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Purpose: Evaluate the feasibility and safety of a robotic electrode insertion in pediatric cochlear implantation and compare the results with manually inserted electrodes in the same subject., Methods: Retrospective case series review of four children who underwent bilateral cochlear implantation with the same array: on one side, the array was inserted using the robot, while on the other side the array was inserted manually. Behavioural and electrophysiological measures were compared., Results: The duration of surgery when the robot was adopted was significantly longer than when a manual insertion was performed (161.15 ± 27.59 minutes vs. 122.6 ± 37.71 min, paired t-test: p = 0.029). Moreover, robotic electrode insertion was significantly slower (average insertion speed 0.3 mm/second vs. 0.52 ± 0.17 mm/s, paired t-test: p = 0.0055). On radiologic examination, none of the arrays was misplaced. Impedance, both at activation and at one year of cochlear implant use, was significantly lower on the robotic side in monopolar mode compared to the manual side (mean 9.64 ± 2.41kΩ and 9.97 ± 1.39 kΩ vs. 10.43 ± 2.69 kΩ and 10.94 ± 1.11 kΩ, paired t test, p = 0.0251 and p = 0.0061, respectively). Both the threshold stimulation level and the most comfortable loud stimulation level were significantly lower in the robotic inserted ear compared to the manually inserted ear (mean 108.1 ± 5.98 and 169 ± 4.84 vs. 112.1 ± 7.43 and 172.7 ± 6.83, respectively, paired t test p < 0.0001)., Conclusions: Although we present a small group of cases, our results show how robot-based array insertion is associated with lower impedance and stimulation levels compared to manually inserted arrays., Competing Interests: Declarations. Ethical approval: This retrospective case series review involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The institutional review board (n. 332 of June 17th, 2022) approved the use of the RobOtol® (Collin Orl, France) on pediatric cochlear implant surgeries and informed consent was obtained from all individual participants’ parents for whom information is included in this article. However, the article does not contain any direct information regarding patient identity., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: Children affected by hearing loss can experience difficulties in challenging and noisy environments even when deafness is corrected by Cochlear implant (CI) devices. These patients have a selective attention deficit in multiple listening conditions. At present, the most effective ways to improve the performance of speech recognition in noise consists of providing CI processors with noise reduction algorithms and of providing patients with bilateral CIs. The aim of this study was to compare speech performances in noise, across increasing noise levels, in CI recipients using two kinds of wireless remote-microphone radio systems that use digital radio frequency transmission: the Roger Inspiro accessory and the Cochlear Wireless Mini Microphone accessory., Methods: Eleven Nucleus Cochlear CP910 CI young user subjects were studied. The signal/noise ratio, at a speech reception threshold (SRT) value of 50%, was measured in different conditions for each patient: with CI only, with the Roger or with the MiniMic accessory. The effect of the application of the SNR-noise reduction algorithm in each of these conditions was also assessed. The tests were performed with the subject positioned in front of the main speaker, at a distance of 2.5 m. Another two speakers were positioned at 3.50 m. The main speaker at 65 dB issued disyllabic words. Babble noise signal was delivered through the other speakers, with variable intensity., Results: The use of both wireless remote microphones improved the SRT results. Both systems improved gain of speech performances. The gain was higher with the Mini Mic system (SRT = -4.76) than the Roger system (SRT = -3.01). The addition of the NR algorithm did not statistically further improve the results., Conclusion: There is significant improvement in speech recognition results with both wireless digital remote microphone accessories, in particular with the Mini Mic system when used with the CP910 processor. The use of a remote microphone accessory surpasses the benefit of application of NR algorithm., (Copyright © 2017. Published by Elsevier B.V.)

Perovskite solar cells employing CH3NH3PbI3-xClx active layers show power conversion efficiency (PCE) as high as 20% in single cells and 13% in large area modules. However, their operational stability has often been limited due to degradation of the CH3NH3PbI3-xClx active layer. Here, we report a perovskite solar module (PSM, best and av. PCE 10.5 and 8.1%), employing solution-grown TiO2 nanorods (NRs) as the electron transport layer, which showed an increase in performance (∼5%) even after shelf-life investigation for 2500 h. A crucial issue on the module fabrication was the patterning of the TiO2 NRs, which was solved by interfacial engineering during the growth process and using an optimized laser pulse for patterning. A shelf-life comparison with PSMs built on TiO2 nanoparticles (NPs, best and av. PCE 7.9 and 5.5%) of similar thickness and on a compact TiO2 layer (CL, best and av. PCE 5.8 and 4.9%) shows, in contrast to that observed for NR PSMs, that PCE in NPs and CL PSMs dropped by ∼50 and ∼90%, respectively. This is due to the fact that the CH3NH3PbI3-xClx active layer shows superior phase stability when incorporated in devices with TiO2 NR scaffolds.

