Emotional tones of voice affect the acoustics and perception of Mandarin tones.

Lexical tones and emotions are conveyed by a similar set of acoustic parameters; therefore, listeners of tonal languages face the challenge of processing lexical tones and emotions in the acoustic signal concurrently. This study examined how emotions affect the acoustics and perception of Mandarin tones. In Experiment 1, Mandarin tones were produced by professional actors with angry, fear, happy, sad, and neutral tones of voice. Acoustic analyses on mean F0, F0 range, mean amplitude, and duration were conducted on syllables excised from a carrier phrase. The results showed that emotions affect Mandarin tone acoustics to different degrees depending on specific Mandarin tones and specific emotions. In Experiment 2, selected syllables from Experiment 1 were presented in isolation or in context. Listeners were asked to identify the Mandarin tones and emotions of the syllables. The results showed that emotions affect Mandarin tone identification to a greater extent than Mandarin tones affect emotion recognition. Both Mandarin tones and emotions were identified more accurately in syllables presented with the carrier phrase, but the carrier phrase affected Mandarin tone identification and emotion recognition to different degrees. These findings suggest that lexical tones and emotions interact in complex but systematic ways.

Human Motion Tracking Using 3D Image Features with a Long Short-Term Memory Mechanism Model-An Example of Forward Reaching.

Human motion tracking is widely applied to rehabilitation tasks, and inertial measurement unit (IMU) sensors are a well-known approach for recording motion behavior. IMU sensors can provide accurate information regarding three-dimensional (3D) human motion. However, IMU sensors must be attached to the body, which can be inconvenient or uncomfortable for users. To alleviate this issue, a visual-based tracking system from two-dimensional (2D) RGB images has been studied extensively in recent years and proven to have a suitable performance for human motion tracking. However, the 2D image system has its limitations. Specifically, human motion consists of spatial changes, and the 3D motion features predicted from the 2D images have limitations. In this study, we propose a deep learning (DL) human motion tracking technology using 3D image features with a deep bidirectional long short-term memory (DBLSTM) mechanism model. The experimental results show that, compared with the traditional 2D image system, the proposed system provides improved human motion tracking ability with RMSE in acceleration less than 0.5 (m/s2) X, Y, and Z directions. These findings suggest that the proposed model is a viable approach for future human motion tracking applications.

A Mobile Phone-Based Approach for Hearing Screening of School-Age Children: Cross-Sectional Validation Study.

BACKGROUND: Pure-tone screening (PTS) is considered as the gold standard for hearing screening programs in school-age children. Mobile devices, such as mobile phones, have the potential for audiometric testing. OBJECTIVE: This study aimed to demonstrate a new approach to rapidly screen hearing status and provide stratified test values, using a smartphone-based hearing screening app, for each screened ear of school-age children. METHOD: This was a prospective cohort study design. The proposed smartphone-based screening method and a standard sound-treated booth with PTS were used to assess 85 school-age children (170 ears). Sound-treated PTS involved applying 4 test tones to each tested ear: 500 Hz at 25 dB and 1000 Hz, 2000 Hz, and 4000 Hz at 20 dB. The results were classified as pass (normal hearing in the ear) or fail (possible hearing impairment). The proposed smartphone-based screening employs 20 stratified hearing scales. Thresholds were compared with those of pure-tone average (PTA). RESULTS: A total of 85 subjects (170 ears), including 38 males and 47 females, aged between 11 and 12 years with a mean (SD) of 11 (0.5) years, participated in the trial. Both screening methods produced comparable pass and fail results (pass in 168 ears and fail in 2 ears). The smartphone-based screening detected moderate or worse hearing loss (average PTA>25 dB) accurately. Both the sensitivity and specificity of the smartphone-based screening method were calculated at 100%. CONCLUSIONS: The results of the proposed smartphone-based self-hearing test demonstrated high concordance with conventional PTS in a sound-treated booth. Our results suggested the potential use of the proposed smartphone-based hearing screening in a school-age population.

Reference equivalent threshold sound pressure levels for Apple EarPods.

