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Brennan MA, McCreery RW, Buss E, Jesteadt W. The Influence of Hearing Aid Gain on Gap-Detection Thresholds for Children and Adults With Hearing Loss. Ear Hear 2018; 39:969-79. [PMID: 29489468 DOI: 10.1097/AUD.0000000000000558] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objective of this experiment was to examine the contributions of audibility to the ability to perceive a gap in noise for children and adults. Sensorineural hearing loss (SNHL) in adulthood is associated with a deficit in gap detection. It is well known that reduced audibility in adult listeners with SNHL contributes to this deficit; however, it is unclear the extent to which hearing aid amplification can restore gap-detection thresholds, and the effect of childhood SNHL on gap-detection thresholds have not been described. For adults, it was hypothesized that restoring the dynamic range of hearing for listeners with SNHL would lead to approximately normal gap-detection thresholds. Children with normal hearing (NH) exhibit poorer gap-detection thresholds than adults. Because of their hearing loss, children with SNHL have less auditory experience than their peers with NH. Yet, it is unknown the extent to which auditory experience impacts their ability to perceive gaps in noise. Even with the provision of amplification, it was hypothesized that children with SNHL would show a deficit in gap detection, relative to their peers with normal hearing, because of reduced auditory experience. DESIGN The ability to detect a silent interval in noise was tested by adapting the stimulus level required for detection of gap durations between 3 and 20 ms for adults and children with and without SNHL. Stimulus-level thresholds were measured for participants with SNHL without amplification and with two prescriptive procedures-the adult and child versions of the desired sensation level i/o program-using a hearing aid simulator. The child version better restored the normal dynamic range than the adult version. Adults and children with NH were tested without amplification. RESULTS When fitted using the procedure that best restored the dynamic range, adults with SNHL had stimulus-level thresholds similar to those of adults with normal hearing. Compared to the children with NH, the children with SNHL required a higher stimulus level to detect a 5-ms gap, despite having used the procedure that better restored the normal dynamic range of hearing. Otherwise, the two groups of children had similar stimulus-level thresholds. CONCLUSION These findings suggest that apparent deficits in temporal resolution, as measured using stimulus-level thresholds for the detection of gaps, are dependent on age and audibility. These novel results indicate that childhood SNHL may impair temporal resolution as measured by stimulus-level thresholds for the detection of a gap in noise. This work has implications for understanding the effects of amplification on the ability to perceive temporal cues in speech.
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Wiinberg A, Jepsen ML, Epp B, Dau T. Effects of Hearing Loss and Fast-Acting Compression on Amplitude Modulation Perception and Speech Intelligibility. Ear Hear 2019; 40:45-54. [DOI: 10.1097/aud.0000000000000589] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Xia J, Xu B, Pentony S, Xu J, Swaminathan J. Effects of reverberation and noise on speech intelligibility in normal-hearing and aided hearing-impaired listeners. J Acoust Soc Am 2018; 143:1523. [PMID: 29604671 DOI: 10.1121/1.5026788] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Many hearing-aid wearers have difficulties understanding speech in reverberant noisy environments. This study evaluated the effects of reverberation and noise on speech recognition in normal-hearing listeners and hearing-impaired listeners wearing hearing aids. Sixteen typical acoustic scenes with different amounts of reverberation and various types of noise maskers were simulated using a loudspeaker array in an anechoic chamber. Results showed that, across all listening conditions, speech intelligibility of aided hearing-impaired listeners was poorer than normal-hearing counterparts. Once corrected for ceiling effects, the differences in the effects of reverberation on speech intelligibility between the two groups were much smaller. This suggests that, at least, part of the difference in susceptibility to reverberation between normal-hearing and hearing-impaired listeners was due to ceiling effects. Across both groups, a complex interaction between the noise characteristics and reverberation was observed on the speech intelligibility scores. Further fine-grained analyses of the perception of consonants showed that, for both listener groups, final consonants were more susceptible to reverberation than initial consonants. However, differences in the perception of specific consonant features were observed between the groups.
