A psychoacoustic "NofM"-type speech coding strategy for cochlear implants

We describe a new signal processing technique for cochlear implants using a psychoacoustic-masking model. The technique is based on the principle of a so-called "NofM" strategy. These strategies stimulate fewer channels (N) per cycle than active electrodes (NofM; N < M). In "NofM" strategies such as ACE or SPEAK, only the N channels with higher amplitudes are stimulated. The new strategy is based on the ACE strategy but uses a psychoacoustic-masking model in order to determine the essential components of any given audio signal. This new strategy was tested on device users in an acute Study, with either 4 or 8 channels stimulated per cycle. For the first condition (4 channels), the mean improvement over the ACE strategy was 17%. For the second condition (8 channels), no significant difference was found between the two strategies

Binaurales Hören : Auf dem Weg zum räumlichen Hören mit Cochlea-Implantaten

Räumliches Hören soll verbessert werden. Während die Auditory Prosthetic Group (APG) der HNO-Klinik der Medizinische Hochschule Hannover (MHH) sich auf binaurale Soundcodierungsstrategien für Cochlea-Implantate sowie grundlegende Experimente am Menschen konzentriert, werden Wissenschaftler vom Institut für Informationsverarbeitung (TNT) der Leibniz Universität Hannover (LUH) an Kompressionsalgorithmen zur drahtlosen Übertragung von Audio und elektrischen Signalen für bilaterale Cochlea-Implantate arbeiten

Hydrographic variability (1994-2020) in the Ría de Vigo and adjacent shelf (NW Iberia)

The Spanish Institute of Oceanography (IEO-CSIC) carries out monthly oceanographic samplings at across-shelf sections off the northern Spanish coast under the monitoring program RADIALES (https://www.seriestemporales-ieo.net/). This is a multidisciplinary marine research effort addressing long-term variability issues at the ecosystem level (Bode et al., 2015; Valdés et al., 2002). Currently, the monitoring program includes 5 perpendicular coastal transects in Northern Spain: Santander, Gijón, Cudillero, A Coruña and Vigo. Focusing on the section located in the Ría de Vigo and adjacent shelf, we have analysed a 27-year time series (1994 - 2020) of temperature and salinity obtained through CTD profiles in three stations, two inside the Ría (~30 and ~40 m depth) and one in the mid-shelf (~90 m depth). This study summarizes the hydrographic variability in the region through the construction of a local climatology. In addition, long-term trends and interannual changes in seasonality are examined. The results show a change in the salinity regime in medium depth waters in 2013, although not in temperature. Near the surface, the temperature undergoes a negative shift from 2016, in correspondence with the entry of the AMO into a new negative phase

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Data_Sheet_1_Selective attention decoding in bimodal cochlear implant users.pdf

The growing group of cochlear implant (CI) users includes subjects with preserved acoustic hearing on the opposite side to the CI. The use of both listening sides results in improved speech perception in comparison to listening with one side alone. However, large variability in the measured benefit is observed. It is possible that this variability is associated with the integration of speech across electric and acoustic stimulation modalities. However, there is a lack of established methods to assess speech integration between electric and acoustic stimulation and consequently to adequately program the devices. Moreover, existing methods do not provide information about the underlying physiological mechanisms of this integration or are based on simple stimuli that are difficult to relate to speech integration. Electroencephalography (EEG) to continuous speech is promising as an objective measure of speech perception, however, its application in CIs is challenging because it is influenced by the electrical artifact introduced by these devices. For this reason, the main goal of this work is to investigate a possible electrophysiological measure of speech integration between electric and acoustic stimulation in bimodal CI users. For this purpose, a selective attention decoding paradigm has been designed and validated in bimodal CI users. The current study included behavioral and electrophysiological measures. The behavioral measure consisted of a speech understanding test, where subjects repeated words to a target speaker in the presence of a competing voice listening with the CI side (CIS) only, with the acoustic side (AS) only or with both listening sides (CIS+AS). Electrophysiological measures included cortical auditory evoked potentials (CAEPs) and selective attention decoding through EEG. CAEPs were recorded to broadband stimuli to confirm the feasibility to record cortical responses with CIS only, AS only, and CIS+AS listening modes. In the selective attention decoding paradigm a co-located target and a competing speech stream were presented to the subjects using the three listening modes (CIS only, AS only, and CIS+AS). The main hypothesis of the current study is that selective attention can be decoded in CI users despite the presence of CI electrical artifact. If selective attention decoding improves combining electric and acoustic stimulation with respect to electric stimulation alone, the hypothesis can be confirmed. No significant difference in behavioral speech understanding performance when listening with CIS+AS and AS only was found, mainly due to the ceiling effect observed with these two listening modes. The main finding of the current study is the possibility to decode selective attention in CI users even if continuous artifact is present. Moreover, an amplitude reduction of the forward transfer response function (TRF) of selective attention decoding was observed when listening with CIS+AS compared to AS only. Further studies to validate selective attention decoding as an electrophysiological measure of electric acoustic speech integration are required.</p