Reference equivalent threshold sound pressure levels (RETSPLs) are used when calibrating audiometric equipment to a hearing threshold level of zero at various frequencies. To the best of the authors' knowledge, the RETSPLs for Apple EarPods (MB770G) have not been reported, and so this study aimed to measure them. The hearing thresholds of 36 normal-hearing subjects (72 ears) were measured at 250, 500, 1000, 2000, 4000, and 8000 Hz, with the measurements being performed twice in 33 subjects (66 ears) for evaluating the test-retest reliability. This study provides Apple EarPod RETSPLs and shows significant Pearson's correlations (p < 0.001) with no significant Wilcoxon signed-rank test differences (p > 0.01), which confirm the test reliability.

Effects of pudendal neuromodulation on bladder function in chronic spinal cord-injured rats.

BACKGROUND/PURPOSE: Few studies have investigated the feasibility of using pudendal neuromodulation to regulate bladder function in spinal cord-injured (SCI) animals. The present study aimed to determine the effects of electrical activation of the pudendal sensory branch on improving voiding functions in rats 6 weeks after a spinal cord injury and to explore the underlying neuromodulatory mechanisms. METHODS: Two urodynamic measurements were used to assess the effects of electrical stimulation (ES) on bladder and urethral functions: simultaneous recordings of the intravesical pressure (IVP) during continuous isotonic transvesical infusion (i.e., isotonic IVP) and external urethral sphincter (EUS) electromyography (EUS-EMG), and simultaneous recordings of transvesical pressure under isovolumetric conditions (i.e., isovolumetric IVP) and urethral perfusion pressure (UPP). RESULTS: Six weeks after the SCI, the rats showed voiding dysfunction, as indicated by abnormal cystometric measurements (e.g., increased volume threshold, increased contraction amplitude, and increased residual volume, and decreased voided volume). The voiding efficiency (VE) decreased to 13% after the SCI, but increased to 22-34% after applying pudendal afferent stimulation. In addition, pudendal stimulation significantly increased the EUS burst period and increased the difference between the UPP and the high-frequency oscillation (HFO) baselines, and changed the time offset between bladder and EUS activities. These findings suggest that pudendal afferent stimulation improved the VE by prolonging the micturition interval, decreased the urethral resistance, and recovered detrusor-sphincter dyssynergia during the voiding phase. CONCLUSION: This study demonstrates the feasibility of using pudendal neuromodulation in chronic SCI rats. These results could aid in developing an advanced neural prosthesis to restore bladder function in clinical settings.

The binaural masking-level difference of mandarin tone detection and the binaural intelligibility-level difference of mandarin tone recognition in the presence of speech-spectrum noise.

Binaural hearing involves using information relating to the differences between the signals that arrive at the two ears, and it can make it easier to detect and recognize signals in a noisy environment. This phenomenon of binaural hearing is quantified in laboratory studies as the binaural masking-level difference (BMLD). Mandarin is one of the most commonly used languages, but there are no publication values of BMLD or BILD based on Mandarin tones. Therefore, this study investigated the BMLD and BILD of Mandarin tones. The BMLDs of Mandarin tone detection were measured based on the detection threshold differences for the four tones of the voiced vowels /i/ (i.e., /i1/, /i2/, /i3/, and /i4/) and /u/ (i.e., /u1/, /u2/, /u3/, and /u4/) in the presence of speech-spectrum noise when presented interaurally in phase (S0N0) and interaurally in antiphase (SπN0). The BILDs of Mandarin tone recognition in speech-spectrum noise were determined as the differences in the target-to-masker ratio (TMR) required for 50% correct tone recognitions between the S0N0 and SπN0 conditions. The detection thresholds for the four tones of /i/ and /u/ differed significantly (p<0.001) between the S0N0 and SπN0 conditions. The average detection thresholds of Mandarin tones were all lower in the SπN0 condition than in the S0N0 condition, and the BMLDs ranged from 7.3 to 11.5 dB. The TMR for 50% correct Mandarin tone recognitions differed significantly (p<0.001) between the S0N0 and SπN0 conditions, at -13.4 and -18.0 dB, respectively, with a mean BILD of 4.6 dB. The study showed that the thresholds of Mandarin tone detection and recognition in the presence of speech-spectrum noise are improved when phase inversion is applied to the target speech. The average BILDs of Mandarin tones are smaller than the average BMLDs of Mandarin tones.

Development and preliminary verification of a Mandarin-based hearing-aid fitting strategy.

