Relationship between noise levels and intensive care patients' clinical complexity: An observational simulation study

BACKGROUND

Noise pollution in intensive care units is a relevant problem, associated with psychological and physiological consequences for patients and healthcare staff. Sources of noise pollution include medical equipment, alarms, communication tools, staff activities, and conversations.

AIMS

To explore the cumulative effects of noise caused by an increasing number and type of medical devices in an intensive care setting on simulated patients with increasing clinical complexity. Secondly, to measure medical device alarms and nursing activities' sound levels, evaluating their role as potentially disruptive noises.

STUDY DESIGN

Observational simulation study (reported according to the STROBE checklist). Using an electronic sound meter, the sound levels of an intensive care room in seven simulated clinical scenarios were measured on a single day (09 March 2022), each featuring increasing numbers of devices, hypothetically corresponding to augmented patients' clinical complexity. Secondly, noise levels of medical device alarms and specific nursing activities performed at a distance of three meters from the sound meter were analysed.

RESULTS

The empty room's mean baseline noise level was 37.8 (±0.7) dBA; among the simulated scenarios, noise ranged between 45.3 (±1.0) and 53.5 (±1.5) dBA. Alarms ranged between 76.4 and 81.3 dBA, while nursing tasks (closing a drawer, opening a saline bag overwrap, or sterile packages) and speaking were all over 80 dBA. The noisiest activity was opening a sterile package (98 dBA).

CONCLUSION

An increased number of medical devices, an expression of patients' higher clinical complexity, is not a significant cause of increased noise. Some specific nursing activities and conversations produce higher noise levels than medical devices and alarms. This study's findings suggest further research to assess the relationships between these factors and to encourage adequate noise reduction strategies.

RELEVANCE TO CLINICAL PRACTICE

Excessive noise level in the intensive care unit is a clinical issue that negatively affects patients' and healthcare providers' well-being. The increase in baseline room noise from medical devices is generally limited. Typical nursing tasks and conversations produce higher noise levels than medical devices and alarms. These findings could be helpful to raise awareness among healthcare professionals to recognize noise sources. The noisiest components of the environment can be modified by staff behaviour, promoting noise reduction strategies and improving the critical care environment.

Acoustic biomarkers in asthma: a systematic review

OBJECTIVE

Current monitoring methods of asthma, such as peak expiratory flow testing, have important limitations. The emergence of automated acoustic sound analysis, capturing cough, wheeze, and inhaler use, offers a promising avenue for improving asthma diagnosis and monitoring. This systematic review evaluated the validity of acoustic biomarkers in supporting the diagnosis of asthma and its monitoring.

DATA SOURCES

A search was performed using two databases (PubMed and Embase) for all relevant studies published before November 2023.

STUDY SELECTION

27 studies were included for analysis. Eligible studies focused on acoustic signals as digital biomarkers in asthma, utilizing recording devices to register or analyze sound.

RESULTS

Various respiratory acoustic signal types were analyzed, with cough and wheeze being predominant. Data collection methods included smartphones, custom sensors and digital stethoscopes. Across all studies, automated acoustic algorithms achieved average accuracy of cough and wheeze detection of 88.7% (range: 61.0 - 100.0%) with a median of 92.0%. The sensitivity of sound detection ranged from 54.0% to 100.0%, with a median of 90.3%; specificity ranged from 67.0% to 99.7%, with a median of 95.0%. Moreover, 70.4% (19/27) studies had a risk of bias identified.

CONCLUSIONS

This systematic review establishes the promising role of acoustic biomarkers, particularly cough and wheeze, in supporting the diagnosis of asthma and monitoring. The evidence suggests the potential for clinical integration of acoustic biomarkers, emphasizing the need for further validation in larger, clinically-diverse populations.

Feasibility and Acceptability of Pediatric Smartphone Lung Auscultation by Parents: Cross-Sectional Study

Background

The use of a smartphone built-in microphone for auscultation is a feasible alternative to the use of a stethoscope, when applied by physicians.

Objective

This cross-sectional study aims to assess the feasibility of this technology when used by parents-the real intended end users.

Methods

Physicians recruited 46 children (male: n=33, 72%; age: mean 11.3, SD 3.1 y; children with asthma: n=24, 52%) during medical visits in a pediatric department of a tertiary hospital. Smartphone auscultation using an app was performed at 4 locations (trachea, right anterior chest, and right and left lung bases), first by a physician (recordings: n=297) and later by a parent (recordings: n=344). All recordings (N=641) were classified by 3 annotators for quality and the presence of adventitious sounds. Parents completed a questionnaire to provide feedback on the app, using a Likert scale ranging from 1 ("totally disagree") to 5 ("totally agree").

Results

Most recordings had quality (physicians' recordings: 253/297, 85.2%; parents' recordings: 266/346, 76.9%). The proportions of physicians' recordings (34/253, 13.4%) and parents' recordings (31/266, 11.7%) with adventitious sounds were similar. Parents found the app easy to use (questionnaire: median 5, IQR 5-5) and were willing to use it (questionnaire: median 5, IQR 5-5).

Conclusions

Our results show that smartphone auscultation is feasible when performed by parents in the clinical context, but further investigation is needed to test its feasibility in real life.

The Efficacy of a Multimodal Bedroom-Based 'Smart' Alarm System on Mitigating the Effects of Sleep Inertia

Previous work has demonstrated the modest impact of environmental interventions that manipulate lighting, sound, or temperature on sleep inertia symptoms. The current study sought to expand on previous work and measure the impact of a multimodal intervention that collectively manipulated light, sound, and ambient temperature on sleep inertia. Participants slept in the lab for four nights and were awoken each morning by either a traditional alarm clock or the multimodal intervention. Feelings of sleep inertia were measured each morning through Psychomotor Vigilance Test (PVT) assessments and ratings of sleepiness and mood at five time-points. While there was little overall impact of the intervention, the participant's chronotype and the length of the lighting exposure on intervention mornings both influenced sleep inertia symptoms. Moderate evening types who received a shorter lighting exposure (≤15 min) demonstrated more lapses relative to the control condition, whereas intermediate types exhibited a better response speed and fewer lapses. Conversely, moderate evening types who experienced a longer light exposure (>15 min) during the intervention exhibited fewer false alarms over time. The results suggest that the length of the environmental intervention may play a role in mitigating feelings of sleep inertia, particularly for groups who might exhibit stronger feelings of sleep inertia, including evening types.

Cross-Modal Sensory Boosting to Improve High-Frequency Hearing Loss: Device Development and Validation

Background

High-frequency hearing loss is one of the most common problems in the aging population and with those who have a history of exposure to loud noises. This type of hearing loss can be frustrating and disabling, making it difficult to understand speech communication and interact effectively with the world.

Objective

This study aimed to examine the impact of spatially unique haptic vibrations representing high-frequency phonemes on the self-perceived ability to understand conversations in everyday situations.

