Rationale and design of the PHYSICALFAV trial: a randomized controlled trial to evaluate the effect of preoperative isometric exercise on vascular calibre and maturation of autologous arteriovenous fistulas.

BACKGROUND: A good vascular access (VA) is vital for haemodialysis (HD) patients. HD with an autologous arteriovenous fistula (AVF) is associated with higher survival, lower health care costs and fewer complications. Although a distal forearm AVF is the best option, not all patients are good candidates for this approach and the primary failure rate ranges from 20% to 50%. The optimal AVF depends mainly on the anatomical and haemodynamic characteristics of the artery and the vein chosen for the anastomosis. These characteristics can be modified by performing physical exercise. VA guidelines suggest that isometric exercises should be performed both before and after the AVF is created. While the literature contains few data on the potential efficacy of preoperative exercise, small observational studies point to an improvement in venous and arterial calibre. Postoperative exercise also seems to improve maturation, although there is no consensus on the appropriate exercise protocol. METHODS: The PHYSICALFAV trial (NCT03213756) is an open-label, multicentre, prospective, controlled, randomized trial designed to evaluate the usefulness of preoperative isometric exercise (PIE) in pre-dialysis patients or in prevalent HD patients who are candidates for a new AVF. Patients are randomized 1:1 to the PIE group (isometric exercises for 8 weeks) or the control group (no exercise). The main endpoint is whether the rate of primary failure is lower in the PIE group than in the control group. RESULTS: The trial has already started, with 40 patients having been enrolled as of 21 March 2018; 26.5% of the estimated sample.

Spanish norms for completion of restricted length word stems.

This study presents a normative database of Spanish restricted length word stems that provides useful information for the selection of stimuli in memory experiments with Word Stem Completion (WSC) tasks. The database includes indices relative to stems (total baseline completion, priming baseline completion, priming, number of completions, ratio between given and deleted letters, and syllabic structure), and indices relative to characteristics of the words used to obtain the stems (frequency, familiarity, number of meanings, length, number of syllables, arousal, and valence). A WSC task was performed by 515 participants to calculate priming and baseline indices. An Exploratory Factor Analysis showed that these indices are grouped in four factors: perceptual, lexical, emotional, and response competition. Stepwise regression analyses performed with these factors showed that the lexical, response competition, and perceptual factors predict priming baseline completion, while only the lexical factor predicts priming. The model that best explains the relationship between priming and priming baseline completion was a cubic model, and the optimum baseline values for achieving priming were between .31 and .36. These norms can be downloaded as Supplemental Materials for this article from https://nuvol.uv.es/owncloud/index.php/s/hpj9by1qbENdjfj .

The Effects of Linguistic Context on Word Recognition in Noise by Elderly Listeners Using Spanish Sentence Lists (SSL).

This study evaluated the effects of the linguistic context on the recognition of words in noise in older listeners using the Spanish Sentence Lists. These sentences were developed based on the approach of the SPIN test for the English language, which contains high and low predictability (HP and LP) sentences. In addition, the relative contribution of peripheral hearing sensitivity, measured by pure-tone hearing thresholds (PTA), to the performance on both types of sentences was assessed in a regression analysis. The results showed that older listeners obtained benefits on word recognition from the linguistic context. PTA contributed significantly to explaining the variance in performance on both HP and LP sentences.

Elaboración de una versión reducida de las listas de frases en español (vr-LFE) para evaluar la percepción del habla con ruido / Desing of a short version of the ‘listas de frases en español’ (vr-LFE) (Spanish sentence lists) to evaluate speech perception in noise

