How Do Age and Hearing Loss Impact Spectral Envelope Perception?

Purpose

The goal was to evaluate the potential effects of increasing hearing loss and advancing age on spectral envelope perception.

Method

Spectral modulation detection was measured as a function of spectral modulation frequency from 0.5 to 8.0 cycles/octave. The spectral modulation task involved discrimination of a noise carrier (3 octaves wide from 400 to 3200 Hz) with a flat spectral envelope from a noise having a sinusoidal spectral envelope across a logarithmic audio frequency scale. Spectral modulation transfer functions (SMTFs; modulation threshold vs. modulation frequency) were computed and compared 4 listener groups: young normal hearing, older normal hearing, older with mild hearing loss, and older with moderate hearing loss. Estimates of the internal spectral contrast were obtained by computing excitation patterns.

Results

SMTFs for young listeners with normal hearing were bandpass with a minimum modulation detection threshold at 2 cycles/octave, and older listeners with normal hearing were remarkably similar to those of the young listeners. SMTFs for older listeners with mild and moderate hearing loss had a low-pass rather than a bandpass shape. Excitation patterns revealed that limited spectral resolution dictated modulation detection thresholds at high but not low spectral modulation frequencies. Even when factoring out (presumed) differences in frequency resolution among groups, the spectral envelope perception was worse for the group with moderate hearing loss than the other 3 groups.

Conclusions

The spectral envelope perception as measured by spectral modulation detection thresholds is compromised by hearing loss at higher spectral modulation frequencies, consistent with predictions of reduced spectral resolution known to accompany sensorineural hearing loss. Spectral envelope perception is not negatively impacted by advancing age at any spectral modulation frequency between 0.5 and 8.0 cycles/octave.

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Pairing New Words With Unfamiliar Objects: Comparing Children With and Without Cochlear Implants

Purpose

This study investigates differences between preschool children with cochlear implants and age-matched children with normal hearing during an initial stage in word learning to evaluate whether they (a) match novel words to unfamiliar objects and (b) solicit information about unfamiliar objects during play.

Method

Twelve preschool children with cochlear implants and 12 children with normal hearing matched for age completed 2 experimental tasks. In the 1st task, children were asked to point to a picture that matched either a known word or a novel word. In the 2nd task, children were presented with unfamiliar objects during play and were given the opportunity to ask questions about those objects.

Results

In Task 1, children with cochlear implants paired novel words with unfamiliar pictures in fewer trials than children with normal hearing. In Task 2, children with cochlear implants were less likely to solicit information about new objects than children with normal hearing. Performance on the 1st task, but not the 2nd, significantly correlated with expressive vocabulary standard scores of children with cochlear implants.

Conclusion

This study provides preliminary evidence that children with cochlear implants approach mapping novel words to and soliciting information about unfamiliar objects differently than children with normal hearing.

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How Do Age and Hearing Loss Impact Spectral Envelope Perception?

Purpose

The goal was to evaluate the potential effects of increasing hearing loss and advancing age on spectral envelope perception.

Method

Spectral modulation detection was measured as a function of spectral modulation frequency from 0.5 to 8.0 cycles/octave. The spectral modulation task involved discrimination of a noise carrier (3 octaves wide from 400 to 3200 Hz) with a flat spectral envelope from a noise having a sinusoidal spectral envelope across a logarithmic audio frequency scale. Spectral modulation transfer functions (SMTFs; modulation threshold vs. modulation frequency) were computed and compared 4 listener groups: young normal hearing, older normal hearing, older with mild hearing loss, and older with moderate hearing loss. Estimates of the internal spectral contrast were obtained by computing excitation patterns.

Results

SMTFs for young listeners with normal hearing were bandpass with a minimum modulation detection threshold at 2 cycles/octave, and older listeners with normal hearing were remarkably similar to those of the young listeners. SMTFs for older listeners with mild and moderate hearing loss had a low-pass rather than a bandpass shape. Excitation patterns revealed that limited spectral resolution dictated modulation detection thresholds at high but not low spectral modulation frequencies. Even when factoring out (presumed) differences in frequency resolution among groups, the spectral envelope perception was worse for the group with moderate hearing loss than the other 3 groups.

Conclusions

The spectral envelope perception as measured by spectral modulation detection thresholds is compromised by hearing loss at higher spectral modulation frequencies, consistent with predictions of reduced spectral resolution known to accompany sensorineural hearing loss. Spectral envelope perception is not negatively impacted by advancing age at any spectral modulation frequency between 0.5 and 8.0 cycles/octave.

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Pairing New Words With Unfamiliar Objects: Comparing Children With and Without Cochlear Implants

Purpose

This study investigates differences between preschool children with cochlear implants and age-matched children with normal hearing during an initial stage in word learning to evaluate whether they (a) match novel words to unfamiliar objects and (b) solicit information about unfamiliar objects during play.

Method

Twelve preschool children with cochlear implants and 12 children with normal hearing matched for age completed 2 experimental tasks. In the 1st task, children were asked to point to a picture that matched either a known word or a novel word. In the 2nd task, children were presented with unfamiliar objects during play and were given the opportunity to ask questions about those objects.

Results

In Task 1, children with cochlear implants paired novel words with unfamiliar pictures in fewer trials than children with normal hearing. In Task 2, children with cochlear implants were less likely to solicit information about new objects than children with normal hearing. Performance on the 1st task, but not the 2nd, significantly correlated with expressive vocabulary standard scores of children with cochlear implants.

Conclusion

This study provides preliminary evidence that children with cochlear implants approach mapping novel words to and soliciting information about unfamiliar objects differently than children with normal hearing.

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Author Response to Peck (2018), “Questionable Use of ‘Nonorganic’ in ‘Estimating Nonorganic Hearing Thresholds’”

Purpose

The purpose of this letter is to respond to Dr. Peck's (2018) letter to the editor regarding the use of the term “nonorganic” to describe hearing loss, demonstrated by the pure tone audiogram that cannot be explained or is greater than what can be explained by a physiological auditory disorder.

Conclusions

We prefer the term “nonorganic” rather than the term “false and exaggerated hearing loss.” “Nonorganic,” in our view, is a nonjudgmental term and, as stated by Austen and Lynch (2004), implies “as little as possible about its cause” (p. 450).

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Questionable Use of “Nonorganic” in Norrix et al. (2017), “Estimating Nonorganic Hearing Thresholds”

Purpose

The author of this letter to the editor expresses concern about the use of the word “nonorganic” as a source of confusion in terminology. Specifically, this is in response to the December 2017 American Journal of Audiology article, “Estimating Nonorganic Hearing Thresholds Using Binaural Auditory Stimuli” (Norrix, Rubiano, & Mueller, 2017). “Nonorganic” is a source of confusion in terminology, because it can be used in two different ways. One way can mean to say there is no hearing loss. When used in this sense, it is illogical because it is qualifying a hearing loss believed not to exist. The second usage means there is a real disorder of function, but the organs themselves are not damaged and the basis is unknown. In the place of “nonorganic,” I have proposed “false hearing loss.” “Nonorganic” might carry a negative connotation that “false” might not. Many instances of false hearing loss stem from physical–mental health disturbances. Audiologists must stay alert to signs of psychosocial difficulty and refer for further evaluation accordingly.

Conclusion

“False” hearing loss is a more appropriate term than “nonorganic” hearing loss.

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Author Response to Peck (2018), “Questionable Use of ‘Nonorganic’ in ‘Estimating Nonorganic Hearing Thresholds’”

Purpose

The purpose of this letter is to respond to Dr. Peck's (2018) letter to the editor regarding the use of the term “nonorganic” to describe hearing loss, demonstrated by the pure tone audiogram that cannot be explained or is greater than what can be explained by a physiological auditory disorder.

Conclusions

We prefer the term “nonorganic” rather than the term “false and exaggerated hearing loss.” “Nonorganic,” in our view, is a nonjudgmental term and, as stated by Austen and Lynch (2004), implies “as little as possible about its cause” (p. 450).

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Questionable Use of “Nonorganic” in Norrix et al. (2017), “Estimating Nonorganic Hearing Thresholds”

Purpose

The author of this letter to the editor expresses concern about the use of the word “nonorganic” as a source of confusion in terminology. Specifically, this is in response to the December 2017 American Journal of Audiology article, “Estimating Nonorganic Hearing Thresholds Using Binaural Auditory Stimuli” (Norrix, Rubiano, & Mueller, 2017). “Nonorganic” is a source of confusion in terminology, because it can be used in two different ways. One way can mean to say there is no hearing loss. When used in this sense, it is illogical because it is qualifying a hearing loss believed not to exist. The second usage means there is a real disorder of function, but the organs themselves are not damaged and the basis is unknown. In the place of “nonorganic,” I have proposed “false hearing loss.” “Nonorganic” might carry a negative connotation that “false” might not. Many instances of false hearing loss stem from physical–mental health disturbances. Audiologists must stay alert to signs of psychosocial difficulty and refer for further evaluation accordingly.

