Evaluation of Digits-in-Noise Test and Hearing Handicap Inventory for Adults Screening in Patients with Occupational Noise-Induced Hearing Loss

Objective:To explore the clinical evaluation role of the Digits-in-Noise(DIN)test and Hearing Handicap Inventory for Adults Screening(HHIA-S)for patients with occupational noise-induced hearing loss and to observe and analyze their application values.Methods:Fifty patients with suspected occupational noise-induced hearing loss were randomly selected from the Department of Otolaryngology at the hospital as the research target.The collection period for the research cases spanned from January 2022 to November 2023,and all patients had a history of noise exposure.The DIN test and HHIA-S were used for hearing examinations,with clinical,comprehensive diagnosis serving as the gold standard to study their diagnostic performance.Results:The compliance rate of the DIN test was 88.00%,the HHIA-S’s compliance rate was 80.00%,and the combined compliance rate was 94.00%.The compliance rate of the DIN test and the combined compliance rates of the patients were statistically significant compared to the clinical gold standard data(P<0.05),while there was no difference between the compliance rate of the HHIA-S and the gold standard(P>0.05).The data shows that the sensitivity of the combined diagnosis is significantly higher than the sensitivity data of the DIN test and HHIA-S examination alone(P<0.05).Its specificity is 100.00%,and the accuracy data of the joint diagnosis in the degree were higher than those of the DIN test alone(P>0.05)and the HHIA-S alone(P<0.05).Conclusion:For patients with occupational noise-induced hearing loss,the joint evaluation of the DIN test and HHIA-S can significantly improve their diagnostic value with high sensitivity and accuracy.

标记测验(Token Test)与左侧大脑半球损害所致的各型失语的关系

本文对 33例左侧大脑半球损害所致的各型失语进行了标记测验的检查 ,同时作了标记测验与汉语失语检查中的是 /否题、听辨认、口头指令、听字辨认、听写、结构与视空间、积木、运用、计算、注意及记忆之间的相关性检验。统计结果表明 :标记测验得分与汉语失语检查法中各项测验之间有极显著的正相关 (P<0 .0 1 ) ,对标记测验成绩与失语严重程度进行了相关性检验 ,统计结果表明有显著相关性 (P<0 .0 5)。本文说明 ,注意、记忆、运用、视空间功能、认知等因素均影响标记测验的成绩 ;标记测验成绩与左侧大脑半球损害所致的失语类型及失语的严重程度有关 ,特别是以口语听理解障碍为主的失语类型 ,标记测验成绩极差。

Replace Psychometric Inferences with Direct Brain Measurements: LORETA Reflects Traditional Cerebral Loci for Neuropsychological Tests

Inferences of subtle cerebral injury and dysfunction have been historically dependent upon psychometric tests from which clinical neuropsychological profiles are generated. In addition to being secondary, over-inclusive and crude indicators of cerebral activity, psychometric tests are subject to economic incentives to “re-norm” traditional methods under the pretense of “ensuring” contemporary representations that are sanctioned by regulating organizations dominated by agendas of control over the interpretations of clinicians. The validity of neuropsychological tests is essential for their perspicacious application and interpretations. We measured the quantitative electroen-cephalographic profiles and calculated s-LORETA (standardized Low Resolution Electromagnetic Tomography) profiles in real time for normal men and women while they engaged in both traditional and novel neuropsychological tests that were employed to infer localized brain injury. Conspicuous alterations in source current density within specific frequency bands occurred within various regions of the right prefrontal region during performance of the Category, Design Fluency and Conditioned Spatial Association Test, the prefrontal medial surface during Toe Graphaesthesia, the caudal medial surface during Toe Gnosis, the left temporal region during Speech-Sounds, and within the right retrosplenial-parahippocampal region for Seashore Rhythms. Results supported the well established regional associations with the classic neuropsychological tests, verified the cerebral localization with more recent procedures, and emphasized the utility of modern real-time, direct cerebral imaging procedures.