En este trabajo se presenta una versión reducida de las listas de frases en español (vr-LFE) para evaluar la percepción del habla con ruido. La versión original es una adaptación del test SPIN (Speech Perception in Noise) en lengua inglesa. LFE consiste en 6 listas, cada una con 25 frases predecibles y 25 no predecibles. La comparación entre el porcentaje de reconocimiento correcto de las frases predecibles y no predecibles proporciona una estimación de en qué medida el oyente puede hacer uso del contexto lingüístico (información semántica, sintáctica y pragmática). En el presente trabajo se realizó una selección de 60 frases, del conjunto inicial de 300, agrupadas en 5 listas de 12 frases cada una (6 frases predecibles y 6 frases no predecibles). Esta versión mantiene las características de fiabilidad (equivalencia entre las listas) y validez (sensibilidad a los efectos del contexto lingüístico y de la intensidad del ruido de fondo) del test original, reduciendo considerablemente el tiempo necesario para su administración. Estas listas pueden ser utilizadas para evaluar las dificultades en la percepción de habla con ruido en oyentes mayores con pérdidas auditivas leves o moderadas (presbiacusia) con o sin deterioro cognitivo leve. También pueden utilizarse para evaluar estas dificultades en oyentes no nativos con diferentes grados de competencia lingüística en la segunda lengua (AU)

This article presents, a short version of the "listas de frases en español" (vr-LFE; "Lists of Phrases in Spanish") to evaluate speech perception in noise. The original version is an adaptation of the SPIN (Speech Perception in Noise) test for the English language. The original LFE consists of 6 lists, each of them including 25 high-predictability sentences and 25 low-predictability sentences. The difference between the correct recognition scores on the two types of sentences provides an estimation of the effective use of linguistic context (semantic, syntactic, and pragmatic information) by the listener in the speech perception process. In the present work, 60 sentences were selected from an initial pool of 300 sentences. These 60 sentences were arranged in 5 lists of 12 sentences each (6 high-predictability and 6 low-predictability sentences). This version preserves the same characteristics of reliability (equivalence among the lists) and validity (sensibility to the effects of sentence context and to the signal-to-noise ratio) as the original version, but considerably reduces the time needed for its administration. These lists can be used to evaluate speech perception difficulties in noise in older listeners with mild-to-moderate hearing loss (presbycusis), with or without mild cognitive impairment, and in non-native listeners with different degrees of linguistic competence (AU)

Test of Spanish sentences to measure speech intelligibility in noise conditions.

This article describes the development of a test for measuring the intelligibility of speech in noise for the Spanish language, similar to the test developed by Kalikow, Stevens, and Elliot (Journal of the Acoustical Society of America, 5, 1337-1360, 1977) for the English language. The test consists of six forms, each comprising 25 high-predictability (HP) sentences and 25 low-predictability (LP) sentences. The sentences were used in a perceptual task to assess their intelligibility in babble noise across three different signal-to-noise ratio (SNR) conditions in a sample of 474 normal-hearing listeners. The results showed that the listeners obtained higher scores of intelligibility for HP sentences than for LP sentences, and the scores were lower for the higher SNRs, as was expected. The final six forms were equivalent in intelligibility and phonetic content.

Lists of Spanish sentences with equivalent predictability, phonetic content, length, and frequency of the last word.

This paper presents a pool of Spanish sentences designed for use in cognitive research and speech processing in circumstances in which the effects of context are relevant. These lists of sentences are divided into six lists of 25 equivalent high-predictability sentences and six lists of 25 low-predictability sentences according to the extent to which the last word can be predicted by the preceding context. These lists were also equivalent in phonetic content, length and frequency of the last word. These lists are intended for use in psycholinguistic research with Spanish-speaking listeners.

Speech recognition and working memory capacity in young-elderly listeners: effects of hearing sensitivity.

Young normal-hearing listeners and young-elderly listeners between 55 and 65 years of age, ranging from near-normal hearing to moderate hearing loss, were compared using different speech recognition tasks (consonant recognition in quiet and in noise, and time-compressed sentences) and working memory tasks (serial word recall and digit ordering). The results showed that the group of young-elderly listeners performed worse on both the speech recognition and working memory tasks than the young listeners. However, when pure-tone audiometric thresholds were used as a covariate variable, the significant differences between groups disappeared. These results support the hypothesis that sensory decline in young-elderly listeners seems to be an important factor in explaining the decrease in speech processing and working memory capacity observed at these ages.

Influence of articulation rate on two memory tasks in young and older adults.

