 Αυτό μου είμαι, one. My name is Lydia Stilu. What I'm going to talk about today is the development... ...of the mobile software application. The purpose of this app is to periodically record... ...the course of Sin card of the disease... ...through the performance of automated or양κ δομι Pharm opight. Let me start with some information on Sin card of the disease. The triad of clinical symptoms characterizing... ...the syndrome consist of spontaneous vertigo... ποτέ one, one. But what triggers it but what triggers it while the precise cost of Menier's disease is still unclear. while the precise cost of Menier's disease is still unclear. The most common suggested etiology is thefather which essentially means increased fluid in day near and can be observed as the bottom panel of this image. Another complicated feature of the disease another complicated feature of the disease είναι το π Ouais, νόσης είναι διαπροστά. Διαπροστά είναι διαπροστά. Αυτό θα παρέσει δεύτερα μάνε για να ακούσετε ένα. Η πρώτη εδωachenο θα κάνει είναι να δημιουργεί την ιστορία της ανθρωπής της χεινότητας. Ας το που αποφασίσει έναν δημιουργείο από αυτή η δημιουργία είναι πολύ δύσκολη όπως η δημιουργία μας πρέπει να χρησιμοπούει με την πρόσφυγή της χρησιμοπούτου. This is why patients are always asked to keep a diary where they record the Meniere's Diseases course. The main part of the diagnostic procedure includes pure tone of theometry. All these PTA curves belong to Meniere's Diseases patients and as you can see there is high variability. Epic audiogram, that one in the center, is observed at 42% of Meniere's cases. And it is actually proposed as a diagnostic tool. This shape indicates a better hearing ability in the region of one to two kilohertz. Unfortunately, there is a major problem about pure tone of theometry and that is the fact that hearing loss is so fluctuating. Patients visit the doctor's office many hours after the symptoms have subsided but by that time, the audiogram's shape may have changed. This figure shows three audiograms of the same person during a 24 hour period and the difference is such a tremendous. Not surprisingly for these disease, ideal treatment is still absent. The syndrome shows a different pattern for patient to patient and that's why proposed solutions should be individualized. Now, after describing the diseases features, I think the need for an application like the one we developed has been clarified. So, how does the app help a patient? First of all, it replaces the classic paper diary. The patient can record and evaluate symptoms and retrieve methods. The other usage of Meniere's calendar application is the performance of automated to geometric tests. The task here was to find self-testing methods that are reliable and after extensive research, we ended up in a series of binaural tests, four of intensity matching followed by four of pitch matching. The main idea is to overcome problems like device calibration by measuring the hearing ability of the impaired ear compared to the unaffected. As Meniere's disease is mostly immu-lateral, the test procedure is very easy. The user listens to pairs of sounds, each one played at a different ear and then answers the question, compared to the first one, how does the second tone sound? Now, about the sounds stimuli we used. The first three tests of each set used sinusoidal tones of 250 Hz, 500 Hz and 1 kHz. These sounds are also used during the classic PTA measurement. The fourth sound, however, is a stimuli of sine amplitude modulated white noise, with modulation rate of 250 Hz and modulation depth set at 100%. The idea behind this choice slides the theory that pitch perception results from the combination of both temporal and place information. Place information created by the dysfunctional basilar membrane of Meniere's patient may be incorrect, contrary to temporal information that remain unaffected and is actually used solely for pitch perception of some noise. I will move on describing the methods used during the test procedure. Each test call is to best fit the data received from the patient's answers to a psychometric function with it using logistic regression. Then, the point of subjective equality, which is the red marks code, is calculated. This point corresponds to the intensity level or frequency for which the two ears perceive the sounds as equal. The tones presented during the procedure are calculated using a version of randomized maximum likelihood sequential procedure. The differences between the test tones and the reference tone, which is the horizontal line at zero, aren't the beginning of the test easily noticeable, but as the time goes on, the test sounds get closer to the constant recalculated point of subjective equality and therefore it gets more and more difficult to distinguish the sounds. The goal, of course, is to achieve better accuracy in the results. I will continue with the last part of my presentation, which is the research experiment we carried out. The participants consisted of eight subjects, four with normal hearing and four diagnosed with unilateral Meniere's disease. The iteration of the experiment was two weeks. Now, here, the intensity matching group results are illustrated as box plots. You can see the mediums and the interquartile ranges. Meniere's patients require at all four tests significant higher intensities to obtain equal hardness than the normal hearing group. This is something we expected. In order to capture the hearing loss fluctuation, which is a diagnostic feature, we calculated the absolute average daily differences of our measurements. Meniere's patients show increased fluctuation at all tests except the one kilohertz test. This finding is actually encouraging for the variability of our measurements, as one kilohertz is a frequency known to fluctuate less. And this result can also be associated with the presence of the picodeogram, which I described earlier and also constitutes a diagnostic element. Contrary to intensity matching results, its perception doesn't seem to show significant differences between the two groups. However, moving on to the absolute average daily differences, the clinical picture of Meniere's disease patients is here clear. Now, what I would like to discuss is the results of the somewhat noise test. You can see here that the y-axis is set to 50%, and daily differences of both groups are increased. This, in fact, reflects the difficulty of all subjects in perceiving the pitch of this kind of sounds. I should also mention that the fluctuation of the Meniere's patients results is closer to the normal hearing group at this test compared to the 250-hertz test. In conclusion, Meniere's calendar app can not only be used as a diary recording symptoms and written methods, but also seems to be a very promising diagnostic tool. The ultimate goal, of course, is to collect sufficient data on this peculiar disease that are absent until now. That brings me to the end of my presentation. Thank you very much for the attention.