Methods

To address high-frequency hearing loss, a multi-motor wristband was developed that uses machine learning to listen for specific high-frequency phonemes. The wristband vibrates in spatially unique locations to represent which phoneme was present in real time. A total of 16 participants with high-frequency hearing loss were recruited and asked to wear the wristband for 6 weeks. The degree of disability associated with hearing loss was measured weekly using the Abbreviated Profile of Hearing Aid Benefit (APHAB).

Results

By the end of the 6-week study, the average APHAB benefit score across all participants reached 12.39 points, from a baseline of 40.32 to a final score of 27.93 (SD 13.11; N=16; P=.002, 2-tailed dependent t test). Those without hearing aids showed a 10.78-point larger improvement in average APHAB benefit score at 6 weeks than those with hearing aids (t14=2.14; P=.10, 2-tailed independent t test). The average benefit score across all participants for ease of communication was 15.44 (SD 13.88; N=16; P<.001, 2-tailed dependent t test). The average benefit score across all participants for background noise was 10.88 (SD 17.54; N=16; P=.03, 2-tailed dependent t test). The average benefit score across all participants for reverberation was 10.84 (SD 16.95; N=16; P=.02, 2-tailed dependent t test).

Conclusions

These findings show that vibrotactile sensory substitution delivered by a wristband that produces spatially distinguishable vibrations in correspondence with high-frequency phonemes helps individuals with high-frequency hearing loss improve their perceived understanding of verbal communication. Vibrotactile feedback provides benefits whether or not a person wears hearing aids, albeit in slightly different ways. Finally, individuals with the greatest perceived difficulty understanding speech experienced the greatest amount of perceived benefit from vibrotactile feedback.

Molecular Melodies: Unraveling the Hidden Harmonies of NMR Spectroscopy

This work explores the evolution of auditory analysis in NMR spectroscopy, tracing its journey from a supplementary tool to visual methods such as oscilloscopes, to a technique sidelined due to technological advancements. Despite its renaissance in the late 1990s with artistic and scientific applications, widespread adoption was hindered by the necessity for hardware modifications and reliance on specialized software. Addressing these barriers, this paper introduces a new feature in Mnova NMR software that facilitates the easy auditory interpretation of NMR signals. We discuss new applications of this tool, emphasizing its utility in aiding the identification of specific functional groups by auditory analysis of the spectrum's multiplets, such as distinguishing between aromatic, olefinic, or aliphatic protons, thereby enriching the interpretative capabilities of NMR data.

Talk is cheap: rediscovering sounds made by plants

A recent study and related commentaries have raised new interest in the phenomenon of ultrasonic sound production by plants exposed to stress, especially drought. While recent technological advancements have allowed the demonstration that these sounds can propagate in the air surrounding plants, we remind readers here that research on sound production by plants is more than 100 years old. The mechanisms and patterns of sound emission from plants subjected to different stress factors are also reasonably understood, thanks to the pioneering work of John Milburn and others. By contrast, experimental evidence for a role of these sounds in plant-animal or plant-plant communication remains lacking and, at present, these ideas remain highly speculative.

Effect of Selected Music Soundtracks on Cardiac Vagal Control and Complexity Assessed by Heart Rate Variability

Listening to music is experimentally associated with positive stress reduction effect on human organisms. However, the opinions of therapists about this complementary non-invasive therapy are still different.

PURPOSE

The aim of our study was to investigate the effect of selected passive music therapy frequencies without vocals on selected cardio-vagal and complexity indices of short-term heart rate variability (HRV) in healthy youth, in terms of calming the human.

MAIN METHODS

30 probands (15 male, averaged age: 19.7+/-1.4 years, BMI: 23.3+/-3.8 kg/m2) were examined during protocol (Silence baseline, Music 1 (20-1000 Hz), Silence 1, Music 2 (250-2000 Hz), Silence 2, Music 3 (1000-16000 Hz), and Silence 3). Evaluated HRV parameters in time, spectral, and geometrical domains represent indices of cardio-vagal and emotional regulation. Additionally, HRV complexity was calculated by approximate entropy and sample entropy (SampEn) and subjective characteristics of each phase by Likert scale.

RESULTS

the distance between subsequent R-waves in the electrocardiogram (RR intervals [ms]) and SampEn were significantly higher during Music 3 compared to Silence 3 (p=0.015, p=0.021, respectively). Geometrical cardio-vagal index was significantly higher during Music 2 than during Silence 2 (p=0.006). In the subjective perception of the healthy youths evaluated statistically through a Likert scale, the phases of music were perceived significantly more pleasant than the silent phases (p<0.001, p=0.008, p=0.003, respectively).

CONCLUSIONS

Our findings revealed a rise of cardio-vagal modulation and higher complexity assessed by short-term HRV indices suggesting positive relaxing effect music especially of higher frequency on human organism.

Noise Produced by Neonatal Ventilators Inside and Outside of the Incubators

BACKGROUND

Insufficient data are available about the noise produced by modern neonatal ventilators. We aimed to measure their noise under different ventilatory modes and parameters.

METHODS

This was a bench study measuring the noise produced by 9 neonatal ventilators set in conventional or high-frequency oscillatory ventilation (HFOV), nasal mask-delivered CPAP with variable- or continuous-flow configuration, or bi-level positive airway pressure (considered as noninvasive ventilation [NIV]). Conventional ventilation and HFOV were tested in 2 distinct settings with moderate or higher parameters. Sound measurements were performed inside and outside an incubator mimicking the clinical setting and using a high-end meter meeting the international ISO 226:2003 standard.

RESULTS

Four ventilators remained below the internationally recommended safety threshold but only for measurements outside the incubator. Conventional ventilation (49.1 [3.4] dBA) and HFOV (56.3 [5.2] dBA) were the least and most noisy respiratory support technique, respectively. Noise was greater inside than outside the incubators (P < .0001) and different between the ventilators (P < .0001); better results were achieved by Servo-u and Fabian family devices for conventional ventilation; by fabian HFO for HFOV; and by Servo-u, VN500, and fabian family devices for CPAP and NIV. Noise levels were similar when using moderate or higher parameters in conventional ventilation (P = .81) and in HFOV (P = .45).

CONCLUSIONS

Modern ventilators often produce relevant noise, independent of the respiratory support modality, with acceptable noise levels being measured only outside the incubator. Better results were achieved with Servo-u, VN500, and Fabian family devices.

Vestibular Testing-New Physiological Results for the Optimization of Clinical VEMP Stimuli

Both auditory and vestibular primary afferent neurons can be activated by sound and vibration. This review relates the differences between them to the different receptor/synaptic mechanisms of the two systems, as shown by indicators of peripheral function-cochlear and vestibular compound action potentials (cCAPs and vCAPs)-to click stimulation as recorded in animal studies. Sound- and vibration-sensitive type 1 receptors at the striola of the utricular macula are enveloped by the unique calyx afferent ending, which has three modes of synaptic transmission. Glutamate is the transmitter for both cochlear and vestibular primary afferents; however, blocking glutamate transmission has very little effect on vCAPs but greatly reduces cCAPs. We suggest that the ultrafast non-quantal synaptic mechanism called resistive coupling is the cause of the short latency vestibular afferent responses and related results-failure of transmitter blockade, masking, and temporal precision. This "ultrafast" non-quantal transmission is effectively electrical coupling that is dependent on the membrane potentials of the calyx and the type 1 receptor. The major clinical implication is that decreasing stimulus rise time increases vCAP response, corresponding to the increased VEMP response in human subjects. Short rise times are optimal in human clinical VEMP testing, whereas long rise times are mandatory for audiometric threshold testing.

