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Objectives: Speech recognition on the telephone poses a challenge for patients with cochlear implants (CIs) due to a reduced bandwidth of transmission. This trial evaluates a home-based auditory training with telephone-specific filtered speech material to improve sentence recognition. Design: Randomised controlled parallel double-blind. Setting: One tertiary referral centre. Participants: A total of 20 postlingually deafened patients with CIs. Main outcome measures: Primary outcome measure was sentence recognition assessed by a modified version of the Oldenburg Sentence Test filtered to the telephone bandwidth of 0.3-3.4 kHz. Additionally, pure tone thresholds, recognition of monosyllables and subjective hearing benefit were acquired at two separate visits before and after a home-based training period of 10-14 weeks. For training, patients received a CD with speech material, either unmodified for the unfiltered training group or filtered to the telephone bandwidth in the filtered group. Results: Patients in the unfiltered training group achieved an average sentence recognition score of 70.0%±13.6% (mean±SD) before and 73.6%±16.5% after training. Patients in the filtered training group achieved 70.7%±13.8% and 78.9%±7.0%, a statistically significant difference (P=.034, t10 =2.292; two-way RM ANOVA/Bonferroni). An increase in the recognition of monosyllabic words was noted in both groups. The subjective benefit was positive for filtered and negative for unfiltered training. Conclusions: Auditory training with specifically filtered speech material provided an improvement in sentence recognition on the telephone compared to training with unfiltered material.
BACKGROUND:
While hearing aids for a contralateral routing of signals (CROS-HA) and bone conduction devices have been the traditional treatment for single-sided deafness (SSD) and asymmetric hearing loss (AHL), in recent years, cochlear implants (CIs) have increasingly become a viable treatment choice, particularly in countries where regulatory approval and reimbursement schemes are in place. Part of the reason for this shift is that the CI is the only device capable of restoring bilateral input to the auditory system and hence of possibly reinstating binaural hearing. Although several studies have independently shown that the CI is a safe and effective treatment for SSD and AHL, clinical outcome measures in those studies and across CI centers vary greatly. Only with a consistent use of defined and agreed-upon outcome measures across centers can high-level evidence be generated to assess the safety and efficacy of CIs and alternative treatments in recipients with SSD and AHL.
METHODS:
This paper presents a comparative study design and minimum outcome measures for the assessment of current treatment options in patients with SSD/AHL. The protocol was developed, discussed, and eventually agreed upon by expert panels that convened at the 2015 APSCI conference in Beijing, China, and at the CI 2016 conference in Toronto, Canada.
RESULTS:
A longitudinal study design comparing CROS-HA, BCD, and CI treatments is proposed. The recommended outcome measures include (1) speech in noise testing, using the same set of 3 spatial configurations to compare binaural benefits such as summation, squelch, and head shadow across devices; (2) localization testing, using stimuli that rove in both level and spectral content; (3) questionnaires to collect quality of life measures and the frequency of device use; and (4) questionnaires for assessing the impact of tinnitus before and after treatment, if applicable.
CONCLUSION:
A protocol for the assessment of treatment options and outcomes in recipients with SSD and AHL is presented. The proposed set of minimum outcome measures aims at harmonizing assessment methods across centers and thus at generating a growing body of high-level evidence for those treatment options.
Electrochemical impedance spectroscopy (EIS) is a widely-used diagnostic technique to characterize electrochemical processes. It is based on the dynamic analysis of two electrical observables, that is, current and voltage. Electrochemical cells with gaseous reactants or products (e.g., fuel cells, metal/air cells, electrolyzers) offer an additional observable, that is, the gas pressure. The dynamic coupling of current and/or voltage with gas pressure gives rise to a number of additional impedance definitions, for which we use the term electrochemical pressure impedance. It also gives rise to different experimental probing approaches. In this article we present a model-based study of electrochemical pressure impedance spectroscopy (EPIS). Possible quantifications and realizations of EPIS are discussed. The study of generic cell geometries consisting of gas reservoir, diffusion layer(s) and electrochemically active layer(s) reveals distinct spiral-shaped features in the Nyquist plot. Using the example of a sodium/oxygen (Na/O2) cell, the dynamic spatiotemporal behavior of the state variables is quantified and interpreted. Results are compared to first experimental EPIS measurements by Hartmann et al. [J. Phys. Chem. C118, 1461, 2014]. A sensitivity analysis highlights the properties of EPIS with respect to geometric, transport, and kinetic parameters. We demonstrate that EPIS is sensitive to transport parameters that are not well-accessible with standard EIS.