Objective: To compare speech recognition in noise for the Nucleus Freedom and CP810 sound processors using different directional settings among those available in the SmartSound portfolio., Study Design: Single-subject, repeated measures study., Setting: Tertiary care referral center., Subjects and Methods: Thirty-one monoaurally and binaurally implanted subjects (24 children and 7 adults) were enrolled. They were all experienced Nucleus Freedom sound processor users and achieved a 100% open set word recognition score in quiet listening conditions. Each patient was fitted with the Freedom and the CP810 processor. The program setting incorporated Adaptive Dynamic Range Optimization (ADRO) and adopted the directional algorithm BEAM (both devices) and ZOOM (only on CP810). Speech reception threshold (SRT) was assessed in a free-field layout, with disyllabic word list and interfering multilevel babble noise in the 3 different pre-processing configurations., Results: On average, CP810 improved significantly patients' SRTs as compared to Freedom SP after 1 hour of use. Instead, no significant difference was observed in patients' SRT between the BEAM and the ZOOM algorithm fitted in the CP810 processor., Conclusion: The results suggest that hardware developments achieved in the design of CP810 allow an immediate and relevant directional advantage as compared to the previous-generation Freedom device.

Objective: To describe the rate of occurrence of unsuspected decrease in sensitivity of the sound processor microphone and to evaluate its effect on the patient's audiological performance in terms of reduction in speech recognition scores., Design: Speech processor microphones were tested by connecting the speech processor acoustic monitor circuit to a hearing aid analyzer. The response curves were compared with those obtained from fully working microphones. During a 6-month investigation period, microphone response curves were measured from a group of cochlear implant recipients who had not reported any problems. Despite the absence of any subjective problem, some microphones were found to show a loss of sensitivity. Their users, aged between 4 and 67 years, were tested both with the defective and a working microphone in order to calculate the correlation between the degree of microphone failure and the decline in audiological performance. To quantify the effect of microphone failure, patients' speech recognition skills were measured by live voice connected discourse tracking series administered in different conditions and by recorded sentences lists., Results: A total of 120 apparently fully functioning sound processors were tested in the investigation: 33 (27.5%) were affected by a subjectively unreported sensitivity decrease. Speech-tracking scores correlated significantly with the loss of microphone sensitivity in all test conditions (r = 0.69-0.77, P < 0.05). A high degree of correlation was also found for speech audiometry tests (r = 0.70-0.73, P < 0.05). Microphone sensitivity loss affected speech recognition skills, especially without lip reading and in the presence of background noise., Conclusion: The results indicate that any reduction in sound processor microphone sensitivity causes a degree of hearing decline that negatively affects the cochlear recipient's clinical performance. Microphone faults are often unreported events, and their occurrence rate is underestimated. To establish that the microphone is providing correct input to the speech processor a standard control procedure, including technical and clinical checks, is needed in clinical practice.

Hepatitis E is a classic water-borne disease in developing countries. Detection of anti-HEV IgM and IgG antibodies, in addition to HEV RNA are useful epidemiological markers in diagnosis of hepatitis E. This study was conducted to investigate an outbreak of acute viral hepatitis in South-Pakistan. Anti-HEV IgM and IgG were assessed comparatively with serological kits manufactured by Abbott, Cosmic, TGH, and Wantai, selecting HEV RNA as reference assay. Molecular evolutionary analysis was performed by phylogeny and HEV spread time analysis by Bayesian Coalescent Theory approach. Of the 89 patients, 24 (26.9%) did not have acute hepatitis viral marker. Of the remaining 65 cases, 4 (6.1%) were positive for anti-HAV IgM, one (1.5%) for anti-HBc IgM, 2 (3%) for HCV, 53 (81.5%) for anti-HEV IgM, and 5 (7.7%) were hepatitis-negative. The Wantai test was 100% sensitive and specific followed by Cosmic (98.1% and 100%), TGH (98.1% and 97.2%) and Abbott (79.2% and 83.3%). Two HEV variant strains were detected by phylogeny responsible for this acute hepatitis outbreak. Estimates on demographic history of HEV showed that HEV in Pakistan has remained at a steady nonexpanding phase from around 1970 to the year 2005, in which it expanded explosively with the emergence of new HEV variants. In conclusion, the limited sensitivity of available assay (Abbott anti-HEV EIA) may be a concern in HEV diagnosis in Pakistan. This study cautions that the dissemination of the variant strains to other areas of Pakistan may lead to explosive HEV outbreaks., (Copyright © 2011 Wiley-Liss, Inc.)