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Affiliation(s)
- Jing Xia
- Starkey Hearing Research Center, 2150 Shattuck Avenue, Suite 408, Berkeley, California 94704, USA
| | - Buye Xu
- Starkey Hearing Technologies, 6600 Washington Avenue South, Eden Prairie, Minnesota 55344, USA
| | - Shareka Pentony
- Starkey Hearing Research Center, 2150 Shattuck Avenue, Suite 408, Berkeley, California 94704, USA
| | - Jingjing Xu
- Starkey Hearing Technologies, 6600 Washington Avenue South, Eden Prairie, Minnesota 55344, USA
| | - Jayaganesh Swaminathan
- Starkey Hearing Research Center, 2150 Shattuck Avenue, Suite 408, Berkeley, California 94704, USA
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Brennan MA, McCreery RW, Jesteadt W. The influence of hearing-aid compression on forward-masked thresholds for adults with hearing loss. J Acoust Soc Am 2015; 138:2589-97. [PMID: 26520341 PMCID: PMC4627928 DOI: 10.1121/1.4932028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
This paper describes forward-masked thresholds for adults with hearing loss. Previous research has demonstrated that the loss of cochlear compression contributes to deficits in this measure of temporal resolution. Cochlear compression can be mimicked with fast-acting compression where the normal dynamic range is mapped to the impaired dynamic range. To test the hypothesis that fast-acting compression will most-closely approximate the normal ability to perceive forward-masked pure-tones, forward-masked thresholds were measured for two groups of adults (normal hearing, hearing loss). Adults with normal hearing were tested without amplification. Adults with hearing loss were tested with three different compression speeds and two different prescriptive procedures using a hearing-aid simulator. The two prescriptive procedures differed in the extent to which the normal dynamic range was mapped onto the impaired dynamic range. When using a faster compression speed with the prescriptive procedure that best restored the lost dynamic range, forward-masked thresholds for the listeners with hearing loss approximated those observed for the listeners with normal hearing.
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Affiliation(s)
- Marc A Brennan
- Boys Town National Research Hospital, 555 North 30th Street, Omaha, Nebraska 68131, USA
| | - Ryan W McCreery
- Boys Town National Research Hospital, 555 North 30th Street, Omaha, Nebraska 68131, USA
| | - Walt Jesteadt
- Boys Town National Research Hospital, 555 North 30th Street, Omaha, Nebraska 68131, USA
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Abstract
PURPOSE Authors of previous work using laboratory-based paradigms documented that wide dynamic range compression (WDRC) may improve gap detection compared to linear amplification. The purpose of this study was to measure temporal resolution using WDRC fit with compression ratios set for each listener’s hearing loss. METHOD Nineteen adults with mild-to-moderate hearing loss fitted with WDRC or linear amplification set to a prescriptive fitting method participated in this study. Subjects detected amplitude modulations and gaps. Two types of noise carrier were used: narrowband (1995–2005 Hz) and broadband (100–8000 Hz). RESULTS Small differences between WDRC and linear amplification were observed in the measures of temporal resolution. Modulation detection thresholds worsened by a mean of 0.7 dB with WDRC compared to linear amplification. This reduction was observed for both carrier types. Gap detection thresholds did not differ between the 2 amplification conditions. CONCLUSIONS WDRC set using a prescriptive fitting method with individualized compression ratios had a small but statistically significant effect on measures of modulation thresholds. Differences were not observed between the two amplification conditions for the measures of gap detection. These findings contrast with previous work using fixed compression ratios, suggesting that the effect of the fitting method on the compression ratio should be considered when attempting to generalize the effect of WDRC on temporal resolution to the clinical setting.
