Search Results (27)

Background/Objectives: Adult cochlear implant (CI) users exhibit broad variability in speech perception and production outcomes. Cochlear implantation improves the intelligibility (comprehensibility) of CI users’ speech, but the degraded auditory signal delivered by the CI may attenuate this benefit. Among other effects, degraded auditory feedback can lead to compression of the acoustic–phonetic vowel space, which makes vowel productions confusable, decreasing intelligibility. Sustained exposure to degraded auditory feedback may also weaken phonological representations. The current study examined the relationship between subjective ratings and acoustic measures of speech production, speech recognition accuracy, and phonological processing (cognitive processing of speech sounds) in adult CI users. Methods: Fifteen adult CI users read aloud a series of short words, which were analyzed in two ways. First, acoustic measures of vowel distinctiveness (i.e., vowel dispersion) were calculated. Second, thirty-seven normal-hearing (NH) participants listened to the words produced by the CI users and rated the subjective intelligibility of each word from 1 (least understandable) to 100 (most understandable). CI users also completed an auditory sentence recognition task and a nonauditory cognitive test of phonological processing. Results: CI users rated as having more understandable speech demonstrated more accurate sentence recognition than those rated as having less understandable speech, but intelligibility ratings were only marginally related to phonological processing. Further, vowel distinctiveness was marginally associated with sentence recognition but not related to phonological processing or subjective ratings of intelligibility. Conclusions: The results suggest that speech intelligibility ratings are related to speech recognition accuracy in adult CI users, and future investigation is needed to identify the extent to which this relationship is mediated by individual differences in phonological processing. Full article

Sign language recognition (SLR) plays a crucial role in bridging the communication gap between deaf individuals and the hearing population. However, achieving subject-independent SLR remains a significant challenge due to variations in signing styles, hand shapes, and movement patterns among users. Traditional Markov Chain-based models struggle with generalizing across different signers, often leading to reduced recognition accuracy and increased uncertainty. These limitations arise from the inability of conventional models to effectively capture diverse gesture dynamics while maintaining robustness to inter-user variability. To address these challenges, this study proposes an adaptive SLR framework that integrates Markov Chains with a Niching Genetic Algorithm (NGA). The NGA optimizes the transition probabilities and structural parameters of the Markov Chain model, enabling it to learn diverse signing patterns while avoiding premature convergence to suboptimal solutions. In the proposed SLR framework, GA is employed to determine the optimal transition probabilities for the Markov Chain components operating across multiple signing contexts. To enhance the diversity of the initial population and improve the model’s adaptability to signer variations, a niche model is integrated using a Context-Based Clearing (CBC) technique. This approach mitigates premature convergence by promoting genetic diversity, ensuring that the population maintains a wide range of potential solutions. By minimizing gene association within chromosomes, the CBC technique enhances the model’s ability to learn diverse gesture transitions and movement dynamics across different users. This optimization process enables the Markov Chain to better generalize subject-independent sign language recognition, leading to improved classification accuracy, robustness against signer variability, and reduced misclassification rates. Experimental evaluations demonstrate a significant improvement in recognition performance, reduced error rates, and enhanced generalization across unseen signers, validating the effectiveness of the proposed approach. Full article