Microbiome Diversity of Anaerobic Digesters Is Enhanced by Microaeration and Low Frequency Sound

Biogas is produced by a consortium of bacteria and archaea. We studied how the microbiome of poultry litter digestate was affected by time and treatments that enhanced biogas production. The microbiome was analyzed at six, 23, and 42 weeks of incubation. Starting at week seven, the digesters underwent four treatments: control, microaeration with 6 mL air L-1 digestate per day, treatment with a 1000 Hz sine wave, or treatment with the sound wave and microaeration. Both microaeration and sound enhanced biogas production relative to the control, while their combination was not as effective as microaeration alone. At week six, over 80% of the microbiome of the four digesters was composed of the three phyla Actinobacteria, Proteobacteria, and Firmicutes, with less than 10% Euryarchaeota and Bacteroidetes. At week 23, the digester microbiomes were more diverse with the phyla Spirochaetes, Synergistetes, and Verrucomicrobia increasing in proportion and the abundance of Actinobacteria decreasing. At week 42, Firmicutes, Bacteroidetes, Euryarchaeota, and Actinobacteria were the most dominant phyla, comprising 27.8%, 21.4%, 17.6%, and 12.3% of the microbiome. Other than the relative proportions of Firmicutes being increased and proportions of Bacteroidetes being decreased by the treatments, no systematic shifts in the microbiomes were observed due to treatment. Rather, microbial diversity was enhanced relative to the control. Given that both air and sound treatment increased biogas production, it is likely that they improved poultry litter breakdown to promote microbial growth.

The Role of Sound in Livestock Farming-Selected Aspects

To ensure the optimal living conditions of farm animals, it is essential to understand how their senses work and the way in which they perceive their environment. Most animals have a different hearing range compared to humans; thus, some aversive sounds may go unnoticed by caretakers. The auditory pathways may act through the nervous system on the cardiovascular, gastrointestinal, endocrine, and immune systems. Therefore, noise may lead to behavioral activation (arousal), pain, and sleep disorders. Sounds on farms may be produced by machines, humans, or animals themselves. It is worth noting that vocalization may be very informative to the breeder as it is an expression of an emotional state. This information can be highly beneficial in maintaining a high level of livestock welfare. Moreover, understanding learning theory, conditioning, and the potential benefits of certain sounds can guide the deliberate use of techniques in farm management to reduce the aversiveness of certain events.

Adding Sound Transparency to a Spacesuit: Effect on Cognitive Performance in Females

Spacesuits may block external sound. This induces sensory deprivation; a side effect is lower cognitive performance. This can increase the risk of an accident. This undesirable effect can be mitigated by designing suits with sound transparency. If the atmosphere is available, as on Mars, sound transparency can be realized by augmenting and processing external sounds. If no atmosphere is available, such as on the Moon, then an Earth-like sound can be re-created via generative AR techniques. We measure the effect of adding sound transparency in an Intra-Vehicular Activity suit by means of the Koh Block test. The results indicate that participants complete the test more quickly when wearing a suit with sound transparency.

Determination of steady-state transcriptome modifications associated with repeated homotypic stress in the rat rostral posterior hypothalamic region

Chronic stress is epidemiologically correlated with physical and psychiatric disorders. Whereas many animal models of chronic stress induce symptoms of psychopathology, repeated homotypic stressors to moderate intensity stimuli typically reduce stress-related responses with fewer, if any, pathological symptoms. Recent results indicate that the rostral posterior hypothalamic (rPH) region is a significant component of the brain circuitry underlying response reductions (habituation) associated with repeated homotypic stress. To test whether posterior hypothalamic transcriptional regulation associates with the neuroendocrine modifications induced by repeated homotypic stress, RNA-seq was performed in the rPH dissected from adult male rats that experienced either no stress, 1, 3, or 7 stressful loud noise exposures. Plasma samples displayed reliable increases of corticosterone in all stressed groups, with the smallest increase in the group exposed to 7 loud noises, indicating significant habituation compared to the other stressed groups. While few or no differentially expressed genes were detected 24-h after one or three loud noise exposures, relatively large numbers of transcripts were differentially expressed between the group exposed to 7 loud noises when compared to the control or 3-stress groups, respectively, which correlated with the corticosterone response habituation observed. Gene ontology analyses indicated multiple significant functional terms related to neuron differentiation, neural membrane potential, pre- and post-synaptic elements, chemical synaptic transmission, vesicles, axon guidance and projection, glutamatergic and GABAergic neurotransmission. Some of the differentially expressed genes (Myt1l, Zmat4, Dlx6, Csrnp3) encode transcription factors that were independently predicted by transcription factor enrichment analysis to target other differentially regulated genes in this study. A similar experiment employing in situ hybridization histochemical analysis in additional animals validated the direction of change of the 5 transcripts investigated (Camk4, Gabrb2, Gad1, Grin2a and Slc32a) with a high level of temporal and regional specificity for the rPH. In aggregate, the results suggest that distinct patterns of gene regulation are obtained in response to a repeated homotypic stress regimen; they also point to a significant reorganization of the rPH region that may critically contribute to the phenotypic modifications associated with repeated homotypic stress habituation.

Digital Twin-Driven Tool Condition Monitoring for the Milling Process

Exact observing and forecasting tool conditions fundamentally affect cutting execution, bringing further developed workpiece machining accuracy and lower machining costs. Because of the unpredictability and time-differing nature of the cutting system, existing methodologies cannot achieve ideal oversight progressively. A technique dependent on Digital Twins (DT) is proposed to accomplish extraordinary accuracy in checking and anticipating tool conditions. This technique builds up a balanced virtual instrument framework that matches entirely with the physical system. Collecting data from the physical system (Milling Machine) is initialized, and sensory data collection is carried out. The National Instruments data acquisition system captures vibration data through a uni-axial accelerometer, and a USB-based microphone sensor acquires the sound signals. The data are trained with different Machine Learning (ML) classification-based algorithms. The prediction accuracy is calculated with the help of a confusion matrix with the highest accuracy of 91% through a Probabilistic Neural Network (PNN). This result has been mapped by extracting the statistical features of the vibrational data. Testing has been performed with the trained model to validate the model's accuracy. Later, the modeling of the DT is initiated using MATLAB-Simulink. This model has been created under the data-driven approach. The physical-virtual balance of the DT model is acknowledged utilizing the advances, taking into consideration the detailed planning of the constant state of the tool's condition. The tool condition monitoring system through the DT model is deployed through the machine learning technique. The DT model can predict the different tool conditions based on sensory data.

