Residual Hearing Affects Contralateral Routing of Signals in Cochlear Implant Users

<b><i>Introduction:</i></b> Contralateral routing of signals (CROS) can be used to eliminate the head shadow effect. In unilateral cochlear implant (CI) users, CROS can be achieved with placement of a microphone on the contralateral ear, with the signal streamed to the CI ear. CROS was originally developed for unilateral CI users without any residual hearing in the nonimplanted ear. However, the criteria for implantation are becoming progressively looser, and the nonimplanted ear can have substantial residual hearing. In this study, we assessed how residual hearing in the contralateral ear influences CROS effectiveness in unilateral CI users. <b><i>Methods:</i></b> In a group of unilateral CI users (<i>N</i> = 17) with varying amounts of residual hearing, we deployed free-field speech tests to determine the effects of CROS on the speech reception threshold (SRT) in amplitude-modulated noise. We compared 2 spatial configurations: (1) speech presented to the CROS ear and noise to the CI ear (S_CROSN_CI) and (2) the reverse (S_CIN_CROS). <b><i>Results:</i></b> Compared with the use of CI only, CROS improved the SRT by 6.4 dB on average in the S_CROSN_CI configuration. In the S_CIN_CROS configuration, however, CROS deteriorated the SRT by 8.4 dB. The benefit and disadvantage of CROS both decreased significantly with the amount of residual hearing. <b><i>Conclusion:</i></b> CROS users need careful instructions about the potential disadvantage when listening in conditions where the CROS ear mainly receives noise, especially if they have residual hearing in the contralateral ear. The CROS device should be turned off when it is on the noise side (S_CIN_CROS). CI users with residual hearing in the CROS ear also should understand that contralateral amplification (i.e., a bimodal hearing solution) will yield better results than a CROS device. Unilateral CI users with no functional contralateral hearing should be considered the primary target population for a CROS device.

Assessment of the Situation on Anthrax Based on Ranking Territories by the Degree of Risk

The aim of the study was to develop a unified approach to a comprehensive risk assessment of the anthrax situation deterioration based on the ranking of territories by epidemiologically significant factors.Materials and methods. For a comprehensive risk assessment of the situation complication, the statistical principles of ranking of the estimated indicators were used. These indicators comprise the presence and activity of soil foci of anthrax, the prevailing soil types and their main characteristics, as well as social risk factors associated with the peculiarities of animal husbandry and the possibility of infection of the population. The proposed assessment method has been tested on a national scale, and its content and results are described in this paper by the example of the Volga Federal District. The materials of the study were federal and regional cadastres of stationary hazardous as regards anthrax areas, an atlas and maps of soils, data of statistical accounting and reporting of Federal Service for Veterinary and Phytosanitary Surveillance, Federal Service for State Registration, Cadastre and Cartography and Rospotrebnadzor.Results and discussion. It has been established that in all constituent entities of the district there are potential risks of the situation deterioration that are associated with the presence of soil foci. In terms of the sum of ranks, the greatest potential disadvantage is noted in a number of republics and regions of the Volga Region. At the same time, the real danger is mainly due to social factors, which include the characteristics of animal husbandry, as well as the degree of susceptibility of the population. The maximum risks are currently identified in the territories of the republics of Bashkortostan and Tatarstan, as well as in the Saratov Region. The study is aimed at improving the efficiency of anthrax epidemiological surveillance in the Russian Federation, and the proposed methodology can be used at all levels of surveillance.

Supporting Patients With Untreated Prostate Cancer on Active Surveillance: What Causes an Increase in Anxiety During the First 10 Months?

BackgroundThe psychological burden possibly deriving from not immediately undergoing radical treatment for prostate cancer (PCa) could be a potential disadvantage of active surveillance (AS), especially in the eve of some relevant clinical exams [i.e., re-biopsy, prostate-specific antigen (PSA) test, and medical examination]. Even if it is known from the literature that the majority of PCa men in AS do not report heightened anxiety, there is a minority of patients who show clinically significant levels of anxiety after diagnosis. The present study aimed to investigate if demographic, clinical, and psychological variables at the entrance in AS (T0) were associated with the risk of developing clinically significant PCa-related anxiety 2 months before the first re-biopsy (T1) and to offer psychological support to improve quality of life (QoL).Materials and MethodsA total of 236 patients participated in the PCa Research International: AS (PRIAS) protocol and in PRIAS-QoL study. Demographic/clinical features, health-related QoL domains, coping with cancer, PCa-related anxiety [Memorial Anxiety Scale for PCa (MAX-PC)], personality traits, and decision-making-related factors were assessed at T0. MAX-PC was also administered at T1. PCa-related anxiety at T1 was considered to be of clinical significance if the MAX-PC score was ≥1.5. Multivariable logistic regression coupled to bootstrap was used to detect factors associated with high levels of anxiety.ResultsThe median age was 64.4 years. Fifty-six patients (24%) reported MAX-PC total score above the cutoff. Three factors were associated with a high level of PCa anxiety at T1: anxious preoccupation [odds ratio (OR) = 4.36], extraversion (OR = 1.9), and prostate-related symptoms (median OR = 0.46). Physical well-being was associated with a low PCa anxiety subscale (median OR = 0.15); neuroticism and functional well-being were associated with PSA anxiety (median OR = 7.05 and 0.73, respectively). Neuroticism and helplessness/hopelessness were associated with fear of progression (median OR = 18.1 and 5.8, respectively).ConclusionOnly a partial portion of the sample experienced significant levels of anxiety after 10 months. Psychological assessment should be routinely conducted to detect risk factors (i.e., anxious preoccupation, extraversion) for increased anxiety, offering tailored psychological interventions aimed at promoting interpersonal awareness and emotional well-being.

