Analysis of the Influence of Sound Source Position and Electrode Placement on the Stimulation Pattern of the Cochlear Implant under Noise Conditions: Optimization of Auditory Perceptual Effects

Background: Cochlear implants (CI) are widely used to restore hearing in people with severe to profound hearing loss. However, optimizing CI performance, especially in difficult listening environments with background noise, remains a major challenge. Understanding the influence of factors such as sound source position and electrode placement on CI stimulation patterns is critical to improving auditory perception. Methods: In this study, an analysis was conducted to investigate the influence of sound source position and electrode placement on CI stimulation patterns under noisy conditions. For this purpose, a special measurement setup with a CI speech processor-microphone test box was used to simulate realistic listening scenarios and measure CI performance. Results: The results show that the effectiveness of CI noise reduction systems is influenced by factors such as the position of the sound source and electrode placement. In particular, the beamforming ultra zoom mode showed significantly better noise reduction than the omnidirectional mode, especially under real listening conditions. Furthermore, differences in electrode responses indicate individual variability in the CI user experience, highlighting the importance of personalized fitting algorithms. Conclusions: The results demonstrate the importance of considering environmental factors and individual differences when optimizing CI performance. Future research efforts should focus on the development of personalized fitting algorithms and the exploration of innovative strategies, such as the integration of artificial intelligence, to improve CI functionality in different listening environments. This study contributes to our understanding of CI stimulation patterns and lays the foundation for improving auditory perception in CI users.

Biochemical Changes in the Brain and Metabolism as Risk Factors of Neurological Disorders

This paper aims to examine theories that attempt to explain biochemical changes in the brain as well as the metabolism of individuals who experience symptoms and conditions related to neurological disorders like depression. A systematic literature search was performed on NCBI and PubMed. The search included the keywords neurological disorders, monoamine hypothesis, metabolic syndrome, oxytocin receptor, dietary health, and magnesium intake. Twenty-five research articles met the criteria for the literature review of this examination. In particular, this paper will review multiple studies that investigate the monoamine (MAO) hypothesis of depression and metabolic syndrome (MetS) as a risk factor for neurological disorders. While studies that evaluate additional risk factors for neurological disorders, such as autoimmunity and rheumatic diseases, oxytocin receptor (OXTR) DNA methylation in postpartum depression, dietary health in children and their psychological health, and dietary magnesium and cardiovascular disease, will be reviewed as well.

A Neurobiological Examination of Environmental, Subjective, Peripheral and Central Taste Sensation Processing Variances Associated with Taste Alterations: A Case Study Method

This study examines a common phenomenon that is greatly ignored by the clinical community for numerous reasons. Many people for a multitude of reasons experience taste alterations. The supertaster phenomenon is an alteration of taste that requires more investigation. In this study, a proband was examined for subjective reports of a taste alteration to determine its nature through a medical history examination and interview as well as any recollections of the taste disorder in her life. Through this examination, it was found that medical history examination and interview of the proband that many members of her nuclear family showed traits of the same taste disorder or in the case of one family member being a suspect for the taste alteration and one member not showing any signs because of genetic diversity as a half-sibling. Taste disorders are heritable, have multiple health and mental health consequences, influence life choices including mate choice, avoidance behaviors, social choices, alcohol use/abuse, smoking, food choices, and more. More awareness is needed in the research and clinical community into taste alterations as well as calls for future research from neuroscience, biomedical science, life science, and allied science community to investigate taste alterations.

Efficacy of Remote Hearing Aids Programming Using Teleaudiology: A Systematic Review

Telemedicine is defined as a system that allows healthcare workers to deliver their services and consultations to the patients remotely without the need of their physical presence within academic institutions, hospitals, and medical clinics aiming to reduce the personal contact and limiting it to the need only. The field of telemedicine is growing every day and facilitating more flexible services for patients around the world especially during COVID-19 pandemic. Methods: This systematic review was conducted according to the Cochrane Handbook for Systematic Reviews. Database search was made on several databases including PubMed/Medline, Scopus, Web of Science, Publons, EMBASE, and Google Scholar using the relevant keywords. Inclusion criteria for articles in our study included the following original research (primary research articles), addressing the efficacy of teleaudiology for hearing aids programming and satisfaction of patients. Results: Seven studies were included in this systematic review article. Included studies were assessed using Cochrane handbook guidelines. Conclusions: The results of this work based on the currently available literature denote that remote programming for the hearing aids using modern technology is effective and provide comparable results with the standard face-to-face clinic programming, even for patients with no previous experience in hearing aids fitting in either of in-person physical presence programming or remotely over the internet using teleconferencing which is known as teleaudiology. Most of the results were positive and support the continuity to develop better facilities to improve the teleaudiology to be an essential part of hearing aids programming with its different types. Minimal results provided negative impact from the participating patients, this resulted because of the non-upgraded infrastructure and facilities of the audiology clinic or the personal computer of the patient in his home/ workplace or both sides don’t have enough specifications to smoothly perform this modern approach.

