Sensation Level Research Articles

Measuring sensitivity to envelope interaural time differences by adapting modulation depth

Listeners are sensitive to interaural time differences carried in the envelope of high-frequency sounds (ITDENV), but the salience of this cue depends on several envelope properties. Making use of the fact that sensitivity to ITDENV varies systematically with the depth of modulation of sinusoidally amplitude-modulated tones, we devised a task in which modulation depth is varied adaptively to measure ITDENV sensitivity. In our task, the stimulus is a 4 kHz tone modulated at rates of 32, 64, or 128 Hz, with a fixed ITD of ±500 μs. Modulation depth is adaptively varied (in dB) and listeners make left-right judgements. The data are used to obtain a psychometric function and threshold value. For listeners with normal hearing, we find that thresholds vary with modulation rate and with sensation level as expected. This task provides us with a convenient means for investigating ITDENV sensitivity in listeners with sensorineural hearing loss. Given that this population shows enhanced sensitivity to amplitude modulation under certain conditions, generally attributed to a loss of cochlear compression, we will test the hypothesis that this translates into superior ITDENV sensitivity under similar conditions.

Effects of Spectral Shaping on Speech Auditory Brainstem Responses to Stop Consonant-Vowel Syllables.

Spectral shaping is employed by hearing aids to make consonantal information, such as formant transitions, audible for listeners with hearing loss. How manipulations of the stimuli, such as spectral shaping, may alter encoding in the auditory brainstem has not been thoroughly studied. The aim of this study was to determine how spectral shaping of synthetic consonant-vowel (CV) syllables, varying in their second formant (F2) onset frequency, may affect encoding of the syllables in the auditory brainstem. We employed a repeated measure design. Sixteen young adults (mean = 20.94 years, 6 males) and 11 older adults (mean = 58.60 years, 4 males) participated in this study. Speech-evoked auditory brainstem responses (speech-ABRs) were obtained from each participant using three CV exemplars selected from synthetic stimuli generated for a /ba-da-ga/ continuum. Brainstem responses were also recorded to corresponding three CV exemplars that were spectrally shaped to decrease low-frequency information and provide gain for middle and high frequencies according to a Desired Sensation Level function. In total, six grand average waveforms (3 phonemes [/ba/, /da/, /ga/] X 2 shaping conditions [unshaped, shaped]) were produced for each participant. Peak latencies and amplitudes, referenced to prestimulus baseline, were identified for 15 speech-ABR peaks. Peaks were marked manually using the program cursor on each individual waveform. Repeated-measures analysis of variances were used to determine the effects of shaping on the latencies and amplitudes of the speech-ABR peaks. Shaping effects produced changes within participants in ABR latencies and amplitudes involving onset and major peaks of the speech-ABR waveform for certain phonemes. Specifically, data from onset peaks showed that shaping decreased latency for /ga/ in older listeners, and decreased amplitude onset for /ba/ in younger listeners. Shaping also increased the amplitudes of major peaks for /ga/ stimuli in both groups. Encoding of speech in the ABR waveform may be more complex and multidimensional than a simple demarcation of source and filter information, and may also be influenced by cue intensity and age. These results suggest a more complex subcortical encoding of vocal tract filter information in the ABR waveform, which may also be influenced by cue intensity and age.

Influences of talker gender on second language speech perception

This study examined how talker gender information may influence second language speech perception. The participants were ten right-handed male Japanese adults with normal hearing. The speech stimuli were two minimal pairs of English words, “heed-hod” and “head-had”, recorded from twenty male and twenty female native English speakers. The stimuli were delivered binaurally at a sensation level of 50 dB. In the gender recognition task, the subjects were asked to judge talker gender. In the vowel recognition task, they were asked to identify the vowel category. Magnetoencephalography data were recorded during the experiment. For gender recognition, there was no significant difference in identification accuracy between the two word pairs while reaction time was significantly faster for the difficult “head-had” pair. In the phoneme recognition task, there was a significant phoneme*gender interaction for the difficult “head-had” pair but not for the easy “heed-hod” pair. The MEG data for gender recognition showed right hemisphere dominance, and the phoneme recognition task showed overall bilateral activation. Time-frequency analysis further revealed distinctions between male and female voices and the difficulty differences for the two word pairs in the phoneme recognition task. The results suggest a complex role of paralinguistic gender information in L2 speech perception.

