Search results for: Kishor J. shinde
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 43

Search results for: Kishor J. shinde

13 Efficacy of Comprehensive Diabetic Care Program with the Reduction of HbA1c in Overweight Type II Diabetes Mellitus Patients: A Retrospective Study

Authors: Rohit Sane, Pravin Ghadigaonkar, Purvi Ahuja, Suvarna Tirmare, Archana Kelhe, Kranti Shinde, Rahul Mandole

Abstract:

To evaluate the efficacy of Comprehensive Diabetic Care Program with the reduction of HbA1c in overweight Diabetes Mellitus Type II patients retrospectively. Methods: Retrospective study was carried out on 34 overweight type II diabetic patients (Mean Age = 54.58 ±11.38 yrs). A total of 34 patients were enrolled after screening of 68 patients (HbA1c 7-10%). The patients were on concomitant drugs namely insulin (11.76%), DPP-4 inhibitor (17.64%), Biguanide (55.88%), Sulfonylurea (52.94%), thiazolidinedione (11.76%), other medications (20.58%) and no allopathic medications (14.70%). The patients were given Comprehensive Diabetic Care Program consisting of panchkarma procedures namely snehana (external oleation), swedana (passive heat therapy) and basti (enema), which was completed in 15 sittings. During the therapy and next 90 days, the patients followed low carbohydrate and moderate protein & fat diet. The primary endpoint of this study was the evaluation of reduction in HbA1c at the end of the follow-up after 90 days. Results: Thirty-four overweight type II diabetic patients (mean age: 54.58[±11.38], HbA1c[7-10%], 67.64% male and 32.35% female) were enrolled in the study. A significant reduction was observed in HbA1c levels (14.30%, p<0.05) at the end of the 90 days follow-up as compared to baseline. Also, BMI was reduced by 5.87%. There was reduction in the usage of the concomitant drugs namely insulin (2.94%), DPP-4 inhibitor (2.94%), Biguanide (32.35%), Sulfonylurea (35.29%), thiazolidinedione (5.88%), other medications(17.64%) and no allopathic medications (32.35%). Conclusion: The results of the study highlight not only in the reduction of HbA1c, but also in BMI and drug tapering of the CDC program in the overweight type II diabetic patients with HbA1c (7-10%).

Keywords: HbA1c, low carb diet, Panchakarma therapy, Type II Diabetes

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12 Mental Disorders and Physical Illness in Geriatric Population

Authors: Vinay Kumar, M. Kishor, Sathyanarayana Rao Ts

Abstract:

Background: Growth of elderly people in the general population in recent years is termed as ‘greying of the world’ where there is a shift from high mortality & fertility to low mortality and fertility, resulting in an increased proportion of older people as seen in India. Improved health care promises longevity but socio-economic factors like poverty, joint families and poor services pose a psychological threat. Epidemiological data regarding the prevalence of mental disorders in geriatric population with physical illness is required for proper health planning. Methods: Sixty consecutive elderly patients aged 60 years or above of both sexes, reporting with physical illness to general outpatient registration counter of JSS Medical College and Hospital, Mysore, India, were considered for the Study. With informed consent, they were screened with General Health Questionnaire (GHQ-12) and were further evaluated for diagnosing mental disorders according to WHO International Classification of Diseases (ICD-10) criteria. Results: Mental disorders were detected in 48.3%, predominantly depressive disorders, nicotine dependence, generalized anxiety disorder, alcohol dependence and least was dementia. Most common physical illness was cardiovascular disease followed by metabolic, respiratory and other diseases. Depressive disorders, substance dependence and dementia were more associated with cardiovascular disease compared to metabolic disease and respiratory diseases were more associated with nicotine dependence. Conclusions: Depression and Substance use disorders among elderly population is of concern, which needs to be further studied with larger population. Psychiatric morbidity will adversely have an impact on physical illness which needs proper assessment and management. This will enhance our understanding and prioritize our planning for future.