Comparison of the Effectiveness of TRV Chair and Canalith Repositioning Procedure (CRP) for the Treatment of Benign Paroxysmal Positional Vertigo (BPPV)

The primary goal of this research is to evaluate the efficacy of traditional manual canalith repositioning procedures (CRP) to that of automated multi-axial repositioning chair (TRV). A total of 37 BPPV positive patients were distributed into two groups. The first group consisted of 20 patients, 10 under 50 years old (young group) and 10 over 50 years old (old group), who received TRV chair treatment, whereas the remaining 17 patients, 7 under 50 years old (young group) and 10 over 50 years old (old group) received CRP treatment. The DHI and VAS questionnaires were given to the patients before and after treatment, and the results were compared. The average VAS score for TRV patients was 84.5% (young group) and 77.5% (old group). These patients’ DHI results were as follows: for young patients, 10% had a mild handicap, 80% had a moderate handicap, and 10% had a severe handicap, while for the elderly, 40% had a mild handicap, 40% had a moderate handicap, and 20% had a severe handicap. The results improved significantly after the first treatment session. Old patients had a VAS of 28%, 30% had a mild handicap and only 10% had a moderate handicap. However, only 43% of the young group and 30% of the old group who underwent standard CRP suffered from mild handicap and had a VAS of 20% and 34.3% successively. The third session revealed that all patients in the TRV chair group had no handicap, whereas the CRP patients indicated that they still had a mild handicap. Upon analyzing the results, both treatment methods revealed the same efficacy in treating single canal BPPV. However, TRV chair appeared to be superior to traditional CRP in treating multi-canal BPPV.

The Challenges of Cochlear Implant Users in Jos, North Central Nigeria

Cochlear implants (CIs) are remarkable solutions for severe to profound sensorineural hearing loss globally. Access to cochlear implants in developing countries is not without challenges. This study examined the challenges of CI users in Jos, Nigeria. The study is a cross-sectional survey that used a convenient sampling technique to sample 41 respondents. CICQ questionnaire was used to elicit data from the respondents. A simple percentage was used to analyze the data. The results revealed that 62.5% of the CI users lived below 100,000 Naira (USD244) as their yearly income. The majority (93.75%) have severe to profound hearing loss bilaterally but used CI unilaterally. Cost and access to CI accessories and management have affected the economic, social and psychological life of the CI users and that of their relations. ENT personnel said that the demand for CI in their facility is very high and managing CI users is very challenging due to inadequate manpower, finance and equipment. Easy access to CIs, their accessories and services at affordable cost, effective training for ENT personnel, and adequately equipped health facilities were recommended.

Barriers to Early Pediatric Cochlear Implantation in Kenya

Background: Cochlear implantation is the best management option for children with profound hearing loss and has received no benefit from hearing aids. Early implantation for these children is associated with good speech and language outcomes. Objectives: To determine the barriers to early pediatric cochlear implantation. Methodology: A qualitative cross-sectional study was conducted at Hearing Implants Centre in Nairobi Kenya from August 2022 to February 2023. The target population was 40 children who had undergone cochlear implantation under the auspices of Cochlear Implant Group of Kenya but data was only collected from 30 of them. The remaining were ruled out because 3 were unreachable over the phone, 5 refused to participate and 2 did not meet the inclusion criteria. Results: Patient file reviews and parental telephone interviews were conducted to collect information and analyzed using Microsoft excel and presented using graphs, tables and pie charts. The analysis of the gender showed 46.67% were male and 53.33% were female. Analysis on newborn screening showed that none had it done. The mode age of hearing loss suspicion was between the ages of 2 - 3 years. The hearing loss suspicion done was done by the mothers at 20 children the reminder being 3 by the father, 1 by a family friend, 4 by the school-teacher and 2 by the child’s grandmother. A total of 17 participants noted a delayed in speech and language, 9 noted that the child did not respond to loud sounds, 4 noted that the children did not turn when called. Once hearing loss was identified, 73% saw the ENT, 17% saw a pediatrician, 7% went to see an Audiologist, and 3% saw a speech therapist. The mode age at diagnosis was 1.5 years. The mode age at implantation was 5 years. The mode time from diagnosis was 2 years. Conclusions: This study sought to investigate the barriers to pediatric cochlear implantation in Kenya. From the results it was determined that factors such as lack of newborn screening, high cost of cochlear implantation, lack of awareness have led to late cochlear implantation.