Objectives: This study aimed to investigate the impact of platelet-rich plasma (PRP) and platelet-rich gel (PRG) on tympanic membrane closure rates, hearing improvement, and quality of life following tympanoplasty. Methods: Seventy-two patients with chronic tympanic membrane perforations were enrolled in a double-blinded, randomized controlled trial at a single tertiary referral center. All patients underwent tympanoplasty using a temporalis fascia graft and were randomly assigned to one of two groups: one group received standard tympanoplasty alone, while the other received intraoperative application of autologous PRP and PRG, in addition to the standard procedure. Results: The PRP group demonstrated a significantly higher rate of complete tympanic membrane closure compared to the control group (32/36; 88.9% vs. 24/36; 66.7%; p < 0.05). Bone conduction hearing remained unchanged in both groups, while air conduction hearing improved significantly from pre- to post-treatment in each group. However, the difference in air conduction improvement between the PRP group and the control group was not statistically significant (PRP group: Mdn = −8.25; control group: Mdn = −12.20; U = 618; z = −0.54; p = 0.30). Quality of life improved in both the PRP and control groups; however, the difference between the groups was not statistically significant (PRP group: 10.44 ± 10.46; control group: 10.47 ± 8.22; 95% CI [−4.45; 4.40]; t(66) = −0.01; p = 0.16). Conclusions: Our findings suggest that intraoperative application of autologous PRP and PRG may improve tympanoplasty outcomes, particularly in cases with lower expected success rates or when performing minimally invasive transcanal procedures under local anesthesia. However, variability in PRP preparation, application methods, and graft materials across studies limits direct comparisons. Standardized protocols and further controlled studies are necessary to clarify PRP’s clinical value in tympanoplasty. Full article

Background/Objectives: Cochlear implantation is an advantageous procedure for individuals with severe to profound hearing loss in many aspects related to auditory performance, social communication and quality of life. As machine learning applications have been used in the field of Otorhinolaryngology and Audiology in recent years, signal processing, speech perception and personalised optimisation of cochlear implantation are discussed. Methods: A comprehensive literature review was conducted in accordance with the PRISMA guidelines. PubMed, Scopus, Web of Science, Google Scholar and IEEE databases were searched for studies published between 2010 and 2025. We analyzed 59 articles that met the inclusion criteria. Rayyan AI software was used to classify the studies so that the risk of bias was reduced. Study design, machine learning algorithms, and audiological measurements were evaluated in the data analysis. Results: Machine learning applications were classified as preoperative evaluation, speech perception, and speech understanding in noise and other studies. The success rates of the articles are presented together with the number of articles changing over the years. It was observed that Random Forest, Decision Trees (96%), Bayesian Linear Regression (96.2%) and Extreme machine learning (99%) algorithms reached high accuracy rates. Conclusions: In cochlear implantation applications in the field of audiology, it has been observed that studies have been carried out with a variable number of people and data sets in different subfields. In machine learning applications, it is seen that a high amount of data, data diversity and long training times contribute to achieving high performance. However, more research is needed on deep learning applications in complex problems such as comprehension in noise that require time series processing. Funding and other resources: This study was not funded by any institution or organization. No registration was performed for this study. Full article

Cisplatin (cis-diclorodiamminoplatin, CDDP) is a common chemotherapeutic agent for solid tumors, but its use is limited by severe side effects such as ototoxicity and nephrotoxicity. Variability in CDDP dosing and administration, along with high mortality and sensitivity in animal models, complicates experimental approaches. This study aimed to evaluate ototoxic damage in rats by comparing a single bolus versus three divided CDDP injections, also considering nephrotoxic effects. Twenty-four Sprague-Dawley rats were divided into three groups: eight received a single intraperitoneal injection of CDDP (14 mg/kg), eight received three injections (4.6 mg/kg/day), and eight were untreated controls. All CDDP-treated rats showed significant high-frequency hearing loss and morphological damage, including cochlear outer hair cell loss and renal glomerular atrophy with proximal tubule necrosis. Oxidative stress markers (nitrotyrosine and SOD1 expression) confirmed cochlear and renal alterations. Notably, the single bolus group had a 25% mortality rate and significant weight loss among survivors, unlike the other groups. This study introduces the novel finding that cumulative administration of three doses reduces mortality and weight loss while maintaining similar ototoxic and nephrotoxic effects. Therefore, cumulative administration is recommended for future studies to mitigate ototoxic and nephrotoxic damage, offering a potentially improved protocol for the administration of cisplatin. Full article