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Affiliation(s)
| | - Frederick J. Gallun
- National Center for Rehabilitative Auditory Research, Portland VA Medical Center, Portland, OR
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Horwitz AR, Ahlstrom JB, Dubno JR. Level-dependent changes in detection of temporal gaps in noise markers by adults with normal and impaired hearing. J Acoust Soc Am 2011; 130:2928-38. [PMID: 22087921 PMCID: PMC3248059 DOI: 10.1121/1.3643829] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Compression in the basilar-membrane input-output response flattens the temporal envelope of a fluctuating signal when more gain is applied to lower level than higher level temporal components. As a result, level-dependent changes in gap detection for signals with different depths of envelope fluctuation and for subjects with normal and impaired hearing may reveal effects of compression. To test these assumptions, gap detection with and without a broadband noise was measured with 1, 000-Hz-wide (flatter) and 50-Hz-wide (fluctuating) noise markers as a function of marker level. As marker level increased, background level also increased, maintaining a fixed acoustic signal-to-noise ratio (SNR) to minimize sensation-level effects on gap detection. Significant level-dependent changes in gap detection were observed, consistent with effects of cochlear compression. For the flatter marker, gap detection that declines with increases in level up to mid levels and improves with further increases in level may be explained by an effective flattening of the temporal envelope at mid levels, where compression effects are expected to be strongest. A flatter effective temporal envelope corresponds to a reduced effective SNR. The effects of a reduction in compression (resulting in larger effective SNRs) may contribute to better-than-normal gap detection observed for some hearing-impaired listeners.
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Affiliation(s)
- Amy R Horwitz
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, South Carolina 29425-5500, USA
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Desloge JG, Reed CM, Braida LD, Perez ZD, Delhorne LA. Temporal modulation transfer functions for listeners with real and simulated hearing loss. J Acoust Soc Am 2011; 129:3884-96. [PMID: 21682411 PMCID: PMC3135146 DOI: 10.1121/1.3583550] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Revised: 04/05/2011] [Accepted: 04/07/2011] [Indexed: 05/29/2023]
Abstract
A functional simulation of hearing loss was evaluated in its ability to reproduce the temporal modulation transfer functions (TMTFs) for nine listeners with mild to profound sensorineural hearing loss. Each hearing loss was simulated in a group of three age-matched normal-hearing listeners through spectrally shaped masking noise or a combination of masking noise and multiband expansion. TMTFs were measured for both groups of listeners using a broadband noise carrier as a function of modulation rate in the range 2 to 1024 Hz. The TMTFs were fit with a lowpass filter function that provided estimates of overall modulation-depth sensitivity and modulation cutoff frequency. Although the simulations were capable of accurately reproducing the threshold elevations of the hearing-impaired listeners, they were not successful in reproducing the TMTFs. On average, the simulations resulted in lower sensitivity and higher cutoff frequency than were observed in the TMTFs of the hearing-impaired listeners. Discrepancies in performance between listeners with real and simulated hearing loss are possibly related to inaccuracies in the simulation of recruitment.
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Affiliation(s)
- Joseph G Desloge
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
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Abstract
OBJECTIVE Disrupted auditory nerve activity in auditory neuropathy (AN) significantly impairs the sequential processing of auditory information, resulting in poor speech perception. This study investigated the ability of AN subjects to perceive temporally modified consonant-vowel (CV) pairs and shed light on their phonological awareness skills. DESIGN Four Arabic CV pairs were selected: /ki/-/gi/, /to/-/do/, /si/-/sti/ and /so/-/zo/. The formant transitions in consonants and the pauses between CV pairs were prolonged. Rhyming, segmentation and blending skills were tested using words at a natural rate of speech and with prolongation of the speech stream. STUDY SAMPLE Fourteen adult AN subjects were compared to a matched group of cochlear-impaired patients in their perception of acoustically processed speech. RESULTS The AN group distinguished the CV pairs at a low speech rate, in particular with modification of the consonant duration. Phonological awareness skills deteriorated in adult AN subjects but improved with prolongation of the speech inter-syllabic time interval. CONCLUSIONS A rehabilitation program for AN should consider temporal modification of speech, training for auditory temporal processing and the use of devices with innovative signal processing schemes. Verbal modifications as well as visual imaging appear to be promising compensatory strategies for remediating the affected phonological processing skills.
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Affiliation(s)
- Dalia Mohamed Hassan
- Audiology Unit, ORL Dept., Faculty of Medicine, Ain Shams University, Cairo, Egypt.