A Chinese Medicine Formula (Bushen Huoxue Tongluo) for the Treatment of Chronic Subjective Tinnitus: A Study Protocol for a Pilot, Assessor-Blinded, Randomized Clinical Trial.

Background: Tinnitus is a common problem worldwide. There is still no effective method to cure it. Traditional Chinese medicine (TCM) may be a potentially effective treatment approach for tinnitus. However, there is still no clinical trial with scientifically rigorous methodology to evaluate the treatment effect of TCM for tinnitus. Therefore, we propose a pilot study to inform the feasibility of a future full-scale RCT to establish the efficacy of TCM formula for tinnitus. Objectives: The aim of this study is to determine the feasibility of a full-scale RCT and explore whether a TCM formula (BHT) has an additional effect on improving tinnitus when compared to informative counseling alone. Design: An assessor-blinded, randomized, controlled clinical trial is used. Participants: Twenty-four patients with chronic subjective tinnitus will be enrolled. Interventions: The patients will be allocated randomly to receive a TCM formula (BHT, Bushen Huoxue Tongluo) and informative counseling or informative counseling alone. The oral BHT herbal granules will be taken twice per day continuously for 8 weeks. Main outcome measures: The primary outcomes include recruitment rate, intervention completion rate, and data completion rate to evaluate the feasibility. The secondary outcomes include Tinnitus Handicap Inventory, tinnitus functional index, tinnitus sensation level, self-rated visual analogue scale on tinnitus loudness and annoyance, Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale, and adverse event. The outcome measures will be collected at baseline, end of treatment, and 4-week follow-up. Discussion: This trial is currently ongoing and is recruiting patients. The expected study results will find some preliminary evidence about the clinical effectiveness of BHT on chronic tinnitus and will also determine if it is feasible to conduct a full-scale RCT of BHT and identify the necessary changes to the protocol if possible.

Adaptation to tonic heat in healthy subjects and patients with sensory polyneuropathy.

Background Adaptation to a constant sensory stimulus involves many sites along the path of sensory volleys towards perception. The evaluation of such phenomenon may be of clinical interest. We studied adaptation to a constant temperature stimulus in healthy subjects to set normative data and in patients with sensory polyneuropathy (SPN), as proof of concept. Methods Twenty-six healthy subjects and 26 patients with SPN in the context of chemotherapy treatment with oxaliplatin for colon cancer were instructed to express through an electronic VAS system (eVAS); the level of sensation felt when a thermode set at either 39º, 41º, 43º, 45º or 47º was applied to their ventral forearm. Results The eVAS recordings showed typically an abrupt onset that slowed to approach maximum sensation and continued with a slow decrease indicating adaptation. The time to respond (TR), the velocity of the initial response (VR), the maximum sensation (MA), the time to reach MA (MAt), the onset of adaptation (AO) and the decrease in the sensation level with respect to MA at 30s after stimulus application (SL30), were dependent on the temperature level in all subjects. However, patients showed significantly delayed TR, slowed VR, decreased MA, delayed AO and reduced SL30, with respect to healthy subjects. Differences were more pronounced at low-temperature levels, with absent AO in 25 patients versus 2healthy subjects at temperatures of 39º and 41ºC. Conclusion The study of adaptation to a constant temperature stimulus can furnish valuable data for the assessment of patients with SPN. SIGNIFICANCE: We studied perceptual changes in the intensity of thermoalgesic sensation during 30s of constant temperature stimulation after an abrupt initial contact in healthy subjects and patients with sensory polyneuropathy. Patients showed delayed time to respond, decreased maximal sensation and reduced adaptation with respect to healthy subjects. Differences were more pronounced at low and intermediate temperatures (39ºC to 43ºC). The method is of easy implementation and shows clinically relevant abnormalities in patients with sensory polyneuropathy.

