Comparison of the benefits of cochlear implantation versus contra-lateral routing of signal hearing aids in adult patients with single-sided deafness: study protocol for a prospective within-subject longitudinal trial

Background Individuals with a unilateral severe-to-profound hearing loss, or single-sided deafness, report difficulty with listening in many everyday situations despite having access to well-preserved acoustic hearing in one ear. The standard of care for single-sided deafness available on the UK National Health Service is a contra-lateral routing of signals hearing aid which transfers sounds from the impaired ear to the non-impaired ear. This hearing aid has been found to improve speech understanding in noise when the signal-to-noise ratio is more favourable at the impaired ear than the non-impaired ear. However, the indiscriminate routing of signals to a single ear can have detrimental effects when interfering sounds are located on the side of the impaired ear. Recent published evidence has suggested that cochlear implantation in individuals with a single-sided deafness can restore access to the binaural cues which underpin the ability to localise sounds and segregate speech from other interfering sounds. Methods/Design The current trial was designed to assess the efficacy of cochlear implantation compared to a contra-lateral routing of signals hearing aid in restoring binaural hearing in adults with acquired single-sided deafness. Patients are assessed at baseline and after receiving a contra-lateral routing of signals hearing aid. A cochlear implant is then provided to those patients who do not receive sufficient benefit from the hearing aid. This within-subject longitudinal design reflects the expected care pathway should cochlear implantation be provided for single-sided deafness on the UK National Health Service. The primary endpoints are measures of binaural hearing at baseline, after provision of a contra-lateral routing of signals hearing aid, and after cochlear implantation. Binaural hearing is assessed in terms of the accuracy with which sounds are localised and speech is perceived in background noise. The trial is also designed to measure the impact of the interventions on hearing- and health-related quality of life. Discussion This multi-centre trial was designed to provide evidence for the efficacy of cochlear implantation compared to the contra-lateral routing of signals. A purpose-built sound presentation system and established measurement techniques will provide reliable and precise measures of binaural hearing. Trial registration Current Controlled Trials http://www.controlled-trials.com/ISRCTN33301739 (05/JUL/2013

Weak Responses to Auditory Feedback Perturbation during Articulation in Persons Who Stutter: Evidence for Abnormal Auditory-Motor Transformation

Previous empirical observations have led researchers to propose that auditory feedback (the auditory perception of self-produced sounds when speaking) functions abnormally in the speech motor systems of persons who stutter (PWS). Researchers have theorized that an important neural basis of stuttering is the aberrant integration of auditory information into incipient speech motor commands. Because of the circumstantial support for these hypotheses and the differences and contradictions between them, there is a need for carefully designed experiments that directly examine auditory-motor integration during speech production in PWS. In the current study, we used real-time manipulation of auditory feedback to directly investigate whether the speech motor system of PWS utilizes auditory feedback abnormally during articulation and to characterize potential deficits of this auditory-motor integration. Twenty-one PWS and 18 fluent control participants were recruited. Using a short-latency formant-perturbation system, we examined participants’ compensatory responses to unanticipated perturbation of auditory feedback of the first formant frequency during the production of the monophthong [ε]. The PWS showed compensatory responses that were qualitatively similar to the controls’ and had close-to-normal latencies (~150 ms), but the magnitudes of their responses were substantially and significantly smaller than those of the control participants (by 47% on average, p<0.05). Measurements of auditory acuity indicate that the weaker-than-normal compensatory responses in PWS were not attributable to a deficit in low-level auditory processing. These findings are consistent with the hypothesis that stuttering is associated with functional defects in the inverse models responsible for the transformation from the domain of auditory targets and auditory error information into the domain of speech motor commands

Don't Skype & Type! Acoustic Eavesdropping in Voice-Over-IP.

Acoustic emanations of computer keyboards represent a serious privacy issue. As demonstrated in prior work, physical properties of keystroke sounds might reveal what a user is typing. However, previous attacks assumed relatively strong adversary models that are not very practical in many real-world settings. Such strong models assume: (i) adversary's physical proximity to the victim, (ii) precise profiling of the victim's typing style and keyboard, and/or (iii) significant amount of victim's typed information (and its corresponding sounds) available to the adversary. This paper presents and explores a new keyboard acoustic eavesdropping attack that involves Voice-over-IP (VoIP), called Skype & Type (S&T), while avoiding prior strong adversary assumptions. This work is motivated by the simple observation that people often engage in secondary activities (including typing) while participating in VoIP calls. As expected, VoIP software acquires and faithfully transmits all sounds, including emanations of pressed keystrokes, which can include passwords and other sensitive information. We show that one very popular VoIP software (Skype) conveys enough audio information to reconstruct the victim's input -- keystrokes typed on the remote keyboard. Our results demonstrate that, given some knowledge on the victim's typing style and keyboard model, the attacker attains top-5 accuracy of 91.7% in guessing a random key pressed by the victim. Furthermore, we demonstrate that S&T is robust to various VoIP issues (e.g., Internet bandwidth fluctuations and presence of voice over keystrokes), thus confirming feasibility of this attack. Finally, it applies to other popular VoIP software, such as Google Hangouts.Comment: To appear in ACM Asia Conference on Computer and Communications Security (ASIACCS) 2017. 13 pages, 17 figure