Sound and light levels in intensive care units in a large urban hospital in the United States

Intensive care units (ICUs) may disrupt sleep. Quantitative ICU studies of concurrent and continuous sound and light levels and timings remain sparse in part due to the lack of ICU equipment that monitors sound and light. Here, we describe sound and light levels across three adult ICUs in a large urban United States tertiary care hospital using a novel sensor. The novel sound and light sensor is composed of a Gravity Sound Level Meter for sound level measurements and an Adafruit TSL2561 digital luminosity sensor for light levels. Sound and light levels were continuously monitored in the room of 136 patients (mean age = 67.0 (8.7) years, 44.9% female) enrolled in the Investigation of Sleep in the Intensive Care Unit study (ICU-SLEEP; Clinicaltrials.gov: #NCT03355053), at the Massachusetts General Hospital. The hours of available sound and light data ranged from 24.0 to 72.2 hours. Average sound and light levels oscillated throughout the day and night. On average, the loudest hour was 17:00 and the quietest hour was 02:00. Average light levels were brightest at 09:00 and dimmest at 04:00. For all participants, average nightly sound levels exceeded the WHO guideline of < 35 decibels. Similarly, mean nightly light levels varied across participants (minimum: 1.00 lux, maximum: 577.05 lux). Sound and light events were more frequent between 08:00 and 20:00 than between 20:00 and 08:00 and were largely similar on weekdays and weekend days. Peaks in distinct alarm frequencies (Alarm 1) occurred at 01:00, 06:00, and at 20:00. Alarms at other frequencies (Alarm 2) were relatively consistent throughout the day and night, with a small peak at 20:00. In conclusion, we present a sound and light data collection method and results from a cohort of critically ill patients, demonstrating excess sound and light levels across multiple ICUs in a large tertiary care hospital in the United States. ClinicalTrials.gov, #NCT03355053. Registered 28 November 2017, https://clinicaltrials.gov/ct2/show/NCT03355053.

A Review of Neural Data and Modelling to Explain How a Semicircular Canal Dehiscence (SCD) Causes Enhanced VEMPs, Skull Vibration Induced Nystagmus (SVIN), and the Tullio Phenomenon

Angular acceleration stimulation of a semicircular canal causes an increased firing rate in primary canal afferent neurons that result in nystagmus in healthy adult animals. However, increased firing rate in canal afferent neurons can also be caused by sound or vibration in patients after a semicircular canal dehiscence, and so these unusual stimuli will also cause nystagmus. The recent data and model by Iversen and Rabbitt show that sound or vibration may increase firing rate either by neural activation locked to the individual cycles of the stimulus or by slow changes in firing rate due to fluid pumping ("acoustic streaming"), which causes cupula deflection. Both mechanisms will act to increase the primary afferent firing rate and so trigger nystagmus. The primary afferent data in guinea pigs indicate that in some situations, these two mechanisms may oppose each other. This review has shown how these three clinical phenomena-skull vibration-induced nystagmus, enhanced vestibular evoked myogenic potentials, and the Tullio phenomenon-have a common tie: they are caused by the new response of semicircular canal afferent neurons to sound and vibration after a semicircular canal dehiscence.

Real-Time Detection of Sleep Apnea Based on Breathing Sounds and Prediction Reinforcement Using Home Noises: Algorithm Development and Validation

BACKGROUND

Multinight monitoring can be helpful for the diagnosis and management of obstructive sleep apnea (OSA). For this purpose, it is necessary to be able to detect OSA in real time in a noisy home environment. Sound-based OSA assessment holds great potential since it can be integrated with smartphones to provide full noncontact monitoring of OSA at home.

OBJECTIVE

The purpose of this study is to develop a predictive model that can detect OSA in real time, even in a home environment where various noises exist.

METHODS

This study included 1018 polysomnography (PSG) audio data sets, 297 smartphone audio data sets synced with PSG, and a home noise data set containing 22,500 noises to train the model to predict breathing events, such as apneas and hypopneas, based on breathing sounds that occur during sleep. The whole breathing sound of each night was divided into 30-second epochs and labeled as "apnea," "hypopnea," or "no-event," and the home noises were used to make the model robust to a noisy home environment. The performance of the prediction model was assessed using epoch-by-epoch prediction accuracy and OSA severity classification based on the apnea-hypopnea index (AHI).

RESULTS

Epoch-by-epoch OSA event detection showed an accuracy of 86% and a macro F₁-score of 0.75 for the 3-class OSA event detection task. The model had an accuracy of 92% for "no-event," 84% for "apnea," and 51% for "hypopnea." Most misclassifications were made for "hypopnea," with 15% and 34% of "hypopnea" being wrongly predicted as "apnea" and "no-event," respectively. The sensitivity and specificity of the OSA severity classification (AHI≥15) were 0.85 and 0.84, respectively.

CONCLUSIONS

Our study presents a real-time epoch-by-epoch OSA detector that works in a variety of noisy home environments. Based on this, additional research is needed to verify the usefulness of various multinight monitoring and real-time diagnostic technologies in the home environment.

Soundscape Awareness Intervention Reduced Neuropsychiatric Symptoms in Nursing Home Residents With Dementia: A Cluster-Randomized Trial With MoSART

OBJECTIVES

Auditory environments as perceived by an individual, also called soundscapes, are often suboptimal for nursing home residents. Poor soundscapes have been associated with neuropsychiatric symptoms (NPS). We evaluated the effect of the Mobile Soundscape Appraisal and Recording Technology sound awareness intervention (MoSART+) on NPS in nursing home residents with dementia.

DESIGN

A 15-month, stepped-wedge, cluster-randomized trial. Every 3 months, a nursing home switched from care as usual to the use of the intervention.

INTERVENTION

The 3-month MoSART+ intervention involved ambassador training, staff performing sound measurements with the MoSART application, meetings, and implementation of microinterventions. The goal was to raise awareness about soundscapes and their influence on residents.

SETTING AND PARTICIPANTS

We included 110 residents with dementia in 5 Dutch nursing homes. Exclusion criteria were palliative sedation and deafness.

METHODS

The primary outcome was NPS severity measured with the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) by the resident's primary nurse. Secondary outcomes were quality of life (QUALIDEM), psychotropic drug use (ATC), staff workload (workload questionnaire), and staff job satisfaction (Maastricht Questionnaire of Job Satisfaction).

RESULTS

The mean age of the residents (n = 97) at enrollment was 86.5 ± 6.7 years, and 76 were female (76.8%). The mean NPI-NH score was 17.5 ± 17.3. One nursing home did not implement the intervention because of staff shortages. Intention-to-treat analysis showed a clinically relevant reduction in NPS between the study groups (-8.0, 95% CI -11.7, -2.6). There was no clear effect on quality of life [odds ratio (OR) 2.8, 95% CI -0.7, 6.3], psychotropic drug use (1.2, 95% CI 0.9, 1.7), staff workload (-0.3, 95% CI -0.3, 0.8), or staff job satisfaction (-0.2, 95% CI -1.2, 0.7).

