Environmental Science"=>1, "Nursing and Health Professions"=>1, "Biochemistry, Genetics and Molecular Biology"=>1, "Medicine and Dentistry"=>24, "Neuroscience"=>1, "Psychology"=>14, "Social Sciences"=>4, "Immunology and Microbiology"=>1, "Linguistics"=>4}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>24}, "Social Sciences"=>{"Social Sciences"=>4}, "Psychology"=>{"Psychology"=>14}, "Unspecified"=>{"Unspecified"=>10}, "Environmental Science"=>{"Environmental Science"=>1}, "Arts and Humanities"=>{"Arts and Humanities"=>1}, "Engineering"=>{"Engineering"=>4}, "Neuroscience"=>{"Neuroscience"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>15}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Linguistics"=>{"Linguistics"=>4}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}}, "reader_count_by_country"=>{"United States"=>2, "United Kingdom"=>1}, "group_count"=>8}

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• {"id"=>"512449494504333312", "text"=>"ノイズの中で音を聴く能力は50代から低下していく。特に認知機能が低い人で顕著。Relation between Speech-in-Noise Threshold, Hearing Loss and Cognition from …http://t.co/7mwjODLta8", "created_at"=>"2014-09-18T03:54:15Z", "user"=>"uranus_2", "user_name"=>"マーキュリー２世", "user_profile_image"=>"http://abs.twimg.com/sticky/default_profile_images/default_profile_5_normal.png"}
• {"id"=>"512506080241270784", "text"=>"RT @uranus_2: ノイズの中で音を聴く能力は50代から低下していく。特に認知機能が低い人で顕著。Relation between Speech-in-Noise Threshold, Hearing Loss and Cognition from …http://t.…", "created_at"=>"2014-09-18T07:39:06Z", "user"=>"mumrikka", "user_name"=>"mamriikka", "user_profile_image"=>"http://pbs.twimg.com/profile_images/2214574778/_____normal.jpg"}
• {"id"=>"512956884857679872", "text"=>"Relation between Speech-in-Noise Threshold, Hearing Loss and Cognition from 40–69 Years of Age http://t.co/e67Rv9J4rh http://t.co/OxtweniwBE", "created_at"=>"2014-09-19T13:30:26Z", "user"=>"mario_microfab", "user_name"=>"Gianmario Scotti", "user_profile_image"=>"http://pbs.twimg.com/profile_images/470887319340204032/QbCdr_5M_normal.jpeg"}
• {"id"=>"514726456166187008", "text"=>"The relation between speech-in-noise perception, hearing loss and cognition in 'middle age' (OA) http://t.co/0dI7oCXz1x", "created_at"=>"2014-09-24T10:42:04Z", "user"=>"PattiAdank", "user_name"=>"Patti Adank", "user_profile_image"=>"http://pbs.twimg.com/profile_images/470224549175259136/OVAbcw-P_normal.png"}
• {"id"=>"514756062080409600", "text"=>"La pérdida de la audición puede ser tanto cognitiva como auditiva (subjetiva y objetiva) y se influencian mutuamente. http://t.co/XhdHttVgGB", "created_at"=>"2014-09-24T12:39:43Z", "user"=>"IntraMednet", "user_name"=>"IntraMed", "user_profile_image"=>"http://pbs.twimg.com/profile_images/460768769170620417/L7W1ZCsv_normal.png"}
• {"id"=>"514793456137682944", "text"=>"RT @PattiAdank: The relation between speech-in-noise perception, hearing loss and cognition in 'middle age' (OA) http://t.co/0dI7oCXz1x", "created_at"=>"2014-09-24T15:08:19Z", "user"=>"cst_colorado", "user_name"=>"Chris Tripp", "user_profile_image"=>"http://pbs.twimg.com/profile_images/3683608981/dcd2eb3b6c04c36a7cb9206a20785928_normal.jpeg"}

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Figshare

• {"files"=>["https://ndownloader.figshare.com/files/1679780"], "description"=>"<div><p>Background</p><p>Healthy hearing depends on sensitive ears and adequate brain processing. Essential aspects of both hearing and cognition decline with advancing age, but it is largely unknown how one influences the other. The current standard measure of hearing, the pure-tone audiogram is not very cognitively demanding and does not predict well the most important yet challenging use of hearing, listening to speech in noisy environments. We analysed data from UK Biobank that asked 40–69 year olds about their hearing, and assessed their ability on tests of speech-in-noise hearing and cognition.</p><p>Methods and Findings</p><p>About half a million volunteers were recruited through NHS registers. Respondents completed ‘whole-body’ testing in purpose-designed, community-based test centres across the UK. Objective hearing (spoken digit recognition in noise) and cognitive (reasoning, memory, processing speed) data were analysed using logistic and multiple regression methods. Speech hearing in noise declined exponentially with age for both sexes from about 50 years, differing from previous audiogram data that showed a more linear decline from <40 years for men, and consistently less hearing loss for women. The decline in speech-in-noise hearing was especially dramatic among those with lower cognitive scores. Decreasing cognitive ability and increasing age were both independently associated with decreasing ability to hear speech-in-noise (0.70 and 0.89 dB, respectively) among the population studied. Men subjectively reported up to 60% higher rates of difficulty hearing than women. Workplace noise history associated with difficulty in both subjective hearing and objective speech hearing in noise. Leisure noise history was associated with subjective, but not with objective difficulty hearing.