This study investigated the relation between phonological loop functioning and age. Phonological loop is a time-based subsystem of the Working Memory Model of Baddeley and Wilson, which uses rehearsal of information as an active process to avoid phonological decay. Performance differences were examined between young and older adults in two speech-based memory tasks, such as the immediate serial recall of words and the Digit Ordering Task. Analysis showed that performance on both tasks was lower for the older group. Articulation rate was also measured to test the hypothesis that the impairment of some cognitive functions in adults can be associated to their slowness or the greater time needed by older adults for the rehearsal process. A significant negative correlation was found for articulation rate with age. When the effect of articulation rate on Serial Recall and Digit Ordering Tasks was partialled out, the difference between the two groups was eliminated.

[Difficulties understanding compressed speech in elderly listeners with mild-to-moderate hearing loss]. / Dificultades en la comprensión del habla rápida en oyentes mayores con pérdidas auditivas leves o moderadas.

OBJECTIVE: In this work we evaluated the difficulties in understanding rapid speech (normal, fast and very fast rates) in elderly listeners with and without hearing loss (presbycusis and moderate hearing loss). Rapid speech is common in daily communication, yet few studies have been conducted to assess this problem in Spanish-speaking listeners, as has been done for English speakers. MATERIAL AND METHOD: We compared the recognition of sentences presented at normal, fast, and very fast speech rates in 3 groups of listeners. Recognition scores were correlated to their audiological measures and the score obtained on a Communication Difficulties Questionnaire. RESULTS: Compressed sentences were more poorly perceived in the 2 groups of listeners with hearing loss, compared to the normal group. Moreover, we obtained significant correlations among the 3 measures: recognition of rapid speech, the audiological measures, and the score in the Questionnaire. CONCLUSIONS: Our results suggest that rapid-speech recognition skills deteriorate in the presence of hearing loss, whether due to presbycusis or other moderate hearing loss in all frequency ranges.

Dificultades en la comprensión del habla rápida en oyentes mayores con pérdidas auditivas leves o moderadas / Difficulties understanding compressed speech in elderly listeners with mild-to-moderate hearing loss

Objetivo: En este trabajo se evalúan las dificultades de los adultos mayores, sin y con pérdidas auditivas (presbiacusia y pérdidas moderadas), en la comprensión del habla rápida. El habla rápida es habitual en la comunicación diaria. Sin embargo, no contamos con suficientes estudios que evalúen este problema en oyentes castellanoparlantes, tal como existen para oyentes angloparlantes. Material y método: Se comparó el reconocimiento de frases presentadas a 3 tasas de aceleración: normal, rápida y muy rápida, en los 3 grupos de oyentes. Estas medidas se correlacionaron con medidas audiológicas y con la puntuación obtenida en un cuestionario de problemas de comunicación. Resultados: La ejecución en la comprensión del habla rápida fue peor en los dos grupos de oyentes con pérdidas auditivas que en el grupo de audición normal. Además, las correlaciones entre la comprensión del habla rápida, la audiometría tonal y el cuestionario fueron significativas. Conclusiones: Los resultados de este trabajo indican que las habilidades en el reconocimiento del habla rápida se deterioran cuando el sujeto tiene pérdidas auditivas, sean las típicas de la presbiacusia u otro tipo de pérdidas moderadas en toda la gama de frecuencias

Objective: In this work we evaluated the difficulties in understanding rapid speech (normal, fast and very fast rates) in elderly listeners with and without hearing loss (presbycusis and moderate hearing loss). Rapid speech is common in daily communication, yet few studies have been conducted to assess this problem in Spanish-speaking listeners, as has been done for English speakers. Material and method: We compared the recognition of sentences presented at normal, fast, and very fast speech rates in 3 groups of listeners. Recognition scores were correlated to their audiological measures and the score obtained on a Communication Difficulties Questionnaire. Results: Compressed sentences were more poorly perceived in the 2 groups of listeners with hearing loss, compared to the normal group. Moreover, we obtained significant correlations among the 3 measures: recognition of rapid speech, the audiological measures, and the score in the Questionnaire. Conclusions: Our results suggest that rapid-speech recognition skills deteriorate in the presence of hearing loss, whether due to presbycusis or other moderate hearing loss in all frequency ranges

Randomized comparison of 6-mm straight grafts versus 6- to 8-mm tapered grafts for brachial-axillary dialysis access.

