Παρασκευή 22 Ιανουαρίου 2016

Lenguaje y adopción internacional

Publication date: January–March 2016
Source:Revista de Logopedia, Foniatría y Audiología, Volume 36, Issue 1
Author(s): Ignasi Ivern, Mireia Sala




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Mechanical Damage of Tympanic Membrane in Relation to Impulse Pressure Waveform – A Study in Chinchillas

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): Rong Z. Gan, Don Nakmali, Xiao D. Ji, Kegan Leckness, Zachary Yokell
Mechanical damage to middle ear components in blast exposure directly causes hearing loss, and the rupture of the tympanic membrane (TM) is the most frequent injury of the ear. However, it is unclear how the severity of injury graded by different patterns of TM rupture is related to the overpressure waveforms induced by blast waves. In the present study, the relationship between the TM rupture threshold and the impulse or overpressure waveform has been investigated in chinchillas. Two groups of animals were exposed to blast overpressure simulated in our lab under two conditions: open field and shielded with a stainless steel cup covering the animal head. Auditory brainstem response (ABR) and wideband tympanometry were measured before and after exposure to check the hearing threshold and middle ear function. Results show that waveforms recorded in the shielded case were different from those in the open field and the TM rupture threshold in the shielded case was lower than that in the open field (3.4±0.7 vs. 9.1±1.7 psi or 181±1.6 vs. 190±1.9 dB SPL). The impulse pressure energy spectra analysis of waveforms demonstrates that the shielded waveforms include greater energy at high frequencies than that of the open field waves. Finally, a 3D finite element (FE) model of the chinchilla ear was used to compute the distributions of stress in the TM and the TM displacement with impulse pressure waves. The FE model-derived change of stress in response to pressure loading in the shielded case was substantially faster than that in the open case. This finding provides the biomechanical mechanisms for blast induced TM damage in relation to overpressure waveforms. The TM rupture threshold difference between the open and shielded cases suggests that an acoustic role of helmets may exist, intensifying ear injury during blast exposure.



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Comparison of Mouse Minimum Audible Angle Determined in Prepulse Inhibition and Operant Conditioning Procedures

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): Derik Behrens, Georg M. Klump
Both reward based operant conditioning (OC) and reflex-based prepulse inhibition (PPI) procedures are used in sound localisation studies in mice. Since the results of both procedures are compared in the literature, it is important to assess whether they provide similar results if the same stimulus paradigm is applied. Here, we compare the sensitivity of C57BL/6 mice in OC and PPI procedures for detecting a switch in speaker location using broadband and narrowband noise stimuli and determined their minimum audible angle (MAA). In the OC procedure, we calculated d' values from the hit and false alarm rates. In the PPI procedure, we calculated the area under ROC curves from the startle response amplitudes and derived da values to obtain a sensitivity measure that corresponds to d'. For both procedures, the mean sensitivity to the speaker switch increased with an increase in angular separation. For broadband noise stimuli, a d' of up to 3.3 (OC) and a da of up to 1.1 (PPI) were observed at large speaker separations. Narrowband noise stimuli resulted in lower sensitivities in both procedures, resulting in a maximum d' of 2.0 (OC) and a maximum da of 0.3 (PPI). Using a sensitivity of 1.0 as the threshold criterion, broadband noise MAAs in the range from 32° to 46° were observed in the OC procedure whereas a broadband noise MAAs of 108° or higher were observed in the PPI procedure. In the OC procedure, narrowband noise MAAs in the range from 37° to 62° were observed. In the PPI procedure, no narrowband noise MAA could be determined since none of the subjects reached the threshold. Thus, OC procedures result in a better performance of the subjects in the sound localization task than PPI procedures, challenging the view that both procedures can be used interchangeably.



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Interaction between osseous and non-osseous vibratory stimulation of the human cadaveric head

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): J.H. Sim, I. Dobrev, R. Gerig, F. Pfiffner, S. Stenfelt, A.M. Huber, C. Röösli
Bone conduction (BC) stimulation can be applied by vibration to the bony or skin covered skull (osseous BC), or on soft tissue such as the neck (non-osseous BC). The interaction between osseous and non-osseous bone conduction pathways is assessed in this study. The relation between bone vibrations measured at the cochlear promontory and the intracranial sound pressure for stimulation directly on the dura and for stimulation at the mastoid between 0.2 – 10 kHz was compared. First, for stimulation on the dura, varying the static coupling force of the BC transducer on the dura had only a small effect on promontory vibration. Second, the presence or absence of intracranial fluid did not affect promontory vibration for stimulation on the dura. Third, stimulation on the mastoid elicited both promontory vibration and intracranial sound pressure. Stimulation on the dura caused intracranial sound pressure to a similar extent above 0.5 kHz compared to stimulation on the mastoid, while promontory vibration was less by 20-40 dB. From these findings, we conclude that intracranial sound pressure (non-osseous BC) only marginally affects bone vibrations measured on the promontory (osseous BC), whereas skull vibrations affect intracranial sound pressure.



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Lenguaje y adopción internacional

Publication date: January–March 2016
Source:Revista de Logopedia, Foniatría y Audiología, Volume 36, Issue 1
Author(s): Ignasi Ivern, Mireia Sala




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Mechanical Damage of Tympanic Membrane in Relation to Impulse Pressure Waveform – A Study in Chinchillas

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): Rong Z. Gan, Don Nakmali, Xiao D. Ji, Kegan Leckness, Zachary Yokell
Mechanical damage to middle ear components in blast exposure directly causes hearing loss, and the rupture of the tympanic membrane (TM) is the most frequent injury of the ear. However, it is unclear how the severity of injury graded by different patterns of TM rupture is related to the overpressure waveforms induced by blast waves. In the present study, the relationship between the TM rupture threshold and the impulse or overpressure waveform has been investigated in chinchillas. Two groups of animals were exposed to blast overpressure simulated in our lab under two conditions: open field and shielded with a stainless steel cup covering the animal head. Auditory brainstem response (ABR) and wideband tympanometry were measured before and after exposure to check the hearing threshold and middle ear function. Results show that waveforms recorded in the shielded case were different from those in the open field and the TM rupture threshold in the shielded case was lower than that in the open field (3.4±0.7 vs. 9.1±1.7 psi or 181±1.6 vs. 190±1.9 dB SPL). The impulse pressure energy spectra analysis of waveforms demonstrates that the shielded waveforms include greater energy at high frequencies than that of the open field waves. Finally, a 3D finite element (FE) model of the chinchilla ear was used to compute the distributions of stress in the TM and the TM displacement with impulse pressure waves. The FE model-derived change of stress in response to pressure loading in the shielded case was substantially faster than that in the open case. This finding provides the biomechanical mechanisms for blast induced TM damage in relation to overpressure waveforms. The TM rupture threshold difference between the open and shielded cases suggests that an acoustic role of helmets may exist, intensifying ear injury during blast exposure.