Conclusion

“False” hearing loss is a more appropriate term than “nonorganic” hearing loss.

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Brain-like Emergent Auditory Learning: A Developmental Method

Publication date: Available online 31 August 2018

Source: Hearing Research

Author(s): Dongshu Wang, Hui Shan, Jianbin Xin

Abstract

Compared with machine audition, the human auditory system can recognize speech accurately and quickly. This paper proposes a new developmental network (DN) that simulates the human auditory system and constructs an artificial auditory model for speech recognition. The new model simulates each key element of the human auditory pathway as a deep network; in particular, an additional layer in the network is considered to simulate the function of the superior colliculus in the thalamus for speech context integration. The mel-frequency cepstral coefficient (MFCC) is used to extract the features of the speech signal as the sensory input of the DN. The emergent feature of DN model provides an explanation of how such internal neurons represent the short speech context when they are not supervised by the external world. The experimental results show that the recognition rates of English words and phrases can be improved significantly compared to those reported in the existing literature. The proposed DN model provides a new method to solve difficult problems, such as universal speech recognition, in traditional machine audition systems. Meanwhile, the same learning principle can potentially be used in or adapted to other computational contexts and applications.

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Brain-like Emergent Auditory Learning: A Developmental Method

Publication date: Available online 31 August 2018

Source: Hearing Research

Author(s): Dongshu Wang, Hui Shan, Jianbin Xin

Abstract

Compared with machine audition, the human auditory system can recognize speech accurately and quickly. This paper proposes a new developmental network (DN) that simulates the human auditory system and constructs an artificial auditory model for speech recognition. The new model simulates each key element of the human auditory pathway as a deep network; in particular, an additional layer in the network is considered to simulate the function of the superior colliculus in the thalamus for speech context integration. The mel-frequency cepstral coefficient (MFCC) is used to extract the features of the speech signal as the sensory input of the DN. The emergent feature of DN model provides an explanation of how such internal neurons represent the short speech context when they are not supervised by the external world. The experimental results show that the recognition rates of English words and phrases can be improved significantly compared to those reported in the existing literature. The proposed DN model provides a new method to solve difficult problems, such as universal speech recognition, in traditional machine audition systems. Meanwhile, the same learning principle can potentially be used in or adapted to other computational contexts and applications.

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Unusual discovery of a vestibular schwannoma following eradication therapy for Mycobacterium abscessus.

Related Articles

Unusual discovery of a vestibular schwannoma following eradication therapy for Mycobacterium abscessus.

BMJ Case Rep. 2018 Aug 29;2018:

Authors: Wilson C, Duckers J, Rajenderkumar D

Abstract
A young man with cystic fibrosis in his early 30s presented to accident and emergency with acute onset unilateral lower motor neuron facial palsy, hearing loss and impaired balance following Mycobacterium abscessus eradication induction therapy. The hearing loss and impaired balance developed over a 3-day period prior to the onset of facial palsy. Further investigation with a CT scan and MRI scan led to a diagnosis of vestibular schwannoma. The facial palsy resolved with steroid treatment; however, the hearing loss is irreversible, which has had a profound impact on his life and career. This case is intriguing as the cause and association of events are unclear. A working diagnosis of incidental Bell's palsy and unilateral hearing loss caused by the vestibular schwannoma was applied. However, the onset of these symptoms in relation to M. abscessus eradication induction therapy promotes discussion.

PMID: 30158267 [PubMed - in process]

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Unusual discovery of a vestibular schwannoma following eradication therapy for Mycobacterium abscessus.

Related Articles

Unusual discovery of a vestibular schwannoma following eradication therapy for Mycobacterium abscessus.

BMJ Case Rep. 2018 Aug 29;2018:

Authors: Wilson C, Duckers J, Rajenderkumar D

Abstract
A young man with cystic fibrosis in his early 30s presented to accident and emergency with acute onset unilateral lower motor neuron facial palsy, hearing loss and impaired balance following Mycobacterium abscessus eradication induction therapy. The hearing loss and impaired balance developed over a 3-day period prior to the onset of facial palsy. Further investigation with a CT scan and MRI scan led to a diagnosis of vestibular schwannoma. The facial palsy resolved with steroid treatment; however, the hearing loss is irreversible, which has had a profound impact on his life and career. This case is intriguing as the cause and association of events are unclear. A working diagnosis of incidental Bell's palsy and unilateral hearing loss caused by the vestibular schwannoma was applied. However, the onset of these symptoms in relation to M. abscessus eradication induction therapy promotes discussion.

PMID: 30158267 [PubMed - in process]

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Grxcr2 is required for stereocilia morphogenesis in the cochlea.

Grxcr2 is required for stereocilia morphogenesis in the cochlea.

PLoS One. 2018;13(8):e0201713

Authors: Avenarius MR, Jung JY, Askew C, Jones SM, Hunker KL, Azaiez H, Rehman AU, Schraders M, Najmabadi H, Kremer H, Smith RJH, Géléoc GSG, Dolan DF, Raphael Y, Kohrman DC

Abstract
Hearing and balance depend upon the precise morphogenesis and mechanosensory function of stereocilia, the specialized structures on the apical surface of sensory hair cells in the inner ear. Previous studies of Grxcr1 mutant mice indicated a critical role for this gene in control of stereocilia dimensions during development. In this study, we analyzed expression of the paralog Grxcr2 in the mouse and evaluated auditory and vestibular function of strains carrying targeted mutations of the gene. Peak expression of Grxcr2 occurs during early postnatal development of the inner ear and GRXCR2 is localized to stereocilia in both the cochlea and in vestibular organs. Homozygous Grxcr2 deletion mutants exhibit significant hearing loss by 3 weeks of age that is associated with developmental defects in stereocilia bundle orientation and organization. Despite these bundle defects, the mechanotransduction apparatus assembles in relatively normal fashion as determined by whole cell electrophysiological evaluation and FM1-43 uptake. Although Grxcr2 mutants do not exhibit overt vestibular dysfunction, evaluation of vestibular evoked potentials revealed subtle defects of the mutants in response to linear accelerations. In addition, reduced Grxcr2 expression in a hypomorphic mutant strain is associated with progressive hearing loss and bundle defects. The stereocilia localization of GRXCR2, together with the bundle pathologies observed in the mutants, indicate that GRXCR2 plays an intrinsic role in bundle orientation, organization, and sensory function in the inner ear during development and at maturity.

PMID: 30157177 [PubMed - in process]

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Grxcr2 is required for stereocilia morphogenesis in the cochlea.

Grxcr2 is required for stereocilia morphogenesis in the cochlea.

PLoS One. 2018;13(8):e0201713

Authors: Avenarius MR, Jung JY, Askew C, Jones SM, Hunker KL, Azaiez H, Rehman AU, Schraders M, Najmabadi H, Kremer H, Smith RJH, Géléoc GSG, Dolan DF, Raphael Y, Kohrman DC

Abstract
Hearing and balance depend upon the precise morphogenesis and mechanosensory function of stereocilia, the specialized structures on the apical surface of sensory hair cells in the inner ear. Previous studies of Grxcr1 mutant mice indicated a critical role for this gene in control of stereocilia dimensions during development. In this study, we analyzed expression of the paralog Grxcr2 in the mouse and evaluated auditory and vestibular function of strains carrying targeted mutations of the gene. Peak expression of Grxcr2 occurs during early postnatal development of the inner ear and GRXCR2 is localized to stereocilia in both the cochlea and in vestibular organs. Homozygous Grxcr2 deletion mutants exhibit significant hearing loss by 3 weeks of age that is associated with developmental defects in stereocilia bundle orientation and organization. Despite these bundle defects, the mechanotransduction apparatus assembles in relatively normal fashion as determined by whole cell electrophysiological evaluation and FM1-43 uptake. Although Grxcr2 mutants do not exhibit overt vestibular dysfunction, evaluation of vestibular evoked potentials revealed subtle defects of the mutants in response to linear accelerations. In addition, reduced Grxcr2 expression in a hypomorphic mutant strain is associated with progressive hearing loss and bundle defects. The stereocilia localization of GRXCR2, together with the bundle pathologies observed in the mutants, indicate that GRXCR2 plays an intrinsic role in bundle orientation, organization, and sensory function in the inner ear during development and at maturity.