Background: Parental satisfaction is an important factor in the evaluation of early intervention programs but is rarely investigated. The Muenster Parental Program (MPP) is a short, evidence-based early intervention program that focuses on parental responsiveness. It is a family-centered intervention for parents of infants aged 3–18 months who have recently been diagnosed with hearing loss and fitted with hearing devices, including prior to or following cochlear implant surgery. Objective: We aim to receive feedback from parents regarding the process and outcomes of their participation in the MPP. Method: Following their participation, all participants of the MPP were asked to complete an evaluation questionnaire. This article reports feedback from the first 52 participants (44 mothers, 7 fathers, and 1 godmother). Their infants (N = 45) had moderate to complete hearing loss, they were aged 2–20 months, and 40% of them had an additional disease, disorder, and/or developmental delay. Results: Parents reported high levels of satisfaction with the content, didactics, setting, and individual benefits of the intervention, and a high recommendation rate (92%). The aspects most appreciated were meeting other affected parents and the concrete individual support of parent–child communication, including video feedback. Almost all parents (96%) reported a change in their communication style with their child. This confirms the results of a previous controlled intervention study on the enhancement of parental responsiveness via the MPP. Conclusions: This evaluation of the MPP from a parental point of view has revealed equally high satisfaction with the content, setting, and didactics amongst all parents regardless of any potentially influential parent or child variables. The MPP is well suited to a wide range of close caregivers’ needs despite the known diversity of children with hearing loss and their parents or families. Full article

Noise reduction (NR) algorithms are employed in nearly all commercially available hearing aids to attenuate background noise. However, NR processing also involves undesirable speech distortions, leading to variability in hearing outcomes among individuals with different noise tolerance. Leveraging 30 participants with normal hearing engaged in speech-in-noise tasks, the present study examined whether the cortical measure of neural signal-to-noise ratio (SNR)—the amplitude ratio of auditory evoked responses to target speech onset and noise onset—could predict individual variability in NR outcomes with varying strength, thus serving as a reliable indicator of individual noise tolerance. In addition, we also measured subjective ratings of noise tolerance to see if these measures could capture different perspectives on individual noise tolerance. Results indicated a significant correlation between neural SNR and NR outcomes that intensified with increasing strength of NR processing. While subjective ratings of noise tolerance were not correlated with the neural SNR, noise-tolerance ratings could predict outcomes with stronger NR processing and account for additional variance in the regression model, although the effect was limited. Our findings underscore the importance of accurately assessing an individual’s noise tolerance characteristics in predicting perceptual benefits from various NR processing methods and suggest the advantage of incorporating both cortical and subjective measures in the relevant methodologies. Full article

Objective: The objective of this work was to assess the effect of physical therapy in patients with somatosensory tinnitus (ST) and explore the influence of physical therapy on clinical variables obtained before treatment. Methods: A total of 43 patients with ST were randomized to the immediate-start group (n = 20) and delayed-start group (n = 23). All patients received physical therapy for 1 week (seven sessions). Each session lasted 60 min. The Visual Analogue Scale (VAS), Tinnitus Handicap Inventory (THI), and numerical pain rating scale (NPRS) scores were documented at baseline and after treatment (week 1) for all patients. For subjects in the immediate-start group, the THI, VAS, and NPRS scores were measured after therapy (weeks 6, 9, and 12, respectively). Medical history characteristic functional activity scale (HCFA) scores were measured at baseline to assess the association between somatic symptoms and tinnitus. Results: At week 1, VAS, THI, and NPRS scores of patients in the immediate-start group were improved by 1.25 ± 1.59, 11.10 ± 15.10, and 0.95 ± 1.54 points, respectively, and were significantly higher than those in the delayed-start group (p < 0.05). The change in VAS, THI, and NPRS scores in the treatment group was significantly positively correlated with the scores of the HCFA before treatment (r = 0.786, p < 0.001; r = 0.680, p = 0.001; r = 0.796, p < 0.001). There was no significant difference in THI, VAS, and NPRS scores among patients in the immediate-start group between weeks 1, 6, 9, and 12 after treatment (p > 0.05). Conclusions: Although more participants were necessary in the further study, the study implies that physical therapy can reduce physical pain, improve tinnitus symptoms, and quality of life in ST patients without hearing loss, and the short-term curative effect is stable, especially for tinnitus patients with clear somatic symptoms. Full article