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Comparison of Mouse Minimum Audible Angle Determined in Prepulse Inhibition and Operant Conditioning Procedures

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): Derik Behrens, Georg M. Klump
Both reward based operant conditioning (OC) and reflex-based prepulse inhibition (PPI) procedures are used in sound localisation studies in mice. Since the results of both procedures are compared in the literature, it is important to assess whether they provide similar results if the same stimulus paradigm is applied. Here, we compare the sensitivity of C57BL/6 mice in OC and PPI procedures for detecting a switch in speaker location using broadband and narrowband noise stimuli and determined their minimum audible angle (MAA). In the OC procedure, we calculated d' values from the hit and false alarm rates. In the PPI procedure, we calculated the area under ROC curves from the startle response amplitudes and derived da values to obtain a sensitivity measure that corresponds to d'. For both procedures, the mean sensitivity to the speaker switch increased with an increase in angular separation. For broadband noise stimuli, a d' of up to 3.3 (OC) and a da of up to 1.1 (PPI) were observed at large speaker separations. Narrowband noise stimuli resulted in lower sensitivities in both procedures, resulting in a maximum d' of 2.0 (OC) and a maximum da of 0.3 (PPI). Using a sensitivity of 1.0 as the threshold criterion, broadband noise MAAs in the range from 32° to 46° were observed in the OC procedure whereas a broadband noise MAAs of 108° or higher were observed in the PPI procedure. In the OC procedure, narrowband noise MAAs in the range from 37° to 62° were observed. In the PPI procedure, no narrowband noise MAA could be determined since none of the subjects reached the threshold. Thus, OC procedures result in a better performance of the subjects in the sound localization task than PPI procedures, challenging the view that both procedures can be used interchangeably.



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Interaction between osseous and non-osseous vibratory stimulation of the human cadaveric head

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): J.H. Sim, I. Dobrev, R. Gerig, F. Pfiffner, S. Stenfelt, A.M. Huber, C. Röösli
Bone conduction (BC) stimulation can be applied by vibration to the bony or skin covered skull (osseous BC), or on soft tissue such as the neck (non-osseous BC). The interaction between osseous and non-osseous bone conduction pathways is assessed in this study. The relation between bone vibrations measured at the cochlear promontory and the intracranial sound pressure for stimulation directly on the dura and for stimulation at the mastoid between 0.2 – 10 kHz was compared. First, for stimulation on the dura, varying the static coupling force of the BC transducer on the dura had only a small effect on promontory vibration. Second, the presence or absence of intracranial fluid did not affect promontory vibration for stimulation on the dura. Third, stimulation on the mastoid elicited both promontory vibration and intracranial sound pressure. Stimulation on the dura caused intracranial sound pressure to a similar extent above 0.5 kHz compared to stimulation on the mastoid, while promontory vibration was less by 20-40 dB. From these findings, we conclude that intracranial sound pressure (non-osseous BC) only marginally affects bone vibrations measured on the promontory (osseous BC), whereas skull vibrations affect intracranial sound pressure.



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Lenguaje y adopción internacional

Publication date: January–March 2016
Source:Revista de Logopedia, Foniatría y Audiología, Volume 36, Issue 1
Author(s): Ignasi Ivern, Mireia Sala




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via IFTTT

Mechanical Damage of Tympanic Membrane in Relation to Impulse Pressure Waveform – A Study in Chinchillas

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): Rong Z. Gan, Don Nakmali, Xiao D. Ji, Kegan Leckness, Zachary Yokell
Mechanical damage to middle ear components in blast exposure directly causes hearing loss, and the rupture of the tympanic membrane (TM) is the most frequent injury of the ear. However, it is unclear how the severity of injury graded by different patterns of TM rupture is related to the overpressure waveforms induced by blast waves. In the present study, the relationship between the TM rupture threshold and the impulse or overpressure waveform has been investigated in chinchillas. Two groups of animals were exposed to blast overpressure simulated in our lab under two conditions: open field and shielded with a stainless steel cup covering the animal head. Auditory brainstem response (ABR) and wideband tympanometry were measured before and after exposure to check the hearing threshold and middle ear function. Results show that waveforms recorded in the shielded case were different from those in the open field and the TM rupture threshold in the shielded case was lower than that in the open field (3.4±0.7 vs. 9.1±1.7 psi or 181±1.6 vs. 190±1.9 dB SPL). The impulse pressure energy spectra analysis of waveforms demonstrates that the shielded waveforms include greater energy at high frequencies than that of the open field waves. Finally, a 3D finite element (FE) model of the chinchilla ear was used to compute the distributions of stress in the TM and the TM displacement with impulse pressure waves. The FE model-derived change of stress in response to pressure loading in the shielded case was substantially faster than that in the open case. This finding provides the biomechanical mechanisms for blast induced TM damage in relation to overpressure waveforms. The TM rupture threshold difference between the open and shielded cases suggests that an acoustic role of helmets may exist, intensifying ear injury during blast exposure.



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via IFTTT

Comparison of Mouse Minimum Audible Angle Determined in Prepulse Inhibition and Operant Conditioning Procedures

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): Derik Behrens, Georg M. Klump
Both reward based operant conditioning (OC) and reflex-based prepulse inhibition (PPI) procedures are used in sound localisation studies in mice. Since the results of both procedures are compared in the literature, it is important to assess whether they provide similar results if the same stimulus paradigm is applied. Here, we compare the sensitivity of C57BL/6 mice in OC and PPI procedures for detecting a switch in speaker location using broadband and narrowband noise stimuli and determined their minimum audible angle (MAA). In the OC procedure, we calculated d' values from the hit and false alarm rates. In the PPI procedure, we calculated the area under ROC curves from the startle response amplitudes and derived da values to obtain a sensitivity measure that corresponds to d'. For both procedures, the mean sensitivity to the speaker switch increased with an increase in angular separation. For broadband noise stimuli, a d' of up to 3.3 (OC) and a da of up to 1.1 (PPI) were observed at large speaker separations. Narrowband noise stimuli resulted in lower sensitivities in both procedures, resulting in a maximum d' of 2.0 (OC) and a maximum da of 0.3 (PPI). Using a sensitivity of 1.0 as the threshold criterion, broadband noise MAAs in the range from 32° to 46° were observed in the OC procedure whereas a broadband noise MAAs of 108° or higher were observed in the PPI procedure. In the OC procedure, narrowband noise MAAs in the range from 37° to 62° were observed. In the PPI procedure, no narrowband noise MAA could be determined since none of the subjects reached the threshold. Thus, OC procedures result in a better performance of the subjects in the sound localization task than PPI procedures, challenging the view that both procedures can be used interchangeably.