OBJECTIVE: The purpose of this study was to design and to verify a new hearing-aid fitting strategy (Aescu HRL-1) based on the acoustic features of Mandarin. The subjective and objective outcomes were compared to those fitted with NAL-NL1 (National Acoustic Laboratory Non-Linear, version1) in Mandarin-speaking hearing-aid users. DESIGN: Fifteen subjects with sensorineural hearing loss participated in this preliminary study. Each subject wore a pair of four-channel hearing aids fitted with the Aescu HRL-1 and NAL-NL1 prescriptions alternatively for 1 month. Objective and subjective tests including the Mandarin Monosyllable Recognition Test (MMRT), Mandarin Hearing in Noise Test (MHINT), International Outcome Inventory for Hearing Aids (IOI-HA), and a sound-quality questionnaire were used to evaluate the performance of the two prescriptions. RESULTS: The mean MMRT scores were 79.9% and 81.1% for NAL-NL1 and Aescu HRL-1 respectively. They are not statistically different. The corresponding MHINT signal-to-noise ratios were 0.87 and 0.85 dB, also, no significant difference was found between these two strategies. However, in subjective questionnaires, overall, the sound-quality and IOI-HA scores were higher for Aescu HRL-1. CONCLUSIONS: The speech recognition performance based on Aescu HRL-1 is as good as that of NAL-NL1 for Mandarin-speaking hearing-aid users. Moreover, the subjects generally responded that Aescu HRL-1 provides a more natural, richer, and better sound quality than does NAL-NL1.

Measuring the long-term SNRs of static and adaptive compression amplification techniques for speech in noise.

BACKGROUND: Multichannel wide-dynamic-range compression (WDRC) is a widely adopted amplification scheme in modern digital hearing aids. It attempts to provide individuals with loudness recruitment with superior speech intelligibility and greater listening comfort over a wider range of input levels. However, recent surveys have shown that compression processing (operating in the nonlinear regime) usually reduces the long-term signal-to-noise ratio (SNR). PURPOSE: The purpose of this study was to determine the long-term SNR in an adaptive compression-ratio (CR) amplification scheme called adaptive wide-dynamic-range compression (AWDRC), and to determine whether this concept is better than static WDRC amplification at improving the long-term SNR for speech in noise. DESIGN AND STUDY SAMPLE: AWDRC uses the input short-term dynamic range to adjust the CR to maximize audibility and comfort. Various methods for evaluating the long-term SNR were used to observe the relationship between the CR and output SNR performance in AWDRC for seven typical audiograms, and to compare the results with those for static WDRC amplification. RESULTS: The results showed that the variation of the CR in AWDRC amplification can maintain the comfort and audibility of the output sound. In addition, the average long-term SNR improved by 0.1-5.5 dB for a flat hearing loss, by 0.2-3.4 dB for a reverse sloping hearing loss, by 1.4-4.8 dB for a high-frequency hearing loss, and by 0.3-5.7 dB for a mild-to-moderate-sloping high-frequency hearing loss relative to static WDRC amplification. The output long-term SNR differed significantly (p < .001) between static WDRC and AWDRC amplification. CONCLUSIONS: The results of this study show that AWDRC, which uses the characteristics of the input signal to adaptively adjust the CR, provides better long-term SNR performance than static WDRC amplification.

Decompressed percutaneous vertebroplasty: a secured bone cement delivery procedure for vertebral augmentation in osteoporotic compression fractures.

UNLABELLED: The purpose of this study was to assess the efficacy of a new assistive procedure for injecting cement in percutaneous vertebroplasty (PV). Percutaneous vertebroplasty is frequently used for treating patients with osteoporotic vertebral compression fractures. However, the leakage of bone cement during PV may lead to serious complications, such as spinal cord compression or pulmonary embolism. Herein we present a secure procedure designed to safely and effectively deliver the bone cement into the vertebral column. MATERIALS AND METHODS: Thirty-five patients with a total of 50 levels of osteoporotic compression fracture were consecutively recruited for the study. During a routine PV operation, acrylic cement was injected with a simultaneous application of a continuous negative pressure to the contralateral side of the vertebral body. This negative pressure exerts a pulling force that attracts the bone cement to flow within the vertebral body. RESULTS: With the proposed decompressed PV procedure, cross-filling of the vertebrographies was achieved for all 50 fracture levels, with no paravertebral venous plexus leakage. Three of the 50 levels (6%) exhibited contrast-medium leakage into the intradisc or cortical defect regions. After decompressed cement injection, excellent cross-filling of bone cement deposition was achieved in 38 of the 50 levels (76%; cement cross-filling region >75%), good cross-filling deposition was achieved in 7 levels (14%; cement cross-filling region >50%), deposition was poor in 3 levels (6%; cement cross-filling region <50%), and deposition failed in 2 levels (4%; fixed cement with no sign of cross-filling). Routine postoperative reviews revealed that six fracture levels (12%) had minimal cement leakage, with two leaking into the disc and four into paravertebral cortical defect regions. CONCLUSIONS: Compared to the reported 20-88% cement leakage rate for the conventional PV procedure, the proposed decompressed PV procedure offers a more secure and effective way to perform cement injection, and reduces the likelihood of cement leakage.

