Verification of Hearing Aids by Comparing Real Ear Measurements and Word Recognition Scores

Background and Objectives In this study, we introduce our method of hearing aid (HA) verification using real ear measurement (REM). We verified HAs that have gone through the fitting program using speech mapping REM; we then compared the outcome with word recognition scores (WRS) to evaluate functional gain. Subjects and Method Fifty-six patients of sensorineural hearing loss (81 ears) were enrolled in the study. In REM, if the gap between the target gain of HA and real ear aided response (REAR) was less than 10 dB SPL, fitting was considered successful. In speech audiometry, unaided maximum discrimination score (PB max), unaided WRS at 65 dB HL and aided WRS at 65 dB HL were measured. By comparing PB max and aided WRS at 65 dB HL, patients were sorted into best (n=15), good (n=57), and poorly (n=9) aided groups and analyzed for the successes of fitting. Fitting was deemed unsuccessful if REAR was ≥10 dB SPL lower than the target value of HA.Results The mean aided WRS at 65 dB HL of best, good and poorly aided groups were 85.6%, 77.3%, and 54.2%, respectively. There were statistically significant differences between all groups (p=0.019, 0.001, 0.002). The success rates of HA fitting showed significant differences at 0.5, 0.75, 1, 4 kHz of 55 dB SPL (p=0.023, 0.005, 0.003, 0.014), and at 4 kHz of 65 and 75 dB SPL (p=0.004, 0.001). The high WRS group showed sufficient gain at many frequencies. Conclusion Well fitted HAs can provide sufficient increase in speech intelligibility. Using the speech mapping REM is a great method to verify fitting of HA.

Voice Transformation Using Two-Level Dynamic Warping and Neural Networks

Voice transformation, for example, from a male speaker to a female speaker, is achieved here using a two-level dynamic warping algorithm in conjunction with an artificial neural network. An outer warping process which temporally aligns blocks of speech (dynamic time warp, DTW) invokes an inner warping process, which spectrally aligns based on magnitude spectra (dynamic frequency warp, DFW). The mapping function produced by inner dynamic frequency warp is used to move spectral information from a source speaker to a target speaker. Artifacts arising from this amplitude spectral mapping are reduced by reconstructing phase information. Information obtained by this process is used to train an artificial neural network to produce spectral warping information based on spectral input data. The performance of the speech mapping compared using Mel-Cepstral Distortion (MCD) with previous voice transformation research, and it is shown to perform better than other methods, based on their reported MCD scores.

Awake craniotomy for glioblastoma in COVID-19–positive patients and delivering the standard of care: illustrative case

BACKGROUND Providing the standard of care to patients with glioblastoma (GBM) during the novel coronavirus of 2019 (COVID-19) pandemic is a challenge, particularly if a patient tests positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Further difficulties occur in eloquent cortex tumors because awake speech mapping can theoretically aerosolize viral particles and expose staff. Moreover, microscopic neurosurgery has become difficult because the use of airborne-level personal protective equipment (PPE) crowds the space between the surgeon and the eyepiece. However, delivering substandard care will inevitably lead to disease progression and poor outcomes. OBSERVATIONS A 60-year-old man with a left insular and frontal operculum GBM was found to be COVID-19 positive. Treatment was postponed pending a negative SARS-CoV-2 result, but in the interim, he developed intratumoral hemorrhage with progressive expressive aphasia. Because the tumor was causing dominant hemisphere language symptomatology, an awake craniotomy was the recommended surgical approach. With the use of airborne-level PPE and a surgical drape to protect the surgeon from the direction of potential aerosolization, near-total gross resection was achieved. LESSONS Delaying the treatment of patients with GBM who test positive for COVID-19 will lead to further neurological deterioration. Optimal and timely treatment such as awake speech mapping for COVID-19–positive patients with GBM can be provided safely.

From Insult to Hate Speech: Mapping Offensive Language in German User Comments on Immigration

In recent debates on offensive language in participatory online spaces, the term ‘hate speech’ has become especially prominent. Originating from a legal context, the term usually refers to violent threats or expressions of prejudice against particular groups on the basis of race, religion, or sexual orientation. However, due to its explicit reference to the emotion of hate, it is also used more colloquially as a general label for any kind of negative expression. This ambiguity leads to misunderstandings in discussions about hate speech and challenges its identification. To meet this challenge, this article provides a modularized framework to differentiate various forms of hate speech and offensive language. On the basis of this framework, we present a text annotation study of 5,031 user comments on the topic of immigration and refuge posted in March 2019 on three German news sites, four Facebook pages, 13 YouTube channels, and one right-wing blog. An in-depth analysis of these comments identifies various types of hate speech and offensive language targeting immigrants and refugees. By exploring typical combinations of labeled attributes, we empirically map the variety of offensive language in the subject area ranging from insults to calls for hate crimes, going beyond the common ‘hate/no-hate’ dichotomy found in similar studies. The results are discussed with a focus on the grey area between hate speech and offensive language.

High resolution passive speech mapping in dominant hemisphere glioma surgery

Background. Intraoperative brain mapping is one of the most critical stages of neurosurgical intervention in the eloquent area of the cerebral cortex. Traditionally direct cortical electrical stimulation is used for these purposes, but it can lead to seizures and loss of consciousness that makes it impossible to continue the procedure. Moreover, it significantly changes the surgery plan, especially in case of speech mapping during awake craniotomy.The study objective is to create a setup for intraoperative eloquent cortical areas passive mapping, and to compare informativity and safety of passive and active speech mapping.Materials and methods. We have created and tested a mobile device for high-resolution mapping of the Broca’s area that uses the analysis of the desynchronization processes in high-gamma oscillations in 64 micro-contact grid electrode for electrocorticography during awake craniotomy when patient pronounces the objects and actions.Results. We found precise coincidence for localization of the Broca’s area, determined by analyzing of bioelectric signal obtained from the electrocorticography and cortical mapping performed by bipolar direct cortical stimulation using Penfield method.Conclusion. The passive cortical speech mapping expands the potentialities of neurosurgical operations in the eloquent area of the brain and can increase the number of patients for whom this study is achievable. Further studies needed to evolve algorithms and sets of stimuli to expand the list of functional zones that can be mapped passively.

Synchronized presentation of a language task to the electrical stimulation of cortical regions during speech mapping in an awake surgery

Intraoperative speech mapping is performed to preserve language function during tumour resections that involve eloquent cortical areas. For this technique the synchronization of the picture presentation to the patient with the electrical stimulation of the cortex is of major importance. During the operative routine images are manually presented by a psychologist or neurologist to the patient and have to be coordinated with the neurosurgeon stimulating the cortex by a neurostimulator, operated by an engineer. To increase the efficiency of this procedure and to minimize the time needed to localize functional cortical areas, images should appear automatically with electrical stimulation. To achieve this synchronization, the potential combination of an existing neurostimulator with commercially available software for image display was studied. A trigger signal was created to induce the presentation of a series of line drawings showing different objects. The software to control the neurostimulator and the software for image displaying were installed on two different computers. A cable was developed to transfer the trigger signal from the neurostimulator to the computer used for picture presentation. It was shown that it is possible to induce the image display via the neurostimulator using square-wave pulses of 5 V and a width of 10 ms. Thus, we present a system that enables the automated picture presentation synchronized to the electrical stimulation of cortical regions.