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Interaction between osseous and non-osseous vibratory stimulation of the human cadaveric head

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): J.H. Sim, I. Dobrev, R. Gerig, F. Pfiffner, S. Stenfelt, A.M. Huber, C. Röösli
Bone conduction (BC) stimulation can be applied by vibration to the bony or skin covered skull (osseous BC), or on soft tissue such as the neck (non-osseous BC). The interaction between osseous and non-osseous bone conduction pathways is assessed in this study. The relation between bone vibrations measured at the cochlear promontory and the intracranial sound pressure for stimulation directly on the dura and for stimulation at the mastoid between 0.2 – 10 kHz was compared. First, for stimulation on the dura, varying the static coupling force of the BC transducer on the dura had only a small effect on promontory vibration. Second, the presence or absence of intracranial fluid did not affect promontory vibration for stimulation on the dura. Third, stimulation on the mastoid elicited both promontory vibration and intracranial sound pressure. Stimulation on the dura caused intracranial sound pressure to a similar extent above 0.5 kHz compared to stimulation on the mastoid, while promontory vibration was less by 20-40 dB. From these findings, we conclude that intracranial sound pressure (non-osseous BC) only marginally affects bone vibrations measured on the promontory (osseous BC), whereas skull vibrations affect intracranial sound pressure.



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via IFTTT

Mechanical Damage of Tympanic Membrane in Relation to Impulse Pressure Waveform – A Study in Chinchillas

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): Rong Z. Gan, Don Nakmali, Xiao D. Ji, Kegan Leckness, Zachary Yokell
Mechanical damage to middle ear components in blast exposure directly causes hearing loss, and the rupture of the tympanic membrane (TM) is the most frequent injury of the ear. However, it is unclear how the severity of injury graded by different patterns of TM rupture is related to the overpressure waveforms induced by blast waves. In the present study, the relationship between the TM rupture threshold and the impulse or overpressure waveform has been investigated in chinchillas. Two groups of animals were exposed to blast overpressure simulated in our lab under two conditions: open field and shielded with a stainless steel cup covering the animal head. Auditory brainstem response (ABR) and wideband tympanometry were measured before and after exposure to check the hearing threshold and middle ear function. Results show that waveforms recorded in the shielded case were different from those in the open field and the TM rupture threshold in the shielded case was lower than that in the open field (3.4±0.7 vs. 9.1±1.7 psi or 181±1.6 vs. 190±1.9 dB SPL). The impulse pressure energy spectra analysis of waveforms demonstrates that the shielded waveforms include greater energy at high frequencies than that of the open field waves. Finally, a 3D finite element (FE) model of the chinchilla ear was used to compute the distributions of stress in the TM and the TM displacement with impulse pressure waves. The FE model-derived change of stress in response to pressure loading in the shielded case was substantially faster than that in the open case. This finding provides the biomechanical mechanisms for blast induced TM damage in relation to overpressure waveforms. The TM rupture threshold difference between the open and shielded cases suggests that an acoustic role of helmets may exist, intensifying ear injury during blast exposure.



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via IFTTT

Comparison of Mouse Minimum Audible Angle Determined in Prepulse Inhibition and Operant Conditioning Procedures

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): Derik Behrens, Georg M. Klump
Both reward based operant conditioning (OC) and reflex-based prepulse inhibition (PPI) procedures are used in sound localisation studies in mice. Since the results of both procedures are compared in the literature, it is important to assess whether they provide similar results if the same stimulus paradigm is applied. Here, we compare the sensitivity of C57BL/6 mice in OC and PPI procedures for detecting a switch in speaker location using broadband and narrowband noise stimuli and determined their minimum audible angle (MAA). In the OC procedure, we calculated d' values from the hit and false alarm rates. In the PPI procedure, we calculated the area under ROC curves from the startle response amplitudes and derived da values to obtain a sensitivity measure that corresponds to d'. For both procedures, the mean sensitivity to the speaker switch increased with an increase in angular separation. For broadband noise stimuli, a d' of up to 3.3 (OC) and a da of up to 1.1 (PPI) were observed at large speaker separations. Narrowband noise stimuli resulted in lower sensitivities in both procedures, resulting in a maximum d' of 2.0 (OC) and a maximum da of 0.3 (PPI). Using a sensitivity of 1.0 as the threshold criterion, broadband noise MAAs in the range from 32° to 46° were observed in the OC procedure whereas a broadband noise MAAs of 108° or higher were observed in the PPI procedure. In the OC procedure, narrowband noise MAAs in the range from 37° to 62° were observed. In the PPI procedure, no narrowband noise MAA could be determined since none of the subjects reached the threshold. Thus, OC procedures result in a better performance of the subjects in the sound localization task than PPI procedures, challenging the view that both procedures can be used interchangeably.



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Interaction between osseous and non-osseous vibratory stimulation of the human cadaveric head

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): J.H. Sim, I. Dobrev, R. Gerig, F. Pfiffner, S. Stenfelt, A.M. Huber, C. Röösli
Bone conduction (BC) stimulation can be applied by vibration to the bony or skin covered skull (osseous BC), or on soft tissue such as the neck (non-osseous BC). The interaction between osseous and non-osseous bone conduction pathways is assessed in this study. The relation between bone vibrations measured at the cochlear promontory and the intracranial sound pressure for stimulation directly on the dura and for stimulation at the mastoid between 0.2 – 10 kHz was compared. First, for stimulation on the dura, varying the static coupling force of the BC transducer on the dura had only a small effect on promontory vibration. Second, the presence or absence of intracranial fluid did not affect promontory vibration for stimulation on the dura. Third, stimulation on the mastoid elicited both promontory vibration and intracranial sound pressure. Stimulation on the dura caused intracranial sound pressure to a similar extent above 0.5 kHz compared to stimulation on the mastoid, while promontory vibration was less by 20-40 dB. From these findings, we conclude that intracranial sound pressure (non-osseous BC) only marginally affects bone vibrations measured on the promontory (osseous BC), whereas skull vibrations affect intracranial sound pressure.