Speech and language therapy for aphasia following subacute stroke

The aim of this study was to investigate the time window, duration and intensity of optimal speech and language therapy applied to aphasic patients with subacute stroke in our hospital. The study consisted of 33 patients being hospitalized for stroke rehabilitation in our hospital with first stroke but without previous history of speech and language therapy. Sixteen sessions of impairment-based speech and language therapy were applied to the patients, 30-60 minutes per day, 2 days a week, for 8 successive weeks. Aphasia assess- ment in stroke patients was performed with Giilhane Aphasia Test-2 before and after treatment. Compared with before treatment, fluency of speech, listening comprehension, reading comprehension, oral motor evaluation, automatic speech, repetition and naming were improved after treatment. This suggests that 16 seesions of speech and language therapy, 30-60 minutes per day, 2 days a week, for 8 successive weeks, are effective in the treatment of aphasic patients with subacute stroke.

Robust Speech Endpoint Detection in Airplane Cockpit Voice Background

A method of robust speech endpoint detection in airplane cockpit voice background is presented. Based on the analysis of background noise character, a complex Laplacian distribution model directly aiming at noisy speech is established. Then the likelihood ratio test based on binary hypothesis test is carried out. The decision criterion of conventional maximum a posterior incorporating the inter-frame correlation leads to two separate thresholds. Speech endpoint detection decision is finally made depend on the previous frame and the observed spectrum, and the speech endpoint is searched based on the decision. Compared with the typical algorithms, the proposed method operates robust in the airplane cockpit voice background.

A Comparison of Rey-Osterrieth Complex Figure Test Scores: With/Without Mouthpiece and with/without Noise

In the present study, the ROCF test was initially conducted involving 30 healthy young individuals, in a quiet environment as Experiment 1 to examine variations in the score among different methods to memorize the figure. In such an environment, no significant differences were observed in the score between the copying and outer speech groups, which suggested the possibility of some of the former groups having used outer speech in a voice too low to be heard or moving their lips without vocalization, achieving the same effect as outer speech, and consequently leading to the absence of differences from the outer speech group. On the other hand, the score markedly varied between the mouthpiece and copying or outer speech groups. As lip movements were suppressed in the former case, the unconscious use of outer speech was also prevented, possibly leading to poor results. Based on these findings, it may be possible to enhance the effects of rehabilitation in a clinical setting by promoting patients’ memorization using outer speech to vocalize the contents of training.

中文版hearWHO应用程序在听力筛查中的验证

目的验证中文版hearWHO应用程序,一款噪声下数字言语测试工具,在听力筛查中的有效性。方法招募听力正常者12名,听力损失患者92例。所有受试者依次完成纯音听阈测试、声导抗测试以及中文版hearWHO测试。分析双耳PTA0.5~4kHz和hearWHO得分的相关性,采用受试者工作特性曲线及曲线下面积等参数,确定hearWHO得分在最佳诊断截点下的灵敏度和特异度。结果hearWHO得分与较好耳和较差耳纯音听阈均值PTA0.5~4kHz均呈显著负相关性,相关系数分别为-0.552和-0.693(P<0.001)。按PTA0.5~4kHz≥20dBHL为存在听力损失的标准,当hearWHO得分≤60时,提示至少单耳出现听力下降,灵敏度和特异度分别为0.733、0.690;当hearWHO得分≤50时,提示受试者可能存在双耳听力下降,灵敏度和特异度分别为0.815、0.917。结论hearWHO对检出单耳或双耳听力损失的灵敏度和特异度均较高,当hearWHO得分≤60时,提示受试者有必要转诊进行进一步的听力检测及诊断。

普通话噪声接受度追踪测试材料的开发与等价性评估

目的开发普通话噪声接受度追踪(tracking of noise tolerance,TNT)测试材料并进行等价性评估。方法开发6组易于普通大众理解的言语材料(主题分别为日常生活、娱乐、家庭、节日、户外和学校);选取21例听力正常人分别进行6组测试材料的4分钟TNT测试,分别计算获得31~240 s、31~120 s、151~240 s三个时间窗的可容忍噪声水平(tolerable noise level,TNL)和TNT分数。结果听力正常个体间TNL值存在差异(F=43.611,P<0.05)。6组测试材料的标准化(z-scored)分数在三个时间窗内均有统计学差异(P<0.05),事后比较发现,所有的显著性差异结果都涉及家庭和/或日常生活主题。结论本研究开发的娱乐、节日、户外和学校的主题测试材料可作为普通话TNT测试的正式测试材料,可应用于实验研究和临床测试。