Refractive error study in young subjects：results from a rural area in Paraguay

AIM：To evaluate the distribution of refractive error in young subjects in a rural area of Paraguay in the context of an international cooperation campaign for the prevention of blindness. METHODS：A sample of 1466 young subjects（ranging from 3 to 22 years old）,with a mean age of 11.21±3.63 years old,were examined to assess their distance visual acuity（VA）and refractive error. The first screening examination performed by trained volunteers,included visual acuity testing,autokeratometry and non-cycloplegic autorefraction. Inclusion criteria for a second complete cycloplegic eye examination by an optometrist were VA 〈20/25（0.10 log MAR or 0.8 decimal）and/or corneal astigmatism ≥1.50 D. RESULTS：An uncorrected distance VA of 0 log MAR（1.0decimal）was found in 89.2% of children. VA 〈20/25 and/or corneal astigmatism ≥1.50 D was found in 3.9% of children（n=57）,with a prevalence of hyperopia of 5.2%（0.2%of the total）in this specific group. Furthermore,myopia（spherical equivalent ≤-0.5 D）was found in 37.7% of the refracted children（0.5% of the total）. The prevalence of refractive astigmatism（cylinder ≤-1.50 D）was 15.8%（0.6% of the total）. Visual impairment（VI）（0.05≤VA≤0.3）was found in 12/114（0.4%）of the refracted eyes. Main causes for VI were refractive error（58%）,retinal problems（17%,2/12）,albinism（17%,2/12）and unknown（8%,1/12）.CONCLUSION：A low prevalence of refractive error has been found in this rural area of Paraguay,with higher prevalence of myopia than of hyperopia.

Noise Exposure and Its Auditory Effect on Industrial Workers

This paper analyzes the effect of exposure to noise among industrial workers in Nigeria to discover the level of exposure to noise that causes auditory defects or noise-induced hearing loss (NIHL), this paper primarily covers the evaluation of hearing impairment and its severity on exposure to loud sounds (acoustic trauma) and the role of hearing protective devices for industrial workers for prevention of Noise Induced Hearing Loss (NIHL). The paper also discusses the findings and guides as preventive methods for such industries. A total sample of seventy (70) workers were selected from three (3) manufacturing industries for this study. This study revealed a statistically significant difference in the hearing threshold within the selected industries over the selected period of time relating to the theory of excessive noise present in a given environment tends to affect people or in this case study employees hearing if proper hearing protection isn’t used for prolonged hours or time, the study also surveys the various effect of noise on human health including various steps of noise control in such settings.

Normative eSRT Value among MED-EL Pediatric Population in Indonesia

Introduction: Early stimulation of the auditory sense is essential for the development of language and speech. In children with a cochlear implant, the most common issue is whether the hearing has been optimized or not, as they are still unable to provide reliable feedback regarding their hearing ability. Thus, electrically evoked stapedius reflex threshold (ESRT) based fitting has been used as one of the available methods in programming a cochlear implant (CI) audio processor. As eSRT is an objective test, patient cooperation was not needed making it especially beneficial for children with CI who have limitations in providing feedback. Now that eSRT has been applied commonly almost worldwide, the goal of this study is to determine the normative value of eSRT among the pediatric population in Indonesia. Methods: A total of 32 pediatric CI users in the age range 3 - 11 years implanted with Med-El cochlear implant were included in this study. ESRT was performed during follow-up mapping between September 2021 and January 2022 in the Med-El Indonesia hearing center. Results: The result of the present study showed an average normative value of 20.55 qus. This finding is consistent with the values obtained in previous studies. Conclusion: The result found can be used as a valuable indicator of average optimised MCL among the pediatric population.

Bochner-Kodaira Techniques on Kahler Finsler Manifolds

A horizontal Hodge Laplacian operator □h is defined for Hermitian holomorphic vector bundles over PTM on Khler Finsler manifold,and the expression of □h is obtained explicitly in terms of horizontal covariant derivatives of the Chern-Finsler connection.The vanishing theorem is obtained by using the α_Hα_H-method on Kahler Finsler manifolds.