OBJECTIVE: This report presents the results of a prospective randomized study that compared 2 grafts of different diameter: 6 mm, and 8 mm tapered to 6 mm at the arterial site, placed in the upper arm for hemodialysis in a selected population of patients younger than 71 years without diabetes. METHODS: Seventy consecutive patients younger than 71 years without diabetes who required an upper arm graft between January 1997 and January 2002 and without previous access in the same limb were randomly allocated to receive either a 6-mm graft or 6- to 8-mm graft. Graft flow was measured every 3 months with the Doppler dilution technique. When access flow was less than 600 mL/min, fistulography was performed, and any stenosis was surgically treated with venous outflow replacement. Thrombectomy and associated stenosis treatment in the same stage was performed in all cases immediately after detection of thrombosis. Complication rate, and primary, assisted primary, and secondary patency rates were compared between the two groups with the Student t test and life table analysis. RESULTS: Mean access flow was 975 mL/min for 6-mm grafts (range, 600-1500 mL/min; 95% confidence interval [CI], 889-1070), and for 6- to 8-mm grafts was 1397 mL/min (range, 1122-2700 mL/min; 95% CI, 1122-1672). This difference was significant (P <.01). Complication rate was 0.45 episodes per graft-year in 6-mm grafts, and 0.19 episodes per graft-year in 6- to 8-mm grafts (P <.01). At 1, 2, and 3 years, primary patency rates were 62%, 58%, and 44%, respectively, for 6-mm grafts, and 85%, 78%, and 73% for 6- to 8-mm grafts; log-rank comparison between curves was P =.0259. At 1, 2, and 3 years, secondary patency rates were 85%, 85%, and 85%, respectively, for 6-mm grafts, and 90%, 90%, and 90% for 6- to 8-mm grafts; log-rank comparison between curves was not significant, at P =.0603. At 1, 2, and 3 years, assisted primary patency rates were 84%, 79%, and 76%, respectively, for 6-mm grafts, and 90% for 6- to 8-mm grafts; log-rank comparison was P =.0414. CONCLUSIONS: The results of this study show an advantage in terms of primary and assisted primary patency rates, and complication rate for upper arm grafts with diameter 6 mm to 8 mm over grafts with 6-mm diameter in a patient population younger than 70 years without diabetes. The finding of a similar secondary patency rate in both groups is probably due to the surveillance program with sequential measurement of access flow and prompt surgical treatment of stenosis. However, we needed twice the number of rescue procedures in 6-mm grafts to achieve a similar patency rate as with large-bore grafts. These study results must be carefully evaluated, taking into consideration the small number of patients and the selected patient population.

Acoustic analysis of pathological voices compressed with MPEG system.

The MPEG-1 Layer 3 compression schema of audio signal, commonly known as mp3, has caused a great impact in recent years as it has reached high compression rates while conserving a high sound quality. Music and speech samples compressed at high bitrates are perceptually indistinguishable from the original samples, but very little was known about how compression acoustically affects the voice signal. A previous work with normal voices showed a high fidelity at high-bitrate compressions both in voice parameters and the amplitude-frequency spectrum. In the present work, dysphonic voices were tested through two studies. In the first study, spectrograms, long-term average spectra (LTAS), and fast Fourier transform (FFT) spectra of compressed and original samples of running speech were compared. In the second study, intensities, formant frequencies, formant bandwidths, and a multidimensional set of voice parameters were tested in a set of sustained phonations. Results showed that compression at high bitrates (96 and 128 kbps) preserved the relevant acoustic properties of the pathological voices. With compressions at lower bitrates, fidelity decreases, introducing some important alterations. Results from both works, Gonzalez and Cervera and this paper, open up the possibility of using MPEG-compression at high bitrates to store or transmit high-quality speech recordings, without altering their acoustic properties.