</p><p>Conclusions</p><p>Older people have declining cognitive processing ability associated with reduced ability to hear speech in noise, measured by recognition of recorded spoken digits. Subjective reports of hearing difficulty generally show a higher prevalence than objective measures, suggesting that current objective methods could be extended further.</p></div>", "links"=>[], "tags"=>["Subjective reports", "cognition decline", "Essential aspects", "processing ability", "test centres", "hearing loss", "digit recognition", "0.89 dB", "Objective hearing", "UK Biobank", "objective difficulty hearing.ConclusionsOlder people", "Age BackgroundHealthy hearing", "objective methods", "objective speech hearing", "difficulty hearing", "FindingsAbout half", "brain processing", "Speech hearing", "objective measures", "hearing difficulty", "leisure noise history", "NHS registers", "regression methods", "audiogram data", "50 years", "Workplace noise history", "processing speed"], "article_id"=>1172827, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["David R. Moore", "Mark Edmondson-Jones", "Piers Dawes", "Heather Fortnum", "Abby McCormack", "Robert H. Pierzycki", "Kevin J. Munro"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0107720", "stats"=>{"downloads"=>3, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Relation_between_Speech_in_Noise_Threshold_Hearing_Loss_and_Cognition_from_40_8211_69_Years_of_Age_/1172827", "title"=>"Relation between Speech-in-Noise Threshold, Hearing Loss and Cognition from 40–69 Years of Age", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-09-17 03:07:54"}
• {"files"=>["https://ndownloader.figshare.com/files/1679774"], "description"=>"<p>Cognitive performance of men and women in the UK Biobank study expressed as a mean standardized (z) score for ease of comparison between different tests.</p>", "links"=>[], "tags"=>["Subjective reports", "cognition decline", "Essential aspects", "processing ability", "test centres", "hearing loss", "digit recognition", "0.89 dB", "Objective hearing", "UK Biobank", "objective difficulty hearing.ConclusionsOlder people", "Age BackgroundHealthy hearing", "objective methods", "objective speech hearing", "difficulty hearing", "FindingsAbout half", "brain processing", "Speech hearing", "objective measures", "hearing difficulty", "leisure noise history", "NHS registers", "regression methods", "audiogram data", "50 years", "Workplace noise history", "processing speed"], "article_id"=>1172820, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["David R. Moore", "Mark Edmondson-Jones", "Piers Dawes", "Heather Fortnum", "Abby McCormack", "Robert H. Pierzycki", "Kevin J. Munro"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0107720.g003", "stats"=>{"downloads"=>4, "page_views"=>73, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Cognitive_performance_declines_with_age_/1172820", "title"=>"Cognitive performance declines with age.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-09-17 03:07:54"}
• {"files"=>["https://ndownloader.figshare.com/files/1679778"], "description"=>"<p>General linear modelling of better ear speech reception threshold (dB) based on gender, age, socio-economic, and cognition. Gender, Age and Cognition reference levels were females, the youngest quintile, and the poorest performers, respectively. Factor: Main effect for Age/Deprivation/Cognition. Sex: Interaction with gender.</p><p>Modelling speech-in-noise.</p>", "links"=>[], "tags"=>["Subjective reports", "cognition decline", "Essential aspects", "processing ability", "test centres", "hearing loss", "digit recognition", "0.89 dB", "Objective hearing", "UK Biobank", "objective difficulty hearing.ConclusionsOlder people", "Age BackgroundHealthy hearing", "objective methods", "objective speech hearing", "difficulty hearing", "FindingsAbout half", "brain processing", "Speech hearing", "objective measures", "hearing difficulty", "leisure noise history", "NHS registers", "regression methods", "audiogram data", "50 years", "Workplace noise history", "processing speed"], "article_id"=>1172825, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["David R. Moore", "Mark Edmondson-Jones", "Piers Dawes", "Heather Fortnum", "Abby McCormack", "Robert H. Pierzycki", "Kevin J. Munro"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0107720.t003", "stats"=>{"downloads"=>2, "page_views"=>16, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Modelling_speech_in_noise_/1172825", "title"=>"Modelling speech-in-noise.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-09-17 03:07:54"}