The relationship between cortical auditory evoked potential (CAEP) detection and estimated audibility in infants with sensorineural hearing loss.

OBJECTIVE: To determine the effectiveness of objective statistical detection in CAEP testing to evaluate audibility in young infants with sensorineural hearing loss. DESIGN: CAEP recordings to speech-based stimuli were made at three presentation levels (55, 65, or 75 dB SPL) when a group of hearing-impaired infants were either aided or unaided. Later-obtained behavioral audiograms were used as the gold standard against which to evaluate the accuracy of the automatic detection of the presence/absence of CAEP responses. STUDY SAMPLE: Participants were 18 infants with confirmed sensorineural hearing loss. RESULTS: Higher sensation levels led to a greater number of present CAEP responses being detected. More CAEP waveforms were detected in the aided condition than in the unaided condition. CONCLUSION: Our results suggest that the presence/absence of CAEP responses defined by the automatic statistical criterion was effective in showing whether increased sensation levels provided by amplification were sufficient to reach the cortex. This was clearly apparent from the significant increase in cortical detections when comparing unaided with aided testing.

Different patterns of dynamic variations on electrical conductances of acupoints between Qi Vacuity and Qi non-Vacuity after glucose ingestion.

OBJECTIVES: In Traditional Chinese Medicine (TCM), Qi maintains the physiologic function and indicates physiologic energy. Glucose provides energy to humans, thereby playing a role analogous to "nutritive Qi." This study aims to identify the correlations among blood glucose, Qi Vacuity (QV), and the electrical conductances of acupoints. METHODS: Twenty (20) subjects who had ingested a glucose solution after a 10-hour overnight fast were divided into two groups based on QV score. Then their acupoint conductances were measured sequentially using a Ryodoraku instrument during the following 120 minutes. Data were analyzed using generalized estimating equations as a time-series model. RESULTS: Eight (8) subjects were categorized into a Qi Vacuous group for QV score >6, and the other 12 subjects were categorized into a Qi non-Vacuous group for QV score ≤6. During the first 30 minutes, the acupoint conductances decreased on the left Pericardium, left Heart, right Liver, Kidney, and Gallbladder meridians in the Qi Vacuous group, and increased on the right Pericardium meridian and decreased on the right Gallbladder meridian in the Qi non-Vacuous group. From 30 to 60 and 60 to 90 minutes, the acupoint conductances decreased on the Gallbladder, Heart, left Pericardium, left Kidney, right Liver, and right Stomach meridians in the Qi Vacuous group, and increased on the Pericardium, Heart, left Small Intestine, and left Lung meridians in the Qi non-Vacuous group. During the last 30 minutes, more of the acupoint conductances were increased in the Qi non-Vacuous group, whereas only the acupoint conductance on the liver meridian was increased and that on the left gallbladder meridian was decreased in the Qi Vacuous group. CONCLUSIONS: The findings suggest that the energy distribution and transformation in meridian vessels present different patterns in QV and non-QV groups after glucose consumption.

An audiometer to monitor progressive hearing change in school-aged children.