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Mechanical Damage of Tympanic Membrane in Relation to Impulse Pressure Waveform – A Study in Chinchillas

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): Rong Z. Gan, Don Nakmali, Xiao D. Ji, Kegan Leckness, Zachary Yokell
Mechanical damage to middle ear components in blast exposure directly causes hearing loss, and the rupture of the tympanic membrane (TM) is the most frequent injury of the ear. However, it is unclear how the severity of injury graded by different patterns of TM rupture is related to the overpressure waveforms induced by blast waves. In the present study, the relationship between the TM rupture threshold and the impulse or overpressure waveform has been investigated in chinchillas. Two groups of animals were exposed to blast overpressure simulated in our lab under two conditions: open field and shielded with a stainless steel cup covering the animal head. Auditory brainstem response (ABR) and wideband tympanometry were measured before and after exposure to check the hearing threshold and middle ear function. Results show that waveforms recorded in the shielded case were different from those in the open field and the TM rupture threshold in the shielded case was lower than that in the open field (3.4±0.7 vs. 9.1±1.7 psi or 181±1.6 vs. 190±1.9 dB SPL). The impulse pressure energy spectra analysis of waveforms demonstrates that the shielded waveforms include greater energy at high frequencies than that of the open field waves. Finally, a 3D finite element (FE) model of the chinchilla ear was used to compute the distributions of stress in the TM and the TM displacement with impulse pressure waves. The FE model-derived change of stress in response to pressure loading in the shielded case was substantially faster than that in the open case. This finding provides the biomechanical mechanisms for blast induced TM damage in relation to overpressure waveforms. The TM rupture threshold difference between the open and shielded cases suggests that an acoustic role of helmets may exist, intensifying ear injury during blast exposure.



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via IFTTT

Comparison of Mouse Minimum Audible Angle Determined in Prepulse Inhibition and Operant Conditioning Procedures

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): Derik Behrens, Georg M. Klump
Both reward based operant conditioning (OC) and reflex-based prepulse inhibition (PPI) procedures are used in sound localisation studies in mice. Since the results of both procedures are compared in the literature, it is important to assess whether they provide similar results if the same stimulus paradigm is applied. Here, we compare the sensitivity of C57BL/6 mice in OC and PPI procedures for detecting a switch in speaker location using broadband and narrowband noise stimuli and determined their minimum audible angle (MAA). In the OC procedure, we calculated d' values from the hit and false alarm rates. In the PPI procedure, we calculated the area under ROC curves from the startle response amplitudes and derived da values to obtain a sensitivity measure that corresponds to d'. For both procedures, the mean sensitivity to the speaker switch increased with an increase in angular separation. For broadband noise stimuli, a d' of up to 3.3 (OC) and a da of up to 1.1 (PPI) were observed at large speaker separations. Narrowband noise stimuli resulted in lower sensitivities in both procedures, resulting in a maximum d' of 2.0 (OC) and a maximum da of 0.3 (PPI). Using a sensitivity of 1.0 as the threshold criterion, broadband noise MAAs in the range from 32° to 46° were observed in the OC procedure whereas a broadband noise MAAs of 108° or higher were observed in the PPI procedure. In the OC procedure, narrowband noise MAAs in the range from 37° to 62° were observed. In the PPI procedure, no narrowband noise MAA could be determined since none of the subjects reached the threshold. Thus, OC procedures result in a better performance of the subjects in the sound localization task than PPI procedures, challenging the view that both procedures can be used interchangeably.



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via IFTTT

Interaction between osseous and non-osseous vibratory stimulation of the human cadaveric head

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): J.H. Sim, I. Dobrev, R. Gerig, F. Pfiffner, S. Stenfelt, A.M. Huber, C. Röösli
Bone conduction (BC) stimulation can be applied by vibration to the bony or skin covered skull (osseous BC), or on soft tissue such as the neck (non-osseous BC). The interaction between osseous and non-osseous bone conduction pathways is assessed in this study. The relation between bone vibrations measured at the cochlear promontory and the intracranial sound pressure for stimulation directly on the dura and for stimulation at the mastoid between 0.2 – 10 kHz was compared. First, for stimulation on the dura, varying the static coupling force of the BC transducer on the dura had only a small effect on promontory vibration. Second, the presence or absence of intracranial fluid did not affect promontory vibration for stimulation on the dura. Third, stimulation on the mastoid elicited both promontory vibration and intracranial sound pressure. Stimulation on the dura caused intracranial sound pressure to a similar extent above 0.5 kHz compared to stimulation on the mastoid, while promontory vibration was less by 20-40 dB. From these findings, we conclude that intracranial sound pressure (non-osseous BC) only marginally affects bone vibrations measured on the promontory (osseous BC), whereas skull vibrations affect intracranial sound pressure.



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Academic Training in Vestibular and Balance Function Testing Does Not Ensure Audiologists Will Be the Preferred Providers



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Risk Factors for Hearing Loss in Patients with Cystic Fibrosis



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The Effect of Lexical Content on Dichotic Speech Recognition in Older Adults



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The Effects of Hearing Aid Directional Microphone and Noise Reduction Processing on Listening Effort in Older Adults with Hearing Loss



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Diagnostic Hearing Assessment in Schools: Validity and Time Efficiency of Automated Audiometry



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Preservation of Neural Sensitivity after Noise-Induced Suppression of Sensory Function



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Hearing Loss Terminology: In Response to Wilson and Margolis (2015)



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Erratum



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JAAA CEU Program



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Academic Training in Vestibular and Balance Function Testing Does Not Ensure Audiologists Will Be the Preferred Providers



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Risk Factors for Hearing Loss in Patients with Cystic Fibrosis



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The Effect of Lexical Content on Dichotic Speech Recognition in Older Adults



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Academic Training in Vestibular and Balance Function Testing Does Not Ensure Audiologists Will Be the Preferred Providers



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The Effects of Hearing Aid Directional Microphone and Noise Reduction Processing on Listening Effort in Older Adults with Hearing Loss



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Risk Factors for Hearing Loss in Patients with Cystic Fibrosis



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Diagnostic Hearing Assessment in Schools: Validity and Time Efficiency of Automated Audiometry



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The Effect of Lexical Content on Dichotic Speech Recognition in Older Adults