Enhancing the Security in ElGamal Cryptosystem using Paring Functions

The potential disadvantage of ElGamal cryptosystem is the ciphertext produced is always twice as long as the plaintext i.e., the message expansion by a factor of two takes place during encryption. When the message is too long the ciphertext produced by the ElGamal cryptosystem is also too long. i.e., when the ciphertexts are transmitted through the communication channel which lead to provide less security because if anyone of the ciphertext from two ciphertexts for each character of the plaintext is intercepted by the adversary, the other may be retrieved easily because there is a relationship between the two ciphertexts. If two ciphertexts are reduced to one, the adversary may not be able to predict the two ciphertexts from one. To enhance the security of ElGamal cryptosystem, the binary Cantor function , Rosenberg pairing function and Elegant pairing functions are used in this paper. When the said functions are used, the two ciphertexts produced by each plaintext character are reduced to one, so that the adversary cannot easily be recovered the plaintext. Experimental results clearly revealed enhancing the security of ElGamal cryptosystem after incorporating the pairing functions into it.

The good practice portal in Germany and considerations towards integrating best evidence

The good practice portal of the Federal Centre for Health Education / BZgA consists of a nationwide collection of projects and interventions to promote the health of socially disadvantaged groups at the community/setting level. Currently the portal includes 3067 practices, out of them 124 fulfil the good practice criteria and have been identified as such. The portal aims to disseminate (good) practice in Germany, promote its translation into action, create transparency in terms of quality criteria and make the diversity of practice more visible. A secondary aim is to promote regional networking and the exchange of experience. To this end, an exchange platform (inforo) is also offered via the operating agency, which however is still limited in use. The portal does not intend to identify the most effective practices, but to be a database of well-described interventions that were feasible to implement in Germany. Therefore, the evaluation process was designed as a mutual advisory process: Standardized description of project owners according to 12 good practice criteria- review by experts from the responsible coordinating offices of Equity in Health - peer evaluation by another coordinating body in another federal state - and finally evaluation by an expert from the nationwide working group at the BZgA. Thus, the evaluation process is also set up to promote mutual learning with the goal of in turn increasing quality of the practice nationwide, with the advantage of being close to the implementation needs and the potential disadvantage of lacking objectivity. At the moment, BZgA is assessing different possibilities to integrate evidence as criteria into its good practice portal. Therefore, this presentation will end with a discussion on possibilities to integrate the identification and selection of evidence-based/evidence-informed preventive interventions, including the use of evidence criteria and quality of evidence.

The Next Generation Cognitive Security Operations Center: Network Flow Forensics Using Cybersecurity Intelligence

A Security Operations Center (SOC) can be defined as an organized and highly skilled team that uses advanced computer forensics tools to prevent, detect and respond to cybersecurity incidents of an organization. The fundamental aspects of an effective SOC is related to the ability to examine and analyze the vast number of data flows and to correlate several other types of events from a cybersecurity perception. The supervision and categorization of network flow is an essential process not only for the scheduling, management, and regulation of the network’s services, but also for attacks identification and for the consequent forensics’ investigations. A serious potential disadvantage of the traditional software solutions used today for computer network monitoring, and specifically for the instances of effective categorization of the encrypted or obfuscated network flow, which enforces the rebuilding of messages packets in sophisticated underlying protocols, is the requirements of computational resources. In addition, an additional significant inability of these software packages is they create high false positive rates because they are deprived of accurate predicting mechanisms. For all the reasons above, in most cases, the traditional software fails completely to recognize unidentified vulnerabilities and zero-day exploitations. This paper proposes a novel intelligence driven Network Flow Forensics Framework (NF3) which uses low utilization of computing power and resources, for the Next Generation Cognitive Computing SOC (NGC2SOC) that rely solely on advanced fully automated intelligence methods. It is an effective and accurate Ensemble Machine Learning forensics tool to Network Traffic Analysis, Demystification of Malware Traffic and Encrypted Traffic Identification.

