Daily sound exposure of hearing aids users during COVID-19 pandemic in Europe.

Introduction: This study aimed to investigate the daily sound exposure of hearing aid (HA) users during the COVID-19 pandemic, with a specific focus on the impact of different governance intervention levels. Methods: Modern HA technology was employed to measure and compare the sound exposure of HA users in three distinct periods: pre-pandemic, and two 14-day periods during the pandemic, corresponding to varying levels of governance interventions. The study sample comprised a total of 386 HA users in Europe during the pandemic, with daily sound exposure data collected as part of the main dataset. Results: The results revealed that, during the pandemic, the equivalent continuous sound pressure level (SPL) experienced by HA users decreased, while the signal-to-noise ratio (SNR) increased compared to the pre-pandemic period. Notably, this impact was found to be more pronounced (p < 0.05) when individuals were subjected to stronger governance intervention levels, characterized by lower SPL and higher SNR. Discussion: This study highlights the changes in daily sound exposure experienced by HA users during the COVID-19 pandemic, particularly influenced by the extent of governance interventions that restricted social activities. These findings emphasize the importance of considering the effects of pandemic-related governance measures on the sound environments of HA users and have implications for audiological interventions and support strategies during similar crises.

Combining Multiple Psychophysiological Measures of Listening Effort: Challenges and Recommendations.

About one-third of all recently published studies on listening effort have used at least one physiological measure, providing evidence of the popularity of such measures in listening effort research. However, the specific measures employed, as well as the rationales used to justify their inclusion, vary greatly between studies, leading to a literature that is fragmented and difficult to integrate. A unified approach that assesses multiple psychophysiological measures justified by a single rationale would be preferable because it would advance our understanding of listening effort. However, such an approach comes with a number of challenges, including the need to develop a clear definition of listening effort that links to specific physiological measures, customized equipment that enables the simultaneous assessment of multiple measures, awareness of problems caused by the different timescales on which the measures operate, and statistical approaches that minimize the risk of type-I error inflation. This article discusses in detail the various obstacles for combining multiple physiological measures in listening effort research and provides recommendations on how to overcome them.

The adaptation of noise-induced temporary hearing threshold shift predictive models for modelling the public health policy.

OBJECTIVES: It has been shown that monitoring temporary threshold shift (TTS) after exposure to noise may have a predictive value for susceptibility of developing permanent noise-induced hearing loss. The aim of this study is to present the assumptions of the TTS predictive model after its verification in normal hearing subjects along with demonstrating the usage of this model for the purposes of public health policy. MATERIAL AND METHODS: The existing computational predictive TTS models were adapted and validated in a group of 18 bartenders exposed to noise at the workplace. The performance of adapted TTS predictive model was assessed by receiver operating characteristic (ROC) analysis. The demonstration example of the usage of this model for estimating the risk of TTS in general unscreened population after exposure to loud music in discotheque bars or music clubs is provided. RESULTS: The adapted TTS predictive model shows a satisfactory agreement in distributions of actual and predicted TTS values and good correlations between these values in examined bartenders measured at 4 kHz, and as a mean at speech frequencies (0.5-4 kHz). An optimal cut-off level for recognizing the TTS events, ca. 75% of young people (aged ca. 35 years) may experience TTS >5 dB, while <10% may exhibit TTS of 15-18 dB. CONCLUSIONS: The final TTS predictive model proposed in this study needs to be validated in larger groups of subjects exposed to noise. Actual prediction of TTS episodes in general populations may become a helpful tool in creating the hearing protection public health policy. Int J Occup Med Environ Health. 2023;36(1):125-38.

A modification of the scale illusion into a detection task for assessment of binaural streaming.