智能燃气灶语音识别测试方法研究

随着人工智能的迅速发展,语音识别技术作为一种新型人机交互模式,正逐渐应用于各个行业。智能燃气灶作为语音识别技术在智能家居领域的具体应用之一,由于常规智能家具测试系统缺乏专一性,在语音集、测试环境、测试场地布局等方面,无法满足测试要求。因此,该文在现有家电语音测试方法基础上,针对带有口音的普通话,进行智能燃气灶语音识别测试方法研究,测试方法中明确设备要求、试验环境,并引入正交试验以减少试验次数,为其他智能家具语音识别研究提供参考。

主题统觉测验用于自杀风险识别——基于语音及文本特征的机器学习研究

自杀风险识别是自杀预防的重要环节,但传统的自陈量表筛查存在虚报/漏报率高的局限。通过两步连续实验对主题统觉测验(TAT)进行的改编实现了基于TAT的小程序自助施测方案,并获取音频及文本数据用于机器学习建模,构建了针对自杀意念的自杀风险识别模型。结果发现,在测验耗时更短的情况下,该模型取得了与前人研究相比综合指数更优的模型效果;词频分析及关键词共线网络分析发现高自杀风险组被试在叙述文本中提及了更多与自杀、自伤相关的词汇以及主题,且使用了更多的排除词。经改编后的TAT小程序施测方案流程标准化且施测便捷,后续可收集更多高质量的样本以构建泛化性能更优的模型,应用于自杀风险识别的辅助评估中。

开展智能语音交互系统能力验证项目的可行性研究

本文通过结合日常生活的需求和研究实验室的发展方向,归纳分析不同标准测试方法的技术要求与特点,得出智能语音交互系统能力验证项目的推出是必要且迫不及待的,在智能语音交互系统中,语音唤醒起着基础支撑作用。它使得系统可以从低功率的监听状态,在检测到特定的唤醒词时快速激活语音识别和处理模块,实现用户指令的识别和响应。因此,语音唤醒的性能直接影响并限制了整个智能语音交互系统的性能。将其作为智能语音交互系统能力验证项目具有非常大的可行性。

建筑空间语言清晰度实验设计

将建筑声学设计前沿的语言清晰度STI指标引入建筑学本科实验教学,针对语言类空间开展STI测试,加强学生对概念的理解,达到熟练运用仪器设备进行实测的目标。以华中科技大学建筑与城市规划学院报告厅为对象,开展建筑空间语言清晰度测试实验,将仪器与软件使用、声学现场检测等内容纳入实验教学,并对实验数据和结果进行分析讨论。不同于传统的混响时间测量只是关注纯客观房间内的声传播特性,STI综合考量信噪比、声压级、心理声学效果等,让学生们认识到影响声环境品质更为广泛的作用维度,有利于提高学生在建筑设计创作中对语言清晰度的关注。

耳蜗死区对不同信噪比条件下轻、中度感音神经性听力损失患者言语识别的影响

目的初步探究安静及不同信噪比条件下,有、无耳蜗死区的轻、中度感音神经性听力损失患者的言语识别变化规律,以及不同测试条件下两组患者的言语识别差异。方法通过纯音测听选出符合纳入标准的轻、中度感音神经性听力损失患者44耳,采用均衡噪声阈(threshold equalizing noise,TEN)测试将患者分为非耳蜗死区组24耳和耳蜗死区组20耳。选取汉语(普通话)测听词汇表(Mandarin speech test materials,MSTMs)中单音节词言语测听词表,对两组患者在安静环境和言语谱噪声环境(SNR=6、3、0、-3 dB)下进行言语识别率测试。结果耳蜗死区组患者耳蜗死区1~2个,频率集中在3~4 kHz;两组患者不同测试环境下言语识别率均随信噪比降低而下降(P<0.05);耳蜗死区组患者在各测试条件下言语识别率得分较非耳蜗死区组低,且均有显著差异(P<0.05)。结论无论有无耳蜗死区,轻、中感音神经性听力损失患者的言语识别率均随着信噪比下降呈显著下降的趋势。在本研究各信噪比条件下耳蜗死区组患者的言语识别率均较非耳蜗死区组患者低,对于轻、中度感音神经性听力损失患者开展耳蜗死区测试是必要的。