PMID: 30157177 [PubMed - in process]

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Hearing Protector Attenuation and Noise Exposure Among Metal Manufacturing Workers

Objectives: This study utilized personal noise measurements and fit-testing to evaluate the association between noise exposures and personal attenuation rating (PAR) values among participating workers, and second, to compare the attenuated exposure levels received by the workers and the British Standards Institute’s recommended noise exposure range of 70 to 80 dBA. Design: We measured hearing protection device (HPD) attenuation among a sample of 91 workers at 2 US metal manufacturing facilities, through performance of personal noise dosimetry measurements and HPD fit-testing over multiple work shifts. We compared this testing with participant questionnaires and annual audiometric hearing threshold results. Results: The average 8-hr time-weighted average noise exposures for study participants was 79.8 dBA (SD = 7.0 dBA), and the average PAR from fit-testing was 20.1 dB (±6.7 dB). While differences existed between sites, 84% of the 251 PAR measurements resulted in effective protection levels below the recommended 70 dBA (indicating overprotection), while workers were underprotected (i.e., effective exposures >80 dBA) during

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Hearing Protector Attenuation and Noise Exposure Among Metal Manufacturing Workers

Objectives: This study utilized personal noise measurements and fit-testing to evaluate the association between noise exposures and personal attenuation rating (PAR) values among participating workers, and second, to compare the attenuated exposure levels received by the workers and the British Standards Institute’s recommended noise exposure range of 70 to 80 dBA. Design: We measured hearing protection device (HPD) attenuation among a sample of 91 workers at 2 US metal manufacturing facilities, through performance of personal noise dosimetry measurements and HPD fit-testing over multiple work shifts. We compared this testing with participant questionnaires and annual audiometric hearing threshold results. Results: The average 8-hr time-weighted average noise exposures for study participants was 79.8 dBA (SD = 7.0 dBA), and the average PAR from fit-testing was 20.1 dB (±6.7 dB). While differences existed between sites, 84% of the 251 PAR measurements resulted in effective protection levels below the recommended 70 dBA (indicating overprotection), while workers were underprotected (i.e., effective exposures >80 dBA) during

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Hearing Loss on the Rise among Oil and Gas Drilling Workers

New data shows that hearing loss is on the rise among oil and gas drilling workers despite their increased use of ear protection.

According to Canada's WorkSafeBC, the workers' hearing test data, collected by their employers, revealed increased incidences of hearing loss, from 33 percent in 2012 to 45 percent in 2017. Notably, 65 percent of the workers diagnosed with noise-induced hearing loss (NIHL; 194 out of 294) were under 35 years old. Adding another level of concern is the finding that the percentage of workers using earplugs has actually increased from 94 to 98 percent.

"In British Columbia, employers are required under the Workers Compensation Act to provide annual hearing tests to their employees who work in hazardous noise (85dBA Lex)," explained Sasha Brown, an occupational audiologist at WorkSafeBC.

"These hearing test results are submitted to WorkSafeBC, and that data, which can be separated by industry or occupation, is continuously analyzed. Attention is paid to hearing test results that show a 15dB notch at 3, 4 or 6 kHz, or a deterioration between tests of 15 dB at 3 or 4 kHz."

WorkSafeBC, an independent statutory agency focused on the prevention of occupational injuries and diseases, receives around 170,000 hearing tests per year, and the percentage of those with hearing loss consistent with NIHL has remained about 13 percent across industries. "The high rate of hearing loss found in the oil and gas industry is much higher, above 30 percent, and for those in oil or gas drilling sector, even higher at 45 percent. This finding is concerning and warranted further investigation," Brown told The Hearing Journal.  

The increased cases of NIHL despite the increased use of hearing protection may be attributed to different reasons, on top of which is the improper use of foam earplugs.

"The earplugs or earmuffs might be the wrong size, inserted or worn incorrectly, not worn for long enough, or they may not be providing enough protection for the duration and intensity of noise exposure," Brown noted.

In their report, WorkSafeBC provides measures for employers to prevent NIHL among their workers, including the monitoring of workers' proper use of sufficient and appropriate hearing protection, encouraging workers to get regular hearing tests, and identifying potential engineering controls to mitigate lessen the risk of noise exposure. "Monitoring one's hearing is also important, and comparing the results from year-to-year to see if there are any changes," said Brown. In addition, she highlights some basic but vital strategies for employers, audiologists, and hearing health professionals, who all play an important role in ensuring the hearing health of workers regularly exposed to noise.

"Educating workers is important. Workers exposed to hazardous noise levels should understand that simply wearing hearing protection might not be enough. The hearing protection must be the right size, and the wearer must be able to fit it properly and wear at all times while in hazardous noise. It must be placed before entering the noisy area, and not removed until leaving the area," stressed Brown. "Obviously, this is also important for noisy hobbies and activities outside work too."

"Workers should be taught what to look for and understand the implications. Unfortunately, hearing tests are the only way to determine if their hearing is being protected. I say 'unfortunately' because this is a lagging indicator and means that some hearing loss has occurred," said Brown. "If audiologists and hearing health professionals can help raise awareness about NIHL and how to prevent it, that alone would contribute to improving the hearing health of oil and gas, and all, workers."

Published: 8/29/2018 1:54:00 PM

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Hearing Loss on the Rise among Oil and Gas Drilling Workers

New data shows that hearing loss is on the rise among oil and gas drilling workers despite their increased use of ear protection.

According to Canada's WorkSafeBC, the workers' hearing test data, collected by their employers, revealed increased incidences of hearing loss, from 33 percent in 2012 to 45 percent in 2017. Notably, 65 percent of the workers diagnosed with noise-induced hearing loss (NIHL; 194 out of 294) were under 35 years old. Adding another level of concern is the finding that the percentage of workers using earplugs has actually increased from 94 to 98 percent.

"In British Columbia, employers are required under the Workers Compensation Act to provide annual hearing tests to their employees who work in hazardous noise (85dBA Lex)," explained Sasha Brown, an occupational audiologist at WorkSafeBC.

"These hearing test results are submitted to WorkSafeBC, and that data, which can be separated by industry or occupation, is continuously analyzed. Attention is paid to hearing test results that show a 15dB notch at 3, 4 or 6 kHz, or a deterioration between tests of 15 dB at 3 or 4 kHz."

WorkSafeBC, an independent statutory agency focused on the prevention of occupational injuries and diseases, receives around 170,000 hearing tests per year, and the percentage of those with hearing loss consistent with NIHL has remained about 13 percent across industries. "The high rate of hearing loss found in the oil and gas industry is much higher, above 30 percent, and for those in oil or gas drilling sector, even higher at 45 percent. This finding is concerning and warranted further investigation," Brown told The Hearing Journal.  

The increased cases of NIHL despite the increased use of hearing protection may be attributed to different reasons, on top of which is the improper use of foam earplugs.

"The earplugs or earmuffs might be the wrong size, inserted or worn incorrectly, not worn for long enough, or they may not be providing enough protection for the duration and intensity of noise exposure," Brown noted.

In their report, WorkSafeBC provides measures for employers to prevent NIHL among their workers, including the monitoring of workers' proper use of sufficient and appropriate hearing protection, encouraging workers to get regular hearing tests, and identifying potential engineering controls to mitigate lessen the risk of noise exposure. "Monitoring one's hearing is also important, and comparing the results from year-to-year to see if there are any changes," said Brown. In addition, she highlights some basic but vital strategies for employers, audiologists, and hearing health professionals, who all play an important role in ensuring the hearing health of workers regularly exposed to noise.

"Educating workers is important. Workers exposed to hazardous noise levels should understand that simply wearing hearing protection might not be enough. The hearing protection must be the right size, and the wearer must be able to fit it properly and wear at all times while in hazardous noise. It must be placed before entering the noisy area, and not removed until leaving the area," stressed Brown. "Obviously, this is also important for noisy hobbies and activities outside work too."

"Workers should be taught what to look for and understand the implications. Unfortunately, hearing tests are the only way to determine if their hearing is being protected. I say 'unfortunately' because this is a lagging indicator and means that some hearing loss has occurred," said Brown. "If audiologists and hearing health professionals can help raise awareness about NIHL and how to prevent it, that alone would contribute to improving the hearing health of oil and gas, and all, workers."

Published: 8/29/2018 1:54:00 PM

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Walking balance on a treadmill changes during pregnancy

Publication date: Available online 28 August 2018

Source: Gait & Posture

Author(s): Daniel Flores, Christopher P. Connolly, Nigel Campbell, Robert D. Catena

Abstract

Background

Altered standing balance during pregnancy has been previously reported. To date, body center of mass (bCOM) motion has not been used to track balance changes in this population. We recently compared three methods to determine the torso center of mass (tCOM) location (via force plate acquired center of pressure calculation, using Pavol surface anthropometry measurements, and a combination of the two) to use in calculating the bCOM during pregnancy.

Research question

This current research explored two questions: (1) does walking balance change during pregnancy, and (2) do the methods for identifying tCOM location affect the resulting balance measures?

Methods

Fifteen pregnant women were recruited to perform 60-second trial of treadmill walking at 4-week intervals from 12 weeks gestation until delivery. Walking balance was measured as bCOM motion within the base of support. Gestation time and anthropometric model (force plate, Pavol, and combination) were repeated-measures independent variables in a general linear mixed model analysis.

Results

There was a significant decrease in walking balance during pregnancy. As gestation progressed, we observed non-linear changes in the bCOM motion within the base of support over time, with some changes starting early in pregnancy and others not starting until late 2^nd trimester. The anthropometric model used to locate the bCOM significantly influences balance measures. The results of this study indicate that the force plate method is more appropriate for locating the tCOM in the anterior and lateral directions.