Binaural streaming by frequency-proximity was investigated without subjective listener-feedback by modifying the scale illusion of Deutsch [J. Acoust. Soc. Am. 57, 1156-1160 (1975)] into a detection-task. Nineteen listeners had to detect one deviation within a repeating melody stream, while simultaneously presented with a randomized distractor stream. Every second note in each stream was presented to the opposite ear, requiring binaural streaming to detect the deviant. Listeners performed well in this test but adding interaural delay or timbre-difference let the listeners group by lateralization instead. This confirms the grouping by frequency-proximity. The method could be used to investigate binaural streaming in hearing-impaired patients, where interaural percepts might differ.

A Competing Voices Test for Hearing-Impaired Listeners Applied to Spatial Separation and Ideal Time-Frequency Masks.

People with hearing impairment find competing voices scenarios to be challenging, both with respect to switching attention from one talker to the other, as well as maintaining attention. With the Danish competing voices test (CVT) presented here, the dual-attention skills can be assessed. The CVT provides sentences spoken by three male and three female talkers, played in sentence pairs. The task of the listener is to repeat the target sentence from the sentence pair based on cueing either before or after playback. One potential way of assisting segregation of two talkers is to take advantage of spatial unmasking by presenting one talker per ear after application of time-frequency masks for separating the mixture. Using the CVT, this study evaluated four spatial conditions in 14 moderate-to-severely hearing-impaired listeners to establish benchmark results for this type of algorithm applied to hearing-impaired listeners. The four spatial conditions were as follows: summed (diotic), separate, the ideal ratio mask, and the ideal binary mask. The results show that the test is sensitive to the change in spatial condition. The temporal position of the cue has a large impact, as cueing the target talker before playback focuses the attention toward the target, whereas cueing after playback requires equal attention to the two talkers, which is more difficult. Furthermore, both applied ideal masks show test scores very close to the ideal separate spatial condition, suggesting that this technique is useful for future separation algorithms using estimated rather than ideal masks.

Effects of directional hearing aid settings on different laboratory measures of spatial awareness perception.

Hearing loss can negatively influence the spatial hearing abilities of hearing-impaired listeners, not only in static but also in dynamic auditory environments. Therefore, ways of addressing these deficits with advanced hearing aid algorithms need to be investigated. In a previous study based on virtual acoustics and a computer simulation of different bilateral hearing aid fittings, we investigated auditory source movement detectability in older hearing- impaired (OHI) listeners. We found that two directional processing algorithms could substantially improve the detectability of left-right and near-far source movements in the presence of reverberation and multiple interfering sounds. In the current study, we carried out similar measurements with a loudspeaker-based setup and wearable hearing aids. We fitted a group of 15 OHI listeners with bilateral behind-the-ear devices that were programmed to have three different directional processing settings. Apart from source movement detectability, we assessed two other aspects of spatial awareness perception. Using a street scene with up to five environmental sound sources, the participants had to count the number of presented sources or to indicate the movement direction of a single target signal. The data analyses showed a clear influence of the number of concurrent sound sources and the starting position of the moving target signal on the participants' performance, but no influence of the different hearing aid settings. Complementary artificial head recordings showed that the acoustic differences between the three hearing aid settings were rather small. Another explanation for the lack of effects of the tested hearing aid settings could be that the simulated street scenario was not sufficiently sensitive. Possible ways of improving the sensitivity of the laboratory measures while maintaining high ecological validity and complexity are discussed.

Improving competing voices segregation for hearing impaired listeners using a low-latency deep neural network algorithm.

Hearing aid users are challenged in listening situations with noise and especially speech-on-speech situations with two or more competing voices. Specifically, the task of attending to and segregating two competing voices is particularly hard, unlike for normal-hearing listeners, as shown in a small sub-experiment. In the main experiment, the competing voices benefit of a deep neural network (DNN) based stream segregation enhancement algorithm was tested on hearing-impaired listeners. A mixture of two voices was separated using a DNN and presented to the two ears as individual streams and tested for word score. Compared to the unseparated mixture, there was a 13%-point benefit from the separation, while attending to both voices. If only one output was selected as in a traditional target-masker scenario, a larger benefit of 37%-points was found. The results agreed well with objective metrics and show that for hearing-impaired listeners, DNNs have a large potential for improving stream segregation and speech intelligibility in difficult scenarios with two equally important targets without any prior selection of a primary target stream. An even higher benefit can be obtained if the user can select the preferred target via remote control.