OBJECTIVE: The purpose of this study was to develop a cost-effective and easy to use audiometer to monitor progressive hearing change in school-aged children. DESIGN: The hardware of the audiometer developed included a computer, an external sound blaster and a headphone. The hearing screening software was developed to control the pure tone sound level with modulability in the range of 0-45 dB HL at 1, 2, 4 and 0.5 kHz frequencies. Thirty sixth-grade children, aged 12-13 years old, were randomly divided into two groups for a hearing test in a conference room. Testing for one group was performed by a person with experience and the other group was examined by a graduate student who was not familiar with the device. After the hearing test, all children were immediately screened using a clinical diagnostic audiometer in a soundproof room by an audiologist. RESULTS: Most of the threshold dB values obtained by the audiometer in a conference room (55 ears, 93.2%) were significantly greater than those obtained by the clinical audiometer in a soundproof room. Most of the differences between these two measurements were within 5 dB (94.9%). Only 5.1% had a discrepancy within the maximum range of 10 dB. The correlation and intraclass correlation coefficients between the two measurements were 0.861 and 0.929, respectively. The results also indicated that the experience level of the screening personnel did not affect the testing. CONCLUSION: The newly developed audiometer is quite cost-effective and can be easily operated. The threshold dB values obtained by the audiometer developed in a conference room were comparable with the results of a clinical audiometer in a soundproof room. The audiometer developed could measure the hearing threshold values and, therefore, be useful in monitoring progressive hearing change in school-aged children.

Effect of long-term music therapy intervention on autonomic function in anthracycline-treated breast cancer patients.

Anthracyclines are potent antineoplastic agents associated with cardiotoxicity, which may lead to congestive heart failure, causing impairment of autonomic cardiovascular function as assessed by heart rate variability (HRV). This decreases survival rates. This study aimed to determine whether music therapy intervention improves autonomic function in anthracycline-treated breast cancer patients, and if so, whether such improvements persist after cessation of the intervention. Participants were 12 women with breast cancer who had undergone mastectomy or breast-conserving treatment and adjuvant chemotherapy; they attended 8 weekly music therapy sessions, each lasting 2 hours. Electrocardiogram traces (5 minutes) for HRV analysis were recorded 4 times: prior to the first music session, T1; after the fourth music session, T2; after the eighth music session, T3; and 4 weeks after the completion of music therapy, T4. HRV parameters were subjected to a nonparametric Friedman test on the differences between T1 and T2, T3, and T4. The standard deviation of normal intervals and the total power of HRV parameters, related to global autonomic function, were significantly higher at T3 than at T1. The root-mean-square differences of successive normal R-R intervals and high-frequency (HF) HRV parameters, related to parasympathetic activity, were significantly increased, but no change was seen in the LF/HF ratio of HRV parameters (which is related to sympathetic activity) during the music therapy. Global autonomic function and parasympathetic activity had not changed significantly at T4 relative to T1. The authors provide preliminary evidence of the benefits of music therapy for anthracycline-treated breast cancer survivors.

Effects of music therapy on subjective sensations and heart rate variability in treated cancer survivors: a pilot study.

OBJECTIVE: Data on the effects of music therapy on subjective sensations and the physiological parameters of heart rate variability (HRV) in treated cancer survivors are scarce. The aim of this study was to determine whether or not music therapy affects the sensations of fatigue, comfort, and relaxation in cancer survivors, and affects the activities of the sympathetic and parasympathetic nervous systems as indicated by HRV parameters. METHODS: Twenty-three patients aged 30-67 years and with cancer that had been treated at least 6 months previously received music therapy for about 2h, which included singing, listening to music, learning the recorder, and performing music. Subjective sensations and electrocardiogram were recorded before and after the music therapy. The low-frequency and high-frequency components of HRV were assessed by the frequency analysis of sequential R wave to R wave intervals of electrocardiogram obtained from 5-min recordings. Subjective sensations were quantitatively assessed using a visual analog mood scale. RESULTS: Two hours of music therapy significantly increased relaxation sensations and significantly decreased fatigue sensation in treated cancer survivors. Moreover, the HRV parameters showed that parasympathetic nervous system activity increased and sympathetic nervous system activity decreased. CONCLUSION: This study provides preliminary evidence that music therapy may be clinically useful for promoting relaxation sensation and increasing parasympathetic nervous system activity in treated cancer survivors.

The Hearing Scale Test for hearing screening of school-age children.

