Application of speech audiometry In hearing impaired children

Govorna audiometrija, kao jedna od metoda za ispitivanje sluha nije našla svoju široku primenu u našoj zemlji. Koristi se kod dece i odraslih osoba za procenu razumljivosti govora. Takođe se koristi i za procenu mogućnosti habilitacije sluha i govora pomoću slušnih pomagala. Procena se izvodi u polukabini gde se ispitaniku na odgovarajućem intenzitetu puštaju reči preko slušalica ili u slobodnom polju. Ispitanik treba da, bez čitanja sa lica i usana ispitivača, ponovi reč koja mu je prezentovana. Cilj ovog rada je da se ispita efikasnosti auditivnog pomagala kod dece oštećenog sluha govornom audiometrijom u slobodnom polju. Uzorakom je obuhvaćeno 20-oro dece oba pola sa obostranim prelingvalnim senzorineuralnim oštećenjem sluha veoma teškog stepena (> 90 dB), hronološkog uzrasta od 3-8 godina koja su bila uključena u habilitacioni program. Eksperimentalnu grupu su činili ispitanici sa kohlearnim implantom a kontrolnu oni koji koriste slušni aparat. Dobijeni rezultati potvrđuju činjenicu da govorna audiometrija u slobodnom polju može da nađe primenu prvenstveno kao jedna od metoda za utvrđivanje efikasnosti auditivnog pomagala i habilitacionog postupka kao i verifikaciju fitting-a auditivnih pomagala. Dobijeni rezultati nas upućuju na činjenicu da je prosečan prag razumljivosti ispitivanih reči na govonoj audiometriji u slobodnom polju bio bolji kod dece sa kohlearnim implantom u odnosu na decu sa slušnim aparatima.Speech audiometry, as one of the hearing tests, has not been widely used in our country. It is used in children and adults to assess the intelligibility of speech. It is also used in evaluating the likelihood of hearing and speech rehabilitation with hearing aids. This method is performed in a semi cab where words are played at appropriate intensity level to the subject through headphones or in a free field. The candidate should the given word without reading from the examiner’s lips or face. The aim of this paper is to investigate the efficacy of auditory aids in hearing impaired children by means of speech audiometry in a free field. The sample included 20 children of both sexes with a very severe bilateral prelingual hearing loss (>90 dB), aged betwen 3 and 8, and who are involved in the habilitation program. The children were divided into two groups: experimental (cochlear implant) and control (hearing aids) group. They were examined by a list of words intended to test hearing using speech audiometry. The results confirm that speech audiometry in a free field may be applied primarily as a method for determining the effectiveness of auditory aids and assisted the habilitation procedure, and the verification of fitting auditory aids. The results indicate that the average threshold level for intelligibility of words tested by speech audiometry in a free field was better in children with cochlear implants than in children with hearing aids

