Shuenn-Tsong Young

Effects of music therapy on subjective sensations and heart rate variability in treated cancer survivors: A pilot study

OBJECTIVE Data on the effects of music therapy on subjective sensations and the physiological parameters of heart rate variability (HRV) in treated cancer survivors are scarce. The aim of this study was to determine whether or not music therapy affects the sensations of fatigue, comfort, and relaxation in cancer survivors, and affects the activities of the sympathetic and parasympathetic nervous systems as indicated by HRV parameters. METHODS Twenty-three patients aged 30-67 years and with cancer that had been treated at least 6 months previously received music therapy for about 2h, which included singing, listening to music, learning the recorder, and performing music. Subjective sensations and electrocardiogram were recorded before and after the music therapy. The low-frequency and high-frequency components of HRV were assessed by the frequency analysis of sequential R wave to R wave intervals of electrocardiogram obtained from 5-min recordings. Subjective sensations were quantitatively assessed using a visual analog mood scale. RESULTS Two hours of music therapy significantly increased relaxation sensations and significantly decreased fatigue sensation in treated cancer survivors. Moreover, the HRV parameters showed that parasympathetic nervous system activity increased and sympathetic nervous system activity decreased. CONCLUSION This study provides preliminary evidence that music therapy may be clinically useful for promoting relaxation sensation and increasing parasympathetic nervous system activity in treated cancer survivors.

The relationship between cortical auditory evoked potential (CAEP) detection and estimated audibility in infants with sensorineural hearing loss

Abstract Objective: To determine the effectiveness of objective statistical detection in CAEP testing to evaluate audibility in young infants with sensorineural hearing loss. Design: CAEP recordings to speech-based stimuli were made at three presentation levels (55, 65, or 75 dB SPL) when a group of hearing-impaired infants were either aided or unaided. Later-obtained behavioral audiograms were used as the gold standard against which to evaluate the accuracy of the automatic detection of the presence/absence of CAEP responses. Study sample: Participants were 18 infants with confirmed sensorineural hearing loss. Results: Higher sensation levels led to a greater number of present CAEP responses being detected. More CAEP waveforms were detected in the aided condition than in the unaided condition. Conclusion: Our results suggest that the presence/absence of CAEP responses defined by the automatic statistical criterion was effective in showing whether increased sensation levels provided by amplification were sufficient to reach the cortex. This was clearly apparent from the significant increase in cortical detections when comparing unaided with aided testing.

Effect of Long-Term Music Therapy Intervention on Autonomic Function in Anthracycline-Treated Breast Cancer Patients

Anthracyclines are potent antineoplastic agents associated with cardiotoxicity, which may lead to congestive heart failure, causing impairment of autonomic cardiovascular function as assessed by heart rate variability (HRV). This decreases survival rates. This study aimed to determine whether music therapy intervention improves autonomic function in anthracycline-treated breast cancer patients, and if so, whether such improvements persist after cessation of the intervention. Participants were 12 women with breast cancer who had undergone mastectomy or breast-conserving treatment and adjuvant chemotherapy; they attended 8 weekly music therapy sessions, each lasting 2 hours. Electrocardiogram traces (5 minutes) for HRV analysis were recorded 4 times: prior to the first music session, T1; after the fourth music session, T2; after the eighth music session, T3; and 4 weeks after the completion of music therapy, T4. HRV parameters were subjected to a nonparametric Friedman test on the differences between T1 and T2, T3, and T4. The standard deviation of normal intervals and the total power of HRV parameters, related to global autonomic function, were significantly higher at T3 than at T1. The root-mean-square differences of successive normal R–R intervals and high-frequency (HF) HRV parameters, related to parasympathetic activity, were significantly increased, but no change was seen in the LF/HF ratio of HRV parameters (which is related to sympathetic activity) during the music therapy. Global autonomic function and parasympathetic activity had not changed significantly at T4 relative to T1. The authors provide preliminary evidence of the benefits of music therapy for anthracycline-treated breast cancer survivors.

Development of a mandarin monosyllable recognition test.