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Abstract
This study examined within- and across-electrode-channel processing of temporal gaps in successful users of MED-EL COMBI 40+ cochlear implants. The first experiment tested across-ear gap duration discrimination (GDD) in four listeners with bilateral implants. The results demonstrated that across-ear GDD thresholds are elevated relative to monaural, within-electrode-channel thresholds; the size of the threshold shift was approximately the same as for monaural, across-electrode-channel configurations. Experiment 1 also demonstrated a decline in GDD performance for channel-asymmetric markers. The second experiment tested the effect of envelope fluctuation on gap detection (GD) for monaural markers carried on a single electrode channel. Results from five cochlear implant listeners indicated that envelopes associated with 50-Hz wide bands of noise resulted in poorer GD thresholds than envelopes associated with 300-Hz wide bands of noise. In both cases GD thresholds improved when envelope fluctuations were compressed by an exponent of 0.2. The results of both experiments parallel those found for acoustic hearing, therefore suggesting that temporal processing of gaps is largely limited by factors central to the cochlea.
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Affiliation(s)
- John H Grose
- Department of Otolaryngology - Head & Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7070, USA.
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Goedegebure A, Goedegebure-Hulshof M, Dreschler WA, Verschuure J. Evaluation of phoneme compression schemes designed to compensate for temporal and spectral masking in background noise. Int J Audiol 2006; 44:647-55. [PMID: 16379493 DOI: 10.1080/14992020500266597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The effect of phonemic compression has been studied on speech intelligibility in background noise in hearing-impaired listeners with moderate-to-severe high-frequency losses. One configuration, anti-upward-spread-of-masking (anti-USOM) focuses on a release from spectral masking of high-frequency speech cues by selective spectral tilting. Release from temporal masking is the main goal of a second configuration, high-pass filtered compression (HFC), which reduces the speech modulations within a high-pass filtered compression channel. Speech intelligibility was measured with consonant-vowel-consonant (CVC) words in a multi-talker babble and a single-talker background noise. Anti-USOM has a significant negative effect on the phoneme scores in background noise. HFC compression tends to improve vowel intelligibility in a single-talker background noise, especially for the listeners with a relatively poor speech score. In a multi-talker babble noise the effects of HFC compression tend to be negative. It can be concluded that no significant release from spectral or temporal masking is obtained by the applied processing.
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Affiliation(s)
- A Goedegebure
- Department of Audiology-ENT, Erasmus MC Rotterdam, Postbox 2040, 3000 CA Rotterdam, The Netherlands.
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Abstract
OBJECTIVE Traditionally in the United Kingdom, children with severe and profound hearing loss have been fitted with linear, analog hearing aids. Fast-acting, wide-dynamic-range compression (WDRC) has been shown to give better discrimination of speech than linear amplification for moderately hearing-impaired young adults. For severe and profound hearing losses, higher compression ratios are needed. The resultant distortion of the temporal envelope and reduced modulation depth may offset improvements in audibility offered by WDRC. In this study, speech recognition and discrimination were assessed for severely and profoundly hearing-impaired children, using three different amplification strategies, including WDRC. DESIGN Fifteen children (ages 7 to 15 yr) with severe and profound hearing loss were fitted bilaterally with high-power, multichannel compression hearing aids, incorporating one of three different amplification strategies: linear with peak clipping, linear with compression limiting, or WDRC. Output responses were matched to Desired Sensation Level (DSL i/o) targets. The children wore hearing aids programmed with each of the amplification strategies in turn, for at least 1 wk, in a counterbalanced order across children. After using a particular amplification strategy for at least 1 wk, speech perception tests were carried out. RESULTS Speech scores on closed-set testing for the profound group showed significant benefit for WDRC over the other two algorithms. None of the other results showed a statistically significant effect of algorithm on speech performance. CONCLUSIONS WDRC amplification sometimes led to better performance than linear amplification with peak clipping or output limiting, and it never led to poorer performance. Therefore, it appears to be safe to use well-designed WDRC for hearing-impaired children with severe or profound hearing loss.