Application of speech audiometry In hearing impaired children

Govorna audiometrija, kao jedna od metoda za ispitivanje sluha nije našla svoju široku primenu u našoj zemlji. Koristi se kod dece i odraslih osoba za procenu razumljivosti govora. Takođe se koristi i za procenu mogućnosti habilitacije sluha i govora pomoću slušnih pomagala. Procena se izvodi u polukabini gde se ispitaniku na odgovarajućem intenzitetu puštaju reči preko slušalica ili u slobodnom polju. Ispitanik treba da, bez čitanja sa lica i usana ispitivača, ponovi reč koja mu je prezentovana. Cilj ovog rada je da se ispita efikasnosti auditivnog pomagala kod dece oštećenog sluha govornom audiometrijom u slobodnom polju. Uzorakom je obuhvaćeno 20-oro dece oba pola sa obostranim prelingvalnim senzorineuralnim oštećenjem sluha veoma teškog stepena (> 90 dB), hronološkog uzrasta od 3-8 godina koja su bila uključena u habilitacioni program. Eksperimentalnu grupu su činili ispitanici sa kohlearnim implantom a kontrolnu oni koji koriste slušni aparat. Dobijeni rezultati potvrđuju činjenicu da govorna audiometrija u slobodnom polju može da nađe primenu prvenstveno kao jedna od metoda za utvrđivanje efikasnosti auditivnog pomagala i habilitacionog postupka kao i verifikaciju fitting-a auditivnih pomagala. Dobijeni rezultati nas upućuju na činjenicu da je prosečan prag razumljivosti ispitivanih reči na govonoj audiometriji u slobodnom polju bio bolji kod dece sa kohlearnim implantom u odnosu na decu sa slušnim aparatima.Speech audiometry, as one of the hearing tests, has not been widely used in our country. It is used in children and adults to assess the intelligibility of speech. It is also used in evaluating the likelihood of hearing and speech rehabilitation with hearing aids. This method is performed in a semi cab where words are played at appropriate intensity level to the subject through headphones or in a free field. The candidate should the given word without reading from the examiner’s lips or face. The aim of this paper is to investigate the efficacy of auditory aids in hearing impaired children by means of speech audiometry in a free field. The sample included 20 children of both sexes with a very severe bilateral prelingual hearing loss (>90 dB), aged betwen 3 and 8, and who are involved in the habilitation program. The children were divided into two groups: experimental (cochlear implant) and control (hearing aids) group. They were examined by a list of words intended to test hearing using speech audiometry. The results confirm that speech audiometry in a free field may be applied primarily as a method for determining the effectiveness of auditory aids and assisted the habilitation procedure, and the verification of fitting auditory aids. The results indicate that the average threshold level for intelligibility of words tested by speech audiometry in a free field was better in children with cochlear implants than in children with hearing aids

Razvoj programa ranog otkrivanja i intervencije kod kongenitalnog oštećenja sluha - skrining je nedovoljan