Significance

The results of this study will inform clinicians and patients about the gestational stage-associated changes in balance during pregnancy that increase the risk of falling and injury. Researchers should also carefully consider the method for locating the bCOM.

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Effects of kinesiotaping and athletic taping on ankle kinematics during walking in individuals with chronic ankle instability: A pilot study

Publication date: Available online 28 August 2018

Source: Gait & Posture

Author(s): Sheng-Che Yen, Eric Folmar, Katherine Ann Friend, Ying-Chih Wang, Kevin K. Chui

Abstract

Background

Individuals with chronic ankle instability (CAI) tend to walk with an overly inverted foot, which increases the risk of ankle sprains during stance phase. Clinicians could perform ankle taping using kinesiotape (KT) or athletic tape (AT) to address this issue. Because KT is elastic while AT is not, the techniques and underlying mechanisms for applying these tapes are different, which may lead to different outcomes.

Research Question

To compare the effects of KT and AT interventions on foot motion in the frontal plane and tibial motion in the transverse plane during stance phase of walking.

Methods

Twenty subjects with CAI were assigned to either KT or AT group, and walked on a treadmill in no tape and taped conditions. Their foot and tibial motions were captured by 3D motion analysis system. The main component of KT application was two pieces of tape applied from the medial aspect of the hindfoot to the lateral to generate a pulling tension towards eversion. AT was applied to the ankle using the closed basket weave approach. AT was not stretchable and not able to generate the same pulling tension as KT.

Results

KT increased foot eversion during early stance, but showed no effect during late stance. AT increased tibial internal rotation during late stance, but showed no effect during early stance.

Significance

Compared to AT, KT better provides a flexible pulling force that facilitates foot eversion during early stance, while not restricting normal inversion in late stance during walking. KT may be a useful clinical tool in correcting aberrant motion while not limiting natural movement in sports.

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Posture of the foot: Don’t keep it out of sight, out of mind in knee osteoarthritis

Publication date: Available online 28 August 2018

Source: Gait & Posture

Author(s): Zainb Al-Bayati, Ilke Coskun Benlidayi, Neslihan Gokcen

ABSTRACT

Background

There are many contributors of knee osteoarthritis including the postural abnormalities of the adjacent joints. The relationship between foot posture and the clinical-radiological parameters of knee osteoarthritis is poorly understood.

Research question

Is foot posture related to the clinical and radiological parameters in patients with knee osteoarthritis?

Methods

Patients diagnosed with primary clinical and radiographic medial tibiofemoral knee osteoarthritis were included in the study. Anteroposterior knee radiographs were staged by using the Kellgren-Lawrence grading system. Computer-based measurements of the medial joint space width (mJSW), condylar angle, anatomical axis angle, tibial plateau angle and condylar plateau angle were performed on digital anteroposterior knee radiographs. The Western Ontario and Mc Master University Osteoarthritis Index (WOMAC) questionnaire was used to assess pain and the functional status of the patients. Foot posture was assessed by the Foot Posture Index (FPI) system and feet were categorized into three (pronated, neutral and supinated).

Results

The study included 150 patients (150 knees and feet at one side) with a mean age of 61.2 ± 10.1 years. In terms of foot posture groups; percentages for supination, neutral and pronation were 22.66%, 68.66% and 8.66%, respectively. In the group with supinated FPI; WOMAC total score, pain and function subscale scores were higher (p < 0.001), mJSW was narrowed (p = 0.038) and the condylar plateau angle was increased (p = 0.009). In the FPI pronation group; anatomic axis angle values were found to change in the varus direction (p = 0.012).

Significance

The potential postural dysfunction of the foot should be taken into consideration during the assessment and/or management of a patient with knee osteoarthritis.

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How do children with bilateral spastic cerebral palsy manage walking on inclines?

Publication date: Available online 28 August 2018

Source: Gait & Posture

Author(s): Miray-Su Yilmaz Topcuoglu, Britta K. Krautwurst, Matthias Klotz, Thomas Dreher, Sebastian I. Wolf

Abstract

Background

Walking on inclined surfaces is an everyday task, which challenges stability and propulsion even in healthy adults. Children with cerebral palsy adapt similarly to inclines as healthy children. However, how stability and propulsion in these subjects are influenced by different inclines remained unaddressed as of yet.

Research question

Aim was to examine the feeling of safety, stability and propulsion in children with cerebral palsy on inclines to gain insight into the challenges they might face in these conditions.

Methods

Eighteen children with bilateral spastic cerebral palsy with gross motor function classification scale-level I and II and nineteen healthy children underwent instrumented 3D gait analysis on level ground and on 5° and 10° slopes. A mixed linear model was used to draw between and within group comparisons.

Results

Reduced lateral trunk sway, a relative lengthening of the lower limb at initial contact and a controlled walking speed were employed during downhill gait compared to level walking. Patients showed an increased ROM of trunk (3-4°) and pelvis (2°) and decreased sagittal knee ROM (13°) compared to the typical developed children. During uphill gait, an insufficient increase of push-off power at the ankle (0.48 W/kg) was noted, which appeared to lead to particularly shorter strides (about 0.1 m) in patients compared to healthy children (1.32 W/kg). The sagittal ROM of trunk (3-4°) and pelvis (2-3°) are increased compared to typical developed children.

Significance

Depending on inclination angle, children with cerebral palsy manage to in a controlled manner. The steeper the incline, the more the gait appeared to be affected: Decreased feeling of safety, increased need for stabilising mechanisms for downhill gait and less sufficient uphill propulsion were seen. Helping these patients to attain better control during downhill gait and strengthening uphill gait mechanisms may support their participation in everyday life.

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Walking balance on a treadmill changes during pregnancy

Publication date: Available online 28 August 2018

Source: Gait & Posture

Author(s): Daniel Flores, Christopher P. Connolly, Nigel Campbell, Robert D. Catena

Abstract

Background

Altered standing balance during pregnancy has been previously reported. To date, body center of mass (bCOM) motion has not been used to track balance changes in this population. We recently compared three methods to determine the torso center of mass (tCOM) location (via force plate acquired center of pressure calculation, using Pavol surface anthropometry measurements, and a combination of the two) to use in calculating the bCOM during pregnancy.

Research question

This current research explored two questions: (1) does walking balance change during pregnancy, and (2) do the methods for identifying tCOM location affect the resulting balance measures?

Methods

Fifteen pregnant women were recruited to perform 60-second trial of treadmill walking at 4-week intervals from 12 weeks gestation until delivery. Walking balance was measured as bCOM motion within the base of support. Gestation time and anthropometric model (force plate, Pavol, and combination) were repeated-measures independent variables in a general linear mixed model analysis.

Results

There was a significant decrease in walking balance during pregnancy. As gestation progressed, we observed non-linear changes in the bCOM motion within the base of support over time, with some changes starting early in pregnancy and others not starting until late 2^nd trimester. The anthropometric model used to locate the bCOM significantly influences balance measures. The results of this study indicate that the force plate method is more appropriate for locating the tCOM in the anterior and lateral directions.

Significance

The results of this study will inform clinicians and patients about the gestational stage-associated changes in balance during pregnancy that increase the risk of falling and injury. Researchers should also carefully consider the method for locating the bCOM.

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Effects of kinesiotaping and athletic taping on ankle kinematics during walking in individuals with chronic ankle instability: A pilot study

Publication date: Available online 28 August 2018

Source: Gait & Posture

Author(s): Sheng-Che Yen, Eric Folmar, Katherine Ann Friend, Ying-Chih Wang, Kevin K. Chui

Abstract

Background

Individuals with chronic ankle instability (CAI) tend to walk with an overly inverted foot, which increases the risk of ankle sprains during stance phase. Clinicians could perform ankle taping using kinesiotape (KT) or athletic tape (AT) to address this issue. Because KT is elastic while AT is not, the techniques and underlying mechanisms for applying these tapes are different, which may lead to different outcomes.

Research Question

To compare the effects of KT and AT interventions on foot motion in the frontal plane and tibial motion in the transverse plane during stance phase of walking.

Methods

Twenty subjects with CAI were assigned to either KT or AT group, and walked on a treadmill in no tape and taped conditions. Their foot and tibial motions were captured by 3D motion analysis system. The main component of KT application was two pieces of tape applied from the medial aspect of the hindfoot to the lateral to generate a pulling tension towards eversion. AT was applied to the ankle using the closed basket weave approach. AT was not stretchable and not able to generate the same pulling tension as KT.

Results

KT increased foot eversion during early stance, but showed no effect during late stance. AT increased tibial internal rotation during late stance, but showed no effect during early stance.

Significance

Compared to AT, KT better provides a flexible pulling force that facilitates foot eversion during early stance, while not restricting normal inversion in late stance during walking. KT may be a useful clinical tool in correcting aberrant motion while not limiting natural movement in sports.