Threshold Equalizing Noise Test Reveals Suprathreshold Loss of Hearing Function, Even in the "Normal" Audiogram Range.

Objectives:The threshold equalizing noise (TEN(HL)) is a clinically administered test to detect cochlear “dead regions” (i.e., regions of loss of inner hair cell [IHC] connectivity), using a “pass/fail” criterion based on the degree of elevation of a masked threshold in a tone-detection task. With sensorineural hearing loss, some elevation of the masked threshold is commonly observed but usually insufficient to create a “fail” diagnosis. The experiment reported here investigated whether the gray area between pass and fail contained information that correlated with factors such as age or cumulative high-level noise exposure (>100 dBA sound pressure levels), possibly indicative of damage to cochlear structures other than the more commonly implicated outer hair cells.Design:One hundred and twelve participants (71 female) who underwent audiometric screening for a sensorineural hearing loss, classified as either normal or mild, were recruited. Their age range was 32 to 74 years. They were administered the TEN test at four frequencies, 0.75, 1, 3, and 4 kHz, and at two sensation levels, 12 and 24 dB above their pure-tone absolute threshold at each frequency. The test frequencies were chosen to lie either distinctly away from, or within, the 2 to 6 kHz region where noise-induced hearing loss is first clinically observed as a notch in the audiogram. Cumulative noise exposure was assessed by the Noise Exposure Structured Interview (NESI). Elements of the NESI also permitted participant stratification by music experience.Results:Across all frequencies and testing levels, a strong positive correlation was observed between elevation of TEN threshold and absolute threshold. These correlations were little-changed even after noise exposure and music experience were factored out. The correlations were observed even within the range of “normal” hearing (absolute thresholds ≤15 dB HL).Conclusions:Using a clinical test, sensorineural hearing deficits were observable even within the range of clinically “normal” hearing. Results from the TEN test residing between “pass” and “fail” are dominated by processes not related to IHCs. The TEN test for IHC-related function should therefore only be considered for its originally designed function, to generate a binary decision, either pass or fail.

Determination of thermal sensation levels for Koreans based on perceived temperature and climate chamber experiments with hot and humid settings

People perceive thermal sensation differently despite the same temperature value of thermal comfort index depending on various factors such as climate, culture, and physiological characteristics. The use of the thermal comfort index without optimization may lead to biases in assessment of thermal stress and sensation. This study aims to derive the perceived temperature (PT) ranges of thermal sensation levels related to heat stress for Koreans. The experiments were designed using a controlled environmental chamber to derive the PT ranges and were performed with subjects who are residents of Seoul, South Korea. The experiments were carried out in the summers of 2017 and 2018, and the thermal sensation votes were surveyed from 19 subjects whose mean age, height, weight, and body mass index were 22.5 years, 171 cm, 72 kg, and 23 kg⋅m−2, respectively. The derived PT ranges for Koreans led to a better performance than the reference PT ranges for Germans based on the results of validation. The thresholds of ‘Warm,’ ‘Hot,’ and ‘Very hot’ thermal sensation classes for Koreans were 28 °C, 36 °C, and 43 °C, respectively: higher than those for Germans. The results indicate that Koreans may have higher heat resistance or lower heat sensitivity than Germans.