OBJECTIVES: This study aimed to demonstrate a new modified hearing screening method that can rapidly screen hearing and provide stratified test values for each screened ear of children. METHODS: The proposed Hearing Scale Test (HST) and pure-tone screening (PTS) were applied to 384 school-age children. PTS involved applying four test tones to each tested ear: 500 Hz at 25 dB, and 1000, 2000, 4000 Hz at 20 dB; and classifying the results as "pass" (normal hearing in the ear) or "fail" (possible hearing impairment). The HST employs ten stratified hearing scales from S(1) to S(10), with each hearing scale containing four test tones and where adjacent scales differ from each other by 5 B, ranging from 0 dB (S(1)) to 45 dB (S(10)). The four test tones of hearing scale S(5) are the same hearing criteria and the median reference standard of the stimulus level in the HST. Scales S(1)-S(5) on the HST are equivalent to a PTS "pass" result, while S(6)-S(10) and no response (NR) are equivalent to a PTS "fail" result. RESULTS: The two screening methods produced comparable "pass" and "fail" results. In the HST, the "pass" results were further stratified as S(1) in 4 ears, S(2) in 52 ears, S(3) in 226 ears, S(4) in 272 ears, and S(5) in 169 ears, while the "fail" results were stratified as S(6) in 23 ears, S(7) in 12 ears, S(8) in 1 ear, S(9) in 2 ears, S(10) in 5 ears, and no response (NR) in 2 ears. The hearing screening results of the HST are interpreted as follows: scales S(1)-S(5) indicate normal hearing, scales S(6) and S(7) indicate possible hearing impairment, and scales S(8)-S(10) and NR indicate confirmed hearing impairment. CONCLUSIONS: Conventional PTS only gives a pass/fail result for each screened ear, lacks hearing status assessment, and lacks stratified test values to be recorded for follow-up. In contrast, the HST has stratified hearing scales for each screened ear, which reflects the current hearing status and provides test values that can be recorded for follow-up.

Reducing radiation exposure in intra-medullary nailing procedures: intra-medullary endo-transilluminating (iMET).

The purpose of the study was to reduce the level of radiation exposure during intra-medullary nailing procedures. A visible light source was inserted into the medullary bone cavity in order to detect the distal interlocking screw holes. The light penetrates out of the bone surface, revealing the position of the screw hole, and this allows the subsequent drilling and placing of the interlocking screw to be free of fluoroscopy. Among the 19 consecutive tibia-fracture patients recruited for this study, no repetition of the drilling procedure or insertion of a transverse interlocking screw was needed. The average time to finish the insertion of one distal interlocking screw was 4.1+/-1.8 min. It was extrapolated that 13-41% of previous radiation exposure levels could be saved. The non-fluoroscopic approach thus decreases the health hazards that the patients are experiencing as well as those of the surgical team who need to perform such intra-medullary nailing operations on a routine basis.

Development of a mandarin monosyllable recognition test.

OBJECTIVE: This study aimed to develop a set of 50- and 25-item word lists that exhibited familiarity, homogeneity, and phonemic balance for a Mandarin monosyllable recognition test (MMRT). DESIGN: To achieve the design goal of high subject familiarity with the test material, we selected the 700 most frequently occurring monosyllables to be the test material. The homogeneity of the test material was achieved by evaluating five psychometric characteristics of these 700 monosyllables to obtain 348 homogeneous monosyllables with similar psychometric functions for constructing the word lists. The phonemic balance of the 50-item word lists was achieved by deriving the desired numbers of initials, finals, and tones in these lists according to their occurrence frequencies in 4733 monosyllabic words. The phonemic balance of the 25-item word lists was achieved by equally dividing the desired numbers of initials, finals, and tones in the 50-item word lists into two groups, called half-A and half-B lists. Three half-A lists and three half-B lists were constructed from the 348 homogeneous monosyllables, and they could be paired to form nine 50-item word lists. Accordingly, all of the MMRT word lists are familiar, homogeneous, and phonemically balanced. RESULTS: The homogeneity of the MMRT word lists was examined by evaluating the interlist equivalence, interitem variability, and intersubject variability. A chi test was used to evaluate the interlist equivalence among the MMRT word lists; that is, to determine whether the values of percent correct recognition were distributed identically at 12 different presentation levels among the six 25-item word lists and nine 50-item word lists. No statistically significant differences were found among the word lists: chi(55) = 12.004 and p = 1.000 for the six 25-item word lists, chi(88) = 7.695 and p = 1.000 for the nine 50-item word lists, and chi(154) = 19.699 and p = 1.000 for the six 25-item word lists plus nine 50-item word lists. The chi tests indicated that the six 25-item word lists and nine 50-item word lists exhibited interlist equivalence. The mean interitem variability (2.0 dB) and mean intersubject variability (2.3 dB) are lower for the MMRT word lists than for previously reported word recognition tests. CONCLUSION: This study applied an innovative approach to design MMRT word lists from familiar and homogeneous monosyllables, in which the familiarity, homogeneity, and phonemic balance of the six 25-item and nine 50-item word lists were strictly controlled. These word lists exhibit interlist equivalence with respect to their psychometric functions and five psychometric characteristics; moreover, their interitem and intersubject variability are lower than those of previously reported lists. Future clinical experiments should examine whether such a design approach can improve the reliability and diagnostic sensitivity of word recognition tests for hearing-impaired listeners.