声场不均匀度及语言清晰度在列车广播系统声品质测试中的研究

列车广播系统是列车与旅客进行信息交互最重要的系统,是列车运行工作的重要组成部分,在列车车辆中占有重要的位置。随着列车设计水平的迅速发展以及人们生活水平的提高,对于广播系统的需求不仅局限于功能实现,还要求广播系统声音质量有着越来越好的表现。文章从列车广播系统测试方法的角度出发,参阅非轨道交通行业相关系统的测试标准及要求,介绍了影响声品质的主要参数,即声场不均匀度和语言清晰度。结合已经完成的列车广播系统测试情况,并考虑轨道交通车辆本身的属性和要求,探讨总结了列车广播系统中声场不均匀度和语言清晰度这两个主要参数应该满足的要求,最后总结了适用于列车环境下测试声场不均匀度和语言清晰度的试验方法,为后续形成统一的测试方法和标准提供了一定研究基础。

3岁听障儿童与健听儿童语法、句法能力测试结果分析

目的分析3岁听障儿童与同龄健听儿童语言细节句子测试结果,为提高康复教学效果提供参考依据。方法在康复机构和普通幼儿园选取听障儿童与健听儿童各30例,采用言语听觉反应评估(evaluation of auditory resporse to speech,EARS)中的语言细节句子测试表进行测试,比较两组儿童的句子和词汇水平得分。结果儿童的听力状况对语言细节句子测试得分影响显著(T句子(1,58)=3.36,P<0.01;T词语(1,58)=2.89,P<0.01),健听儿童句子和词汇水平得分(M句子=8.47,M词语=58.23)均显著高于听障儿童(M句子=7.03,M词语=56.63)(P<0.05)。结论与健听儿童相比,语言年龄达到3岁水平的听障儿童句法语法能力滞后,这可能与听障儿童输入性语言信息不足及输入环境有关。康复训练中应加强相应训练,拓展应用到生活场景中。

正常儿童普通话词汇相邻性词表言语测听结果分析

目的从词汇学及语言学方面分析正常儿童言语识别的发育特征。方法随机抽取同一幼儿园中4~、5~、6~6.9岁三个年龄组正常听力儿童各39、33、24名,以普通话词汇相邻性词表（Mandarin lexical neighbor-hood test,M-LNT）为测试材料,采用录音给声后听说复述的方式进行言语识别率测试,分析各年龄儿童不同词表的言语识别率以及声母和声调的错误特征。结果同一年龄组双音节词得分高于单音节词（P〈0.05）。难词和易词表得分随年龄增长而提高,4~岁和5~岁组间得分差异有显著统计学意义（P〈0.017）,5~岁组和6~6.9岁组之间无显著差异（P〉0.017）。4~岁组儿童声母错误率〉10%者依次为z、c、s、p、n、r、chl、、zh、b、g、t;5~岁组儿童声母错误率〉10%者依次为ps、、n、z、c、ch、r、zh;6~6.9岁组儿童声母错误率〉10%者为n和ch。声调的错误现象在4~岁组儿童的发生率很低,在6~6.9岁组没有发生。结论年龄及词汇语音学因素对儿童言语测试得分有显著影响。从发音方式看,通音错误率最高,塞擦音错误率最低;从发音部位看,卷舌音错误率最高,唇齿音错误率最低,声调习得最早。

老年突发性耳聋的临床特征和转归

目的描述老年突发性耳聋的临床特征,分析其预后,并评估相关听力学和影像学检查的价值。以便更好的指导进一步的诊断和治疗。方法对31例老年突发性耳聋患者和同期治疗的31例非老年患者进行了回顾性研究和对比分析。分别将听力损失程度和听力曲线的类型进行分级,并观察其在患者中的分布。将疗效分为:无效、有效、显效、痊愈四个等级。对患者进行积极的药物治疗,并进行了纯音测听,畸变产物耳声发射,听性脑干反应,颈动脉超声,颞骨CT,内听道或颅脑磁共振检查。结果老年突聋占所有突聋患者的比例约为14.6%。伴有系统疾病的患者极重度耳聋比例高于其他患者。畸变产物耳声发射和听性脑干反应检查可反映出听力损失的程度。治疗的总有效率不低(54.8%),但总痊愈率较低(65%),对侧耳正常的患者疗效好于对侧耳异常的患者,疗效与病程无明显相关性。12例患者老年进行了言语识别率的检查,治疗无效患者的治疗前后言语识别率没有明显差异。而治疗有效的患者治疗后的评分高于治疗前。结论老年突聋患者有其独特的临床特征和转归在临床诊疗中应特殊对待。通过特殊检查和临床特征可以反映出听力损失程度和预测疗效。