The multisensory interaction between auditory, visual, and thermal to the overall comfort in public open space: A study in a tropical climate

• Perception of comfort in urban public space is affected by multimodal interaction. • Multimodal interaction exists between auditory and thermal sensations. • Multimodal interaction exists between visual and thermal sensations. • Sun exposures, dynamics, humidity, and noise influence comfort in urban public space. • Auditory factors have a stronger impact on comfort than thermal and visual factors. Human comfort, one of the most critical factors in public space utilization, is influenced by a multisensory interaction between stimuli in the built environment, namely auditory, thermal, and visual. However, the combined interaction between these stimuli and how it affects the perception of comfort and thus the use of space, especially for conditions in public open spaces in a tropical-climate country, is not fully understood. This study utilizes the Structural Equation Modeling method to model the interaction between the auditory, thermal, and visual factors in public open spaces by observing the physical parameters of the environment and the perceptions of space users. The results indicate a multisensory relationship between the visual and thermal factors induced by the sun exposures, in which Visual Sensation increases with an increase in Thermal Sensation. Another multisensory relationship exists between auditory and thermal factors, where Auditory Sensation increases with increased Thermal Sensation and noise level, which explains the dynamic in public open spaces. Additionally, changes in the auditory factor have the most significant influence on comfort in public open space, followed by thermal and visual factors. The findings of this study provide valuable information to support urban designers in creating comfortable urban public spaces.

Influence of Audibility and Distortion on Recognition of Reverberant Speech for Children and Adults with Hearing Aid Amplification.

Adults and children with sensorineural hearing loss (SNHL) have trouble understanding speech in rooms with reverberation when using hearing aid amplification. While the use of amplitude compression signal processing in hearing aids may contribute to this difficulty, there is conflicting evidence on the effects of amplitude compression settings on speech recognition. Less clear is the effect of a fast release time for adults and children with SNHL when using compression ratios derived from a prescriptive procedure. The aim of the study is to determine whether release time impacts speech recognition in reverberation for children and adults with SNHL and to determine if these effects of release time and reverberation can be predicted using indices of audibility or temporal and spectral distortion. This is a quasi-experimental cohort study. Participants used a hearing aid simulator set to the Desired Sensation Level algorithm m[i/o] for three different amplitude compression release times. Reverberation was simulated using three different reverberation times. Participants were 20 children and 16 adults with SNHL. Participants were seated in a sound-attenuating booth and then nonsense syllable recognition was measured. Predictions of speech recognition were made using indices of audibility, temporal distortion, and spectral distortion and the effects of release time and reverberation were analyzed using linear mixed models. While nonsense syllable recognition decreased in reverberation release time did not significantly affect nonsense syllable recognition. Participants with lower audibility were more susceptible to the negative effect of reverberation on nonsense syllable recognition. We have extended previous work on the effects of reverberation on aided speech recognition to children with SNHL. Variations in release time did not impact the understanding of speech. An index of audibility best predicted nonsense syllable recognition in reverberation and, clinically, these results suggest that patients with less audibility are more susceptible to nonsense syllable recognition in reverberation.

The Spectral Extent of Phasic Suppression of Loudness and Distortion-Product Otoacoustic Emissions by Infrasound and Low-Frequency Tones

We investigated the effect of a biasing tone close to 5, 15, or 30 Hz on the response to higher-frequency probe tones, behaviorally, and by measuring distortion-product otoacoustic emissions (DPOAEs). The amplitude of the biasing tone was adjusted for criterion suppression of cubic DPOAE elicited by probe tones presented between 0.7 and 8 kHz, or criterion loudness suppression of a train of tone-pip probes in the range 0.125–8 kHz. For DPOAEs, the biasing-tone level for criterion suppression increased with probe-tone frequency by 8–9 dB/octave, consistent with an apex-to-base gradient of biasing-tone-induced basilar membrane displacement, as we verified by computational simulation. In contrast, the biasing-tone level for criterion loudness suppression increased with probe frequency by only 1–3 dB/octave, reminiscent of previously published data on low-side suppression of auditory nerve responses to characteristic frequency tones. These slopes were independent of biasing-tone frequency, but the biasing-tone sensation level required for criterion suppression was ~ 10 dB lower for the two infrasound biasing tones than for the 30-Hz biasing tone. On average, biasing-tone sensation levels as low as 5 dB were sufficient to modulate the perception of higher frequency sounds. Our results are relevant for recent debates on perceptual effects of environmental noise with very low-frequency content and might offer insight into the mechanism underlying low-side suppression.