CONCLUSIONS AND IMPLICATIONS

MoSART+ empowered staff to adapt the local soundscape, and the intervention effectively reduced staff-reported levels of NPS in nursing home residents with dementia. Nursing homes should consider implementing interventions to improve the soundscape.

The future of sensory substitution, addition, and expansion via haptic devices

Haptic devices use the sense of touch to transmit information to the nervous system. As an example, a sound-to-touch device processes auditory information and sends it to the brain via patterns of vibration on the skin for people who have lost hearing. We here summarize the current directions of such research and draw upon examples in industry and academia. Such devices can be used for sensory substitution (replacing a lost sense, such as hearing or vision), sensory expansion (widening an existing sensory experience, such as detecting electromagnetic radiation outside the visible light spectrum), and sensory addition (providing a novel sense, such as magnetoreception). We review the relevant literature, the current status, and possible directions for the future of sensory manipulation using non-invasive haptic devices.

Transcranial alternating current stimulation combined with sound stimulation improves cognitive function in patients with Alzheimer's disease: Study protocol for a randomized controlled trial

Background

The number of patients with Alzheimer's disease (AD) worldwide is increasing yearly, but the existing treatment methods have poor efficacy. Transcranial alternating current stimulation (tACS) is a new treatment for AD, but the offline effect of tACS is insufficient. To prolong the offline effect, we designed to combine tACS with sound stimulation to maintain the long-term post-effect.

Materials and methods

To explore the safety and effectiveness of tACS combined with sound stimulation and its impact on the cognition of AD patients. This trial will recruit 87 patients with mild to moderate AD. All patients were randomly divided into three groups. The change in Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog) scores from the day before treatment to the end of treatment and 3 months after treatment was used as the main evaluation index. We will also explore the changes in the brain structural network, functional network, and metabolic network of AD patients in each group after treatment.

Discussion

We hope to conclude that tACS combined with sound stimulation is safe and tolerable in 87 patients with mild to moderate AD under three standardized treatment regimens. Compared with tACS alone or sound alone, the combination group had a significant long-term effect on cognitive improvement. To screen out a better treatment plan for AD patients. tACS combined with sound stimulation is a previously unexplored, non-invasive joint intervention to improve patients' cognitive status. This study may also identify the potential mechanism of tACS combined with sound stimulation in treating mild to moderate AD patients.

Clinical Trial Registration

Clinicaltrials.gov, NCT05251649. Registered on February 22, 2022.

Sound-induced analgesia cannot always be observed in adult mice

Music seems promising as an adjuvant pain treatment in humans, while its mechanism remains to be illustrated. In rodent models of chronic pain, few studies reported the analgesic effect of music. Recently, Zhou et al. stated that the analgesic effects of sound depended on a low (5 dB) signal-to-noise ratio (SNR) relative to ambient noise in mice. However, despite employing multiple behavioral analysis approaches, we were unable to extend these findings to a mice model of chronic pain listening to the 5 dB SNR.

Evidence of Receptivity to Vibroacoustic Stimuli in the Spotted Lanternfly Lycorma delicatula (Hemiptera: Fulgoridae)

The spotted lanternfly Lycorma delicatula White (Hemiptera: Fulgoridae) is a polyphagous insect pest that invaded the United States in 2014, in Berks County, Pennsylvania. It has since spread to several northeastern states and poses a significant threat to northeastern grape production. Most studied species of Hemiptera are known to communicate intraspecifically using some form of substrate-borne vibrational signals, although such behavior has not yet been reported in L. delicatula. This report demonstrates that adult and fourth-instar L. delicatula were attracted towards broadcasts of 60-Hz vibroacoustic stimuli directed to a laboratory arena and test substrate, which suggests that both adults and fourth instar nymphs can perceive and respond to vibrational stimuli.

Predicting Vertical Ground Reaction Forces in Running from the Sound of Footsteps

From the point of view of measurement, footstep sounds represent a simple, wearable and inexpensive sensing opportunity to assess running biomechanical parameters. Therefore, the aim of this study was to investigate whether the sounds of footsteps can be used to predict the vertical ground reaction force profiles during running. Thirty-seven recreational runners performed overground running, and their sounds of footsteps were recorded from four microphones, while the vertical ground reaction force was recorded using a force plate. We generated nine different combinations of microphone data, ranging from individual recordings up to all four microphones combined. We trained machine learning models using these microphone combinations and predicted the ground reaction force profiles by a leave-one-out approach on the subject level. There were no significant differences in the prediction accuracy between the different microphone combinations (p < 0.05). Moreover, the machine learning model was able to predict the ground reaction force profiles with a mean Pearson correlation coefficient of 0.99 (range 0.79−0.999), mean relative root-mean-square error of 9.96% (range 2−23%) and mean accuracy to define rearfoot or forefoot strike of 77%. Our results demonstrate the feasibility of using the sounds of footsteps in combination with machine learning algorithms based on Fourier transforms to predict the ground reaction force curves. The results are encouraging in terms of the opportunity to create wearable technology to assess the ground reaction force profiles for runners in the interests of injury prevention and performance optimization.

Cross-modal associations between paintings and sounds: Effects of embodiment

The present study investigated cross-modal associations between a series of paintings and sounds. We studied the effects of sound congruency (congruent vs. non-congruent sounds) and embodiment (embodied vs. synthetic sounds) on the evaluation of abstract and figurative paintings. Participants evaluated figurative and abstract paintings paired with congruent and non-congruent embodied and synthetic sounds. They also evaluated the perceived meaningfulness of the paintings, aesthetic value and immersive experience of the paintings. Embodied sounds (sounds associated with bodily sensations, bodily movements and touch) were more strongly associated with figurative paintings, while synthetic sounds (non-embodied sounds) were more strongly associated with abstract paintings. Sound congruency increased the perceived meaningfulness, immersive experience and aesthetic value of paintings. Sound embodiment increased immersive experience of paintings.

Can Sound Alone Act as a Virtual Barrier for Horses? A Preliminary Study

Virtual fencing is an innovative alternative to conventional fences. Different systems have been studied, including electric-impulse-free systems. We tested the potential of self-applied acoustic stimulus in deterring the horses from further movement. Thirty warmblood horses were individually introduced to a designated corridor leading toward a food reward (variant F) or a familiar horse (variant S). As the subject reached a distance of 30, 15 or 5 m from a finish line, an acute alarming sound was played. Generally, a sudden and unknown sound was perceived by horses as a threat causing an increase in vigilance and sympathetic activation. Horses' behaviour and barrier effectiveness (80% for F vs. 20% for S) depended on motivator (F/S), while the cardiac response indicating some level of stress was similar. The motivation for social interactions was too strong to stop the horses from crossing a designated boundary. Conversely, the sound exposure distance did not vary the barrier effectiveness, but it differentiated HRV responses, with the strongest sympathetic activation noted at a distance of 5 m. Thus, the moment of a sound playback has important welfare implications. Due to the limited potential of sound as a virtual barrier, auditory cues cannot be used as an alternative for conventional fencing.