A remote data access architecture for home-monitoring health-care applications.

With the aging of the population and the increasing patient preference for receiving care in their own homes, remote home care is one of the fastest growing areas of health care in Taiwan and many other countries. Many remote home-monitoring applications have been developed and implemented to enable both formal and informal caregivers to have remote access to patient data so that they can respond instantly to any abnormalities of in-home patients. The aim of this technology is to give both patients and relatives better control of the health care, reduce the burden on informal caregivers and reduce visits to hospitals and thus result in a better quality of life for both the patient and his/her family. To facilitate their widespread adoption, remote home-monitoring systems take advantage of the low-cost features and popularity of the Internet and PCs, but are inherently exposed to several security risks, such as virus and denial-of-service (DoS) attacks. These security threats exist as long as the in-home PC is directly accessible by remote-monitoring users over the Internet. The purpose of the study reported in this paper was to improve the security of such systems, with the proposed architecture aimed at increasing the system availability and confidentiality of patient information. A broker server is introduced between the remote-monitoring devices and the in-home PCs. This topology removes direct access to the in-home PC, and a firewall can be configured to deny all inbound connections while the remote home-monitoring application is operating. This architecture helps to transfer the security risks from the in-home PC to the managed broker server, on which more advanced security measures can be implemented. The pros and cons of this novel architecture design are also discussed and summarized.

Hardness evaluation of penile prostheses.

AIM: This work investigates the hardness and buckling force of penile prostheses to further understand the rigidity of penile prostheses before and after implantation. METHODS: Evaluated herein are four prosthetic samples (three inflatable, one semi-rigid), five real prostheses (one inflatable, four semi-rigid), and one prosthesis after implantation. The hardness is measured with a Shore Durimeter by pressing the tester's indentor to the surface of the specimen. A volunteer with inflatable prosthesis implantation is evaluated with respect to penile hardness versus various numbers of pumping. The buckling force of the prosthesis is also determined by a push-pull gauge and a specially designed sampling table. RESULTS: Results in this study demonstrate that although the inflatable prosthesis could only be pumped to a certain amount of hardness, hardness and buckling force correlate well with each other. After reaching the hardness limit, prostheses can even be pumped a further few times. However, continuous pumping only puts more tension on the prosthetic material without increasing hardness and could induce mechanical failure of the prosthesis. Results also indicate that the buckling force decreases with increasing length of the semirigid prostheses, and increases when the prosthesis has a larger diameter. CONCLUSION: This mechanical measurement of rigidity in penile prostheses could provide more information to clinicians about the penile prosthesis before surgical implantation, and to patients about prosthesis usage after implantation.

Developing a medical image content repository for e-learning.

The integration of medical informatics and e-learning systems could provide many advanced applications including training, knowledge management, telemedicine, etc. Currently, both the domains of e-learning and medical image have sophisticated specifications and standards. It is a great challenge to bring about integration. In this paper, we describe the development of a Web interface for searching and viewing medical images that are stored in standard medical image servers. With the creation of a Web solution, we have reduced the overheads of integration. We have packaged Digital Imaging and Communications in Medicine (DICOM) network services as a component that can be used via a Web server. The Web server constitutes a content repository for searching, editing, and storing Web-based medical image content. This is a simple method by which the use of Picture Archiving and Communication System (PACS) can be extended. We show that the content repository can easily interact and integrate with a learning system. With the integration, the user can easily generate and assign medical image content for e-learning. A Web solution might be the simplest way for system integration. The demonstration in this paper should be useful as a method of expanding the usage of medical information. The construction of a Web-based repository and integrated with a learning system may be also applicable to other domains.