Background: Several screening strategies for identifying congenital CMV (cCMV) have been proposed; however, the optimal solution has yet to be determined. We aimed to determine the prevalence of cCMV by universal screening with saliva pool testing and to identify the clinical variables associated with a higher risk of cCMV to optimize an expanded screening strategy. Methods: We carried out a prospective universal cCMV screening (September/2022 to August/2023) of 2186 newborns, analyzing saliva samples in pools of five (Alethia-LAMP-CMV^®) and then performed confirmatory urine CMV RT-PCR. Infants with risk factors (small for gestational age, failed hearing screening, HIV-exposed, born to immunosuppressed mothers, or <1000 g birth weight) underwent expanded screening. Multivariate analyses were used to assess the association with maternal/neonatal variables. Results: We identified 10 infants with cCMV (prevalence: 0.46%, 95% CI 0.22–0.84), with significantly higher rates (2.1%, 95% CI 0.58–5.3) in the high-risk group (p = 0.04). False positives occurred in 0.09% of cases. No significant differences in maternal/neonatal characteristics were observed, except for a higher prevalence among infants born to non-Chilean mothers (p = 0.034), notably those born to Haitian mothers (1.5%, 95% CI 0.31–4.34), who had higher odds of cCMV (OR 6.82, 95% CI 1.23–37.9, p = 0.04). Incorporating maternal nationality improved predictive accuracy (AUC: 0.65 to 0.83). Conclusions: For low-prevalence diseases such as cCMV, universal screening with pool testing in saliva represents an optimal and cost-effective approach to enhance diagnosis in asymptomatic patients. An expanded screening strategy considering maternal nationality could be beneficial in resource-limited settings. Full article

More and more people quantify their sleep using wearables and are becoming obsessed in their pursuit of optimal sleep (“orthosomnia”). However, it is criticized that many of these wearables are giving inaccurate feedback and can even lead to negative daytime consequences. Acknowledging these facts, we here optimize our previously suggested sleep classification procedure in a new sample of 136 self-reported poor sleepers to minimize erroneous classification during ambulatory sleep sensing. Firstly, we introduce an advanced interbeat-interval (IBI) quality control using a random forest method to account for wearable recordings in naturalistic and more noisy settings. We further aim to improve sleep classification by opting for a loss function model instead of the overall epoch-by-epoch accuracy to avoid model biases towards the majority class (i.e., “light sleep”). Using these implementations, we compare the classification performance between the optimized (loss function model) and the accuracy model. We use signals derived from PSG, one-channel ECG, and two consumer wearables: the ECG breast belt Polar® H10 (H10) and the Polar® Verity Sense (VS), an optical Photoplethysmography (PPG) heart-rate sensor. The results reveal a high overall accuracy for the loss function in ECG (86.3 %, $\kappa$ = 0.79), as well as the H10 (84.4%, $\kappa$ = 0.76), and VS (84.2%, $\kappa$ = 0.75) sensors, with improvements in deep sleep and wake. In addition, the new optimized model displays moderate to high correlations and agreement with PSG on primary sleep parameters, while measures of reliability, expressed in intra-class correlations, suggest excellent reliability for most sleep parameters. Finally, it is demonstrated that the new model is still classifying sleep accurately in 4-classes in users taking heart-affecting and/or psychoactive medication, which can be considered a prerequisite in older individuals with or without common disorders. Further improving and validating automatic sleep stage classification algorithms based on signals from affordable wearables may resolve existing scepticism and open the door for such approaches in clinical practice. Full article