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Preservation of Neural Sensitivity after Noise-Induced Suppression of Sensory Function



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Hearing Loss Terminology: In Response to Wilson and Margolis (2015)



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The Effects of Hearing Aid Directional Microphone and Noise Reduction Processing on Listening Effort in Older Adults with Hearing Loss



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Erratum



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Diagnostic Hearing Assessment in Schools: Validity and Time Efficiency of Automated Audiometry



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JAAA CEU Program



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Preservation of Neural Sensitivity after Noise-Induced Suppression of Sensory Function



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Hearing Loss Terminology: In Response to Wilson and Margolis (2015)



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Erratum



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JAAA CEU Program



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Attentional Bias in Patients with Decompensated Tinnitus: Prima Facie Evidence from Event-Related Potentials

Tinnitus refers to the auditory perception of sound in the absence of external sound or electric stimuli. The influence of tinnitus on cognitive processing is at the cutting edge of ongoing tinnitus research. In this study, we adopted an objective indicator of attentional processing, i.e. the mismatch negativity (MMN), to assess the attentional bias in patients with decompensated tinnitus. Three kinds of pure tones, D1 (8,000 Hz), S (8,500 Hz) and D2 (9,000 Hz), were used to induce event-related potentials (ERPs) in the normal ear. Employing the oddball paradigm, the task was divided into two blocks in which D1 and D2 were set as deviation stimuli, respectively. Only D2 induced a significant MMN in the tinnitus group, while neither D1 nor D2 was able to induce MMN in the control group. In addition, the ERPs in the left hemisphere, which were recorded within the time window of 90-150 ms (ERP90-150 ms), were significantly higher than those in the right hemisphere in the tinnitus group, while no significant difference was observed in the control group. Lastly, the amplitude of ERP90-150 ms in the tinnitus group was significantly higher than that in the control group. These findings suggest that patients with decompensated tinnitus showed automatic processing of acoustic stimuli, thereby indicating that these patients allocated more cognitive resources to acoustic stimulus processing. We suggest that the difficulty in disengaging or facilitated attention of patients might underlie this phenomenon. The limitations of the current study are discussed.
Audiol Neurotol 2016;21:38-44

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Remote care for cochlear implant users

Audiologists from the University of Southampton are investigating how a new patient-centred approach can help cochlear implant users manage their own care programme.

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Remote care for cochlear implant users

Audiologists from the University of Southampton are investigating how a new patient-centred approach can help cochlear implant users manage their own care programme.

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Is low frequency ocean sound increasing globally?

Low frequency sound has increased in the Northeast Pacific Ocean over the past 60 yr [Ross (1993) Acoust. Bull. 18, 5–8; (2005) IEEE J. Ocean. Eng. 30, 257–261; Andrew, Howe, Mercer, and Dzieciuch (2002) J. Acoust. Soc. Am. 129, 642–651; McDonald, Hildebrand, and Wiggins (2006) J. Acoust. Soc. Am. 120, 711–717; Chapman and Price (2011) J. Acoust. Soc. Am. 129, EL161–EL165] and in the Indian Ocean over the past decade, [Miksis-Olds, Bradley, and Niu (2013) J. Acoust. Soc. Am. 134, 3464–3475]. More recently, Andrew, Howe, and Mercer's [(2011) J. Acoust. Soc. Am. 129, 642–651] observations in the Northeast Pacific show a level or slightly decreasing trend in low frequency noise. It remains unclear what the low frequency trends are in other regions of the world. In this work, data from the Comprehensive Nuclear-Test Ban Treaty Organization International Monitoring System was used to examine the rate and magnitude of change in low frequency sound (5–115 Hz) over the past decade in the South Atlantic and Equatorial Pacific Oceans. The dominant source observed in the South Atlantic was seismic air gun signals, while shipping and biologic sources contributed more to the acoustic environment at the Equatorial Pacific location. Sound levels over the past 5–6 yr in the Equatorial Pacific have decreased. Decreases were also observed in the ambient sound floor in the South Atlantic Ocean. Based on these observations, it does not appear that low frequency sound levels are increasing globally.



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Automatic detection of Parkinson's disease in running speech spoken in three different languages

The aim of this study is the analysis of continuous speech signals of people with Parkinson's disease (PD) considering recordings in different languages (Spanish, German, and Czech). A method for the characterization of the speech signals, based on the automatic segmentation of utterances into voiced and unvoiced frames, is addressed here. The energy content of the unvoiced sounds is modeled using 12 Mel-frequency cepstral coefficients and 25 bands scaled according to the Bark scale. Four speech tasks comprising isolated words, rapid repetition of the syllables /pa/-/ta/-/ka/, sentences, and read texts are evaluated. The method proves to be more accurate than classical approaches in the automatic classification of speech of people with PD and healthy controls. The accuracies range from 85% to 99% depending on the language and the speech task. Cross-language experiments are also performed confirming the robustness and generalization capability of the method, with accuracies ranging from 60% to 99%. This work comprises a step forward for the development of computer aided tools for the automatic assessment of dysarthric speech signals in multiple languages.



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A fast and stable solver for acoustic scattering problems based on the nonuniform grid approach

A fast and stable boundary element method(BEM) algorithm for solving external problems of acoustic scattering by impenetrable bodies is developed. The method employs the Burton–Miller integral equation, which provides stable convergence of iterative solvers, and a generalized multilevel nonuniform grid (MLNG) algorithm for fast evaluation of field integrals. The MLNG approach is used here for the removal of computational bottlenecks involved with repeated matrix-vector multiplications as well as for the low-order basis function regularization of the hyper-singular integral kernel. The method is used for calculating the fields scattered by large acoustic scatterers, including nonconvex bodies with piece-wise smooth surfaces. As a result, the algorithm is capable of accurately incorporating high-frequency effects such as creeping waves and multiple-edges diffractions. In all cases, stable convergence of the method is observed. High accuracy of the method is demonstrated by comparison with the traditional BEMsolution. The computational complexity of the method in terms of both the computation time and storage is estimated in practical computations and shown to be close to the asymptotic dependence.



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The effect of presentation level on spectral weights for sentences

Psychophysical data indicate that spectral weights tend to increase with increasing presentation level at high frequencies. The present study examined whether spectral weights for speech perception are similarly affected by presentation level. Stimuli were sentences filtered into five contiguous frequency bands and presented at each of two levels (75 and 95 dB sound pressure level [SPL]). For the highest band (2807–10 000 Hz), normal-hearing listeners' weights were higher for the higher presentation level. Weights for the 95-dB-SPL level resembled those previously estimated for hearing-impaired listeners tested at comparably high levels, suggesting that hearing loss itself may not play a large role in spectral weighting for a sentence recognition task.