Keywords: Geriatric, mental disorders, physical illness, psychiatry

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11 Energy Performance Gaps in Residences: An Analysis of the Variables That Cause Energy Gaps and Their Impact

Authors: Amrutha Kishor

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Today, with the rising global warming and depletion of resources every industry is moving toward sustainability and energy efficiency. As part of this movement, it is nowadays obligatory for architects to play their part by creating energy predictions for their designs. But in a lot of cases, these predictions do not reflect the real quantities of energy in newly built buildings when operating. These can be described as ‘Energy Performance Gaps’. This study aims to determine the underlying reasons for these gaps. Seven houses designed by Allan Joyce Architects, UK from 1998 until 2019 were considered for this study. The data from the residents’ energy bills were cross-referenced with the predictions made with the software SefairaPro and from energy reports. Results indicated that the predictions did not match the actual energy usage. An account of how energy was used in these seven houses was made by means of personal interviews. The main factors considered in the study were occupancy patterns, heating systems and usage, lighting profile and usage, and appliances’ profile and usage. The study found that the main reasons for the creation of energy gaps were the discrepancies in occupant usage and patterns of energy consumption that are predicted as opposed to the actual ones. This study is particularly useful for energy-conscious architectural firms to fine-tune the approach to designing houses and analysing their energy performance. As the findings reveal that energy usage in homes varies based on the way residents use the space, it helps deduce the most efficient technological combinations. This information can be used to set guidelines for future policies and regulations related to energy consumption in homes. This study can also be used by the developers of simulation software to understand how architects use their product and drive improvements in its future versions.

Keywords: architectural simulation, energy efficient design, energy performance gaps, environmental design

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10 Study of Microbial Diversity Associated with Tarballs and Their Exploitation in Crude Oil Degradation

Authors: Varsha Shinde, Belle Damodara Shenoy

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Tarballs are crude oil remnants found in oceans after long term weathering process and are a global concern since several decades as potential marine pollutant. Being complicated in structure microbial remediation of tarballs in natural environment is a slow process. They are rich in high molecular weight alkanes and poly aromatic hydrocarbons which are resistant to microbial attack and other environmental factors, therefore remain in environment for long time. However, it has been found that many bacteria and fungi inhabit on tarballs for nutrients and shelter. Many of them are supposed to be oil degraders, while others are supposed to be getting benefited by byproducts formed during hydrocarbon metabolism. Thus tarballs are forming special interesting ecological niche of microbes. This work aimed to study diversity of bacteria and fungi from tarballs and to see their potential application in crude oil degradation. The samples of tarballs were collected from Betul beach of south Goa (India). Different methods were used to isolate culturable fraction of bacteria and fungi from it. Those were sequenced for 16S rRNA gene and ITS for molecular level identification. The 16S rRNA gene sequence analysis revealed the presence of 13 bacterial genera/clades (Alcanivorax, Brevibacterium, Bacillus, Cellulomonas, Enterobacter, Klebsiella, Marinobacter, Nitratireductor, Pantoea, Pseudomonas, Pseudoxanthomonas, Tistrella and Vibrio), while the ITS sequence analysis placed the fungi in 8 diverse genera/ clades (Aspergillus, Byssochlamys, Monascus, Paecilomyces, Penicillium, Scytalidium/ Xylogone, Talaromyces and Trichoderma). All bacterial isolates were screened for oil degradation capacity. Potential strains were subjected to crude oil degradation experiment for quantification. Results were analyzed by GC-MS-MS.

Keywords: bacteria, biodegradation, crude oil, diversity, fungi, tarballs

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9 A Study of Parental Acceptance: Avoidance Attitude and Adjustment of Urban and Rural Junior College Students

Authors: Ramesh K. Adsul, V. R. Shinde, S. S. Jadhav

Abstract:

The main aim of the present study was to explore the effect of various levels of parental acceptance – avoidance attitude on various areas of adjustment of urban and rural junior college students. It was hypothesized that 1. There exists no significant effect of various levels of parental acceptance attitude on adjustment of urban and rural junior college students. 2. There exists no significant effect of various levels of parental avoidance attitude on adjustment of urban and rural junior college students. 3. There would be no significant difference between urban and rural Junior College students on various areas of (home, health, social, and emotional) adjustment. The 847 students (427 boys and 420 girls) studying in 11th class of various Junior colleges in Sangli ,Satara and Kolhapur districts of Maharashtra State, India were selected by random sampling method. Study was conducted by using two psychological tests namely 1. Family Relationship Inventory. 2.Bell’s Adjustment Inventory. One way ANOVA was employed to find out the effect of parental acceptance – avoidance attitude and adjustment in various areas of urban and rural junior college students. ‘t’ test was used to find out the difference between urban and rural students on various areas of adjustment. The results of the study indicate that (1) It is observed that three groups of parental acceptance attitude (PA) are significantly varied on home and social adjustment. It means that PA affects home and social adjustment of adolescents. High PA creates excellent adjustment and low PA creates poor adjustment in adolescents. (2) Study revealed that PV significantly affects adjustment of adolescents. High PV significantly creates poor adjustment in adolescents than average and low PV. (3) There is significant difference between urban and rural adolescents on adjustment. Urban adolescents have better adjustment than rural adolescents.