Introduction of systematic hearing check-upsin maternity hospitals - neonatal hearing screening, induced progress in early detection of congenital hearing loss. Average age at diagnosis and intervention is shifted from 30 months to 3 and 6 months respectively thus improving final outcome in hearing and speech functions tremendously. Early intervention in hearing impaired infant, using hearing aids or cochlear implants when necessary, during period of maximal CNS plasticity enables optimal achievements in auditory perception and speech and language similar to their hearing peers. The model of early hearing loss detection and intervention in Audiology Rehabilitation Department in ENT Clinic of Clinical Center of Serbia in Belgrade is reviewed. Apart from audiology controls in well babies who failed neonatal screening novorođenčadi, special attention is paid to population of babies and infants with risk factors for hearing impairment. Neonatal hearing screening (NHS) in well babies and neonatal intensive care unit (NICU) of Gynecology and Obstetrics Clinic of Clinical Center of Serbia in Belgrade is done in two steps using transient evoked otoacoustic emissions (TEOAE). Each baby who NHS twice is referred to Audiology Rehabilitation Department for further audiological testing using pediatric battery (Behavioral Observation Audiometry-BOA, Transient Evoked Otoacoustic Emissions - TEOAE, Distortion Products Otoacoustic Emissions - DPOAE, Brainstem Evoked Response Audiometry - BERA, tympanometry, acoustic reflex measurements). BERA stimuli are tone bursts from 0.5 to 4 kHz at 40 dB. If the morphology and latencies of BERA waves are correct it is assumed that hearing thresholdis normal. Well babies are tested at the age of one month, three months and six months. If any risk factor is present periodic testing should be continued until 12 months of age. Infants with hereditary burden of familiar deafness should be followed up to 3 years of age and even longer when necessary. During six - month period, from June to December 2010. , 3271 babies out of 3635 newborns were screened (90%). Failure rate on the first screening was 9% (294/3271) and 5.3% (174/3271) respectively. Profound bilateral hearing loss requiring amplification and speech and hearing habilitation was detected in one child. A group of 23 at risk babies underwent complete audiological diagnostics without prior screening procedures. Two of them had significant hearing loss and additional 3 had auditory neuropathy spectrum disorder with next to normal behavioral thresholds. Neonatal hearing screening is initial step in early hearing loss detection and intervention (EHDI). Development of detailed protocols for neonatal hearing screening, early audiologic diagnosis and early intervention for congenitalhearing loss, along with national program, national database, technological support, family guidance and legislation are prerogatives of successful EHDI program. If diagnostic and habilitation protocols are consequently implemented congenitally deaf children could achieve their full potential.Uvođenje sistematskog pregleda sluha u porodilištu, neonatalnog skrininga, značajno je pomerilo vreme otkrivanja kongenitalnih oštećenja sluha. Ranije vreme dijagnoze i početka intervencije koje je sa 30 meseci pomereno na 3, odnosno 6 meseci, bitno je poboljšalo krajnji uspeh habilitacije slušanja i govora. Rana intervencija uz primenu slušnih amplifikatora, a po potrebi i kohlearnog implanta odvija se u vreme maksimalne plasitčnosti CNS, pa se time krajni rezultat u razvoju auditivne percepcije, govora i jezika približava normativima za čujuću decu. Prikazan je model rada u Klinici za ORL i MFH Kliničkog centra Srbije, gde se sprovodi sistem rane dijagnostike i rehabilitacije, kao i provera novorođenčadi koja nisu prošla na skriningu u porodilištu, kao i posebno praćenje novorođenčadi sa povećanim rizikom za oštećenje sluha. U porodilištu Ginekološko akušerske kli nike KCS se radi dvostepena provera TEOAE metodom. Dete koje dva puta ne prođe na jednom ili oba uva upućuje se kompletnu audiološku obradu u Odsek za audiološku rehabilitacju KCS gde se sluh proverava baterijom audioloških testova: BOA, TEOAE, DPOAE, BERA, timpanometrija, merenje akustičkog refleksa. BERA je rađena frekventno specifičnim stimulusima (tone burst) na 0.5, 1, 2 i 4 kHz intenzitetom od 40 dB, pri čemu je prisustvo svih talasa sa odgovarajućim latencijama za uzrast smatrano urednim sluhom. Prva audiološka provera se radi oko prvog meseca, a zatim se pregled ponavlja sa navršenih 3 i 6 meseci kod dece bez riziko faktora, a do godinu dana sa faktorima rizika. Deca gde u postoji hereditarno opterećenje u familiji prate se do navršene 3 godine, a po potrebi i duže. U periodu od 1.06.2010. do 1.12.2010. od 3635 novorođenčadi skriningom je obuhvaćeno 3271 (90%). Neuspešno je bilo na prvom skriningu 294 (9% a na drugom 174 (5.3%). Od 174 dece upućene na audiološku proveru, 59 (33,9%) je imalo neki od faktora rizika za oštećenje sluha.). Teško oštećenje sluha koje je zahtevalo amplifikaciju i habilitaciju slušanja i govora utvrdili smo kod jednog deteta. Takođe je urađena i kompletna audiološka obrada kod 23 bebe s faktorima rizika, koje su rođene u drugim porodilištima gde se ne radi skrining. Kod 2 bebe je utvrđeno senzorineuralno oštećenje sluha, dok su kod još 3 registrovani elementi auditivne neuropatije-disinhronije i pored uredne bihevioralne reakcije na zvuk. Neonatalni skrining otećenja sluha početna je karika u sistemu rane dijagnostike i intervencije kod kongenitalnog oštećenja sluha. Neophodno je dosledno sprovođenje dijagnostičkih i habilitacionih protokola da bi se postigli optimalni rezultati

Mercerized jute fabrics suitable for technical textiles

Simple chemical modifications by using 17.5 % NaOH (for 5, 15, or 30 min) were applied to obtain jute fabrics suitable for various types of technical textiles such as carpet backing and advanced protective textiles, i.e., protective clothing in environments sensitive to electrical discharges. The raw, as well as mercerized jute fabrics, were characterized in terms of their chemical composition (cellulose and hemicellulose content), structural characteristics (fabric weight, thickness, and porosity), and fibbers’ surface morphology (determined by FESEM). In order to assess their ability for utilization as technical textiles, the compression properties (compressibility and compression resilience), abrasion resistance (by determining mass loss after 750 and 1000 cycles), and volume electrical resistivity were studied. The obtained results revealed that with prolonging the mercerization duration from 5 up to 30 min, the hemicellulose content decreased, fabrics' compactness increases contributing to decreased compressibility and increased compression resilience. Concerning the abrasion resistance, a mass loss of about 19 % was observed after 750 cycles in the case of raw jute fabric, while the mercerized jute fabrics possessed up to 7.6 % mass loss even after 1000 cycles. Such behaviour could be ascribed to the higher friction force between the yarns within the mercerized fabrics and between the fibres within the yarns enabling less loss of fibres from the fabric surface. Mercerization for 5 min leads to a decrease, while those performed for 30 min resulted in an increased volume electrical resistivity