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The intelligibility of interrupted and temporally altered speech: Effects of context, age, and hearing lossa)

Temporal constraints on the perception of interrupted speech were investigated by comparing the intelligibility of speech that was periodically gated (PG) and subsequently either temporally compressed (PGTC) by concatenating remaining speech fragments or temporally expanded (PGTE) by doubling the silent intervals between speech fragments. Experiment 1 examined the effects of PGTC and PGTE at different gating rates (0.5 –16 Hz) on the intelligibility of words and sentences for young normal-hearing adults. In experiment 2, older normal-hearing (ONH) and older hearing-impaired (OHI) adults were tested with sentences only. The results of experiment 1 indicated that sentences were more intelligible than words. In both experiments, PGTC sentences were less intelligible than either PG or PGTE sentences. Compared with PG sentences, the intelligibility of PGTE sentences was significantly reduced by the same amount for ONH and OHI groups. Temporal alterations tended to produce a U-shaped rate-intelligibility function with a dip at 2–4 Hz, indicating that temporal alterations interacted with the duration of speech fragments. The present findings demonstrate that both aging and hearing loss negatively affect the overall intelligibility of interrupted and temporally altered speech. However, a mild-to-moderate hearing loss did not exacerbate the negative effects of temporal alterations associated with aging.



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A study on transvelar coupling for non-nasalized sounds

Previous studies have found that the velum in speech production may not only serve as a binary switch with on-off states for nasal and non-nasal sounds, but also partially alter the acoustic characteristics of non-nasalized sounds. The present study investigated the unique functions of the velum in the production of non-nasalized sounds by using morphological, mechanical, and acoustical measurements. Magnetic resonance imaging movies obtained from three Japanese speakers were used to measure the behaviors of the velum and dynamic changes in the pseudo-volume of the pharyngeal cavity during utterances of voiced stops and vowels. The measurements revealed no significant enlargements in the supraglottal cavity as subjects uttered voiced stops. It is found that the velum thickness varied across utterances in a way that depended on vowels, but not on consonants. The mechanical and acoustical observations in the study suggested that the velum is actively controlled to augment the voice bars of voiced stops, and nostril-radiated sound is one of the most important sources for voice bars, just as is laryngeal wall vibration. This study also proposed a two-layer diaphragm model that simulates transvelar coupling during the production of non-nasalized speech sounds. The simulation demonstrated that the model accurately represented the basic velar functions involved in speech production.



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Smartphone threshold audiometry in underserved primary health-care contexts

10.3109/14992027.2015.1124294<br/>Josefin Sandström

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Adaptation of the STARR test for adult Italian population: A speech test for a realistic estimate in real-life listening conditions

10.3109/14992027.2015.1124296<br/>Hilal Dincer D’Alessandro

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Assessment of low-frequency hearing with narrow-band chirp-evoked 40-Hz sinusoidal auditory steady-state response

10.3109/14992027.2015.1122238<br/>Uzma S. Wilson

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Knowledge, attitudes, behaviors, and noise exposure of baristas

10.3109/14992027.2015.1124295<br/>Alyssa J. Pursley

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Smartphone threshold audiometry in underserved primary health-care contexts

10.3109/14992027.2015.1124294<br/>Josefin Sandström

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Adaptation of the STARR test for adult Italian population: A speech test for a realistic estimate in real-life listening conditions

10.3109/14992027.2015.1124296<br/>Hilal Dincer D’Alessandro

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Assessment of low-frequency hearing with narrow-band chirp-evoked 40-Hz sinusoidal auditory steady-state response

10.3109/14992027.2015.1122238<br/>Uzma S. Wilson

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Knowledge, attitudes, behaviors, and noise exposure of baristas

10.3109/14992027.2015.1124295<br/>Alyssa J. Pursley

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Long-term Stability of the Active Middle-ear Implant with Floating-mass Transducer Technology: A Single-center Study.

Objective: To examine the long-term results of an active middle-ear implant (AMEI) with floating-mass transducer (FMT) technology. Study Design: Prospective cohort study of German-speaking patients implanted with an AMEI between 2006 and 2013. Setting: Single-center study. Patients: Eighty-three patients. Intervention: AMEI with FMT technology implantation. Main Outcome Measures: Long-term outcome (27 mo; range, 12-84 mo) for FMT position in correlation with pure-tone audiometry, auditory thresholds for frequency-modulated (warble) tones, vibroplasty thresholds for pure tones, and speech audiometry in quiet and noise. Results: In 15.6% of patients, a revision surgery was necessary to improve functional performance of the AMEI, and the highest revision rate was found with FMT coupling to the round window not using couplers. A peak number of revision surgeries were observed 3 years after the initial surgery. Stable audiological results (pure-tone audiometry and speech audiometry in quiet and noise) were observed up to 84-month post-surgery. Incus vibroplasty (classic indication) showed a significantly lower functional gain compared with oval and round window vibroplasty. Vibroplasty in combined or conductive hearing loss showed no functional difference between forward and reverse stimulation of the cochlea; however, significantly lower vibroplasty thresholds were detected when using a coupler. Conclusions: The AMEI with FMT technology can be safely used in treatment of patients with mild-to-severe sensorineural, conductive, or mixed hearing loss. Optimized coupling, especially in incus vibroplasty, has to be developed to achieve enhanced audiological results. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Smartphone threshold audiometry in underserved primary health-care contexts

10.3109/14992027.2015.1124294<br/>Josefin Sandström

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Adaptation of the STARR test for adult Italian population: A speech test for a realistic estimate in real-life listening conditions

10.3109/14992027.2015.1124296<br/>Hilal Dincer D’Alessandro

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Assessment of low-frequency hearing with narrow-band chirp-evoked 40-Hz sinusoidal auditory steady-state response

10.3109/14992027.2015.1122238<br/>Uzma S. Wilson

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Knowledge, attitudes, behaviors, and noise exposure of baristas

10.3109/14992027.2015.1124295<br/>Alyssa J. Pursley

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Smartphone threshold audiometry in underserved primary health-care contexts

10.3109/14992027.2015.1124294<br/>Josefin Sandström

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Adaptation of the STARR test for adult Italian population: A speech test for a realistic estimate in real-life listening conditions