Statistical Pass-By for Unattended Road Traffic Noise Measurement in an Urban Environment

Low-noise surfaces have become a common mitigation action in the last decade, so much so that different methods for feature extraction have been established to evaluate their efficacy. Among these, the Close Proximity Index (CPX) evaluates the noise emissions by means of multiple runs at different speeds performed with a vehicle equipped with a reference tire and with acoustic sensors close to the wheel. However, signals acquired with CPX make it source oriented, and the analysis does not consider the real traffic flow of the studied site for a receiver-oriented approach. These aspects are remedied by Statistical Pass-By (SPB), a method based on sensor feature extraction with live detection of events; noise and speed acquisitions are performed at the roadside in real case scenarios. Unfortunately, the specific SPB requirements for its measurement setup do not allow an evaluation in urban context unless a special setup is used, but this may alter the acoustical context in which the measurement was performed. The present paper illustrates the testing and validation of a method named Urban Pass-By (U-SPB), developed during the LIFE NEREiDE project. U-SPB originates from standard SPB, exploits unattended measurements and develops an in-lab feature detection and extraction procedure. The U-SPB extends the evaluation in terms of before/after data comparison of the efficiency of low-noise laying in an urban context while combining the estimation of long-term noise levels and traffic parameters for other environmental noise purposes, such as noise mapping and action planning.

The Sonic Meanings of the Life and Death of My Disabled Brother: Listening as a Method for Qualitative Research

Long neglected listening is an underdeveloped element in western epistemology in general and in qualitative research in particular. However, recent developments in philosophy, sound art, anthropology, and qualitative research open promising pathways for mastering listening as a method and metaphor of inquiry also in health research, where understanding multiple layers of emotionally challenging experiences is crucial, yet often elusive. Through a sonic analysis of autobiographical data about life, death, and my disabled brother, I will try to demonstrate how paying attention to listening and sounds in research can add evolving layers of meaning to the data gathering and analyzing processes. Ultimately, such an analysis provides insights into a sibling's role as a caregiver by revealing mechanisms of nonconscious emotional coping and also into the acts of a disabled sibling as a teacher of subtle ways of listening.

Ambient ageism: Exploring ageism in acoustic representations of older adults in AgeTech advertisements

Ageing-in-place environments are increasingly marked by ambient digital technologies designed to keep older adults safe while they live independently at home. These AgeTech companies market their products by constructing imagined visual and aural worlds of the smart home, usually deploying ageist representations of ageing and older adults. The advertisements are multimodal, and while what is seen on screen is often considered most important in a visuo-centric western culture, scholars have argued that it is what audiences hear that has the greatest impact. The acoustic domain of AgeTech advertisements and its relationship to ageism in marketing has not yet been explored. Accordingly, this paper will address this gap by following Van Leeuwen's framework for critical analysis of musical discourse to explore what AgeTech companies say about ageing, older adults, and ageing-in-place technologies using sound in an illustrative set of smart home advertisements for ageing-in-place. The paper will discuss how music, voice, and sound are semiotic resources that are used to construct stereotypical (both negative and positive) portrayals of older adults, reinforce the narrative of "technology as saviour," and trouble the private/public boundaries of the ageing-in-place smart home.

Musical and Non-Musical Sounds Influence the Flavour Perception of Chocolate Ice Cream and Emotional Responses

Auditory cues, such as real-world sounds or music, influence how we perceive food. The main aim of the present study was to investigate the influence of negatively and positively valenced mixtures of musical and non-musical sounds on the affective states of participants and their perception of chocolate ice cream. Consuming ice cream while listening to liked music (LM) and while listening to the combination of liked music and pleasant sound (LMPS) conditions gave rise to more positive emotions than listening to just pleasant sound (PS). Consuming ice cream during the LM condition resulted in the longest duration of perceived sweetness. On the other hand, PS and LMPS conditions resulted in cocoa dominating for longer. Bitterness and roasted were dominant under the disliked music and unpleasant sound (DMUS) and DM conditions respectively. Positive emotions correlated well with the temporal sensory perception of sweetness and cocoa when consuming chocolate ice cream under the positively valenced auditory conditions. In contrast, negative emotions were associated with bitter and roasted tastes/flavours under the negatively valenced auditory conditions. The combination of pleasant music and non-musical sound conditions evoked more positive emotions than when either was presented in isolation. Taken together, the results of this study support the view that sensory attributes correlated well with emotions evoked when consuming ice cream under different auditory conditions varying in terms of their valence.

Coloured hearing, colour music, colour organs, and the search for perceptually meaningful correspondences between colour and sound

There has long been interest in the nature of the relationship(s) between hue and pitch or, in other words, between colour and musical/pure tones, stretching back at least as far as Newton, Goethe, Helmholtz, and beyond. In this narrative historical review, we take a closer look at the motivations that have lain behind the various assertions that have been made in the literature concerning the analogies, and possible perceptual similarities, between colour and sound. During the last century, a number of experimental psychologists have also investigated the nature of the correspondence between these two primary dimensions of perceptual experience. The multitude of different crossmodal mappings that have been put forward over the centuries are summarized, and a distinction drawn between physical/structural and psychological correspondences. The latter being further sub-divided into perceptual and affective categories. Interest in physical correspondences has typically been motivated by the structural similarities (analogous mappings) between the organization of perceptible dimensions of auditory and visual experience. Emphasis has been placed both on the similarity in terms of the number of basic categories into which pitch and colour can be arranged and also on the fact that both can be conceptualized as circular dimensions. A distinction is drawn between those commentators who have argued for a dimensional alignment of pitch and hue (based on a structural mapping), and those who appear to have been motivated by the existence of specific correspondences between particular pairs of auditory and visual stimuli instead (often, as we will see, based on the idiosyncratic correspondences that have been reported by synaesthetes). Ultimately, though, the emotional-mediation account would currently appear to provide the most parsimonious account for whatever affinity the majority of people experience between musical sounds and colour.

Customer Engagement in Multi-Sensory Virtual Reality Advertising: The Effect of Sound and Scent Congruence

Despite the power of VR in immersing viewers in an experience, it generally only targets viewers via visual and auditory cues. Human beings use more senses to gather information, so expectedly, the full potential of this medium is currently not yet tapped. This study contributes in answering two research questions: (1) How can conventional VR ads be enriched by also addressing the forgotten sense of smell?; and (2) Does doing so indeed instill more engaging experiences? A 2 × 3 between-subjects study (n = 235) is conducted, whereby an existing branded VR commercial (Boursin Sensorium Experience) is augmented with “sound” (on/off) and (congruent/incongruent/no) “scents.” The power of these sensory augmentations is evaluated by inspecting emotional, cognitive and conative dimensions of customer engagement. The results identify product-scent congruence (with sound) as a deal-maker, albeit product-scent incongruence is not necessarily a deal-breaker. The article concludes with further research avenues and a translation into managerial implications.