Amplification Strategies to Reduce Tinnitus: A Paired Comparison Method.

Background : The study investigates the best amplification strategy that provides tinnitus relief in a quiet environment, for individuals with sensorineural hearing loss with bothersome tinnitus.Methods: The repeated measures research design was utilized. Twenty participants (age range 25 years to 65 years; mean: 48.28 years) with bilateral symmetrical sloping sensorineural hearing loss with bothersome unilateral tinnitus were recruited. They were sub-grouped into low- and high-pitched tinnitus groups. A preference score was obtained for each of the strategies in hearing aid fitting, using the paired comparison method. The 4 strategies used were the desired sensation level (input/output) and the National Acoustic Laboratories’ nonlinear fitting method (version 1), at each of the low (30 dB SPL) and high (50 dB SPL) compression thresholds. Besides, the severity of tinnitus was assessed using the tinnitus severity index before and after 1 month of using the hearing aid in the best-selected strategy. Results: A repeated-measure ANOVA revealed no significant effect of the group on the preference score but was significant for strategies on relief from tinnitus. The desired sensation level (input/output) at a low compression threshold was the best strategy for alleviating tinnitus. Thirty-five percent of the study participants preferred the desired sensation level (input/output) strategy at low and high compression threshold, respectively. The remaining 25% preferred the National Acoustic Laboratories’ nonlinear hearing aid (version 1) at low compression threshold, and 5% selected the same device at high compression threshold. Furthermore, a significant association was observed in the severity of tinnitus before and after the hearing aid fitting set at the preferred program. Conclusion: The desired sensation level (input/output) method at the low compression threshold is the best program to alleviate bothersome tinnitus.

A Retrospective Study of Bimodal Benefits of Cochlear Implant Children

Purpose: Bimodal children showed various improvements in speech, language, and music perception. The purpose of this study is to investigate bimodal benefits and bimodal hearing aid fitting of cochlear implant children with a retrospective chart review.Methods: A total of 44 charts of cochlear implant children were retrospectively reviewed in this study. Hearing thresholds, word recognition scores, and hearing aid fitting procedures were reviewed and summarized.Results: Bimodal children showed 4%points improvements in word recognition scores and 30~40 gains across frequencies with hearing aids. For bimodal hearing aid fitting, all children used desired sensation level v5 fitting formula with wide frequency bands. Real ear measurements were performed to match with targets and loudness balancing across ears was also conducted. Hearing thresholds with and without hearing aids were not correlated with word recognition scores in bimodal condition.Conclusion: Bimodal children showed improved hearing thresholds with hearing aids and little bimodal benefits in word recognition tests. Additional protocols including speech in noise tests, subjective questionnaires are recommended to evaluate bimodal benefits.

Divided listening in the free field becomes asymmetric when acoustic cues are limited