Keywords: parental acceptance, avoidance attitude, adjustment, urban-rural student

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8 Development of a Regression Based Model to Predict Subjective Perception of Squeak and Rattle Noise

Authors: Ramkumar R., Gaurav Shinde, Pratik Shroff, Sachin Kumar Jain, Nagesh Walke

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Advancements in electric vehicles have significantly reduced the powertrain noise and moving components of vehicles. As a result, in-cab noises have become more noticeable to passengers inside the car. To ensure a comfortable ride for drivers and other passengers, it has become crucial to eliminate undesirable component noises during the development phase. Standard practices are followed to identify the severity of noises based on subjective ratings, but it can be a tedious process to identify the severity of each development sample and make changes to reduce it. Additionally, the severity rating can vary from jury to jury, making it challenging to arrive at a definitive conclusion. To address this, an automotive component was identified to evaluate squeak and rattle noise issue. Physical tests were carried out for random and sine excitation profiles. Aim was to subjectively assess the noise using jury rating method and objectively evaluate the same by measuring the noise. Suitable jury evaluation method was selected for the said activity, and recorded sounds were replayed for jury rating. Objective data sound quality metrics viz., loudness, sharpness, roughness, fluctuation strength and overall Sound Pressure Level (SPL) were measured. Based on this, correlation co-efficients was established to identify the most relevant sound quality metrics that are contributing to particular identified noise issue. Regression analysis was then performed to establish the correlation between subjective and objective data. Mathematical model was prepared using artificial intelligence and machine learning algorithm. The developed model was able to predict the subjective rating with good accuracy.

Keywords: BSR, noise, correlation, regression

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7 Designing Energy Efficient Buildings for Seasonal Climates Using Machine Learning Techniques

Authors: Kishor T. Zingre, Seshadhri Srinivasan

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Energy consumption by the building sector is increasing at an alarming rate throughout the world and leading to more building-related CO₂ emissions into the environment. In buildings, the main contributors to energy consumption are heating, ventilation, and air-conditioning (HVAC) systems, lighting, and electrical appliances. It is hypothesised that the energy efficiency in buildings can be achieved by implementing sustainable technologies such as i) enhancing the thermal resistance of fabric materials for reducing heat gain (in hotter climates) and heat loss (in colder climates), ii) enhancing daylight and lighting system, iii) HVAC system and iv) occupant localization. Energy performance of various sustainable technologies is highly dependent on climatic conditions. This paper investigated the use of machine learning techniques for accurate prediction of air-conditioning energy in seasonal climates. The data required to train the machine learning techniques is obtained using the computational simulations performed on a 3-story commercial building using EnergyPlus program plugged-in with OpenStudio and Google SketchUp. The EnergyPlus model was calibrated against experimental measurements of surface temperatures and heat flux prior to employing for the simulations. It has been observed from the simulations that the performance of sustainable fabric materials (for walls, roof, and windows) such as phase change materials, insulation, cool roof, etc. vary with the climate conditions. Various renewable technologies were also used for the building flat roofs in various climates to investigate the potential for electricity generation. It has been observed that the proposed technique overcomes the shortcomings of existing approaches, such as local linearization or over-simplifying assumptions. In addition, the proposed method can be used for real-time estimation of building air-conditioning energy.