Objective: This study aimed to develop a set of 50- and 25-item word lists that exhibited familiarity, homogeneity, and phonemic balance for a Mandarin monosyllable recognition test (MMRT). Design: To achieve the design goal of high subject familiarity with the test material, we selected the 700 most frequently occurring monosyllables to be the test material. The homogeneity of the test material was achieved by evaluating five psychometric characteristics of these 700 monosyllables to obtain 348 homogeneous monosyllables with similar psychometric functions for constructing the word lists. The phonemic balance of the 50-item word lists was achieved by deriving the desired numbers of initials, finals, and tones in these lists according to their occurrence frequencies in 4733 monosyllabic words. The phonemic balance of the 25-item word lists was achieved by equally dividing the desired numbers of initials, finals, and tones in the 50-item word lists into two groups, called half-A and half-B lists. Three half-A lists and three half-B lists were constructed from the 348 homogeneous monosyllables, and they could be paired to form nine 50-item word lists. Accordingly, all of the MMRT word lists are familiar, homogeneous, and phonemically balanced. Results: The homogeneity of the MMRT word lists was examined by evaluating the interlist equivalence, interitem variability, and intersubject variability. A &khgr;2 test was used to evaluate the interlist equivalence among the MMRT word lists; that is, to determine whether the values of percent correct recognition were distributed identically at 12 different presentation levels among the six 25-item word lists and nine 50-item word lists. No statistically significant differences were found among the word lists: &khgr;2(55) = 12.004 and p = 1.000 for the six 25-item word lists, &khgr;2(88) = 7.695 and p = 1.000 for the nine 50-item word lists, and &khgr;2(154) = 19.699 and p = 1.000 for the six 25-item word lists plus nine 50-item word lists. The &khgr;2 tests indicated that the six 25-item word lists and nine 50-item word lists exhibited interlist equivalence. The mean interitem variability (2.0 dB) and mean intersubject variability (2.3 dB) are lower for the MMRT word lists than for previously reported word recognition tests. Conclusion: This study applied an innovative approach to design MMRT word lists from familiar and homogeneous monosyllables, in which the familiarity, homogeneity, and phonemic balance of the six 25-item and nine 50-item word lists were strictly controlled. These word lists exhibit interlist equivalence with respect to their psychometric functions and five psychometric characteristics; moreover, their interitem and intersubject variability are lower than those of previously reported lists. Future clinical experiments should examine whether such a design approach can improve the reliability and diagnostic sensitivity of word recognition tests for hearing-impaired listeners.

Measuring the long-term SNRs of static and adaptive compression amplification techniques for speech in noise.

BACKGROUND Multichannel wide-dynamic-range compression (WDRC) is a widely adopted amplification scheme in modern digital hearing aids. It attempts to provide individuals with loudness recruitment with superior speech intelligibility and greater listening comfort over a wider range of input levels. However, recent surveys have shown that compression processing (operating in the nonlinear regime) usually reduces the long-term signal-to-noise ratio (SNR). PURPOSE The purpose of this study was to determine the long-term SNR in an adaptive compression-ratio (CR) amplification scheme called adaptive wide-dynamic-range compression (AWDRC), and to determine whether this concept is better than static WDRC amplification at improving the long-term SNR for speech in noise. DESIGN AND STUDY SAMPLE AWDRC uses the input short-term dynamic range to adjust the CR to maximize audibility and comfort. Various methods for evaluating the long-term SNR were used to observe the relationship between the CR and output SNR performance in AWDRC for seven typical audiograms, and to compare the results with those for static WDRC amplification. RESULTS The results showed that the variation of the CR in AWDRC amplification can maintain the comfort and audibility of the output sound. In addition, the average long-term SNR improved by 0.1-5.5 dB for a flat hearing loss, by 0.2-3.4 dB for a reverse sloping hearing loss, by 1.4-4.8 dB for a high-frequency hearing loss, and by 0.3-5.7 dB for a mild-to-moderate-sloping high-frequency hearing loss relative to static WDRC amplification. The output long-term SNR differed significantly (p < .001) between static WDRC and AWDRC amplification. CONCLUSIONS The results of this study show that AWDRC, which uses the characteristics of the input signal to adaptively adjust the CR, provides better long-term SNR performance than static WDRC amplification.

Modification of the wavelet method used in transiently evoked otoacoustic emission pass/fail criterion to increase its accuracy.

Transiently evoked otoacoustic emissions (TEOAEs) are widely used in newborn hearing screening programmes for early detection of hearing losses. To increase the accuracy of a TEOAE pass/fail criterion that uses the wavelet method, it was demonstrated that the large estimation variance is a possible reason for the inaccuracy, and a modified wavelet method is proposed to solve the inaccuracy problem. In the modified wavelet method, N paired buffers, instead of only one, were used to store the total 512 subaveraged responses, and then the average of the calculated N cross-correlation coefficients between N pairs of TEOAE signals was taken in the pass/fail criterion. Four sets of 256 synthesised noise and eight sets of 256 synthesised noisy TEOAE signals were tested, and each set was tested 1000 times. The results showed that the standard deviation of the correlation estimation was greatly reduced by using this average value with N selected as 4. As a result, the total number of single-scale cross-correlation coefficients below 50% decreased from 1281 to 195 for noisy TEOAE signals, and the total number of single-scale cross-correlation coefficients above 50% decreased from 90 to 0 for synthesised noise.