Verbal communication in social environments often requires dividing attention between two or more simultaneous talkers. The ability to do this, however, may be diminished when the listener has limited access to acoustic cues or those cues are degraded, as is the case for hearing-impaired listeners or users of cochlear implants or hearing aids. The aim of the present study was to investigate the ability of normal-hearing (NH) listeners to divide their attention and recognize speech from two simultaneous talkers in simulated free-field listening conditions, with and without reduced acoustic cues. Participants (N = 11 or 12 depending on the experiment) were asked to recognize and repeat as many words as possible from two simultaneous, time-centered sentences uttered by a male and a female talker. In Experiment 1, the female and male talkers were located at 15° and +15°, 45° and +45°, or 90° and +90° azimuth, respectively. Speech was natural or processed through a noise vocoder and was presented at a comfortable loudness level (∼65 dB SPL). In Experiment 2, the female and male talkers were located at 45° and +45° azimuth, respectively. Speech was natural but was presented at a lower level (35 dB SPL) to reduce audibility. In Experiment 3, speech was vocoded and presented at a comfortable loudness level (∼65 dB SPL), but the location of the talkers was switched relative to Experiment 1 (i.e., the male and female talkers were at 45° and +45°, respectively) to reveal possible interactions of talker sex and location. Listeners recognized overall more natural words at a comfortable loudness level (76%) than vocoded words at a similar level (39%) or natural words at a lower level (43%). This indicates that recognition was more difficult for the two latter stimuli. On the other hand, listeners recognized roughly the same proportion of words (76%) from the two talkers when speech was natural and comfortable in loudness, but a greater proportion of words from the male than from the female talker when speech was vocoded (50% vs 27%, respectively) or was natural but lower in level (55% vs 32%, respectively). This asymmetry occurred and was similar for the three spatial configurations. These results suggest that divided listening becomes asymmetric when speech cues are reduced. They also suggest that listeners preferentially recognized the male talker, located on the right side of the head. Switching the talker's location produced similar recognition for the two talkers for vocoded speech, suggesting an interaction between talkers’ location and their speech characteristics. For natural speech at comfortable loudness level, listeners can divide their attention almost equally between two simultaneous talkers. When speech cues are limited (as is the case for vocoded speech or for speech at low sensation level), by contrast, the ability to divide attention equally between talkers is diminished and listeners favor one of the talkers based on their location, sex, and/or speech characteristics. Findings are discussed in the context of limited cognitive capacity affecting dividing listening in difficult listening situations.

Senzorna integracija kao preduslov za razvoj akademskih veština dece

The readiness to start school includes the emotional and social maturity of the child. In order for a child to master the demands of the school program as easily as possible, a certain harmony is needed in the development of his abilities. The ability of sensory perception and the ability to integrate sensory stimuli specifically determine the development of reading and writing skills. The aim of this study is to analyze the ability to read and write in hypersensitive and hyposensitive types of sensory integration disorders, with special reference to the analysis of individualization measures in the work with these students in the school system. Disorder of sensory integration is expressed in two basic forms: increased sensitivity (hypersensitivity) and decreased sensitivity (hyposensitivity). In the school system, both forms of sensory integration disorders dominate. Hypersensitivity is manifested by rapid mental fatigue compared to other children. These children have difficulty reading and writing at the same time. They can read a word in many different ways without realizing it. Compared to the hypersensitive child who seems inert, the hyposensitive child is in constant motion, craving additional sensory stimuli in the classroom. These children have great problems with reading and writing figures and symbols such as tables, geometric shapes and musical symbols. Adjusting the teaching material for these children means increasing the font and font color before reading, dividing large-scale tasks into smaller units, using different types of writing pens, constantly emphasizing important units in the lesson, providing a summary of the lesson at the end of the lesson, and occasionally checking the legibility of the handwriting. In this way, students are provided with easier visual, auditory and tactile processing, and therefore more successful writing, reading and understanding of the read material. Thus, a student with sensory processing disorder can achieve academic success, but it is necessary to adapt the curriculum to the appropriate level of sensations.

Effects of Hearing Loss on Interaural Time Difference Sensitivity at Low and High Frequencies.

While many studies have reported a loss of sensitivity to interaural time differences (ITDs) carried in the fine structure of low-frequency signals for listeners with hearing loss, relatively few data are available on the perception of ITDs carried in the envelope of high-frequency signals in this population. The relevant studies found stronger effects of hearing loss at high frequencies than at low frequencies in most cases, but small subject numbers and several confounding effects prevented strong conclusions from being drawn. In the present study, we revisited this question while addressing some of the issues identified in previous studies. Participants were ten young adults with normal hearing (NH) and twenty adults with sensorineural hearing impairment (HI) spanning a range of ages. ITD discrimination thresholds were measured for octave-band-wide “rustle” stimuli centered at 500 Hz or 4000 Hz, which were presented at 20 or 40 dB sensation level. Broadband rustle stimuli and 500-Hz pure-tone stimuli were also tested. Thresholds were poorer on average for the HI group than the NH group. The ITD deficit, relative to the NH group, was similar at low and high frequencies for most HI participants. For a small number of participants, however, the deficit was strongly frequency-dependent. These results provide new insights into the binaural perception of complex sounds and may inform binaural models that incorporate effects of hearing loss.