Keywords: building energy efficiency, energyplus, machine learning techniques, seasonal climates

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6 Identification and Classification of Medicinal Plants of Indian Himalayan Region Using Hyperspectral Remote Sensing and Machine Learning Techniques

Authors: Kishor Chandra Kandpal, Amit Kumar

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The Indian Himalaya region harbours approximately 1748 plants of medicinal importance, and as per International Union for Conservation of Nature (IUCN), the 112 plant species among these are threatened and endangered. To ease the pressure on these plants, the government of India is encouraging its in-situ cultivation. The Saussurea costus, Valeriana jatamansi, and Picrorhiza kurroa have also been prioritized for large scale cultivation owing to their market demand, conservation value and medicinal properties. These species are found from 1000 m to 4000 m elevation ranges in the Indian Himalaya. Identification of these plants in the field requires taxonomic skills, which is one of the major bottleneck in the conservation and management of these plants. In recent years, Hyperspectral remote sensing techniques have been precisely used for the discrimination of plant species with the help of their unique spectral signatures. In this background, a spectral library of the above 03 medicinal plants was prepared by collecting the spectral data using a handheld spectroradiometer (325 to 1075 nm) from farmer’s fields of Himachal Pradesh and Uttarakhand states of Indian Himalaya. The Random forest (RF) model was implied on the spectral data for the classification of the medicinal plants. The 80:20 standard split ratio was followed for training and validation of the RF model, which resulted in training accuracy of 84.39 % (kappa coefficient = 0.72) and testing accuracy of 85.29 % (kappa coefficient = 0.77). This RF classifier has identified green (555 to 598 nm), red (605 nm), and near-infrared (725 to 840 nm) wavelength regions suitable for the discrimination of these species. The findings of this study have provided a technique for rapid and onsite identification of the above medicinal plants in the field. This will also be a key input for the classification of hyperspectral remote sensing images for mapping of these species in farmer’s field on a regional scale. This is a pioneer study in the Indian Himalaya region for medicinal plants in which the applicability of hyperspectral remote sensing has been explored.

Keywords: himalaya, hyperspectral remote sensing, machine learning; medicinal plants, random forests

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5 Advanced Study on Hydrogen Evolution Reaction based on Nickel sulfide Catalyst

Authors: Kishor Kumar Sadasivuni, Mizaj Shabil Sha, Assim Alajali, Godlaveeti Sreenivasa Kumar, Aboubakr M. Abdullah, Bijandra Kumar, Mithra Geetha

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A potential pathway for efficient hydrogen production from water splitting electrolysis involves catalysis or electrocatalysis, which plays a crucial role in energy conversion and storage. Hydrogen generated by electrocatalytic water splitting requires active, stable, and low-cost catalysts or electrocatalysts to be developed for practical applications. In this study, we evaluated combination of 2D materials of NiS nanoparticle catalysts for hydrogen evolution reactions. The photocatalytic H₂ production rate of this nanoparticle is high and exceeds that obtained on components alone. Nanoparticles serve as electron collectors and transporters, which explains this improvement. Moreover, a current density was recorded at reduced working potential by 0.393 mA. Calculations based on density functional theory indicate that the nanoparticle's hydrogen evolution reaction catalytic activity is caused by strong interaction between its components at the interface. The samples were analyzed by XPS and morphologically by FESEM for the best outcome, depending on their structural shapes. Use XPS and morphologically by FESEM for the best results. This nanocomposite demonstrated higher electro-catalytic activity, and a low tafel slope of 60 mV/dec. Additionally, despite 1000 cycles into a durability test, the electrocatalyst still displays excellent stability with minimal current loss. The produced catalyst has shown considerable potential for use in the evolution of hydrogen due to its robust synthesis. According to these findings, the combination of 2D materials of nickel sulfide sample functions as good electocatalyst for H₂ evolution. Additionally, the research being done in this fascinating field will surely push nickel sulfide-based technology closer to becoming an industrial reality and revolutionize existing energy issues in a sustainable and clean manner.

Keywords: electrochemical hydrogenation, nickel sulfide, electrocatalysts, energy conversion, catalyst

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4 Sexually Transmitted Diseases Taboo: Time to Rethink