Gaucher disease (GD) has been increasingly recognized as a continuum of phenotypes with variable neurological and sensory involvement. No study has yet specifically explored the spectrum of neuropsychiatric and sensory abnormalities in GD patients through a multidisciplinary approach. Abnormalities involving the nervous system, including sensory abnormalities, cognitive disturbances, and psychiatric comorbidities, have been identified in GD1 and GD3 patients. In this prospective study, named SENOPRO, we performed neurological, neuroradiological, neuropsychological, ophthalmological, and hearing assessments in 22 GD patients: 19 GD1 and 3 GD3. First, we highlighted a high rate of parkinsonian motor and non-motor symptoms (including high rates of excessive daytime sleepiness), especially in GD1 patients harboring severe glucocerebrosidase variants. Secondly, neuropsychological evaluations revealed a high prevalence of cognitive impairment and psychiatric disturbances, both in patients initially classified as GD1 and GD3. Thirdly, hippocampal brain volume reduction was associated with impaired short- and long-term performance in an episodic memory test. Fourthly, audiometric assessment showed an impaired speech perception in noise in the majority of patients, indicative of an impaired central processing of hearing, associated with high rates of slight hearing loss both in GD1 and GD3 patients. Finally, relevant structural and functional abnormalities along the visual system were found both in GD1 and GD3 patients by means of visual evoked potentials and optical coherence tomography. Overall, our findings support the concept of GD as a spectrum of disease subtypes, and support the importance of in-depth periodic monitoring of cognitive and motor performances, mood, sleep patterns, and sensory abnormalities in all patients with GD, independently from the patient’s initial classification. Full article

Malawi, as a low-income country in southeastern Africa, severely lacks early identification, diagnosis and intervention measures for hearing loss. Due to its constrained resources, an educational awareness campaign targeted at professionals can be a cost-effective instrument in promoting good health care through awareness, prevention, and early identification of hearing loss. The aim of this study is to assess school teachers’ knowledge of hearing health, audiology services, identification, and management of hearing issues before and after an educational intervention. Methods: A Pre-Survey, followed by an educational intervention, and a Post-Survey were completed by teacher participants. A similar World Health Organization-derived survey was also administered to compare to our locally adapted survey. Trends related to efficacy, performance, and survey improvement were evaluated. Results: A total of 387 teachers participated. The average score on the Post-Survey was significantly improved compared to the Pre-Survey (71% to 97% correct responses) with the educational intervention. The only predictive variable related to performance was the location of the school within the capital of Lilongwe compared to rural sites outside of the capital. Our locally adapted survey compared favorably to the WHO survey. Conclusions: The results suggest that there is a statistically significant improvement in the implementation of an educational program to increase the knowledge and awareness of hearing health care among teachers. Some topics were more poorly understood than others, suggesting the need for targeted awareness interventions. Location within the capital city had some effect on performance but a high rate of correct responses was achievable across the participants independent of age, teaching experience, or gender. Our data support the idea that hearing health awareness interventions can be an effective and low-cost option to equip teachers to effectively serve as an advocate for improved identification, early diagnosis and appropriate referral of students with hearing loss. Full article

Mitochondrial pathologies are clinically composite and show highly variable phenotypes amongst all inherited disorders, mainly due to their heteroplasmic nature. Mutations in mitochondrial DNA (mtDNA) and the nuclear genome (gDNA), or both, have been reported in mitochondrial diseases, suggesting common pathophysiological pathways. Nuclear gene mutations identified in mitochondrial diseases are mostly involved in mtDNA replication, transcription and translation, oxidative phosphorylation (OXPHOS), the biosynthesis of mtDNA, nucleoside transport, salvage or synthesis, and the homeostasis of mitochondrial deoxyribonucleoside triphosphates (dNTP) pool. The m.3243 A>G mtDNA mutation in the MT-TL1 gene coding for the tRNALeu (UUR) is one of the most common mitochondrial disease-causing mutations, with a carrier rate as high as 1:400. Recent studies suggest that patients with the m.3243 A>G mutation present a huge clinical heterogeneity supporting the necessity to investigate the nuclear genome to improve the knowledge on composite mitochondrial disorders, such as mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS), maternally inherited diabetes and deafness (MIDD) and myopathy. MIDD is a multi-system disorder characterized by diabetes, hearing impairment, and maculopathy but can present several other clinical manifestations. The present study aimed to analyze the whole mitochondrial genome and the whole exome of a clinically characterized MIDD family, negative to the m.3243 A>G variant, and identify mutations in both gDNA and mtDNA, as well as their biological role in their heterogeneous phenotype. The obtained results permitted us to hypothesize that the mitochondrial defects might be due to the epigenetic deregulation of the mitochondrial and nuclear-encoded genes coding for mitochondrial structure and functions. Thus, epigenetic modifications in the context of mitochondrial dysfunctions represent an emerging area of research, possibly useful for innovative mtDNA-related disease differential analyses. Full article

