Reduction of roadway noise in a coastal city underwater soundscape during COVID-19 confinement.

Confinement due to the COVID-19 pandemic drastically reduced human activities. Underwater soundscape variations are discussed in this study, comparing a typical and confinement day in a coastal lagoon near a popular tourist city in Mexico. Recording devices were located at 2 m in depth and 430 m away from the main promenade-a two-way avenue for light vehicle traffic-where main tourist infrastructure is located. The nearby marine environment is habitat to birds and dolphins as well as fish and invertebrates of commercial importance. Medium and small boats usually transit the area. The main underwater sound level reduction was measured at low frequencies (10-2000 Hz) because of the decrease in roadway noise. Vessel traffic also decreased by almost three quarters, although the level reduction due to this source was less noticeable. As typical day levels in the roadway noise band can potentially mask fish sounds and affect other low frequency noise-sensitive marine taxa, this study suggests that comprehensive noise analysis in coastal marine environments should consider the contribution from nearby land sources.

[Technical advancements in cochlear implants : State of the art]. / Technische Entwicklungen bei Cochleaimplantaten : Stand der Technik.

Twenty years ago, cochlear implants (CI) were indicated only in cases of profound hearing loss or complete deafness. While from today's perspective the technology was clumsy and provided patients with only limited speech comprehension in quiet scenarios, successive advances in CI technology and the consequent substantial hearing improvements over time have since then resulted in continuous relaxation of indication criteria toward residual hearing. While achievements in implant and processor electronics have been one key factor for the ever-improving hearing performance, development of electro-acoustic CI systems-together with atraumatic implantation concepts-has led to enormous improvements in patients with low-frequency residual hearing. Manufactures have designed special processors with integrated hearing aid components for this patient group, which are capable of conveying acoustic and electric stimulation. A further milestone in improvement of hearing in challenging listening environments was the adoption of signal enhancement algorithms and assistive listening devices from the hearing aid industry. This article gives an overview of the current state of the art in the abovementioned areas of CI technology.

Computer-aided auscultation of the heart: from anatomy and physiology to diagnostic decision support.

There is a clear and present need for computer-aided auscultation of the heart which arises from the highly informative nature of heart sounds, the inherent difficulty of auscultation and increasing pressure in healthcare for rapid, accurate, objective, documented and cost-effective patient evaluation and diagnostic decision making. There are advanced signal processing technologies that hold promise for developing computer-aided auscultation solutions that are intuitive, efficient, informative and accurate. Computer-aided auscultation offers an objective, quantitative and cost-effective tool for acquiring and analyzing heart sounds, providing archival records that support the patient evaluation and referral decision as well as serial comparisons for patient monitoring. There is the further promise of new quantitative acoustic measures and auscultatory findings that have more precise correlation with underlying physiological parameters. These solutions are being developed with the benefits of a rich literature of clinical studies in phonocardiography, the added insights derived from echocardiography, and advances in signal processing technology.

Evolution of breast cancer screening in countries with intermediate and increasing incidence of breast cancer.

BACKGROUND: Few studies have been published regarding the practice of breast cancer screening in Asian countries. AIMS: The present study illustrates how the health policy for breast cancer screening has evolved in Taiwan from selective mammographic screening within a high-risk group, firstly to a programme of physical examination by public health nurses, and finally to a two-stage breast cancer screening programme, with a risk assessment followed by mammography for those at moderate to high risk. DATA SOURCES: Breast cancer screening has evolved from 1995 to 2004 in Taiwan in three stages: (1) selective screening for breast cancer with mammography, ultrasound and physical examination only in first-degree relatives of breast cancer cases (1995-1998); (2) a programme of mass screening (1999-2001) with physical examination by public health nurses; and (3) two-stage breast cancer screening with a risk factor questionnaire and mammography for those deemed at moderate-to-high risk (2002-2004). The questionnaire was based on significant risk factors in a previous epidemiological study, in conjunction with the physical examination programme, a risk score was constructed from the logistic regression coefficients from the previous study, and women with a score above the median in the previous epidemiological study were assigned to mammography. RESULTS: Two-stage mammography screening had the most favourable results compared with the two previous screening regimes. It had a positive predictive value of recall after mammography of 14%, compared with 8% for selective screening and 2% for physical examination. Of screen-detected cancers in the two-stage programme, 71% were either ductal carcinoma in situ or stage T1, compared with 61% for selective screening and 60% for physical examination. The area under the receiver operating characteristic curve was 71% for the two-stage programme. CONCLUSIONS: For a low- to medium-risk country such as Taiwan, two-stage screening has acceptable parameters of recall and cancer detection, and compares well with other screening strategies.