Biomedical subjects

J Kiefer

Publications and source records attributed to J Kiefer.

171 records · Page 10Linked to original sources

PubMedDate not supplied

Speech understanding in quiet and in noise with the CIS speech coding strategy (MED-EL Combi-40) compared to the multipeak and spectral peak strategies (nucleus).

This study compares sentence understanding in quiet and in noise with 3 different speech coding strategies for cochlear implants. The results show that the spectral-peak (SPEAK) and continuous-interleaved-sampling (CIS) coding strategies, based on spectral signal analysis, allow for better speech understanding in quiet as well as in noise, than the multipeak (MPEAK) coding strategy, which relys on speech feature extraction. In the intrasubject comparison of the MPEAK and SPEAK strategies, the SPEAK coding strategy provided a considerable improvement in quiet and in noise for the majority of patients using the Nucleus 22 Mini-implant. In the intersubject comparisons, the mean results in noise with the CIS strategy were superior to both the MPEAK and the SPEAK strategies. The difference was greatest for the most difficult tests in noise. Understanding in noise was least reduced for the CIS strategy. Understanding in quiet was not significantly different between the CIS and the SPEAK strategies; both strategies were significantly better than the MPEAK strategy in quiet. These results are still preliminary, due to the relatively small number of patients and the great inherent intersubject variability of results.

Adolescent↗

PubMedDate not supplied

Evaluation of performance with the COMBI40 cochlear implant in adults: a multicentric clinical study.

The present multicentric clinical study involves 19 centres, 16 of them in German-speaking countries, 1 British, 1 Polish and 1 Hungarian. 60 postlingually deafened adults with a mean age of 47.5 years (20-70) and mean duration of deafness of 5.3 years (0.5-20) have been evaluated with the MED-EL COMBI 40 cochlear implant which implements a high-rate continuous-interleaved-sampling strategy with 8 channels. Safety and effectiveness data have been collected. Speech perception tests include a 16-consonant, an 8-vowel, a sentence and a monosyllabic-word test in all languages and a 2-digit figure test in all languages but English. Test intervals are 1, 3, 6 months and 1 year after first fitting. 41 of the 60 postlingually deafened adult study patients have completed their 6-month evaluation. While their pre-operative monosyllabic-word score was 0%, their mean monosyllabic-word score 6 months after first fitting was 48% (8-90) with a median of 50%. The mean sentence understanding was 84% (24-100) with a median of 90%. The respective values for the 1-year evaluations with 25 patients are a mean of 50% (5-85), with a median of 60% for the monosyllables and a mean of 89% (30-100), with a median of 97%, for the sentences.

Adult↗

PubMedDate not supplied

Protein synthesis and amino acid pools in irradiated yeast cells.

Protein synthesis after UV- and X-irradiation was investigated in diploid yeast. The incorporation of radioactively labelled lysine and phenylalanine was measured 2.5 and 4 hours after exposure. By varying the specific activity the pool sizes could be estimated. At 2.5 hours there is some increase in pool sizes and a dose-dependent enhancement of protein synthesis. At 4 hours pools are again normal, but the increase of synthetic activity prevails.

Amino Acids↗

PubMedDate not supplied

Comparison of speech recognition with different speech coding strategies (SPEAK, CIS, and ACE) and their relationship to telemetric measures of compound action potentials in the nucleus CI 24M cochlear implant system.

Speech understanding and subjective preference for three different speech coding strategies (spectral peak coding [SPEAK], continuous interleaved sampling [CIS], and advanced combination encoders [ACE]) were investigated in 11 post-lingually deaf adult subjects, using the Nucleus CI 24M cochlear implant system. Subjects were randomly assigned to two groups in a balanced crossover study design. The first group was initially fitted with SPEAK and the second group with CIS. The remaining strategies were tested sequentially over 8 to 10 weeks with systematic variations of number of channels and rate of stimulation. Following a further interval of 3 months, during which subjects were allowed to listen with their preferred strategy, they were tested again with all three strategies. Compound action potentials (CAPs) were recorded using neural response telemetry. Input/output functions in relation to increasing stimulus levels and inter-stimulus intervals between masker and probe were established to assess the physiological status of the cochlear nerve. Objective results and subjective rating showed significant differences in favour of the ACE strategy. Ten of the 11 subjects preferred the ACE strategy at the end of the study. The estimate of the refractory period based on the inter-stimulus interval correlated significantly with the overall performance with all three strategies, but CAP measures could not be related to individual preference of strategy or differences in performance between strategies. Based on these results, the ACE strategy can be recommended as an initial choice specifically for the Nucleus CI 24M cochlear implant system. Nevertheless, access to the other strategies may help to increase performance in individual patients.

Acoustic Stimulation↗

PubMedDate not supplied

Results of cochlear implantation in patients with severe to profound hearing loss--implications for patient selection.

In patients with some residual hearing and minor benefit from conventional hearing aids, the benefits of cochlear implantation have to be weighed carefully against eventual adverse effects. In this study, pre- and post-operative thresholds as well as functional results after cochlear implantation are reported; 17 of 44 implanted adults had residual hearing pre-operatively (mean threshold(250 to 4000 Hz): 106 dB HL) in the implanted ear. Residual hearing in the implanted ear could not, in general, be preserved post-operatively. Seventeen of 44 implanted children had some amount of residual hearing in the implanted ear pre-operatively (implanted ear: 114 dB HL; contralateral ear: 109.9 dB HL; mean thresholds(250 to 4000 Hz))). Contrary to the results in adults, residual hearing in the implanted ear remained statistically unchanged. Hearing in the contralateral ear increased significantly from 109.9 to 101.9 dB HL post-operatively. This increase was mainly attributed to maturation of the central auditory pathway. In adults with residual hearing, the monosyllable word recognition scores increased significantly from 9 per cent pre-operatively to 42 per cent post-operatively. Children with residual hearing tended to perform better on speech-related test material compared to children without prior auditory experience. Cochlear implantation is indicated in adults and children with residual hearing and minor benefit from conventional amplification. The contralateral ear in children should be considered for additional acoustical stimulation.

Adult↗

PubMedDate not supplied