Who uses digital drugs? An international survey of 'binaural beat' consumers

INTRODUCTION

Digital drugs, or binaural beats claimed to elicit specific cognitive or emotional states, are a phenomenon about which little is known. In this brief report, we describe demographic and drug use correlates of binaural beat use, patterns of use, reasons for use and methods of access.

METHODS

The Global Drug Survey 2021 was translated into 11 languages; 30 896 responses were gathered from 22 countries.

RESULTS

The use of binaural beats to experience altered states was reported by 5.3% of the sample (median age 27; 60.5% male), with the highest rates from the United States, Mexico, Brazil, Poland, Romania and the United Kingdom. Controlling for all variables, age and non-male gender predicted binaural beat use, as did the recent use of cannabis, psychedelics and novel/new drugs. Respondents most commonly used binaural beats 'to relax or fall asleep' (72.2%) and 'to change my mood' (34.7%), while 11.7% reported trying 'to get a similar effect to that of other drugs'. This latter motivation was more commonly reported among those who used classic psychedelics (16.5% vs. 7.9%; P < 0.001). The majority sought to connect with themselves (53.1%) or 'something bigger than themselves' (22.5%) through the experience. Binaural beats were accessed primarily through video streaming sites via mobile phones.

DISCUSSION AND CONCLUSIONS

This paper establishes the existence of the phenomenon of listening to binaural beats to elicit changes in embodied and psychological states. Future research directions include the cultural context for consumption and proximate experiences, including co-use with ingestible drugs and other auditory phenomena.

Modular multilevel TMS device with wide output range and ultrabrief pulse capability for sound reduction

Objective.This article presents a novel transcranial magnetic stimulation (TMS) pulse generator with a wide range of pulse shape, amplitude, and width.Approach.Based on a modular multilevel TMS (MM-TMS) topology we had proposed previously, we realized the first such device operating at full TMS energy levels. It consists of ten cascaded H-bridge modules, each implemented with insulated-gate bipolar transistors, enabling both novel high-amplitude ultrabrief pulses as well as pulses with conventional amplitude and duration. The MM-TMS device can output pulses including up to 21 voltage levels with a step size of up to 1100 V, allowing relatively flexible generation of various pulse waveforms and sequences. The circuit further allows charging the energy storage capacitor on each of the ten cascaded modules with a conventional TMS power supply.Main results. The MM-TMS device can output peak coil voltages and currents of 11 kV and 10 kA, respectively, enabling suprathreshold ultrabrief pulses (>8.25μs active electric field phase). Further, the MM-TMS device can generate a wide range of near-rectangular monophasic and biphasic pulses, as well as more complex staircase-approximated sinusoidal, polyphasic, and amplitude-modulated pulses. At matched estimated stimulation strength, briefer pulses emit less sound, which could enable quieter TMS. Finally, the MM-TMS device can instantaneously increase or decrease the amplitude from one pulse to the next in discrete steps by adding or removing modules in series, which enables rapid pulse sequences and paired-pulse protocols with variable pulse shapes and amplitudes.Significance.The MM-TMS device allows unprecedented control of the pulse characteristics which could enable novel protocols and quieter pulses.

Headphone Audio in Training Systems or Systems That Convey Important Sound Information

In the work environment, miniature electroacoustic transducers are often used in communication, for the transmission of warning signals or during training. They can be used in headphones or mounted in personal protective equipment. It is often important to reproduce sounds accurately. The purpose of this work was to assess audio strips by comparing the frequency response of the signal in the electrical outputs of six common-purpose devices. Based on the risk of hearing damage, the level of noise exposure was assessed. The following headphones were investigated: low-budget closed-back, open-back for instant messengers, open-back for music, and in-ear. A head and torso simulator with a transfer function was used. The most uniform shape of the frequency response of the signal at the electrical outputs was found to be in smartphones. Sound cards integrated into laptop motherboards had highly unequal characteristics (up to 23 dB). In the case of one of the laptops, the upper range of the transmitted frequencies was limited to the 12,500 Hz band. An external sound card or wireless headphones can improve the situation. In the worst-case scenario, i.e., rock music, the listening time was limited to 2 h and 18 min.

Impact of Noise Exposure on Risk of Developing Stress-Related Health Effects Related to the Cardiovascular System: A Systematic Review and Meta-Analysis

Background

: Exposure to acute noise can cause an increase in biological stress reactions, which provides biological plausibility for a potential association between sustained noise exposure and stress-related health effects. However, the certainty in the evidence for an association between exposures to noise on short- and long-term biomarkers of stress has not been widely explored. The objective of this review was to evaluate the strength of evidence between noise exposure and changes in the biological parameters known to contribute to the development of stress-related adverse cardiovascular responses.

Materials and Methods

This systematic review comprises English language comparative studies available in PubMed, Cochrane Central, EMBASE, and CINAHL databases from January 1, 1980 to December 29, 2021. Where possible, random-effects meta-analyses were used to examine the effect of noise exposure from various sources on stress-related cardiovascular biomarkers. The risk of bias of individual studies was assessed using the risk of bias of nonrandomized studies of exposures instrument. The certainty of the body of evidence for each outcome was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Results

: The search identified 133 primary studies reporting on blood pressure, hypertension, heart rate, cardiac arrhythmia, vascular resistance, and cardiac output. Meta-analyses of blood pressure, hypertension, and heart rate suggested there may be signals of increased risk in response to a higher noise threshold or incrementally higher levels of noise. Across all outcomes, the certainty of the evidence was very low due to concerns with the risk of bias, inconsistency across exposure sources, populations, and studies and imprecision in the estimates of effects.

Conclusions

: This review identifies that exposure to higher levels of noise may increase the risk of some short- and long-term cardiovascular events; however, the certainty of the evidence was very low. This likely represents the inability to compare across the totality of the evidence for each outcome, underscoring the value of continued research in this area. Findings from this review may be used to inform policies of noise reduction or mitigation interventions.

Impact of Noise Exposure on Risk of Developing Stress-Related Obstetric Health Effects: A Systematic Review and Meta-Analysis

Background

Exposure to noise can increase biological stress reactions and that could increase the risk of stress-related prenatal effects, including adverse obstetric outcomes; however, the association between exposure to noise and adverse obstetric outcomes has not been extensively explored. The objective of this review was to evaluate the evidence between noise exposures and adverse obstetric outcomes, specifically preeclampsia, gestational diabetes, and gestational hypertension.

Materials and Methods

A systematic review of English language, comparative studies available in PubMed, Cochrane Central, EMBASE, and CINAHL databases between January 1, 1980 and December 29, 2021 was performed. Risk of bias for individual studies was assessed using the Risk of Bias Instrument for Nonrandomized Studies of Exposures, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the certainty of the body of evidence for each outcome.

Results

Six studies reporting on preeclampsia, gestational diabetes, and gestational hypertension were identified. Although some studies suggested there may be signals of increased responses to increased noise exposure for preeclampsia and gestational hypertension, the certainty in the evidence of an effect of increased noise on all the outcomes was very low due to concerns with risk of bias, inconsistency across studies, and imprecision in the effect estimates.