Electrogastrographic characteristics in patients of stomach cancer.

Using a homemade electrogastrography (EGG) system, we studied the characteristics of myoelectrical rhythm in gastric cancer (GC) patients. Based on a short-term Fourier transform, recorded slow waves could be automatically analyzed to obtain the following parameters: dominant frequency/power, percent of normal rhythm (2.4–3.7 cpm), power ratio, etc. Fifty histologically confirmed GC patients (34 men, 16 women) were enrolled before surgical intervention to measure their fasting and postprandial EGG parameters for 30 min. The cancerous parameters of GC patients were then obtained postoperatively. In addition, 46 healthy subjects were enrolled for comparison. When compared to controls, GC patients had the following characteristics: absence of postprandial increase in dominant frequency (GC: 3.04 ± 0.47 vs 3.07 ± 0.44 cpm, NS; controls: 3.02 ± 0.31 vs 3.21 ± 0.25 cpm, P < 0.001), marked power response after meal (P < 0.05), and obvious power ratio (4.58 ± 7.38 vs 2.27 ± 2.05, P < 0.05). Multivariate analysis indicated that advanced GC was the factor responsible for the obvious dominant power enhancement after meal (P < 0.05). Other demographic, clinical, and cancerous factors did not influence EGG parameters. We conclude that apparent arrhythmia is not encountered in GC patients, although they mainly exhibit obvious postprandial power response. Advanced GC is likely responsible for this power enhancement on EGG recording.

Industrial wideband noise reduction for hearing aids using a headset with adaptive-feedback active noise cancellation

High-intensity noises are a health hazard for industrial workers, and hearing protection is necessary to prevent hearing loss. Passive methods, such as ear muffs, are ineffective against low-frequency noise. Moreover, many hearing-impaired workers must wear hearing aids to enable communication at their workplace, and such aids can amplify ambient noise. To overcome this problem, the present study developed a headset equipped with a digital signal processing system to implement adaptive-feedback active noise cancellation (AFANC) to reduce low-frequency noise. The proposed AFANC headset was effective against wideband industrial noise, with a maximum noise spectrum power reduction of 30 dB. Furthermore, when used with a hearing aid, it improved the speech signal-to-noise ratio by up to 14 dB. These results suggest that a headset with AFANC would be useful for hearing protection in workplaces with high levels of low-frequency industrial noise, especially for hearing-impaired workers.

A computer based software for hearing impaired children's speech training and learning between teacher and parents in Taiwan

The objective is to design a computer-based software for hearing impaired childrens speech training and learning. To use a visual assistant method for training and developing the speech ability of hearing impaired children, we used the technique of dynamic computer graphics to establish an animation display system. The system can display the dynamic relations among the basic elements of the articulators. The position and the change of nose chamber, mouth chamber, tongue, and lips during speech will be shown from different profiles. This makes sure that the subject with hearing impaired children can catch the accurate speech technique. In the future, we will use the network tuition model to assist special education teachers in their teaching methods. Using such an assistant system, we are sure of achieving improvement of the efficiency and efficacy for developing the language and speech ability of hearing impaired children.

Real-time display of the stomach slow wave and its parameters in a newly designed electrogastrographic system

Abstract: We designed a new three-channel electrogastrographic (EGG) system, which was easily operated on the Windows 95 platform and could automatically provide slow wave parameters. The purpose of the present study was to test its reliability and accuracy in clinical recording. The system included a signal acquisition device assembled on a printed circuit board. Recorded myoelectrical signals were filtered, amplified, digitized, and transmitted via this device into a notebook personal computer (PC). Based on the short-term Fourier transform the software could transfer the time domain of the signal into the frequency domain. Real-time displayed slow wave parameters, including dominant frequency/power, percent of normal frequency (2–4 cpm), instability coefficient in frequency/power, and power ratio, were automatically renewed every 64 s. Twenty healthy subjects (M/F, 12/8; age, 23–51 years) were enrolled to measure both fast and postprandial myoelectrical activities for each 30-min recording. Our results indicated that meal ingestion significantly increased dominant frequency (3.15 ± 0.20 vs 3.23 ± 0.23 cpm; P < 0.05) and power (26.1 ± 3.8 vs 28.4 ± 3.9 dB; P < 0.05). The power ratio of the meal effect was 2.02 ± 2.07. Other parameters, including instability coefficient and percent of normal frequency, remained similar despite food ingestion. This newly designed EGG system is acceptable for clinically measuring gastric myoelectrical activity; the real-time display of many EGG parameters is an advantage with this new system.