普通话儿童词汇相邻性测试词表总体信度评估

目的对等价性的普通话儿童词汇相邻性测试词表(mandarin lexical neighborhood test,M-LNT)进行可行性、可靠性以及效能的评估,通过词表的得分-强度(performance-intensity,P-I)函数曲线、言语识别阈以及临界差值等指标,以期获得M-LNT词表的总体信度,为临床听力障碍患者的使用建立基准曲线。方法选取听力正常者52名,对双音节难、易词表和单音节难、易词表的4类12张词表进行测试。实验先期获得材料的P-I函数曲线的6个测试强度,依次采用随机区组设计方法,受试者随机分到奇数位或偶数位强度组,测试顺序为先易后难,3张表顺序轮换。获得每一强度下的识别率得分,用Matlab 7.1软件进行P-I曲线拟合、计算曲线的斜率、言语识别阈和临界差值。结果 4类词表的每类词表间的结果差异无统计学意义(P>0.05),表间等价。对拟合P-I曲线分析得出单音节易词表、单音节难词表、双音节易词表和双音节难词表平均阈值分别为25 dB SPL、31 dBSPL、20 dB SPL、24 dB SPL,50%斜率分别为2.8%/dB SPL、3.0%/dB SPL、5.8%/dB SPL、4.1%/dB SPL,95%置信区间下的总体临界差值分别为±22.2%、±26.1%、±32.7%、±29.9%。结论本实验以普通话儿童词汇相邻性测试词表为测试材料,4类词表的总体临界差值分别为±22.2%、±26.1%、±32.7%、±29.9%,总体信度可靠,并且获得P-I曲线,建立了M-LNT词表言语识别率的基准曲线。

普通话快速噪声下言语测听材料的等价性评估

目的开发一套标准的普通话版快速噪声下言语测听材料,评估依据听力学要求和语言学特征选取的300个语句材料的等价性,并获得其在50%正确识别时所对应的信噪比(记为SNR-50)的正常值。方法首先将这些语句材料按照数字化录制原则录制为女声音频材料,背景噪声为4人同时谈话的言语噪声。言语声和噪声混合在一起。选取30例正常受试者,采用听说复述方式,分别在+6、+3、0、-3、-6 dB信噪比条件下测试。对测试所得结果使用SPSS17.0统计软件进行数据分析和强度-识别率函数曲线的拟合。结果 300个语句在噪声环境下测试结果分析显示,斜率和阈值不呈正态分布。剔除斜率过大(>0.72)的语句,及曲线拟合相关系数过小(r<0.7)的语句,精选出等价性较好的78句。后者呈正态分布。结论经过对300个语句的等价性评估,经过严格的筛选及精细调整,最终保留的78个语句在正常人中的等价性较好,下一步可进行这些语句复测信度的测试。

儿童词语理解能力测验的编制及其信度与效度研究

目的:编制儿童词语理解能力测验(VCTC),并建立上海地区的参考标准,以用于低龄儿童言语障碍筛查及言语障碍儿童言语理解能力评估。方法:从儿童词语获得的规律出发,结合言语障碍儿童在词语理解方面的特点,编制试用测题。抽取138例2—4岁普通儿童,对试用测题进行项目检验,从鉴别力和难度两个角度对试用测题进行筛选。最后,抽取120例2—4岁普通儿童,对测验进行信度和效度检验。因而得出上海市2—4岁普通儿童的参考标准。结果:通过项目检验,由40道测题组成儿童词语理解能力测验。对测验进行分半相关分析和α系数分析,分半信度系数与α系数均为0.82,说明本测验总体上是可靠的。单因素方差分析显示,不同年龄儿童在测验中取得的成绩具有极其显著的差异(F=33.91,P<0.01),说明测验的编制符合儿童言语发展规律,能够反映不同年龄儿童在言语理解方面的不同水平。结论:儿童词语理解能力测验的编制过程符合心理测量量表的编制规范,测验具有良好的信度和效度且难度较低、操作简便,适用于言语障碍儿童的筛查与评估。