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Affiliation(s)
- Josephine E Marriage
- Department of Experimental Psychology, University of Cambridge, Cambridge, United Kingdom
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Abstract
Buus and Florentine [J. Assoc. Res. Otolaryngol. 3, 120-139 (2002)] have proposed that loudness recruitment in cases of cochlear hearing loss is caused partly by an abnormally large loudness at absolute threshold. This has been called "softness imperception." To evaluate this idea, loudness-matching functions were obtained using tones at very low sensation levels. For subjects with asymmetrical hearing loss, matches were obtained for a single frequency across ears. For subjects with sloping hearing loss, matches were obtained between tones at two frequencies, one where the absolute threshold was nearly normal and one where there was a moderate hearing loss. Loudness matching was possible for sensation levels (SLs) as low as 2 dB. When the fixed tone was presented at a very low SL in an ear (or at a frequency) where there was hearing impairment, it was matched by a tone with approximately the same SL in an ear (or at a frequency) where hearing was normal (e.g., 2 dB SL matched 2 dB SL). This relationship held for SLs up to 4-10 dB, depending on the subject. These results are not consistent with the concept of softness imperception.
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Affiliation(s)
- Brian C J Moore
- Department of Experimental Psychology, University of Cambridge, Downing Street, Cambridge CB2 3EB, United Kingdom.
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Marriage JE, Moore BCJ. New speech tests reveal benefit of wide-dynamic-range, fast-acting compression for consonant discrimination in children with moderate-to-profound hearing loss. Int J Audiol 2004; 42:418-25. [PMID: 14582638 DOI: 10.3109/14992020309080051] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Fast-acting, wide-dynamic-range compression (WDRC) has been shown to give better discrimination of soft speech and shouted speech than linear amplification for moderately hearing-impaired young adults. For severe and profound hearing losses, higher compression ratios are needed. The resultant distortion of the temporal envelope and reduced modulation depth may offset improvements in audibility offered by WDRC. This study compares the effectiveness of WDRC and linear amplification for children with different degrees of hearing loss. Pre-recorded tests of closed-set consonant confusions and open-set word recognition were developed to assess performance. Three groups of subjects (aged 4-14 years) with moderate (51-70 dB), severe (71-90 dB) and profound (91-115 dB) hearing loss were fitted with hearing aids programmed with WDRC or linear amplification. The frequency response was adjusted to match each child's own hearing aid prescription. For each group, stimuli were presented both in quiet and in noise at levels chosen to avoid floor and ceiling effects. Consonant confusion scores for the profound and severe groups combined and for the moderate group were significantly better with WDRC than with linear amplification. Open-set test results showed greater variability. Although mean scores were higher for WDRC than for linear processing, the effects were of marginal statistical significance.
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Abstract
The topic of compression has been discussed quite extensively in the last 20 years (eg, Braida et al., 1982; Dillon, 1996, 2000; Dreschler, 1992; Hickson, 1994; Kuk, 2000 and 2002; Kuk and Ludvigsen, 1999; Moore, 1990; Van Tasell, 1993; Venema, 2000; Verschuure et al., 1996; Walker and Dillon, 1982). However, the latest comprehensive update by this journal was published in 1996 (Kuk, 1996). Since that time, use of compression hearing aids has increased dramatically, from half of hearing aids dispensed only 5 years ago to four out of five hearing aids dispensed today (Strom, 2002b). Most of today's digital and digitally programmable hearing aids are compression devices (Strom, 2002a). It is probable that within a few years, very few patients will be fit with linear hearing aids. Furthermore, compression has increased in complexity, with greater numbers of parameters under the clinician's control. Ideally, these changes will translate to greater flexibility and precision in fitting and selection. However, they also increase the need for information about the effects of compression amplification on speech perception and speech quality. As evidenced by the large number of sessions at professional conferences on fitting compression hearing aids, clinicians continue to have questions about compression technology and when and how it should be used. How does compression work? Who are the best candidates for this technology? How should adjustable parameters be set to provide optimal speech recognition? What effect will compression have on speech quality? These and other questions continue to drive our interest in this technology. This article reviews the effects of compression on the speech signal and the implications for speech intelligibility, quality, and design of clinical procedures.
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Affiliation(s)
- Pamela E Souza
- Department of Speech and Hearing Sciences, University of Washington, 1417 NE 42nd Street, Seattle, WA 98105
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