Authors: Kalpana Gupta

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Sexually transmitted infections (STIs) are infections that are spread primarily through sexual contact. In our daily practice, we see gonorrhea, chancroid, syphilis, and chlamydial infections that can be cured, as well as HIV, genital herpes, HPV, and hepatitis B infections that cannot be cured but can be managed with available treatments. Many people in India are infected with Sexually transmitted diseases (STDs), and the figures are quite high because of a lack of awareness and communication, as well as a taboo against these diseases. Numerous taboos and associated stigma shape patients’ lives and have a significant impact on health care policies, medical research, and current issues in medical ethics. Current statistics emphasize the importance of delivering sex education to this important demographic promptly. The long-standing tradition of girls marrying very young, especially in rural areas, and often too much older men, causes a slew of STIs. Stigma and HIV have a cyclical relationship; people who experience stigma and discrimination are marginalized and made more vulnerable to HIV/STDs, while those living with HIV are more vulnerable to stigma and discrimination. As urban pressures have grown, so have slums - and they have fast become ideal breeding grounds for STDs. In developed countries, strict laws have been enacted requiring people suffering from STDs to seek immediate treatment as well as contact the health department. Unfortunately, because of the stigma associated with the disease, patients in India are reluctant to reveal the source of infection. With various schemes, India is attempting to promote sex education and awareness. For example, the Ministry of Health and Family Welfare developed the National Adolescent Health Programme (also known as the Rashtriya Kishor Swasthya Karyakram) in partnership with the United Nations Population Fund (UNFPA). Whereas, National AIDS Control Organisation was set up so that every person living with HIV has access to quality care and is treated with dignity and breaking all taboos. It becomes clear that research and healthcare policies will not be effective in assisting patients with STDs unless these "nonscientific" elements are taken into account.

Keywords: sexually transmitted diseases, sexually transmitted infections, taboo, stigma, HIV/STDs, sex education and awareness, treatment, quality care, medications, healthcare policies

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3 Charcoal Production from Invasive Species: Suggested Shift for Increased Household Income and Forest Plant Diversity in Nepal

Authors: Kishor Prasad Bhatta, Suman Ghimire, Durga Prasad Joshi

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Invasive Alien Species (IAS) are considered waste forest resources in Nepal. The rapid expansion of IAS is one of the nine main drivers of forest degradation, though the extent and distribution of this species are not well known. Further, the knowledge of the impact of IAS removal on forest plant diversity is hardly known, and the possibilities of income generation from them at the grass-root communities are rarely documented. Systematic sampling of 1% with nested circular plots of 500 square meters was performed in IAS removed and non-removed area, each of 30 hectares in Udayapur Community Forest User Group (CFUG), Chitwan, central Nepal to observe whether the removal of IAS contributed to an increase in plant diversity. In addition, ten entrepreneurs of Udaypur CFUG, involved in the charcoal production, briquette making and marketing were interviewed and interacted as well as their record keeping booklets were reviewed to understand if the charcoal production contributed to their income and employment. The average annual precipitation and temperature of the study area is 2100 mm and 34 degree Celsius respectively with Shorea robusta as main tree species and Eupatorium odoratum as dominant IAS. All the interviewed households were from the ̔below-poverty-line’ category as per Community Forestry Guidelines. A higher Shannon-Weiner plant diversity index at regeneration level was observed in IAS removed areas (2.43) than in control site (1.95). Furthermore, the number of tree seedlings and saplings in the IAS harvested blocks were significantly higher (p < 0.005) compared to the unharvested one. The sale of charcoal produced through the pyrolysis of IAS in ̔ Bio-energy kilns’ contributed for an average increased income of 30.95 % (Nepalese rupees 31,000) of the involved households. Despite above factors, some operational policy hurdles related to charcoal transport and taxation existed at field level. This study suggests that plant diversity could be increased through the removal of IAS, and considerable economic benefits could be achieved if charcoal is substantially produced and utilized.

Keywords: briquette, economic benefits, pyrolysis, regeneration

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2 The Projection of Breaking Sexual Repression: Modern Women in Indian Fictions in Marathi