Choice of imaging techniques

Cardiovascular non-invasive imaging has become an important component in the diagnosis and guidance of therapy in patients with cardiovascular disease. Currently, the four main non-invasive imaging techniques are echocardiography, nuclear imaging with single-photon emission computed tomography (SPECT) and positron emission tomography (PET), cardiovascular magnetic resonance (CMR), and multidetector computed tomography (MDCT). Over recent years, each of these modalities has witnessed rapid technological developments. All of the techniques can presently provide integrated cardiac anatomical and functional information, whereas in the past, the techniques could mostly only provide information on just one of these parameters. This has resulted in an increased implementation of cardiovascular imaging in clinical patient management. Consequently, improved diagnosis and therapeutic decision-making has become possible. However, clinicians have become confused about which imaging techniques to use and when, with the potential disadvantage of ‘over-using’ the imaging techniques. When selecting imaging techniques for a particular patient, various issues need to be considered: the cardiovascular disease, the information on that disease that is needed for the clinical management of the patient, and the characteristics of the patient. Frequently, different techniques can provide the required information; it is therefore also important to consider the local availability, expertise, and experience with the imaging techniques. In this chapter, three specific disease states (the patient with stable chest pain with suspected coronary artery disease, the patient with atrial fibrillation, and the patient with chronic heart failure) will be used as examples to illustrate these issues.

Clogging of pervious concrete pile caused by soil piping: an approximate experimental study

Due to their high permeability and high strength, pervious concrete piles (PCPs) can improve ground bearing capacity. However, clogging of pervious concrete in practice is a potential disadvantage. To investigate the clogging mechanism of PCPs due to sand piping, a series of laboratory simulation tests is conducted on a developed hydraulic conductivity test system. This testing demonstrates the effects of pervious concrete porosity, grading of fine movable particles, mix ratio of skeleton particles to movable particles, relative density of soil, and distance between PCPs on PCP clogging. The experimental test results show that the hydraulic conductivity of PCP decreases for approximately 70 min and then becomes relatively stable. In addition, it is observed that PCP clogging rarely occurs in cases of low pervious concrete porosity, small movable sand particle size, high sand relative density, and large pile distance. The results also show that measurement of electrical conductivity can be an alternative method of hydraulic conductivity measurement. Based on the test results, preliminary clogging models are proposed.

An Analysis of School-Based Contextual Indicators for Possible Use in Widening Participation

This paper looks at the National Pupil Database for England in terms of variables that could be used by universities to help them assess undergraduate applications. Where a young person is obviously disadvantaged, this can be taken into account in contextualised admissions. Of the indicators available, which give the most accurate assessment of that context—singly or in combination? This paper looks at missing data, and what is known about students for whom data is missing. It looks at changes in indicators of potential disadvantage over time. And it looks at the relationship between all indicators and student attainment and progress at school. The safest and clearest indicators are the sex (male) and age in year (summer born) of a student but neither of these is currently considered in widening participation. Otherwise, the best general indicator is eligibility for free school meals (poverty), and this is best computed as the number of years a student has been known to be eligible. Having a special educational need is also a promising indicator, but doubts are raised about its validity and it anyway covers a wide range of factors, some of which are already dealt with by the education system. Very few students registered as living in care continue in education post-16, and this indicator could be used safely and to advantage. The rest, including area measures, school type, performance relative to school, ethnicity and first language are generally not safe to use.

A new surgical technique for functional implant alignment in varus osteoarthritis using patient-specific instrumentation (PSI)

Aims and Objectives: The use of patient-specific instruments (PSI) in total knee arthroplasty (TKA) has seen growing interest over the past years. A potential disadvantage of PSI is that functional implant alignment is not applicable in this technique. This study therefore aimed to develop a surgical technique for ligament-balanced implant alignment based on PSI, and to present the results obtained using this technique. Materials and Methods: 25 patients were included in this prospective study. PSI was used for the resection of the extension gap. Ligament tension was measured after removal of all accessible osteophytes. In the event of asymmetry, the distal femur resection was adjusted up to 2.5° using an adjustable cutting block. The aim was to achieve a symmetrical extension gap without release, not a neutral leg axis. Femoral rotation was aligned on the basis of ligament tension. Patients were followed up 3 months postoperatively. Results: The postoperative whole-leg axis was 2.8°±1.6° varus. Patients achieved a flexion of 118.9°±9°, a Knee Score of 91.5±3.2 and a Function Score of 86.8±8.3 points. Conclusion: For the first time, the new surgical technique described here permits a functional, ligament-balanced implant alignment based on PSI. It was shown to be safe, with encouraging clinical and radiological results.