• {"files"=>["https://ndownloader.figshare.com/files/1679776"], "description"=>"<p>Number and performance of participants completing each auditory and cognitive measure. Percentages for each N other than gender are corrected for missing data. Mean ± sd: descriptive statistics for age, SRT, cognitive tests. % +ve: percent positive responses to each question. Cognitive test performance shows number of questions correctly answered (FI), % correct responses (PM), and number of incorrectly chosen pairs (VM).</p><p>Characteristics of UK Biobank participants.</p>", "links"=>[], "tags"=>["Subjective reports", "cognition decline", "Essential aspects", "processing ability", "test centres", "hearing loss", "digit recognition", "0.89 dB", "Objective hearing", "UK Biobank", "objective difficulty hearing.ConclusionsOlder people", "Age BackgroundHealthy hearing", "objective methods", "objective speech hearing", "difficulty hearing", "FindingsAbout half", "brain processing", "Speech hearing", "objective measures", "hearing difficulty", "leisure noise history", "NHS registers", "regression methods", "audiogram data", "50 years", "Workplace noise history", "processing speed"], "article_id"=>1172823, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["David R. Moore", "Mark Edmondson-Jones", "Piers Dawes", "Heather Fortnum", "Abby McCormack", "Robert H. Pierzycki", "Kevin J. Munro"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0107720.t001", "stats"=>{"downloads"=>5, "page_views"=>50, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_UK_Biobank_participants_/1172823", "title"=>"Characteristics of UK Biobank participants.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-09-17 03:07:54"}
• {"files"=>["https://ndownloader.figshare.com/files/1679777"], "description"=>"<p><u>Objective (SRT)</u>: General linear modelling of better ear speech reception threshold (dB) based on number of years workplace noise exposure relative to no exposure. Factor: Main effect for noise/music exposure. Sex: Interaction with gender. The model also includes terms for age, sex and cognition (<a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0107720#pone-0107720-t003\" target=\"_blank\">Table 3</a>).</p><p><u>Subjective (‘Difficulty hearing’)</u>: Logistic modelling of question association yielding odds ratios (OR) between no exposure and number of years indicated. Other details as for objective test. Similar results were obtained for ‘Difficulty hearing in noise’ (Table S1 in <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0107720#pone.0107720.s001\" target=\"_blank\">Results S1</a>).</p><p>Noisy workplace and music exposure: objective and subjective effects on hearing.</p>", "links"=>[], "tags"=>["Subjective reports", "cognition decline", "Essential aspects", "processing ability", "test centres", "hearing loss", "digit recognition", "0.89 dB", "Objective hearing", "UK Biobank", "objective difficulty hearing.ConclusionsOlder people", "Age BackgroundHealthy hearing", "objective methods", "objective speech hearing", "difficulty hearing", "FindingsAbout half", "brain processing", "Speech hearing", "objective measures", "hearing difficulty", "leisure noise history", "NHS registers", "regression methods", "audiogram data", "50 years", "Workplace noise history", "processing speed"], "article_id"=>1172824, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["David R. Moore", "Mark Edmondson-Jones", "Piers Dawes", "Heather Fortnum", "Abby McCormack", "Robert H. Pierzycki", "Kevin J. Munro"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0107720.t002", "stats"=>{"downloads"=>8, "page_views"=>27, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Noisy_workplace_and_music_exposure_objective_and_subjective_effects_on_hearing_/1172824", "title"=>"Noisy workplace and music exposure: objective and subjective effects on hearing.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-09-17 03:07:54"}