10.3109/14992027.2015.1124296<br/>Hilal Dincer D’Alessandro

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Assessment of low-frequency hearing with narrow-band chirp-evoked 40-Hz sinusoidal auditory steady-state response

10.3109/14992027.2015.1122238<br/>Uzma S. Wilson

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Knowledge, attitudes, behaviors, and noise exposure of baristas

10.3109/14992027.2015.1124295<br/>Alyssa J. Pursley

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Smartphone threshold audiometry in underserved primary health-care contexts

10.3109/14992027.2015.1124294<br/>Josefin Sandström

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Adaptation of the STARR test for adult Italian population: A speech test for a realistic estimate in real-life listening conditions

10.3109/14992027.2015.1124296<br/>Hilal Dincer D’Alessandro

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Assessment of low-frequency hearing with narrow-band chirp-evoked 40-Hz sinusoidal auditory steady-state response

10.3109/14992027.2015.1122238<br/>Uzma S. Wilson

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Knowledge, attitudes, behaviors, and noise exposure of baristas

10.3109/14992027.2015.1124295<br/>Alyssa J. Pursley

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Effects of auditory enhancement on the loudness of masker and target components

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): Ningyuan Wang, Andrew J. Oxenham
Auditory enhancement refers to the observation that the salience of one spectral region (the “signal”) of a broadband sound can be enhanced and can “pop out” from the remainder of the sound (the “masker”) if it is preceded by the broadband sound without the signal. The present study investigated auditory enhancement as an effective change in loudness, to determine whether it reflects a change in the loudness of the signal, the masker, or both. In the first experiment, the 500-ms precursor, an inharmonic complex with logarithmically spaced components, was followed after a 50-ms gap by the 100-ms signal or masker alone, the loudness of which was compared with that of the same signal or masker presented 2 s later. In the second experiment, the loudness of the signal embedded in the masker was assessed with and without a precursor using the same method, as was the loudness of the entire signal-plus-masker complex. The results suggest that the precursor does not affect the loudness of the signal or the masker alone, but enhances the loudness of the signal in the presence of the masker, while leaving the loudness of the surrounding masker unaffected. The results are consistent with an explanation based on “adaptation of inhibition” [Viemeister and Bacon (1982). J. Acoust. Soc. Am. 71, 1502-1507].



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Effects of auditory enhancement on the loudness of masker and target components

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): Ningyuan Wang, Andrew J. Oxenham
Auditory enhancement refers to the observation that the salience of one spectral region (the “signal”) of a broadband sound can be enhanced and can “pop out” from the remainder of the sound (the “masker”) if it is preceded by the broadband sound without the signal. The present study investigated auditory enhancement as an effective change in loudness, to determine whether it reflects a change in the loudness of the signal, the masker, or both. In the first experiment, the 500-ms precursor, an inharmonic complex with logarithmically spaced components, was followed after a 50-ms gap by the 100-ms signal or masker alone, the loudness of which was compared with that of the same signal or masker presented 2 s later. In the second experiment, the loudness of the signal embedded in the masker was assessed with and without a precursor using the same method, as was the loudness of the entire signal-plus-masker complex. The results suggest that the precursor does not affect the loudness of the signal or the masker alone, but enhances the loudness of the signal in the presence of the masker, while leaving the loudness of the surrounding masker unaffected. The results are consistent with an explanation based on “adaptation of inhibition” [Viemeister and Bacon (1982). J. Acoust. Soc. Am. 71, 1502-1507].



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Effects of auditory enhancement on the loudness of masker and target components

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): Ningyuan Wang, Andrew J. Oxenham
Auditory enhancement refers to the observation that the salience of one spectral region (the “signal”) of a broadband sound can be enhanced and can “pop out” from the remainder of the sound (the “masker”) if it is preceded by the broadband sound without the signal. The present study investigated auditory enhancement as an effective change in loudness, to determine whether it reflects a change in the loudness of the signal, the masker, or both. In the first experiment, the 500-ms precursor, an inharmonic complex with logarithmically spaced components, was followed after a 50-ms gap by the 100-ms signal or masker alone, the loudness of which was compared with that of the same signal or masker presented 2 s later. In the second experiment, the loudness of the signal embedded in the masker was assessed with and without a precursor using the same method, as was the loudness of the entire signal-plus-masker complex. The results suggest that the precursor does not affect the loudness of the signal or the masker alone, but enhances the loudness of the signal in the presence of the masker, while leaving the loudness of the surrounding masker unaffected. The results are consistent with an explanation based on “adaptation of inhibition” [Viemeister and Bacon (1982). J. Acoust. Soc. Am. 71, 1502-1507].



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In-shoe plantar pressure measurements for the evaluation and adaptation of foot orthoses in patients with rheumatoid arthritis: A proof of concept study

Publication date: March 2016
Source:Gait & Posture, Volume 45
Author(s): Marloes Tenten-Diepenmaat, Joost Dekker, Menno Steenbergen, Elleke Huybrechts, Leo D. Roorda, Dirkjan van Schaardenburg, Sicco A. Bus, Marike van der Leeden
ObjectivesImproving foot orthoses (FOs) in patients with rheumatoid arthritis (RA) by using in-shoe plantar pressure measurements seems promising. The objectives of this study were to evaluate (1) the outcome on plantar pressure distribution of FOs that were adapted using in-shoe plantar pressure measurements according to a protocol and (2) the protocol feasibility.MethodsForty-five RA patients with foot problems were included in this observational proof-of concept study. FOs were custom-made by a podiatrist according to usual care. Regions of Interest (ROIs) for plantar pressure reduction were selected. According to a protocol, usual care FOs were evaluated using in-shoe plantar pressure measurements and, if necessary, adapted. Plantar pressure–time integrals at the ROIs were compared between the following conditions: (1) no-FO versus usual care FO and (2) usual care FO versus adapted FO. Semi-structured interviews were held with patients and podiatrists to evaluate the feasibility of the protocol.ResultsAdapted FOs were developed in 70% of the patients. In these patients, usual care FOs showed a mean 9% reduction in pressure–time integral at forefoot ROIs compared to no-FOs (p=0.01). FO adaptation led to an additional mean 3% reduction in pressure–time integral (p=0.05). The protocol was considered feasible by patients. Podiatrists considered the protocol more useful to achieve individual rather than general treatment goals. A final protocol was proposed.ConclusionsUsing in-shoe plantar pressure measurements for adapting foot orthoses for patients with RA leads to a small additional plantar pressure reduction in the forefoot. Further research on the clinical relevance of this outcome is required.