Influence of Multi-microphone Signal Enhancement Algorithms on the Acoustics and Detectability of Angular and Radial Source Movements.

Hearing-impaired listeners are known to have difficulties not only with understanding speech in noise but also with judging source distance and movement, and these deficits are related to perceived handicap. It is possible that the perception of spatially dynamic sounds can be improved with hearing aids (HAs), but so far this has not been investigated. In a previous study, older hearing-impaired listeners showed poorer detectability for virtual left-right (angular) and near-far (radial) source movements due to lateral interfering sounds and reverberation, respectively. In the current study, potential ways of improving these deficits with HAs were explored. Using stimuli very similar to before, detailed acoustic analyses were carried out to examine the influence of different HA algorithms for suppressing noise and reverberation on the acoustic cues previously shown to be associated with source movement detectability. For an algorithm that combined unilateral directional microphones with binaural coherence-based noise reduction and for a bilateral beamformer with binaural cue preservation, movement-induced changes in spectral coloration, signal-to-noise ratio, and direct-to-reverberant energy ratio were greater compared with no HA processing. To evaluate these two algorithms perceptually, aided measurements of angular and radial source movement detectability were performed with 20 older hearing-impaired listeners. The analyses showed that, in the presence of concurrent interfering sounds and reverberation, the bilateral beamformer could restore source movement detectability in both spatial dimensions, whereas the other algorithm only improved detectability in the near-far dimension. Together, these results provide a basis for improving the detectability of spatially dynamic sounds with HAs.

The effect of tone-vocoding on spatial release from masking for old, hearing-impaired listeners.

Old, hearing-impaired listeners generally benefit little from lateral separation of multiple talkers when listening to one of them. This study aimed to determine how spatial release from masking (SRM) in such listeners is affected when the interaural time differences (ITDs) in the temporal fine structure (TFS) are manipulated by tone-vocoding (TVC) at the ears by a master hearing aid system. Word recall was compared, with and without TVC, when target and masker sentences from a closed set were played simultaneously from the front loudspeaker (co-located) and when the maskers were played 45° to the left and right of the listener (separated). For 20 hearing-impaired listeners aged 64 to 86, SRM was 3.7 dB smaller with TVC than without TVC. This difference in SRM correlated with mean audiometric thresholds below 1.5 kHz, even when monaural TFS sensitivity (discrimination of frequency-shifts in identically filtered complexes) was partialed out, suggesting that low-frequency audiometric thresholds may be a good indicator of candidacy for hearing aids that preserve ITDs. The TVC difference in SRM was not correlated with age, pure-tone ITD thresholds, nor fundamental frequency difference limens, and only with monaural TFS sensitivity before control for low-frequency audiometric thresholds.

Preferred signal path delay and high-pass cut-off in open fittings.

The combination of delayed sound from a digital hearing aid with direct sound through an open or vented fitting can potentially degrade the sound quality due to audible changes in timbre and/or perception of echo. The present study was designed to test a number of delay and high-pass combinations under worst-case (i.e. most sensitive) conditions. Eighteen normal-hearing and 18 mildly hearing-impaired subjects performed the test in a paired comparison (A/B) task. The subjects were asked to select a preferred setting with respect to sound quality. The test was set in an anechoic chamber using recorded speech, environmental sounds, and own voice. Experimental hearing aids were fitted binaurally with open domes thus providing maximum ventilation. The preference data were processed using a statistical choice model that derives a ratio-scale. The analysis indicated that in these test conditions there was no change in sound quality when varying the delay in the range 5-10 ms and that there was a preference for 2000 Hz high-pass filtering in most conditions, regardless of the hearing losses tested.