Lithium–oxygen cells with nonaqueous electrolyte show high overpotentials during charge, indicating asymmetric charge/discharge reaction mechanisms. We present a kinetic modeling and simulation study of the lithium–oxygen cell cycling behavior. The model includes a multistep reaction mechanism of the cell reaction (2Li + O2 ⇄ Li2O2) forming lithium peroxide by precipitation, coupled to a 1D porous-electrode transport model. We apply the model to study the asymmetric discharge/charge characteristics and analyze the influence of a redox mediator dissolved homogeneously in the liquid electrolyte. Model predictions are compared to experimental galvanostatic cycling data of cells without and with 2,2,6,6-tetramethylpiperidinyloxyl (TEMPO) as redox mediator. The predicted discharge behavior shows good agreement with the experimental results. A spatiotemporal analysis of species concentrations reveals inhomogeneous distributions of dissolved oxygen and reaction products within the cathode during discharge. The experimentally observed charge overpotentials as well as their reduction by using a redox mediator can be qualitatively reproduced with a partially irreversible reaction mechanism. However, the proposed models fail to reproduce the particular shape of the experimental charge curve with continuously increasing charge overpotential, which implies that part of the reaction mechanism is still open for investigation in future work.
In this study, we tested the function of a replica of the over 500-year-old original of the
famous Franconian Imperial Knight Götz von Berlichingen’s first “iron hand”, which we
reconstructed by computer-aided design (CAD) and recently printed using a multi-material
3D printer. In different everyday tasks, the artificial hand prosthesis proved to be remarkably
helpful. Thus, the hand could hold a wine glass, some grapes, or a smartphone. With a
suitable pencil, even writing was possible without any problem. Although for all these
functions the healthy other hand was necessary to assist at the beginning, the artificial hand
is an astonishing mechanical aid with many possibilities. Therefore, in certain cases, the
non-invasive approach of a passive mechanical hand replacement, which is an individual,
quick and cheap solution due to modern 3D printing, may always be worth considering
also for today’s requirements.
In the past two decades much has been published on whiplash injury, yet both the confusion regarding the condition, and the medicolegal discussion about it have increased. In this paper, functional imaging research results are summarized using MRIcroGL3D visualization software and assembled in an image comprising regions of cerebral activation and deactivation.
n this work a mathematical model for describing the performance of lithium-ion battery electrodes consisting of porous active material particles is presented. The model represents an extension of the Newman-type model, accounting for the agglomerate structure of the active material particles, here Li(Ni1/3Co1/3Mn1/3)O2 (NCM) and Li(Ni1/3Co1/3Al1/3)O2 (NCA). To this goal, an additional pore space is introduced on the active material level. The space is filled with electrolyte and a charge-transfer reaction takes place at the liquid-solid interface within the porous active material particles. Volume-averaging techniques are used to derive the model equations. A local Thiele modulus is defined and provides an insight into the potentially limiting factors on the active material level. The introduction of a liquid-phase ion transport within the active material reduces the overall transport losses, while the additional active surface area within the agglomerate lowers the charge-transfer resistance. As a consequence, calculated discharge capacities are higher for particles modeled as agglomerates. This finding is more pronounced in the case of high C-rates
Structured Innovation with TRIZ in Science and Industry - Creating Value for Customers and Society
(2016)
Lithium-oxygen cells with organic electrolyte suffer high overpotentials during charge, indicating asymmetric charge/discharge reaction mechanisms. We present a multi-physics dynamic modeling and simulation study of the Li/O2 cell cycling behavior. We present three different multi-step mechanisms of the 2 Li + O2 ⇄ Li2O2 cell reaction, (A) a reversible 5-step mechanism, (B) a partially irreversible 6-step mechanism, and (C) a partially irreversible 8-step mechanism that includes reactions of a redox mediator. Model predictions are compared to experimental galvanostatic cycling data of Swagelok cells without and with 2,2,6,6-tetramethylpiperidinyloxyl (TEMPO) as redox mediator. All mechanisms are able to predict the discharge behavior in good agreement to the experimental results. The experimentally observed high charge overpotentials as well as their reduction by using a redox mediator can be qualitatively reproduced with the irreversible reaction mechanisms. However, the particular shape of the experimental charge curve with continuously increasing charge overpotential cannot be reproduced with the present mechanisms.
Serendipities in der Medizin
(2016)
Zufälle begleiten unser Leben. Auch bei wichtigen Entdeckungen und Entwicklungen in der Medizin spielt der „Zufall“ (engl. „serendipity“) eine Rolle. Hierzu gehören u. a. die Mendelschen Gesetze, die Ermittlung der menschlichen Chromosomenzahl, die Entdeckung der DNS durch Watson und Crick, der PAP-Test oder die Entdeckung der Röntgenstrahlung und der Radioaktivität. Aber auch und gerade in der Pharmakologie gibt es viele Beispiele für Serendipitäten. Einige gehen eng mit Zufällen bei der Entdeckung der Bakteriologie einher.