• {"files"=>["https://ndownloader.figshare.com/files/1679775"], "description"=>"<p>Relation between mean SRT and mean performance on each cognitive test (by decile of standardized score from 1 = low to 10 = high), all ages (40–69 y.o.) combined.</p>", "links"=>[], "tags"=>["Subjective reports", "cognition decline", "Essential aspects", "processing ability", "test centres", "hearing loss", "digit recognition", "0.89 dB", "Objective hearing", "UK Biobank", "objective difficulty hearing.ConclusionsOlder people", "Age BackgroundHealthy hearing", "objective methods", "objective speech hearing", "difficulty hearing", "FindingsAbout half", "brain processing", "Speech hearing", "objective measures", "hearing difficulty", "leisure noise history", "NHS registers", "regression methods", "audiogram data", "50 years", "Workplace noise history", "processing speed"], "article_id"=>1172822, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["David R. Moore", "Mark Edmondson-Jones", "Piers Dawes", "Heather Fortnum", "Abby McCormack", "Robert H. Pierzycki", "Kevin J. Munro"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0107720.g004", "stats"=>{"downloads"=>0, "page_views"=>14, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Better_cognition_is_associated_with_better_hearing_/1172822", "title"=>"Better cognition is associated with better hearing.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-09-17 03:07:54"}
• {"files"=>["https://ndownloader.figshare.com/files/1679772"], "description"=>"<p>Prevalence of self-report of (A) hearing difficulty and (B) difficulty hearing speech-in-noise in women and men from 40–70 y.o., corrected for socio-economic.</p>", "links"=>[], "tags"=>["Subjective reports", "cognition decline", "Essential aspects", "processing ability", "test centres", "hearing loss", "digit recognition", "0.89 dB", "Objective hearing", "UK Biobank", "objective difficulty hearing.ConclusionsOlder people", "Age BackgroundHealthy hearing", "objective methods", "objective speech hearing", "difficulty hearing", "FindingsAbout half", "brain processing", "Speech hearing", "objective measures", "hearing difficulty", "leisure noise history", "NHS registers", "regression methods", "audiogram data", "50 years", "Workplace noise history", "processing speed"], "article_id"=>1172819, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["David R. Moore", "Mark Edmondson-Jones", "Piers Dawes", "Heather Fortnum", "Abby McCormack", "Robert H. Pierzycki", "Kevin J. Munro"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0107720.g002", "stats"=>{"downloads"=>3, "page_views"=>16, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Men_report_greater_difficulty_hearing_than_women_/1172819", "title"=>"Men report greater difficulty hearing than women.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-09-17 03:07:54"}
• {"files"=>["https://ndownloader.figshare.com/files/1679771"], "description"=>"<p>(A) UK Biobank: Mean DTT speech reception threshold (SRT; better ear) data, corrected for differences in socio-economic between samples. Exponential functions with an additive constant are fitted to the data. (B) National Study of Hearing (UK <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0107720#pone.0107720-Davis1\" target=\"_blank\">[14]</a>): Mean pure tone average (PTA) thresholds (0.5, 1, 2, 4 kHz; better ear). (C) National Health and Nutrition Examination Survey (NHANES, US <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0107720#pone.0107720-Hoffman1\" target=\"_blank\">[16]</a>): Mean PTA thresholds (0.5–4 kHz). Other data points from NIH Toolbox (US, 2011 <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0107720#pone.0107720-Gershon1\" target=\"_blank\">[18]</a>), Beaver Dam Epidemiology of Hearing Loss Study (US, 1993 <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0107720#pone.0107720-Cruickshanks1\" target=\"_blank\">[15]</a>), Blue Mountains Hearing Study (Australia, 1997–2000 <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0107720#pone.0107720-Chia1\" target=\"_blank\">[17]</a>).</p>", "links"=>[], "tags"=>["Subjective reports", "cognition decline", "Essential aspects", "processing ability", "test centres", "hearing loss", "digit recognition", "0.89 dB", "Objective hearing", "UK Biobank", "objective difficulty hearing.ConclusionsOlder people", "Age BackgroundHealthy hearing", "objective methods", "objective speech hearing", "difficulty hearing", "FindingsAbout half", "brain processing", "Speech hearing", "objective measures", "hearing difficulty", "leisure noise history", "NHS registers", "regression methods", "audiogram data", "50 years", "Workplace noise history", "processing speed"], "article_id"=>1172818, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["David R. Moore", "Mark Edmondson-Jones", "Piers Dawes", "Heather Fortnum", "Abby McCormack", "Robert H. Pierzycki", "Kevin J. Munro"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0107720.g001", "stats"=>{"downloads"=>2, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Hearing_declines_from_40_8211_69_years_of_age_/1172818", "title"=>"Hearing declines from 40–69 years of age.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-09-17 03:07:54"}

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Relative Metric

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F1000Prime