THE PROSTHODONTIC TREATMENT OF THE MANDIBLE EDENTULOUSNESS. CLINICAL CASE

The article presents a clinical case of the prosthodontic treatment of the mandible edentulousness.
 Edentulousness is a widespread pathology that depends on the social and economic situation in the country, the demographic situation, the level of dental care and prevention organization. The current worldwide trend of population aging leads to an increase in the number of the elderly, and this number is expected to increase in the future. According to the WHO, today about 600 million people are people over 60, and this number will have doubled by 2030 and will constitute 2 billion in 2050 mostly in developed countries. The situation in Ukraine is not better.
 Functional and aesthetic rehabilitation of patients with edentulousness requires a comprehensive approach to the prosthodontic treatment planning. Complete removable laminar dentures on the mandible have a number of disadvantages. Insufficient fixation, stabilization, diction problems, aesthetic problems, decreased self-esteem of the patient are among the key ones. Modern protocols of the prosthodontic treatment require the manufacture of dental prostheses based on intraosseous dental implants.
 Complete dentures based on intraosseous dental implants have a number of advantages over the fixed dentures. Compensation for deficient bone support of the facial soft tissues occurs by means of the basis. Patients’ possibility to remove a secondary restoration by themselves lead to proper hygiene of the oral cavity and peri-implant area in particular.
 The clinical research conducted by S. Wolfart (2016) showed the possibility of fixed/removable dental prosthesis fixation in 14-31 days (early loading) after the surgical stage of implantation provided that 4-6 intraosseous dental implants were installed. The maximum mobilization of the patient to comply with the recommendations and prescriptions is the main task considering the limited postoperative period before the dental prosthesis fixation.
 Our publication describes the treatment of a patient born in 1967, who was diagnosed with a mandible complete absence of teeth. Diagnosis, examination and treatment were performed on the basis of the Department of Dentistry Postgraduate Education of Ivano-Frankivsk National Medical University.
 The described prosthodontic treatment plan involves the manufacture of a complete denture with bar system based on four intraosseous dental implants according to the early loading protocol in a patient with primary treatment of mandible edentulousness.
 The choice of treatment plan was based on the results of past medical history, the patient’s disease, basic and additional methods of examination, analysis of individual indications and contraindications and readiness for the selected treatment plan.
 This treatment protocol has its advantages over the protocol of manufacturing a fixed prosthesis based on intraosseous dental implants such as a higher level of proprioceptive sensations, increased level of hygiene, lower complexity of clinical and laboratory stages, affordability.
 The term of clinical and laboratory stages of manufacturing (from the surgical stage of implant treatment to the fixation of the dental prosthesis) constituted 16 days.
 Additional opportunities for success in clinical and laboratory stages of treatment, the accuracy of manufacture and minimization of complications in the future were created as a result of the combination of digital and analog treatment methods in dental prosthesis manufacturing.

OPRACOWANIE, STANDARYZACJA I WALIDACJA DWUSYLABOWEGO, FONEMATYCZNIE ZRÓWNOWAŻONEGO TAMILSKIEGO TESTU SŁOWNEGO W CISZY I W SZUMIE

BackgroundThe present study aimed to develop and standardize a phonemically balanced bisyllabic word test in Tamil for adult listeners.Material and methodsIn total, 1015 bisyllabic Tamil words were collected from different sources; 20 Tamil speakers rated the words for familiarity and 5 experts validated the content. Based on the familiarity rating and content validation, 760 words were shortlisted for phonemic balancing. Then 25 phonemically-balanced lists were prepared with 25 words in each. The prepared lists were presented to 100 normal-hearing listeners at 40 dB SL in quiet, and 30 listeners in noise at −5 dB SNR for the standardization process. The lists were also presented at different sensation levels (SLs) in quiet to 30 listeners to obtain a psychometric function.ResultsThe mean speech identification scores (SISs) in adults was 99.8% in quiet. The results revealed no significant difference in SIS across the 25 word lists, indicative of list equivalency. The scores increased as the level increased from 10 to 40 dB SL for all the lists, suggesting homogeneity in difficulty and audibility. However, in noise, only 23 lists were equivalent to each other.ConclusionsAll the test lists can be utilized for testing during audiological evaluation in quiet, and 23 word lists are useful in noise.