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Posture of the foot: Don’t keep it out of sight, out of mind in knee osteoarthritis

Publication date: Available online 28 August 2018

Source: Gait & Posture

Author(s): Zainb Al-Bayati, Ilke Coskun Benlidayi, Neslihan Gokcen

ABSTRACT

Background

There are many contributors of knee osteoarthritis including the postural abnormalities of the adjacent joints. The relationship between foot posture and the clinical-radiological parameters of knee osteoarthritis is poorly understood.

Research question

Is foot posture related to the clinical and radiological parameters in patients with knee osteoarthritis?

Methods

Patients diagnosed with primary clinical and radiographic medial tibiofemoral knee osteoarthritis were included in the study. Anteroposterior knee radiographs were staged by using the Kellgren-Lawrence grading system. Computer-based measurements of the medial joint space width (mJSW), condylar angle, anatomical axis angle, tibial plateau angle and condylar plateau angle were performed on digital anteroposterior knee radiographs. The Western Ontario and Mc Master University Osteoarthritis Index (WOMAC) questionnaire was used to assess pain and the functional status of the patients. Foot posture was assessed by the Foot Posture Index (FPI) system and feet were categorized into three (pronated, neutral and supinated).

Results

The study included 150 patients (150 knees and feet at one side) with a mean age of 61.2 ± 10.1 years. In terms of foot posture groups; percentages for supination, neutral and pronation were 22.66%, 68.66% and 8.66%, respectively. In the group with supinated FPI; WOMAC total score, pain and function subscale scores were higher (p < 0.001), mJSW was narrowed (p = 0.038) and the condylar plateau angle was increased (p = 0.009). In the FPI pronation group; anatomic axis angle values were found to change in the varus direction (p = 0.012).

Significance

The potential postural dysfunction of the foot should be taken into consideration during the assessment and/or management of a patient with knee osteoarthritis.

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How do children with bilateral spastic cerebral palsy manage walking on inclines?

Publication date: Available online 28 August 2018

Source: Gait & Posture

Author(s): Miray-Su Yilmaz Topcuoglu, Britta K. Krautwurst, Matthias Klotz, Thomas Dreher, Sebastian I. Wolf

Abstract

Background

Walking on inclined surfaces is an everyday task, which challenges stability and propulsion even in healthy adults. Children with cerebral palsy adapt similarly to inclines as healthy children. However, how stability and propulsion in these subjects are influenced by different inclines remained unaddressed as of yet.

Research question

Aim was to examine the feeling of safety, stability and propulsion in children with cerebral palsy on inclines to gain insight into the challenges they might face in these conditions.

Methods

Eighteen children with bilateral spastic cerebral palsy with gross motor function classification scale-level I and II and nineteen healthy children underwent instrumented 3D gait analysis on level ground and on 5° and 10° slopes. A mixed linear model was used to draw between and within group comparisons.

Results

Reduced lateral trunk sway, a relative lengthening of the lower limb at initial contact and a controlled walking speed were employed during downhill gait compared to level walking. Patients showed an increased ROM of trunk (3-4°) and pelvis (2°) and decreased sagittal knee ROM (13°) compared to the typical developed children. During uphill gait, an insufficient increase of push-off power at the ankle (0.48 W/kg) was noted, which appeared to lead to particularly shorter strides (about 0.1 m) in patients compared to healthy children (1.32 W/kg). The sagittal ROM of trunk (3-4°) and pelvis (2-3°) are increased compared to typical developed children.

Significance

Depending on inclination angle, children with cerebral palsy manage to in a controlled manner. The steeper the incline, the more the gait appeared to be affected: Decreased feeling of safety, increased need for stabilising mechanisms for downhill gait and less sufficient uphill propulsion were seen. Helping these patients to attain better control during downhill gait and strengthening uphill gait mechanisms may support their participation in everyday life.

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Negative Association of Hepatitis B Virus With Hearing Impairment

Purpose

Hearing impairment is one of the most common chronic diseases causing deterioration of the quality of life in elderly individuals. Several viral infections have been suggested to cause hearing impairment. We investigated association of hepatitis B virus (HBV) infection with hearing impairment using a representative sample of the Korean population.

Method

Participants included 6,583 men and 8,702 women, who were ≥ 20 years of age from the Korea National Health and Nutritional Examination Surveys of the Korean population (2010–2012). Air-conduction pure-tone thresholds were measured in a soundproof booth using an automatic audiometer for each ear at 6 frequencies (500, 1000, 2000, 3000, 4000, and 6000 Hz). An audiometric test and a laboratory examination, including an HBV surface antigen (HBsAg) test, were performed.

Results

Subjects who are HBsAg positive had lower average of pure-tone thresholds and lower prevalence of hearing impairment at both low/mid and high frequency compared with those without. Adjusted means of hearing thresholds were also lower among subjects who are HBsAg positive compared with subjects who are HBsAg negative. After the adjustment for age and gender, the odds of high-frequency mild hearing impairment were lower for subjects with HBV infection. In the multiple logistic regression analyses adjusting for confounding variables, the significant negative association between HBV infection and high-frequency mild hearing impairment still remained.

Conclusions

Contrary to previous reports, subjects who are HBsAg positive had a lower prevalence of hearing impairment compared with subjects who are HBsAg negative. Further studies are warranted to investigate the underlying mechanism regarding their negative relationship.

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Negative Association of Hepatitis B Virus With Hearing Impairment

Purpose

Hearing impairment is one of the most common chronic diseases causing deterioration of the quality of life in elderly individuals. Several viral infections have been suggested to cause hearing impairment. We investigated association of hepatitis B virus (HBV) infection with hearing impairment using a representative sample of the Korean population.

Method

Participants included 6,583 men and 8,702 women, who were ≥ 20 years of age from the Korea National Health and Nutritional Examination Surveys of the Korean population (2010–2012). Air-conduction pure-tone thresholds were measured in a soundproof booth using an automatic audiometer for each ear at 6 frequencies (500, 1000, 2000, 3000, 4000, and 6000 Hz). An audiometric test and a laboratory examination, including an HBV surface antigen (HBsAg) test, were performed.

Results

Subjects who are HBsAg positive had lower average of pure-tone thresholds and lower prevalence of hearing impairment at both low/mid and high frequency compared with those without. Adjusted means of hearing thresholds were also lower among subjects who are HBsAg positive compared with subjects who are HBsAg negative. After the adjustment for age and gender, the odds of high-frequency mild hearing impairment were lower for subjects with HBV infection. In the multiple logistic regression analyses adjusting for confounding variables, the significant negative association between HBV infection and high-frequency mild hearing impairment still remained.

Conclusions

Contrary to previous reports, subjects who are HBsAg positive had a lower prevalence of hearing impairment compared with subjects who are HBsAg negative. Further studies are warranted to investigate the underlying mechanism regarding their negative relationship.

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An Application of Network Science to Phonological Sequence Learning in Children With Developmental Language Disorder

Purpose

Network science has been a valuable tool in language research for investigating relationships between complex linguistic elements but has not yet been applied to sound sequencing in production. In the present work, we used standard error-based accuracy and articulatory kinematic approaches as well as novel measures from network science to evaluate variability and sequencing errors in speech production in children with developmental language disorder (DLD; aka specific language impairment).

Method

Twelve preschoolers with DLD and 12 age-matched controls participated in a 3-day novel word learning study. Transcription and articulatory movement data were collected to measure accuracy and variability of productions, and networks of speech productions were generated to analyze syllable co-occurrence patterns.

Results

Results indicated that children with DLD were less accurate than children with typical language at the segmental level. Crucially, these findings did not align with performance at the articulatory level, where there were no differences in movement variability between children with DLD and those with typical language. Network analyses revealed characteristics that were not captured by standard measures of phonetic accuracy, including a larger inventory of syllable forms, more connections between the forms, and less consistent production patterns.

Conclusions

Network science provides significant insights into phonological learning trajectories in children with DLD and their typically developing peers. Importantly, errors in word production by children with DLD do not surface as a result of weakness in articulatory control. Instead, results suggest that speech errors in DLD may relate to deficits in sound sequencing.

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Perceived Voice Quality and Voice-Related Problems Among Older Adults With Hearing Impairments

The auditory system helps regulate phonation. A speaker's perception of their own voice is likely to be of both emotional and functional significance. Although many investigations have observed deviating voice qualities in individuals who are prelingually deaf or profoundly hearing impaired, less is known regarding how older adults with acquired hearing impairments perceive their own voice and potential voice problems.

Purpose

The purpose of this study was to investigate problems relating to phonation and self-perceived voice sound quality in older adults based on hearing ability and the use of hearing aids.

Method

This was a cross-sectional study, with 290 participants divided into 3 groups (matched by age and gender): (a) individuals with hearing impairments who did not use hearing aids (n = 110), (b) individuals with hearing impairments who did use hearing aids (n = 110), and (c) individuals with no hearing impairments (n = 70). All participants underwent a pure-tone audiometry exam; completed standardized questionnaires regarding their hearing, voice, and general health; and were recorded speaking in a soundproof room.