The ability to detect a target signal masked by noise is improved in normal-hearing listeners when interaural phase differences (IPDs) between the ear signals exist either in the masker or in the signal. To improve binaural hearing in bilaterally implanted cochlear implant (BiCI) users, a coding strategy providing the best possible access to IPD is highly desirable. In this study, we compared two coding strategies in BiCI users provided with CI systems from MED-EL (Innsbruck, Austria). The CI systems were bilaterally programmed either with the fine structure processing strategy FS4 or with the constant rate strategy high definition continuous interleaved sampling (HDCIS). Familiarization periods between 6 and 12 weeks were considered. The effect of IPD was measured in two types of experiments: (a) IPD detection thresholds with tonal signals addressing mainly one apical interaural electrode pair and (b) with speech in noise in terms of binaural speech intelligibility level differences (BILD) addressing multiple electrodes bilaterally. The results in (a) showed improved IPD detection thresholds with FS4 compared with HDCIS in four out of the seven BiCI users. In contrast, 12 BiCI users in (b) showed similar BILD with FS4 (0.6 ± 1.9 dB) and HDCIS (0.5 ± 2.0 dB). However, no correlation between results in (a) and (b) both obtained with FS4 was found. In conclusion, the degree of IPD sensitivity determined on an apical interaural electrode pair was not an indicator for BILD based on bilateral multielectrode stimulation.
The effect of fluctuating maskers on speech understanding of high-performing cochlear implant users
(2016)
Objective: The present study evaluated whether the poorer baseline performance of cochlear implant (CI) users or the technical and/or physiological properties of CI stimulation are responsible for the absence of masking release. Design: This study measured speech reception thresholds (SRTs) in continuous and modulated noise as a function of signal to noise ratio (SNR). Study sample: A total of 24 subjects participated: 12 normal-hearing (NH) listeners and 12 subjects provided with recent MED-EL CI systems. Results: The mean SRT of CI users in continuous noise was −3.0 ± 1.5 dB SNR (mean ± SEM), while the normal-hearing group reached −5.9 ± 0.8 dB SNR. In modulated noise, the difference across groups increased considerably. For CI users, the mean SRT worsened to −1.4 ± 2.3 dB SNR, while it improved for normal-hearing listeners to −18.9 ± 3.8 dB SNR. Conclusions: The detrimental effect of fluctuating maskers on SRTs in CI users shown by prior studies was confirmed by the current study. Concluding, the absence of masking release is mainly caused by the technical and/or physiological properties of CI stimulation, not just the poorer baseline performance of many CI users compared to normal-hearing subjects. Speech understanding in modulated noise was more robust in CI users who had a relatively large electrical dynamic range.
Die Kommunikationstechnik für die Zählerfernauslesung (Smart Metering) und für die Energieerzeugungs- und -verteilnetze (Smart Grid) hat das Potenzial, zu einer der ersten hoch skalierten M2M-Anwendungen zu werden. In den vergangenen Jahren konnten zwei vielversprechende Entwicklungen im Umfeld der drahtlosen Kommunikation für die Smart-Grid-Kommunikation vorbereitet werden, die das Marktgeschehen über Deutschland und über die Versorgungstechnik hinaus beeinflussen könnten. Neben der Spezifikation der OMS-Gruppe ist die Erarbeitung eines Schutzprofils (Protection Profile, PP) sowie einer Technischen Richtlinie (TR) für die Kommunikationseinheit eines intelligenten Messsystems (Smart Meter Gateway) durch das Bundesamt für Sicherheit in der Informationstechnik (BSI) zu nennen. Diese greifen, wie der Beitrag beschreibt, den Stand der Technik auf und geben praxisorientierte Umsetzungen vor.
This paper presents an overview of the coding aspects of a GNSS receiver. Coding allows detection and correction of channel-induced errors at the receiver, here the focus is on the mitigation of threats from malicious interferences. Although the effects of interference at different stages of GNSS baseband processing has been deeply analyzed in the literature, little attention was devoted to its impact on the navigation message decoding stage. Theis paper provides an introduction to the various coding schemes employed by current GNSS signals, discussing their performance in the presence of noise in terms of block-error rate. Additionally, the benefits of soft-decoding schemes for navigation message decoding are highlighted when jamming interferences are present. The proposed scheme requires estimating the noise plus interference power, yielding to enhanced decoding performances under severe jamming conditions. Finally, cryptographic schemes as a means of providing anti-spoofing for geosecurity location-based services, and their potential vulnerability are discussed, with particular emphasis on the dependence on the dependence of the scheme on successful navigation message decoding