Sensory Reconstruction of a Posterior Heel Defect Using a Proximally Based Sensate Medial Plantar Flap with Retrograde Nerve Cleavage Technique.

Reconstruction of posterior heel defects is important because it requires thick and durable skin that can withstand pressure and shear from shoe and bed contact. Therefore, the sensate flap could be a better option for the defect. This paper reports on the safety of a medial plantar sensory flap for these defects as well as an objective measurement of the sensation of the medial plantar flap and the plantar surface distal to the donor site. Twelve patients had soft-tissue defects in the posterior heel and underwent reconstructive surgery using a proximally based sensate medial plantar sensory flap. Cases of plantar defects involving not posterior heel were excluded. For wider flap coverage, special neurovascular dissection was required. We evaluated levels of sensation quantitatively using Semmes-Weinstein (SW) monofilaments and a two-point discriminator at the final follow-up. All flaps survived without major complications. Postoperative follow-up was 12 to 64 months (mean 26 months). All 12 flaps healed without postoperative complications. There was no significant difference in minimal two-point discrimination and SW evaluator size between the transferred medial plantar flap area and the contralateral heel area or between the plantar area distal to the donor site and the contralateral side. Patients could walk normally and sleep without protective shoes or brace. A proximally based sensate medial plantar flap is a good option for the reconstruction of posterior heel defects. It can restore the characteristics of the posterior heel for shoe wearing and sleeping.

Meta-learning for fake news detection surrounding the Syrian war

SummaryIn this article, we pursue the automatic detection of fake news reporting on the Syrian war using machine learning and meta-learning. The proposed approach is based on a suite of features that include a given article's linguistic style; its level of subjectivity, sensationalism, and sectarianism; the strength of its attribution; and its consistency with other news articles from the same “media camp”. To train our models, we use FA-KES, a fake news dataset about the Syrian war. A suite of basic machine learning models is explored, as well as the model-agnostic meta-learning algorithm (MAML) suitable for few-shot learning, using datasets of a modest size. Feature-importance analysis confirms that the collected features specific to the Syrian war are indeed very important predictors for the output label. The meta-learning model achieves the best performance, improving upon the baseline approaches that are trained exclusively on text features in FA-KES.

Neural mechanism by which physical fatigue sensation suppresses physical performance: a magnetoencephalography study.

The right dorsolateral prefrontal cortex (DLPFC) has been proposed to be the brain region regulating performance through fatigue sensation in fatigue, but direct evidence has been lacking for right DLPFC activation when physical performance is suppressed in the presence of fatigue sensation. We examined whether the right DLPFC is activated when physical performance is suppressed by remembering a physical fatigue sensation. Eighteen healthy male volunteers participated. They performed a rest session followed by a handgrip session to induce physical fatigue sensation. Then, they were instructed to remember the state of the right hand with (i.e., the target condition) and without (i.e., the control condition) fatigue sensation as experienced in the handgrip and rest sessions, respectively while performing motor imagery of maximum handgrip of the right hand. Neural activity during both conditions was recorded using magnetoencephalography. The level of fatigue sensation was higher in the target condition than in the control condition. Decreases of handgrip strength and beta band power in the right Brodmann's area 46 were observed in the target condition, suggesting that the right DLPFC is involved in the regulation of physical performance through fatigue sensation. These findings may help elucidate the neural mechanisms regulating performance under fatigue conditions.