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Effects of auditory enhancement on the loudness of masker and target components

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): Ningyuan Wang, Andrew J. Oxenham
Auditory enhancement refers to the observation that the salience of one spectral region (the “signal”) of a broadband sound can be enhanced and can “pop out” from the remainder of the sound (the “masker”) if it is preceded by the broadband sound without the signal. The present study investigated auditory enhancement as an effective change in loudness, to determine whether it reflects a change in the loudness of the signal, the masker, or both. In the first experiment, the 500-ms precursor, an inharmonic complex with logarithmically spaced components, was followed after a 50-ms gap by the 100-ms signal or masker alone, the loudness of which was compared with that of the same signal or masker presented 2 s later. In the second experiment, the loudness of the signal embedded in the masker was assessed with and without a precursor using the same method, as was the loudness of the entire signal-plus-masker complex. The results suggest that the precursor does not affect the loudness of the signal or the masker alone, but enhances the loudness of the signal in the presence of the masker, while leaving the loudness of the surrounding masker unaffected. The results are consistent with an explanation based on “adaptation of inhibition” [Viemeister and Bacon (1982). J. Acoust. Soc. Am. 71, 1502-1507].



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In-shoe plantar pressure measurements for the evaluation and adaptation of foot orthoses in patients with rheumatoid arthritis: A proof of concept study

Publication date: March 2016
Source:Gait & Posture, Volume 45
Author(s): Marloes Tenten-Diepenmaat, Joost Dekker, Menno Steenbergen, Elleke Huybrechts, Leo D. Roorda, Dirkjan van Schaardenburg, Sicco A. Bus, Marike van der Leeden
ObjectivesImproving foot orthoses (FOs) in patients with rheumatoid arthritis (RA) by using in-shoe plantar pressure measurements seems promising. The objectives of this study were to evaluate (1) the outcome on plantar pressure distribution of FOs that were adapted using in-shoe plantar pressure measurements according to a protocol and (2) the protocol feasibility.MethodsForty-five RA patients with foot problems were included in this observational proof-of concept study. FOs were custom-made by a podiatrist according to usual care. Regions of Interest (ROIs) for plantar pressure reduction were selected. According to a protocol, usual care FOs were evaluated using in-shoe plantar pressure measurements and, if necessary, adapted. Plantar pressure–time integrals at the ROIs were compared between the following conditions: (1) no-FO versus usual care FO and (2) usual care FO versus adapted FO. Semi-structured interviews were held with patients and podiatrists to evaluate the feasibility of the protocol.ResultsAdapted FOs were developed in 70% of the patients. In these patients, usual care FOs showed a mean 9% reduction in pressure–time integral at forefoot ROIs compared to no-FOs (p=0.01). FO adaptation led to an additional mean 3% reduction in pressure–time integral (p=0.05). The protocol was considered feasible by patients. Podiatrists considered the protocol more useful to achieve individual rather than general treatment goals. A final protocol was proposed.ConclusionsUsing in-shoe plantar pressure measurements for adapting foot orthoses for patients with RA leads to a small additional plantar pressure reduction in the forefoot. Further research on the clinical relevance of this outcome is required.



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Effects of auditory enhancement on the loudness of masker and target components

Publication date: Available online 22 January 2016
Source:Hearing Research
Author(s): Ningyuan Wang, Andrew J. Oxenham
Auditory enhancement refers to the observation that the salience of one spectral region (the “signal”) of a broadband sound can be enhanced and can “pop out” from the remainder of the sound (the “masker”) if it is preceded by the broadband sound without the signal. The present study investigated auditory enhancement as an effective change in loudness, to determine whether it reflects a change in the loudness of the signal, the masker, or both. In the first experiment, the 500-ms precursor, an inharmonic complex with logarithmically spaced components, was followed after a 50-ms gap by the 100-ms signal or masker alone, the loudness of which was compared with that of the same signal or masker presented 2 s later. In the second experiment, the loudness of the signal embedded in the masker was assessed with and without a precursor using the same method, as was the loudness of the entire signal-plus-masker complex. The results suggest that the precursor does not affect the loudness of the signal or the masker alone, but enhances the loudness of the signal in the presence of the masker, while leaving the loudness of the surrounding masker unaffected. The results are consistent with an explanation based on “adaptation of inhibition” [Viemeister and Bacon (1982). J. Acoust. Soc. Am. 71, 1502-1507].



from #Audiology via ola Kala on Inoreader http://ift.tt/1Ps99Yk
via IFTTT

In-shoe plantar pressure measurements for the evaluation and adaptation of foot orthoses in patients with rheumatoid arthritis: A proof of concept study

Publication date: March 2016
Source:Gait & Posture, Volume 45
Author(s): Marloes Tenten-Diepenmaat, Joost Dekker, Menno Steenbergen, Elleke Huybrechts, Leo D. Roorda, Dirkjan van Schaardenburg, Sicco A. Bus, Marike van der Leeden
ObjectivesImproving foot orthoses (FOs) in patients with rheumatoid arthritis (RA) by using in-shoe plantar pressure measurements seems promising. The objectives of this study were to evaluate (1) the outcome on plantar pressure distribution of FOs that were adapted using in-shoe plantar pressure measurements according to a protocol and (2) the protocol feasibility.MethodsForty-five RA patients with foot problems were included in this observational proof-of concept study. FOs were custom-made by a podiatrist according to usual care. Regions of Interest (ROIs) for plantar pressure reduction were selected. According to a protocol, usual care FOs were evaluated using in-shoe plantar pressure measurements and, if necessary, adapted. Plantar pressure–time integrals at the ROIs were compared between the following conditions: (1) no-FO versus usual care FO and (2) usual care FO versus adapted FO. Semi-structured interviews were held with patients and podiatrists to evaluate the feasibility of the protocol.ResultsAdapted FOs were developed in 70% of the patients. In these patients, usual care FOs showed a mean 9% reduction in pressure–time integral at forefoot ROIs compared to no-FOs (p=0.01). FO adaptation led to an additional mean 3% reduction in pressure–time integral (p=0.05). The protocol was considered feasible by patients. Podiatrists considered the protocol more useful to achieve individual rather than general treatment goals. A final protocol was proposed.ConclusionsUsing in-shoe plantar pressure measurements for adapting foot orthoses for patients with RA leads to a small additional plantar pressure reduction in the forefoot. Further research on the clinical relevance of this outcome is required.



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