Uticaj kohlearne implantacije na razvoj neposrednog verbalnog pamćenja kod dece

Short term auditory memory is extremely important for speech development in hearing or hearing impaired children. Objective of this study was to assess development of auditory memory in a group of cochlear implanted children and to discover the factors that affect it. A group of 30 CI children aged 3 to 12 has been tested using a Test of immediate verbal memory developed by Spasenija Vladisavljević (Subtests I-IV).The test consists of four subtests of increasing complexity. Children were divided in three subgroups according to hearing age: A. With less than 1 year, B. 1- 2 years and C. More than 2 years. Two subgroups were compared regarding age at implantation: those implanted before the age of 3 and those implanted later than 3 years of age. Duration of rehabilitation was analyzed in this study as well and the children were divided in two groups, those with less than 3 years of speech and hearing rehabilitation and those with more than 3 years. Results have shown that short-term auditory memory is constantly improving over time in all of the cochlear implantees. Scores are increasing after three years of rehabilitation, especially for the most complex subtest of short sentences. Children that were implanted before the age of 3, have show considerably better scores in all four subtests, which implies that development of auditory memory is dependent on central nervous system plasticity. Improvement of short-term auditory memory is consistently seen over time in postoperative rehabilitation of cochlear implanted children. Early implantation, before the age of 3, enables maximal achievement in hearing, speech and auditory memory.Neposredno verbalno pamćenje je izuzetno važno za razvoj govora i jezika kod dece bilo da ona sasvim normalno čuju ili imaju oštećen sluh. Cilj ovog rada je da proceni uticaj kohlearne implantacije na razvoj auditivne memorije u grupi kohlearno implantirane dece i da utvrdi faktore koji na to utiču. Grupa od 30 dece sa kohlearnim implantom, uzrasta od 3 do 12 godina ispitana je Testom neposrednog verbalnog pamćenja no Spaseniji Vladisavljević (prva 4 subtesta). Složenost subtestova raste od subtesta I do IV. Deca su podeljena u tri podgrupe prema slušnom uzrastu, t.j. vremenu od priključenja kohlearnog implanta: Podgrupa A: Slušni uzrast ispod godinu dana; Podgrupa B: Slušni uzrast između jedne i dve godine; Podgrupa C: Slušni uzrast iznad dve godine. Prema vremenu operacije deca su podeljena u dve podgrupe: implantirane pre treće godine života i one implantirane kasnije. Prema trajanju rehabilitacije deca su podeljena u dve grupe, na rehabilitaciji manje od 3 i više od 3 godine. Rezultati testiranja neposrednog verbalnog pamćenja pokazuju da se ono konstantno razvija tokom vremena kod sve kohlearno implantirane dece. Skorovi značajno rastu posle više od 3 godine rehabilitacije, posebno za složenije subtestove. Deca implantirana pre 3 godine života imaju bolje rezultate na testovima neposrednog verbalnog pamćenja, što ukazuje na uticaj plastičnosti centralnog nervnog sistema na razvoj auditivne memorije. Uočava se konstantan razvoj neposrednog verbalnog pamćenja tokom rehabilitacije kod sve dece sa kohlearnim implantom. Rana implantacija, pre treće godine, omogućava maksimalan razvoj funkcije slušanja, govora i auditivne memorije

Alkali Treated Jute Fabrics Suitable for the Production of Inexpensive Technical Textiles