Results

The hearing aid users surpassed the benchmarks for having a voice disorder on the Voice Handicap Index (VHI; Jacobson et al., 1997) at almost double the rate predicted by the Swedish normative values for their age range, although there was no significant difference in acoustical measures between any of the groups. Both groups with hearing impairments scored significantly higher on the VHI than the control group, indicating more impairment. It remains inconclusive how much hearing loss versus hearing aids separately contribute to the difference in voice problems. The total scores on the Hearing Handicap Inventory for the Elderly (Ventry & Weinstein, 1982), in combination with the variables gender and age, explained 21.9% of the variance on the VHI. Perceiving one's own voice as being distorted, dull, or hollow had a strong negative association with a general satisfaction about the sound quality of one's own voice. In addition, groupwise differences in own-voice descriptions suggest that a negative perception of one's voice could be influenced by alterations caused by hearing aid processing.

Conclusions

The results indicate that hearing impairments and hearing aids affect several aspects of vocal satisfaction in older adults. A greater understanding of how hearing impairments and hearing aids relate to voice problems may contribute to better voice and hearing care.

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Pure-Tone Frequency Discrimination in Preschoolers, Young School-Age Children, and Adults

Purpose

Published data indicate nearly adultlike frequency discrimination in infants but large child–adult differences for school-age children. This study evaluated the role that differences in measurement procedures and stimuli may have played in the apparent nonmonotonicity. Frequency discrimination was assessed in preschoolers, young school-age children, and adults using stimuli and procedures that have previously been used to test infants.

Method

Listeners were preschoolers (3–4 years), young school-age children (5–6 years), and adults (19–38 years). Performance was assessed using a single-interval, observer-based method and a continuous train of stimuli, similar to that previously used to evaluate infants. Testing was completed using 500- and 5000-Hz standard tones, fixed within a set of trials. Thresholds for frequency discrimination were obtained using an adaptive, two-down one-up procedure. Adults and most school-age children responded by raising their hands. An observer-based, conditioned-play response was used to test preschoolers and those school-age children for whom the hand-raise procedure was not effective for conditioning.

Results

Results suggest an effect of age and frequency on thresholds but no interaction between these 2 factors. A lower proportion of preschoolers completed training compared with young school-age children. For those children who completed training, however, thresholds did not improve significantly with age; both groups of children performed more poorly than adults. Performance was better for the 500-Hz standard frequency compared with the 5000-Hz standard frequency.

Conclusions

Thresholds for school-age children were broadly similar to those previously observed using a forced-choice procedure. Although there was a trend for improved performance with increasing age, no significant age effect was observed between preschoolers and school-age children. The practice of excluding participants based on failure to meet conditioning criteria in an observer-based task could contribute to the relatively good performance observed for preschoolers in this study and the adultlike performance previously observed in infants.

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A Simple Method to Obtain Basic Acoustic Measures From Video Recordings as Subtitles

Purpose

Sound pressure level (SPL) and fundamental frequency (f^o) are very basic and important measures in the acoustical assessment of voice quality, and their variation influences also the vocal fold vibration characteristics. Most sophisticated laryngeal videostroboscopic systems therefore also measure and display the SPL and f^o values directly over the video frames by means of a rather expensive special hardware setup. An alternative simple software-based method is presented here to obtain these measures as video subtitles.

Method

The software extracts acoustic data from the video recording, calculates the SPL and f^o parameters, and saves their values in a separate subtitle file. To ensure the correct SPL values, the microphone signal is calibrated beforehand with a sound level meter.

Results

The new approach was tested on videokymographic recordings obtained laryngoscopically. The results of SPL and f^o values calculated from the videokymographic recording, subtitles creation, and their display are presented.

Conclusions

This method is useful in integrating the acoustic measures with any kind of video recordings containing audio data when inbuilt hardware means are not available. However, calibration and other technical aspects related to data acquisition and synchronization described in this article should be properly taken care of during the recording.

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An Application of Network Science to Phonological Sequence Learning in Children With Developmental Language Disorder

Purpose

Network science has been a valuable tool in language research for investigating relationships between complex linguistic elements but has not yet been applied to sound sequencing in production. In the present work, we used standard error-based accuracy and articulatory kinematic approaches as well as novel measures from network science to evaluate variability and sequencing errors in speech production in children with developmental language disorder (DLD; aka specific language impairment).

Method

Twelve preschoolers with DLD and 12 age-matched controls participated in a 3-day novel word learning study. Transcription and articulatory movement data were collected to measure accuracy and variability of productions, and networks of speech productions were generated to analyze syllable co-occurrence patterns.

Results

Results indicated that children with DLD were less accurate than children with typical language at the segmental level. Crucially, these findings did not align with performance at the articulatory level, where there were no differences in movement variability between children with DLD and those with typical language. Network analyses revealed characteristics that were not captured by standard measures of phonetic accuracy, including a larger inventory of syllable forms, more connections between the forms, and less consistent production patterns.

Conclusions

Network science provides significant insights into phonological learning trajectories in children with DLD and their typically developing peers. Importantly, errors in word production by children with DLD do not surface as a result of weakness in articulatory control. Instead, results suggest that speech errors in DLD may relate to deficits in sound sequencing.

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Perceived Voice Quality and Voice-Related Problems Among Older Adults With Hearing Impairments

The auditory system helps regulate phonation. A speaker's perception of their own voice is likely to be of both emotional and functional significance. Although many investigations have observed deviating voice qualities in individuals who are prelingually deaf or profoundly hearing impaired, less is known regarding how older adults with acquired hearing impairments perceive their own voice and potential voice problems.

Purpose

The purpose of this study was to investigate problems relating to phonation and self-perceived voice sound quality in older adults based on hearing ability and the use of hearing aids.

Method

This was a cross-sectional study, with 290 participants divided into 3 groups (matched by age and gender): (a) individuals with hearing impairments who did not use hearing aids (n = 110), (b) individuals with hearing impairments who did use hearing aids (n = 110), and (c) individuals with no hearing impairments (n = 70). All participants underwent a pure-tone audiometry exam; completed standardized questionnaires regarding their hearing, voice, and general health; and were recorded speaking in a soundproof room.

Results

The hearing aid users surpassed the benchmarks for having a voice disorder on the Voice Handicap Index (VHI; Jacobson et al., 1997) at almost double the rate predicted by the Swedish normative values for their age range, although there was no significant difference in acoustical measures between any of the groups. Both groups with hearing impairments scored significantly higher on the VHI than the control group, indicating more impairment. It remains inconclusive how much hearing loss versus hearing aids separately contribute to the difference in voice problems. The total scores on the Hearing Handicap Inventory for the Elderly (Ventry & Weinstein, 1982), in combination with the variables gender and age, explained 21.9% of the variance on the VHI. Perceiving one's own voice as being distorted, dull, or hollow had a strong negative association with a general satisfaction about the sound quality of one's own voice. In addition, groupwise differences in own-voice descriptions suggest that a negative perception of one's voice could be influenced by alterations caused by hearing aid processing.

Conclusions

The results indicate that hearing impairments and hearing aids affect several aspects of vocal satisfaction in older adults. A greater understanding of how hearing impairments and hearing aids relate to voice problems may contribute to better voice and hearing care.

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Pure-Tone Frequency Discrimination in Preschoolers, Young School-Age Children, and Adults

Purpose

Published data indicate nearly adultlike frequency discrimination in infants but large child–adult differences for school-age children. This study evaluated the role that differences in measurement procedures and stimuli may have played in the apparent nonmonotonicity. Frequency discrimination was assessed in preschoolers, young school-age children, and adults using stimuli and procedures that have previously been used to test infants.

Method

Listeners were preschoolers (3–4 years), young school-age children (5–6 years), and adults (19–38 years). Performance was assessed using a single-interval, observer-based method and a continuous train of stimuli, similar to that previously used to evaluate infants. Testing was completed using 500- and 5000-Hz standard tones, fixed within a set of trials. Thresholds for frequency discrimination were obtained using an adaptive, two-down one-up procedure. Adults and most school-age children responded by raising their hands. An observer-based, conditioned-play response was used to test preschoolers and those school-age children for whom the hand-raise procedure was not effective for conditioning.

Results

Results suggest an effect of age and frequency on thresholds but no interaction between these 2 factors. A lower proportion of preschoolers completed training compared with young school-age children. For those children who completed training, however, thresholds did not improve significantly with age; both groups of children performed more poorly than adults. Performance was better for the 500-Hz standard frequency compared with the 5000-Hz standard frequency.

Conclusions

Thresholds for school-age children were broadly similar to those previously observed using a forced-choice procedure. Although there was a trend for improved performance with increasing age, no significant age effect was observed between preschoolers and school-age children. The practice of excluding participants based on failure to meet conditioning criteria in an observer-based task could contribute to the relatively good performance observed for preschoolers in this study and the adultlike performance previously observed in infants.