The aims of this study were to (i) analyze the physical and physiological responses of four matches competition and (ii) to investigate the relationships among three different pitch dimensions of small-sided game (SSG) on the youth soccer players. Fifteen male U19 soccer players (age 17.3 ± 0.5 years, height 175.7 ± 5.6 cm, weight 68.5 ± 8.6 kg, playing experience 7.8 ± 1.4 years) were randomly assigned to three play areas: small (50 m²), medium (SSG-m, 150 m²) and large (SSG-l, 250 m²) area per player including goalkeeper. During the 4-week intervention, both groups performed three sets of 8 min with a passive rest period of 5 min between games. Differences in time-motion characteristics of players were measured with the Global Positioning System and assessed using a repeated measures ANOVA to compare the three game conditions and the magnitude-based inference to evaluate the pairwise comparison effects. The results showed that only the variables distance covered between 7.0–12.9 km·h⁻¹ was not statistically significantly different among game conditions (p < 0.05; η = 0.21; small) and physiological response (i.e., hear rate of playing time spent 85–89% HR_max) also showed differences (p < 0.05; η = 0.25; small). The responses in SSG-m and SSG-l established them ass the format sizes ideal for replicating the physical responses during match competition. These findings could provide relevant information for coaches for use adequate pitch size (areas of 150 m² and 250 m²) to reach the match-play scenarios found in match competition. Full article

Millions of children in the United States are growing up hearing multiple languages. Memory flexibility is the ability to apply information from a past experience to future situations that are perceptually different from the initial learning experience and differs between monolinguals and bilinguals during infancy. We use a new, non-verbal object sequencing imitation task (OSI) to measure memory flexibility changes in monolingual and bilingual preschoolers. In the OSI task, children imitate target actions to produce a final pose on a robot figure. Children are tested with different robots than those used to demonstrate the target actions to test memory flexibility. We hypothesized that both monolingual and bilingual children would imitate the sequences significantly above baseline, but bilingual preschoolers would do so at a greater rate than their monolingual peers. To test this hypothesis, we visited 101 3-year-olds in their homes. An experimenter demonstrated 2- to 5-step sequences on one robot, and children were tested on a functionally similar but perceptually different robot. All preschoolers performed significantly above baseline on the total composite percentage score (the correct number of movements and pairs summed across all sequences, divided by the possible maximum score). There were no significant differences between monolinguals and bilinguals in baseline and test trials. We repeated the same pattern of results using a multi-level model, including all trials. The common binary classification of bilinguals and monolinguals often does not adequately describe the complex experience of growing up in a bilingual environment. Modeling the heterogeneity that arises from growing up in a bilingual home is important for understanding how this arrangement could impact an individual’s cognitive development. To consider such heterogeneity, we implemented latent profile modeling to identify language groups based on a series of variables such as L2, L3 exposure, speakers’ nativeness to the languages, and speakers’ proficiency and identified three profiles (low, medium, and high multilingual exposure). The pattern of results remained the same. We conclude that memory flexibility differences exhibited during infancy may plateau during early childhood. Full article