The influence of perceived talker differences on the talker variability effect under cochlear implant simulation

Speech recognition is harder when communicating with multiple talkers. This “talker variability effect” has not been extensively examined for cochlear implant (CI) users, who have difficulty discriminating same-gender talkers but not different-gender talkers. A shadowing task was conducted with normal hearing listeners (N=19) under CI simulation. The test consisted of a single-talker condition (ST), and two multi-talker conditions with different male and female voices (MT-M) or only different female voices (MT-F). Response times were longer and accuracy was lower in MT-M compared to MT-F. Thus, the talker variability effect was observed only when talkers were perceptible under CI simulation

Talker variability in word recognition under cochlear implant simulation:Does talker gender matter?

Normal-hearing listeners are less accurate and slower to recognize words with trial-to-trial talker changes compared to a repeating talker. Cochlear implant (CI) users demonstrate poor discrimination of same-gender talkers and, to a lesser extent, different-gender talkers, which could affect word recognition. The effects of talker voice differences on word recognition were investigated using acoustic noise-vocoder simulations of CI hearing. Word recognition accuracy was lower for multiple female and male talkers, compared to multiple female talkers or a single talker. Results suggest that talker variability has a detrimental effect on word recognition accuracy under CI simulation, but only with different-gender talkers

Prognostics of recovery in hip fracture patients

Proximal femoral fractures (often denoted as hip fractures) are amongst the most prevalent fractures in older patients and associated with significant mortality and morbidity.Failure to recover to prefracture levels of function has important social and economic implications, as these patient’s risk losing their independence and self-reliance. The primary aim of this thesis is to provide a better understanding of the factors relevant for the functional prognosis of patients with a proximal femoral fracture.This thesis covers two parts, focusing on the effects of surgical aspects and patient demographics.​​​​​​​Outcomes of previously performed studies on prognostic factors of recovery proved hard to compare. This can be attributed to the high level of heterogeneity and methodology of these studies, for instance in the method to objectify recovery. For the studies in this thesis, we have opted to compare outcomes with the patients’ individual prefracture level of function. Surgical aspects, such as different approaches to place a prosthesis, seemed to have a reserved effect on recovery. Factors which seemed of conclusive relevance were health scores based on the comorbidity and prefracture level of function. This emphasizes the importance of a holistic and geriatric approach for patients with proximal hip fractures. ChipSoft, Castor EDC, Nutricia Nederland BV, Mathys Orthopaedics BV, ABN AMRO, Stichting Anna Fonds|NOREF, Haaglanden Medisch Centrum, Traumacentrum West, the department of Public Health and Primary Care of the LUMC, the Leiden University Libraries.LUMC / Geneeskund

Which Soft Tissue Sarcoma Patients with Lung Metastases Should not Undergo Pulmonary Resection?

Using the second best method of meta-analysis it is significantly shown that patients with an interval of less than 7 months between diagnosis of soft tissue sarcoma and lung surgery for metastases do not benefit

High relapse-free survival after preoperative and intraoperative radiotherapy and resection for sulcus superior tumors

STUDY OBJECTIVES: Relapse-free survival in patients with sulcus superior tumors. DESIGN: Prospective registration study. SETTING: Department of surgical oncology of a university hospital. PATIENTS: Twenty-one patients treated with preoperative radiotherapy (46 Gy), lobectomy and chest-wall resection, and intraoperative radiotherapy (10 Gy). RESULTS: After a median follow-up of 18 months, 18 patients (85%) were free from locoregional relapse, while 8 patients were still alive. CONCLUSIONS: The results show that this protocol can achieve excellent local tumor control and can even be used for palliative treatment

Isolated hypoxic hepatic perfusion with tumor necrosis factor-alpha, melphalan, and mitomycin C using balloon catheter techniques: a pharmacokinetic study in pigs