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A Simple Method to Obtain Basic Acoustic Measures From Video Recordings as Subtitles

Purpose

Sound pressure level (SPL) and fundamental frequency (f^o) are very basic and important measures in the acoustical assessment of voice quality, and their variation influences also the vocal fold vibration characteristics. Most sophisticated laryngeal videostroboscopic systems therefore also measure and display the SPL and f^o values directly over the video frames by means of a rather expensive special hardware setup. An alternative simple software-based method is presented here to obtain these measures as video subtitles.

Method

The software extracts acoustic data from the video recording, calculates the SPL and f^o parameters, and saves their values in a separate subtitle file. To ensure the correct SPL values, the microphone signal is calibrated beforehand with a sound level meter.

Results

The new approach was tested on videokymographic recordings obtained laryngoscopically. The results of SPL and f^o values calculated from the videokymographic recording, subtitles creation, and their display are presented.

Conclusions

This method is useful in integrating the acoustic measures with any kind of video recordings containing audio data when inbuilt hardware means are not available. However, calibration and other technical aspects related to data acquisition and synchronization described in this article should be properly taken care of during the recording.

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Development and validation of a method to record electrophysiological responses in direct acoustic cochlear implant subjects

Publication date: Available online 28 August 2018

Source: Hearing Research

Author(s): Hanne Deprez, Robin Gransier, Michael Hofmann, Jan Wouters, Nicolas Verhaert

Abstract

Acoustic hearing implants, such as direct acoustic cochlear implants (DACIs), can be used to treat profound mixed hearing loss. Electrophysiological responses in DACI subjects are of interest to confirm auditory processing intra-operatively, and to assist DACI fitting post-operatively. We present two related studies, focusing on DACI artifacts and electrophysiological measurements in DACI subjects, respectively. In the first study we aimed to characterize DACI artifacts, to study the feasibility of measuring frequency-specific electrophysiological responses in DACI subjects. Measurements of DACI artifacts were collected in a cadaveric head to disentangle possible DACI artifact sources and compared to a constructed DACI artifact template. It is shown that for moderate stimulation levels, DACI artifacts are mainly dominated by the artifact from the radio frequency (RF) communication signal, that can be modeled if the RF encoding protocol is known. In a second study, the feasibility of measuring intra-operative responses, without applying the RF artifact models, in DACI subjects is investigated. Auditory steady-state and brainstem responses were measured intra-operatively in three DACI subjects, immediately after implantation, to confirm proper DACI functioning and coupling to the inner ear. Intra-operative responses could be measured in two of the three tested subjects. Absence of intra-operative responses in the third subject can possibly be explained by the hearing loss, attenuation of intra-operative responses, the difference between electrophysiological and behavioral threshold, and a temporary threshold shift due to the DACI surgery. In conclusion, RF artifacts can be modeled, such that electrophysiological responses to frequency-specific stimuli could possibly be measured in DACI subjects, and intra-operative responses in DACI subjects can be obtained.

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Development and validation of a method to record electrophysiological responses in direct acoustic cochlear implant subjects

Publication date: Available online 28 August 2018

Source: Hearing Research

Author(s): Hanne Deprez, Robin Gransier, Michael Hofmann, Jan Wouters, Nicolas Verhaert

Abstract

Acoustic hearing implants, such as direct acoustic cochlear implants (DACIs), can be used to treat profound mixed hearing loss. Electrophysiological responses in DACI subjects are of interest to confirm auditory processing intra-operatively, and to assist DACI fitting post-operatively. We present two related studies, focusing on DACI artifacts and electrophysiological measurements in DACI subjects, respectively. In the first study we aimed to characterize DACI artifacts, to study the feasibility of measuring frequency-specific electrophysiological responses in DACI subjects. Measurements of DACI artifacts were collected in a cadaveric head to disentangle possible DACI artifact sources and compared to a constructed DACI artifact template. It is shown that for moderate stimulation levels, DACI artifacts are mainly dominated by the artifact from the radio frequency (RF) communication signal, that can be modeled if the RF encoding protocol is known. In a second study, the feasibility of measuring intra-operative responses, without applying the RF artifact models, in DACI subjects is investigated. Auditory steady-state and brainstem responses were measured intra-operatively in three DACI subjects, immediately after implantation, to confirm proper DACI functioning and coupling to the inner ear. Intra-operative responses could be measured in two of the three tested subjects. Absence of intra-operative responses in the third subject can possibly be explained by the hearing loss, attenuation of intra-operative responses, the difference between electrophysiological and behavioral threshold, and a temporary threshold shift due to the DACI surgery. In conclusion, RF artifacts can be modeled, such that electrophysiological responses to frequency-specific stimuli could possibly be measured in DACI subjects, and intra-operative responses in DACI subjects can be obtained.

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Effects of physical exhaustion on local dynamic stability and automaticity of walking

Publication date: Available online 27 August 2018

Source: Gait & Posture

Author(s): Daniel Hamacher, Dennis Hamacher, Michèle Hohnbaum, Karsten Gerth, Lutz Schega, Astrid Zech

Abstract

Background

While the effects of diseases, performance of proprioceptors, anxiety or pain on gait stability or automaticity of walking are well-explored, physical fatigue might be another relevant factor whose consequences are not sufficiently investigated, yet.

Research question

The aim of the current study was to evaluate the effect of physical exhaustion on local dynamic stability (LDS) and automaticity of gait.

Methods

In a randomized controlled trial, 30 young and healthy adults were randomly assigned to either a passive control group or a fatigue group. The participants assigned to the fatigue group passed a shuttle-run test which finished at maximal exhaustion while those of the control group rested in sitting position for 15 minutes. Immediately before and after the intervention, local dynamic gait stability as well as the cognitive (serial seven subtractions) and motor dual-task costs, as a measure of automaticity, were registered.

Results

While there was no effect of fatigue on LDS during single-task walking, we observed an interaction effect for LDS in the dual-task condition (p = .034) and for the motor dual-task costs (p = .031). Lower dual-task costs were found in the fatigued group in the post-test compared to the pre-test while the control group increased their costs at the same time.

Significance

In conclusion, gait automaticity might increase after total exhaustion in young adults. Still, the underlying mechanisms are not completely resolved and further research incorporating measurements of cortical gait control might be promising.

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Effects of physical exhaustion on local dynamic stability and automaticity of walking

Publication date: Available online 27 August 2018

Source: Gait & Posture

Author(s): Daniel Hamacher, Dennis Hamacher, Michèle Hohnbaum, Karsten Gerth, Lutz Schega, Astrid Zech

Abstract

Background

While the effects of diseases, performance of proprioceptors, anxiety or pain on gait stability or automaticity of walking are well-explored, physical fatigue might be another relevant factor whose consequences are not sufficiently investigated, yet.

Research question

The aim of the current study was to evaluate the effect of physical exhaustion on local dynamic stability (LDS) and automaticity of gait.

Methods

In a randomized controlled trial, 30 young and healthy adults were randomly assigned to either a passive control group or a fatigue group. The participants assigned to the fatigue group passed a shuttle-run test which finished at maximal exhaustion while those of the control group rested in sitting position for 15 minutes. Immediately before and after the intervention, local dynamic gait stability as well as the cognitive (serial seven subtractions) and motor dual-task costs, as a measure of automaticity, were registered.

Results

While there was no effect of fatigue on LDS during single-task walking, we observed an interaction effect for LDS in the dual-task condition (p = .034) and for the motor dual-task costs (p = .031). Lower dual-task costs were found in the fatigued group in the post-test compared to the pre-test while the control group increased their costs at the same time.

Significance

In conclusion, gait automaticity might increase after total exhaustion in young adults. Still, the underlying mechanisms are not completely resolved and further research incorporating measurements of cortical gait control might be promising.

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Phonak Virto B-Titanium Wins International Awards for 2018’s Best New Product

Phonak Virto B-Titanium won of two renowned international awards: the 2018 Red Dot Award for Product Design, and a Gold Stevie® Award for Best New Product or Service of the Year in the health and pharmaceutical industry. , the tiny hearing device is made by Phonak, the world's leading provider of hearing aids.

Virto B-Titanium devices are custom 3D-printed and almost invisible when worn. Wearers get the benefits of a medical-grade titanium hearing aid. The device is powered by Phonak's latest technology featuring AutoSense OS™ that gives wearers a fully-automatic and seamless hearing experience in different hearing situations.

One of these wearers is William Goode, Senior Advancement Officer for Athletics at Ferris State University in Michigan. Will had dealt with hearing loss in one ear for most of his life, yet never sought treatment. As a first-time hearing aid wearer, Will wanted something ultra-discreet yet durable enough to keep up with his active lifestyle.

"My new titanium hearing aid has been a blessing," said Goode. "At work I'm able to pick up on key conversations and information that allows me to develop, incorporate, and execute plans. Before, it was difficult to hear ideas, take suggestions, and process information quickly. Outside of work in restaurants the Virto B-Titanium has helped me focus on the people at the table and not background noise. It has changed the way I go about everyday life, giving me confidence at work, outside of work, and at home."