This work aimed to obtain jute fabrics suitable for the production of inexpensive technical textiles by using simple alkali treatments. The influences of alkali concentration (1–17.5 % NaOH) and treatment duration (5–30 min) on the fabrics’ compression properties, abrasion resistance, and sound absorption coefficient were studied in detail. With increasing the treatment severity, the fabric compressibility decreases by 19.6–33.9 % due to increased fabric compactness. In parallel, the fiber crystallinity index and hemicellulose content decrease, while the fibers’ interfibrillar regions become less dense and less rigid contributing to 19.0–27.0 % better recoverability after compression. The mercerized fabrics possessed a notably lower mass loss (4.1–5.9 %) after 750 abrasion cycles compared to the other investigated fabrics (18.9–30.9 %), which could be ascribed to the higher friction forces existing between the yarns within the mercerized fabrics and between the fibers within the yarns, as well as higher elongation at maximum force. In the case of the fabrics treated for 5 or 15 min with different NaOH concentrations, their mass losses during abrasion decrease with increasing the elementary fiber liberation, while the sound absorption coefficients increase with increasing the fabric compactness. Mercerized fabrics are capable of absorbing about 28 % to 2.7 times (at 990 Hz) and 2.0 to 2.4 times (at 4090 Hz) higher mechanical sound energy compared to the untreated fabric. The jute fabric mercerized during 30 min could be used for the production of carpet backings, while those mercerized during 5 min is the most suitable for the production of sound-absorbing materials

Multifunctional jute fabrics obtained by different chemical modifications

Abstract: The aim of the present research is first to reduce the jute fabric non-cellulosic components by using different chemical modifications (i.e. alkali and oxidative) and then to analyze their influence on the jute fabric properties. For that purpose, the jute fabrics were characterized in terms of their chemical composition, structural parameters, mechanical properties, volume electrical resistivity, antibacterial activity and biosorption of Zn2+. Moreover, the jute fabrics were functionalized by incorporation of silver ions and the fabrics were evaluated as sorption material with a further perspective of reuse. After the alkali modifications, the hemicelluloses were selectively removed and the fabric structural parameters increased. Alkali modifications under mild conditions (1% NaOH for 30 min and 5% NaOH for 5 min) lead to a decrease, while the most intensive alkali modification (17.5% NaOH for 30 min) contributed to an increase in the volume electrical resistivity and fabric maximum force compared to unmodified fabric. A relationship between the jute fabric chemical composition, crystallinity index, conversion of cellulose I to cellulose II, fabric structural parameters and volume electrical resistivity was found. The oxidations lead to selective lignin removal, which consequently causes a decrease in the volume electrical resistivity and fabric maximum force. Ag+ incorporated in the selected samples decreased their electrical resistivity even further. Following the increased focus on the concept of circular economy and sustainable development goals, the biosorption potential of damaged and waste jute fabrics for Zn2+ was investigated. Jute fabrics with incorporated Ag+ and those obtained after the biosorption of Zn2+ provided maximum bacterial reduction (99.99%) for Escherichia coli and Staphylococcus aureus. The chemically modified jute fabrics can be utilized as carpet backing and protective clothing in environments sensitive to electrical discharges, but also as filters for water disinfection and biosorbents for Zn2+.Graphic abstract: [Figure not available: see fulltext.]

Influence of pilling on the quality of flax single jersey knitted fabrics

In this work, the quality of four plain single jersey weft-knitted fabrics (produced from the same flax yarn) having different structural characteristics (stitch density, weight, and thickness) before and after pilling, was examined. The quality of knitted fabrics was evaluated in terms of their compression (compressibility, thickness loss, and compressive resilience), comfort (air permeability and water retention), and strength (bursting strength and ball traverse elongation) properties. The obtained results revealed that the fabric with the lowest structural characteristic values has the highest compressibility, thickness loss, and air permeability, while the least compressive resilience, water retention, bursting strength, and ball traverse elongation, both before and after pilling. Pilling causes a decrease of compressibility, thickness loss, air permeability, water retention (for three lightweight fabrics), bursting strength, and ball traverse elongation but an increase in compressive resilience and water retention (for the most compact fabric). All studied knitted fabrics have excellent quality before pilling and excellent to good quality after pilling. A pilling leads to a decrease in the quality of all fabrics, especially of those with the least compact structure. Sample with moderate compactness possesses the best overall quality