Authors: Suresh B. Shinde

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The present paper examined the selective fictional works of the Indian writers in the Marathi language which reflects the gradual erosion of sexual repression of modern women characters. Furthermore, the study employed the attitudinal survey method to counter check the fictional reality of the Indian women in real life in the modern era. The Indian writers in an early stage from the pre and post-independence period pictured the women characters such as sexually suppressed and adherence to male sexual dominance. Gangadhar Gadgil a ‘Sahitya Akademi’ award winner writer in his story ‘Ek Manus’ shown that a husband, abnormally exploited her wife. G. A. Kulkarni a ‘Sahitya Akademi’ award winner writer shown that a young lady character suppressed her proposal of marriage with she loved due to the social pressure and conventions. Arvind Gokhale and Kamal Desai have also pictured lady characters who suppressed their sexual urges even they were highly educated. In the late 20th century and early 21st century, the trends of Marathi literature is dramatically changed accordingly the women fictions. Gouri Deshpande, the popular story writer, penetrates modern woman very clearly. Two lady characters are living happily together accepting revolts of society for a sexual relationship. Meghna Pethe, another well-known writer in her story, depicts a women character who was lived with her friend as live-in-relationship and enjoying the erotic sex. How so far, it was seen that the pre and post-independence women fictions are gradually changed regarding her sexually urges. This reality leads to design the survey research design in which 100 college girls and 100 middle-aged women were surveyed with sexual attitude scale and feminist identity test. It was hypothesized that the today's college girls would higher on sexual attitude and feminist identity than middle-aged women. Moreover, it was also assumed that sexual attitude and feminist identity would have a strong positive correlation. The obtained data analyzed through Students’ test and Pearson Product Moment Correlation (PPMC). The results reveal that the today's college girls are having a high level of sexual attitude and feminist identity than middle-aged women. Results also reveal that sexual attitude and feminist identity have a strongest positive correlation. How so far the survey research has provided the reality ground to the modern women in Indian fictions in Marathi literature. The findings of the research have been discussed accordingly the gender equality as well as psychological perspectives.

Keywords: sexual repression, women in Indian fictions, sexual attitude, feminist perspectives

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1 Multi-Modality Brain Stimulation: A Treatment Protocol for Tinnitus

Authors: Prajakta Patil, Yash Huzurbazar, Abhijeet Shinde

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Aim: To develop a treatment protocol for the management of tinnitus through multi-modality brain stimulation. Methodology: Present study included 33 adults with unilateral (31 subjects) and bilateral (2 subjects) chronic tinnitus with and/or without hearing loss independent of their etiology. The Treatment protocol included 5 consecutive sessions with follow-up of 6 months. Each session was divided into 3 parts: • Pre-treatment: a) Informed consent b) Pitch and loudness matching. • Treatment: Bimanual paper pen task with tinnitus masking for 30 minutes. • Post-treatment: a) Pitch and loudness matching b) Directive counseling and obtaining feedback. Paper-pen task is to be performed bimanually that included carrying out two different writing activities in different context. The level of difficulty of the activities was increased in successive sessions. Narrowband noise of a frequency same as that of tinnitus was presented at 10 dBSL of tinnitus for 30 minutes simultaneously in the ear with tinnitus. Result: The perception of tinnitus was no longer present in 4 subjects while in remaining subjects it reduced to an intensity that its perception no longer troubled them without causing residual facilitation. In all subjects, the intensity of tinnitus decreased by an extent of 45 dB at an average. However, in few subjects, the intensity of tinnitus also decreased by more than 45 dB. The approach resulted in statistically significant reductions in Tinnitus Functional Index and Tinnitus Handicap Inventory scores. The results correlate with pre and post treatment score of Tinnitus Handicap Inventory that dropped from 90% to 0%. Discussion: Brain mapping(qEEG) Studies report that there is multiple parallel overlapping of neural subnetworks in the non-auditory areas of the brain which exhibits abnormal, constant and spontaneous neural activity involved in the perception of tinnitus with each subnetwork and area reflecting a specific aspect of tinnitus percept. The paper pen task and directive counseling are designed and delivered respectively in a way that is assumed to induce normal, rhythmically constant and premeditated neural activity and mask the abnormal, constant and spontaneous neural activity in the above-mentioned subnetworks and the specific non-auditory area. Counseling was focused on breaking the vicious cycle causing and maintaining the presence of tinnitus. Diverting auditory attention alone is insufficient to reduce the perception of tinnitus. Conscious awareness of tinnitus can be suppressed when individuals engage in cognitively demanding tasks of non-auditory nature as the paper pen task used in the present study. To carry out this task selective, divided, sustained, simultaneous and split attention act cumulatively. Bimanual paper pen task represents a top-down activity which underlies brain’s ability to selectively attend to the bimanual written activity as a relevant stimulus and to ignore tinnitus that is the irrelevant stimuli in the present study. Conclusion: The study suggests that this novel treatment approach is cost effective, time saving and efficient to vanish the tinnitus or to reduce the intensity of tinnitus to a negligible level and thereby eliminating the negative reactions towards tinnitus.

Keywords: multi-modality brain stimulation, neural subnetworks, non-auditory areas, paper-pen task, top-down activity

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