ABSTRACT
Recent advances in haptic technology could allow haptic hearing aids, which convert audio to tactile stimulation, to become viable for supporting people with hearing loss. A tactile vocoder strategy for audio-to-tactile conversion, which exploits these advances, has recently shown significant promise. In this strategy, the amplitude envelope is extracted from several audio frequency bands and used to modulate the amplitude of a set of vibro-tactile tones. The vocoder strategy allows good consonant discrimination, but vowel discrimination is poor and the strategy is susceptible to background noise. In the current study, we assessed whether multi-band amplitude envelope expansion can effectively enhance critical vowel features, such as formants, and improve speech extraction from noise. In 32 participants with normal touch perception, tactile-only phoneme discrimination with and without envelope expansion was assessed both in quiet and in background noise. Envelope expansion improved performance in quiet by 10.3% for vowels and by 5.9% for consonants. In noise, envelope expansion improved overall phoneme discrimination by 9.6%, with no difference in benefit between consonants and vowels. The tactile vocoder with envelope expansion can be deployed in real-time on a compact device and could substantially improve clinical outcomes for a new generation of haptic hearing aids.
Subject(s)
Hearing Aids , Noise , Speech Perception , Humans , Speech Perception/physiology , Male , Female , Adult , Young Adult , Touch/physiology , Acoustic Stimulation/methods , Touch Perception/physiology , Hearing Loss/physiopathologyABSTRACT
Timely detection and treatment of postpartum hemorrhage (PPH) are crucial to prevent complications or death. A calibrated blood-collection drape can help provide objective, accurate and early diagnosis of PPH, and a treatment bundle can address delays or inconsistencies in the use of effective interventions. Here we conducted an economic evaluation alongside the E-MOTIVE trial, an international, parallel cluster-randomized trial with a baseline control phase involving 210,132 women undergoing vaginal delivery across 78 secondary-level hospitals in Kenya, Nigeria, South Africa and Tanzania. We aimed to assess the cost-effectiveness of the E-MOTIVE intervention, which included a calibrated blood-collection drape for early detection of PPH and a bundle of first-response treatments (uterine massage, oxytocic drugs, tranexamic acid, intravenous fluids, examination and escalation), compared with usual care. We used multilevel modeling to estimate incremental cost-effectiveness ratios from the perspective of the public healthcare system for outcomes of cost per severe PPH (blood loss ≥1,000 ml) avoided and cost per disability-adjusted life-year averted. Our findings suggest that the use of a calibrated blood-collection drape for early detection of PPH and bundled first-response treatment is cost-effective and should be perceived by decision-makers as a worthwhile use of healthcare budgets. ClinicalTrials.gov identifier: NCT04341662 .
Subject(s)
Cost-Benefit Analysis , Postpartum Hemorrhage , Humans , Postpartum Hemorrhage/therapy , Postpartum Hemorrhage/diagnosis , Postpartum Hemorrhage/economics , Female , Pregnancy , Early Diagnosis , Adult , Oxytocics/therapeutic use , Oxytocics/economics , Cost-Effectiveness AnalysisABSTRACT
Many people with hearing loss struggle to understand speech in noisy environments, making noise robustness critical for hearing-assistive devices. Recently developed haptic hearing aids, which convert audio to vibration, can improve speech-in-noise performance for cochlear implant (CI) users and assist those unable to access hearing-assistive devices. They are typically body-worn rather than head-mounted, allowing additional space for batteries and microprocessors, and so can deploy more sophisticated noise-reduction techniques. The current study assessed whether a real-time-feasible dual-path recurrent neural network (DPRNN) can improve tactile speech-in-noise performance. Audio was converted to vibration on the wrist using a vocoder method, either with or without noise reduction. Performance was tested for speech in a multi-talker noise (recorded at a party) with a 2.5-dB signal-to-noise ratio. An objective assessment showed the DPRNN improved the scale-invariant signal-to-distortion ratio by 8.6 dB and substantially outperformed traditional noise-reduction (log-MMSE). A behavioural assessment in 16 participants showed the DPRNN improved tactile-only sentence identification in noise by 8.2%. This suggests that advanced techniques like the DPRNN could substantially improve outcomes with haptic hearing aids. Low-cost haptic devices could soon be an important supplement to hearing-assistive devices such as CIs or offer an alternative for people who cannot access CI technology.
Subject(s)
Cochlear Implantation , Cochlear Implants , Hearing Loss , Speech Perception , Humans , Speech , Hearing Loss/surgery , Cochlear Implantation/methods , Neural Networks, ComputerABSTRACT
Four preregistered experiments (N = 4,307) explored whether anti-Christian bias claims can discreetly signal White allyship among Christian American adults. In Experiments 1 and 2, reading about anti-Christian bias led White, but not Black, Christians to perceive more anti-White bias. Experiments 3 and 4 demonstrate the connection between Christian and White can be leveraged by politicians in the form of a racial dog whistle. In Experiment 3, White Christians perceived a politician concerned about anti-Christian bias as caring more about anti-White bias and more willing to fight for White people (relative to a control). This politician was also perceived as less offensive than a politician concerned about anti-White bias. In Experiment 4, Black Christians perceived a politician concerned about anti-Christian bias as less offensive than one concerned about anti-White bias yet still unlikely to fight for Black people. Results suggest "anti-Christian bias" can provide a relatively palatable way to signal allegiance to White people.
Subject(s)
Black or African American , Racism , White , Adult , Humans , Bias , United StatesABSTRACT
Haptic hearing aids, which provide speech information through tactile stimulation, could substantially improve outcomes for both cochlear implant users and for those unable to access cochlear implants. Recent advances in wide-band haptic actuator technology have made new audio-to-tactile conversion strategies viable for wearable devices. One such strategy filters the audio into eight frequency bands, which are evenly distributed across the speech frequency range. The amplitude envelopes from the eight bands modulate the amplitudes of eight low-frequency tones, which are delivered through vibration to a single site on the wrist. This tactile vocoder strategy effectively transfers some phonemic information, but vowels and obstruent consonants are poorly portrayed. In 20 participants with normal touch perception, we tested (1) whether focusing the audio filters of the tactile vocoder more densely around the first and second formant frequencies improved tactile vowel discrimination, and (2) whether focusing filters at mid-to-high frequencies improved obstruent consonant discrimination. The obstruent-focused approach was found to be ineffective. However, the formant-focused approach improved vowel discrimination by 8%, without changing overall consonant discrimination. The formant-focused tactile vocoder strategy, which can readily be implemented in real time on a compact device, could substantially improve speech perception for haptic hearing aid users.