OBJECTIVE: To validate the methodology of isolated hypoxic hepatic perfusion (IHHP) using balloon catheter techniques and to gain insight into the distribution of tumor necrosis factor-alpha (TNF), melphalan, and mitomycin C (MMC) through the regional and systemic blood compartments when applying these techniques. SUMMARY BACKGROUND DATA: There is no standard treatment for unresectable liver tumors. Clinical results of isolated limb perfusion with high-dose TNF and melphalan for the treatment of melanoma and sarcoma have been promising, and attempts have been made to extrapolate this success to the isolated liver perfusion setting. The magnitude and toxicity of the surgical procedure, however, have limited clinical applicability. METHODS: Pigs underwent IHHP with TNF, melphalan, and MMC using balloon catheters or served as controls, receiving equivalent dosages of these agents intravenously. After a 20-minute perfusion, a washout procedure was performed for 10 minutes, after which isolation was terminated. Throughout the procedure and afterward, blood samples were obtained from the hepatic and systemic blood compartments and concentrations of perfused agents were determined. RESULTS: During perfusion, locoregional plasma drug concentrations were 20- to 40-fold higher than systemic concentrations. Compared with systemic concentrations after intravenous administration, regional concentrations during IHHP were up to 10-fold higher. Regional MMC and melphalan levels steadily declined during perfusion, indicating rapid uptake by the liver tissue; minimal systemic concentrations indicated virtually no leakage to the systemic blood compartment. During isolation, concentrations of TNF in the perfusate declined only slightly, indicating limited uptake by the liver tissue; no leakage of TNF to the systemic circulation was observed. After termination of isolation, systemic TNF levels showed only a minor transient elevation, indicating that the washout procedure at the end of the perfusions was fully effective. CONCLUSIONS: Complete isolation of the hepatic vascular bed can be accomplished when performing IHHP using this balloon catheter technique. Thus, as in extremities, an ideal leakage-free perfusion of the liver can now be performed, and repeated, without major surgery. The effective washout allows the addition of TNF in this setting

Effect of the Deepening of the Tasman Gateway on the Global Ocean

We examine the effect of the deepening of the Tasman Seaway at the end of the Eocene in a climate model with realistic late Eocene bathymetry and winds. For this, we have constructed an Eocene numerical model based on the University of Victoria climate model with wind forcing derived from a fully coupled Eocene simulation. The model climate state is characterized by an oceanic meridional overturning circulation (MOC) involving Southern Hemisphere sinking and a northward atmospheric moisture transport across the equator. The deepening of the Tasman Seaway in the presence of an open Drake Passage and the associated establishment of the Antarctic Circumpolar Current (ACC) have a limited climatic impact on Antarctica. Nonetheless, the Antarctic deep sinking regions cool sufficiently to lead to a global deep ocean cooling of 3°C. No initiation of Northern Component Water is found, indicating that this may require the development of a more mature ACC. Previous studies suggest that the Ross Sea gyre cools the east coast of Australia, and expected the deepening of the Tasman Seaway to lead to a warming east of Australia due to the introduction of warmer water from the Australo-Antarctic Gulf. We here find that this warming is limited to close to the Australian coast, and that widespread cooling prevails further off shore

Antarctic climate, Southern Ocean circulation patterns, and deep water formation during the Eocene

We assess early-to-middle Eocene seawater neodymium (Nd) isotope records from seven Southern Ocean deep-sea drill sites to evaluate the role of Southern Ocean circulation in long-term Cenozoic climate change. Our study sites are strategically located on either side of the Tasman Gateway and are positioned at a range of shallow (Nd(t) = −9.3 ± 1.5). IODP Site U1356 off the coast of Adélie Land, a locus of modern-day Antarctic Bottom Water production, is identified as a site of persistent deep water formation from the early Eocene to the Oligocene. East of the Tasman Gateway an additional local source of intermediate/deep water formation is inferred at ODP Site 277 in the SW Pacific Ocean (εNd(t) = −8.7 ± 1.5). Antarctic-proximal shelf sites (ODP Site 1171 and Site U1356) reveal a pronounced erosional event between 49 and 48 Ma, manifested by ~2 εNd unit negative excursions in seawater chemistry toward the composition of bulk sediments at these sites. This erosional event coincides with the termination of peak global warmth following the Early Eocene Climatic Optimum and is associated with documented cooling across the study region and increased export of Antarctic deep waters, highlighting the complexity and importance of Southern Ocean circulation in the greenhouse climate of the Eocene