The Virto B-Titanium is the smallest and most discreet custom hearing aid Phonak has ever produced. Compared to traditional acrylic, titanium shells are half as thin yet 15 times stronger. Thinner shells result in smaller devices. This means the hearing aid can be placed even deeper in the canal, resulting in a more discreet fit that delivers natural sound quality. Virto B-Titanium has also received an IP68 rating for resistance to both water and dust.

"Phonak is extremely proud of the amount of success and praise Virto B-Titanium has received, most recently with these two prestigious product awards," said Thomas Lang, Senior Vice President of Phonak. But there's an even greater sense of pride when we hear the many stories about what the hearing aid is doing for people. And that can be summed up in three words: "it changes lives."

Virto B-Titanium will be honored at the International Business Awards gala on October 20, 2018 in London. It previously took honors for product excellence along with two other Phonak products at the Red Dot Awards gala on July 9 in Essen, Germany. The other two international Red Dot Awards winners included Phonak Audéo B-Direct, a revolutionary hearing aid using Bluetooth.​

Published: 8/27/2018 2:16:00 PM

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New Hotline Launched for Parents & Caregivers of Children with Hearing Loss

​As part of its Cradle to Career initiative, the Alexander Graham Bell Association for the Deaf and Hard of Hearing (AG Bell) launched Listen-Learn-Link, its international new parent hotline for parents, caregivers and guardians of children with hearing loss. The hotline is the first-ever confidential, bilingual (English/Spanish) hotline for parents, caregivers and guardians of newly identified children with hearing loss worldwide who possess any degree of unilateral or bilateral hearing loss. The hotline connects parents via telephone, email and video conference to the organization's Early Intervention Parent Consultant eager to answer parents' questions, provide hearing loss resources, information, support and next steps related to early hearing detection and intervention (EHDI) and communication options for those with hearing loss.

"Having access to another parent who has traveled a similar road can be a lifesaver for new parents of a child with hearing loss. AG Bell is launching its new hotline so new parents, caregivers and guardians can have easy access to a parent who has had similar experiences and who also understands the systems and services that they will soon access for their own child and family," said Gayla Guignard, AG Bell's Chief Strategy Officer, who is also an audiologist, speech-language pathologist, and certified Listening and Spoken Language Specialist through AG Bell's Academy.  

Early identification and intervention is extremely important for an infant with hearing loss to achieve listening and spoken language skills. The human brain is programmed to learn language during the first six years of life – with the first three-and-a-half years being the most critical. Without intervention, it becomes increasingly difficult to acquire language and literacy as a child grows older.

 Parents, caregivers and guardians who call the hotline will speak to Julie ­­­­Swaim, AG Bell's early intervention parent consultant. As a parent whose child has hearing loss and a seven-year veteran in the EHDI field, Ms. Swaim is fully aware of the challenges associated with hearing loss in children as well as next steps needed to ensure they receive proper diagnosis and treatment. She will connect them with other resources related to hearing loss. She also has access to qualified hearing and speech professionals whom she can contact for important medical information.  

Published: 8/27/2018 2:01:00 PM

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Phonak Virto B-Titanium Wins International Awards for 2018’s Best New Product

Phonak Virto B-Titanium won of two renowned international awards: the 2018 Red Dot Award for Product Design, and a Gold Stevie® Award for Best New Product or Service of the Year in the health and pharmaceutical industry. , the tiny hearing device is made by Phonak, the world's leading provider of hearing aids.

Virto B-Titanium devices are custom 3D-printed and almost invisible when worn. Wearers get the benefits of a medical-grade titanium hearing aid. The device is powered by Phonak's latest technology featuring AutoSense OS™ that gives wearers a fully-automatic and seamless hearing experience in different hearing situations.

One of these wearers is William Goode, Senior Advancement Officer for Athletics at Ferris State University in Michigan. Will had dealt with hearing loss in one ear for most of his life, yet never sought treatment. As a first-time hearing aid wearer, Will wanted something ultra-discreet yet durable enough to keep up with his active lifestyle.

"My new titanium hearing aid has been a blessing," said Goode. "At work I'm able to pick up on key conversations and information that allows me to develop, incorporate, and execute plans. Before, it was difficult to hear ideas, take suggestions, and process information quickly. Outside of work in restaurants the Virto B-Titanium has helped me focus on the people at the table and not background noise. It has changed the way I go about everyday life, giving me confidence at work, outside of work, and at home."

The Virto B-Titanium is the smallest and most discreet custom hearing aid Phonak has ever produced. Compared to traditional acrylic, titanium shells are half as thin yet 15 times stronger. Thinner shells result in smaller devices. This means the hearing aid can be placed even deeper in the canal, resulting in a more discreet fit that delivers natural sound quality. Virto B-Titanium has also received an IP68 rating for resistance to both water and dust.

"Phonak is extremely proud of the amount of success and praise Virto B-Titanium has received, most recently with these two prestigious product awards," said Thomas Lang, Senior Vice President of Phonak. But there's an even greater sense of pride when we hear the many stories about what the hearing aid is doing for people. And that can be summed up in three words: "it changes lives."

Virto B-Titanium will be honored at the International Business Awards gala on October 20, 2018 in London. It previously took honors for product excellence along with two other Phonak products at the Red Dot Awards gala on July 9 in Essen, Germany. The other two international Red Dot Awards winners included Phonak Audéo B-Direct, a revolutionary hearing aid using Bluetooth.​

Published: 8/27/2018 2:16:00 PM

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via IFTTT

New Hotline Launched for Parents & Caregivers of Children with Hearing Loss

​As part of its Cradle to Career initiative, the Alexander Graham Bell Association for the Deaf and Hard of Hearing (AG Bell) launched Listen-Learn-Link, its international new parent hotline for parents, caregivers and guardians of children with hearing loss. The hotline is the first-ever confidential, bilingual (English/Spanish) hotline for parents, caregivers and guardians of newly identified children with hearing loss worldwide who possess any degree of unilateral or bilateral hearing loss. The hotline connects parents via telephone, email and video conference to the organization's Early Intervention Parent Consultant eager to answer parents' questions, provide hearing loss resources, information, support and next steps related to early hearing detection and intervention (EHDI) and communication options for those with hearing loss.

"Having access to another parent who has traveled a similar road can be a lifesaver for new parents of a child with hearing loss. AG Bell is launching its new hotline so new parents, caregivers and guardians can have easy access to a parent who has had similar experiences and who also understands the systems and services that they will soon access for their own child and family," said Gayla Guignard, AG Bell's Chief Strategy Officer, who is also an audiologist, speech-language pathologist, and certified Listening and Spoken Language Specialist through AG Bell's Academy.  

Early identification and intervention is extremely important for an infant with hearing loss to achieve listening and spoken language skills. The human brain is programmed to learn language during the first six years of life – with the first three-and-a-half years being the most critical. Without intervention, it becomes increasingly difficult to acquire language and literacy as a child grows older.

 Parents, caregivers and guardians who call the hotline will speak to Julie ­­­­Swaim, AG Bell's early intervention parent consultant. As a parent whose child has hearing loss and a seven-year veteran in the EHDI field, Ms. Swaim is fully aware of the challenges associated with hearing loss in children as well as next steps needed to ensure they receive proper diagnosis and treatment. She will connect them with other resources related to hearing loss. She also has access to qualified hearing and speech professionals whom she can contact for important medical information.  

Published: 8/27/2018 2:01:00 PM

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Improved directional hearing of children with congenital unilateral conductive hearing loss implanted with an active bone-conduction implant or an active middle ear implant

Publication date: Available online 26 August 2018

Source: Hearing Research

Author(s): K. Vogt, H. Frenzel, S. Ausili, D. Hollfelder, B. Wollenberg, A.F.M. Snik, M.J.H. Agterberg

Abstract

Different amplification options are available for listeners with congenital unilateral conductive hearing loss (UCHL). For example, bone-conduction devices (BCDs) and middle ear implants. The present study investigated whether intervention with an active BCD, the Bonebridge, or a middle ear implant, the Vibrant Soundbridge (VSB), affected sound-localization performance of listeners with congenital UCHL. Listening with a Bonebridge or VSB might provide access to binaural cues. However, when fitted with the Bonebridge, but not with a VSB, binaural processing might be affected through cross stimulation of the contralateral normal hearing ear, and could interfere with processing of binaural cues. In the present study twenty-three listeners with congenital UCHL were included. To assess processing of binaural cues, we investigated localization abilities of broadband (BB, 0.5-20 kHz) filtered noise presented at varying sound levels. Sound localization abilities were analysed separately for stimuli presented at the side of the normal-hearing ear, and for stimuli presented at the side of the hearing-impaired ear. Twenty-six normal hearing children and young adults were tested as control listeners. Sound localization abilities were measured under open-loop conditions by recording head-movement responses. We demonstrate improved sound localization abilities of children with congenital UCHL, when listening with a Bonebridge or VSB, predominantly for stimuli presented at the impaired (aided) side. Our results suggest that the improvement is not related to accurate processing of binaural cues. When listening with the Bonebridge, despite cross stimulation of the contralateral cochlea, localization performance was not deteriorated compared to listening with a VSB.

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