Conclusions

While the certainty of the evidence for noise exposure and adverse obstetric outcomes was very low, the findings from this review may be useful for directing further research in this area, as there is currently limited evidence available. These findings may also be useful for informing guidelines and policies involving noise exposure situations or environments.

[Visual and acoustic interventions for improving mental health in advanced age.]

Data accumulated in the last years indicate that certain visual and acoustic interventions are of geroprotective potential. Among them are bright light, white noise, and also rhythmic sensory stimulation (flickering light, binaural rhythms), etc. It should be noted that visual and acoustic interventions are simple in use, safe and practically do not have adverse side effects and do not need special medical control. Here, we review the studies on using the visual and acoustic interventions for improving mental health with regard to the advanced age and age-related pathology. We also discuss possible mechanisms of their therapeutic action and points for the future investigations.

Does Sound Influence Perceived Duration of Visual Motion?

Multimodal perception is a key factor in obtaining a rich and meaningful representation of the world. However, how each stimulus combines to determine the overall percept remains a matter of research. The present work investigates the effect of sound on the bimodal perception of motion. A visual moving target was presented to the participants, associated with a concurrent sound, in a time reproduction task. Particular attention was paid to the structure of both the auditory and the visual stimuli. Four different laws of motion were tested for the visual motion, one of which is biological. Nine different sound profiles were tested, from an easier constant sound to more variable and complex pitch profiles, always presented synchronously with motion. Participants' responses show that constant sounds produce the worst duration estimation performance, even worse than the silent condition; more complex sounds, instead, guarantee significantly better performance. The structure of the visual stimulus and that of the auditory stimulus appear to condition the performance independently. Biological motion provides the best performance, while the motion featured by a constant-velocity profile provides the worst performance. Results clearly show that a concurrent sound influences the unified perception of motion; the type and magnitude of the bias depends on the structure of the sound stimulus. Contrary to expectations, the best performance is not generated by the simplest stimuli, but rather by more complex stimuli that are richer in information.

Prediction of Oxygen Desaturation by Using Sound Data From a Noncontact Device: A Proof-of-Concept Study

OBJECTIVES/HYPOTHESIS

Prediction of the apnea-hypopnea index (AHI) from breathing sounds during sleep could be used to prescreen for obstructive sleep apnea (OSA). In addition, the oxygen desaturation index (ODI) is a known risk factor for developing cardiovascular disease in OSA patients. This study focused on estimation of ODI from a noncontact manner from sleep breathing sounds.

STUDY DESIGN

Retrospective study.

METHODS

Patients who visited the sleep center due to snoring or sleep apnea underwent polysomnography in lab overnight. Sound recordings were made during polysomnography using a microphone. After noise reduction, the sound data were segmented into 5 seconds windows and features were extracted. Binary classification and regression analyses were performed to estimate the ODI during sleep (model 1). This was re-tested after inclusion of body mass index (BMI) and age as additional features (model 2: BMI only, model 3: BMI and age).

RESULTS

We included 116 patients. The mean age and AHI of all patients were 50.4 ± 16.7 years and 23.0 ± 24.0 events/hr. In binary classification, for ODI cutoff values of 5, 15, and 30 events/hr, the areas under the curve were 0.88, 0.93, 0.91, respectively, and accuracies were 85.34, 86.21, and 87.07, respectively. In regression analysis, the correlation coefficient and mean absolute error were 0.80 and 9.60 events/hr, respectively. In models 2 and 3, the correlation coefficient and mean absolute error were 0.82, 9.44 events/hr and 0.81, 9.6 events/hr, respectively.

CONCLUSION

Prediction of ODI from sleep sound seems to be feasible. Additional clinical feature such as BMI may increase overall predictability.

LEVEL OF EVIDENCE

IV Laryngoscope, 2021.

The Effect of Sound Frequency and Intensity on Yeast Growth, Fermentation Performance and Volatile Composition of Beer

This study investigated the impact of varying sound conditions (frequency and intensity) on yeast growth, fermentation performance and production of volatile organic compounds (VOCs) in beer. Fermentations were carried out in plastic bags suspended in large water-filled containers fitted with underwater speakers. Ferments were subjected to either 200-800 or 800-2000 Hz at 124 and 140 dB @ 20 µPa. Headspace solid-phase microextraction (HS-SPME) coupled with gas chromatography-mass spectrometry (GC-MS) was used to identify and measure the relative abundance of the VOCs produced. Sound treatment had significant effects on the number of viable yeast cells in suspension at 10 and 24 h (p < 0.05), with control (silence) samples having the highest cell numbers. For wort gravity, there were significant differences between treatments at 24 and 48 h, with the silence control showing the lowest density before all ferments converged to the same final gravity at 140 h. A total of 33 VOCs were identified in the beer samples, including twelve esters, nine alcohols, three acids, three aldehydes, and six hop-derived compounds. Only the abundance of some alcohols showed any consistent response to the sound treatments. These results show that the application of audible sound via underwater transmission to a beer fermentation elicited limited changes to wort gravity and VOCs during fermentation.

Improved Environment-Aware-Based Noise Reduction System for Cochlear Implant Users Based on a Knowledge Transfer Approach: Development and Usability Study

BACKGROUND

Cochlear implant technology is a well-known approach to help deaf individuals hear speech again and can improve speech intelligibility in quiet conditions; however, it still has room for improvement in noisy conditions. More recently, it has been proven that deep learning-based noise reduction, such as noise classification and deep denoising autoencoder (NC+DDAE), can benefit the intelligibility performance of patients with cochlear implants compared to classical noise reduction algorithms.

OBJECTIVE

Following the successful implementation of the NC+DDAE model in our previous study, this study aimed to propose an advanced noise reduction system using knowledge transfer technology, called NC+DDAE_T; examine the proposed NC+DDAE_T noise reduction system using objective evaluations and subjective listening tests; and investigate which layer substitution of the knowledge transfer technology in the NC+DDAE_T noise reduction system provides the best outcome.

METHODS

The knowledge transfer technology was adopted to reduce the number of parameters of the NC+DDAE_T compared with the NC+DDAE. We investigated which layer should be substituted using short-time objective intelligibility and perceptual evaluation of speech quality scores as well as t-distributed stochastic neighbor embedding to visualize the features in each model layer. Moreover, we enrolled 10 cochlear implant users for listening tests to evaluate the benefits of the newly developed NC+DDAE_T.

RESULTS

The experimental results showed that substituting the middle layer (ie, the second layer in this study) of the noise-independent DDAE (NI-DDAE) model achieved the best performance gain regarding short-time objective intelligibility and perceptual evaluation of speech quality scores. Therefore, the parameters of layer 3 in the NI-DDAE were chosen to be replaced, thereby establishing the NC+DDAE_T. Both objective and listening test results showed that the proposed NC+DDAE_T noise reduction system achieved similar performances compared with the previous NC+DDAE in several noisy test conditions. However, the proposed NC+DDAE_T only required a quarter of the number of parameters compared to the NC+DDAE.

CONCLUSIONS

This study demonstrated that knowledge transfer technology can help reduce the number of parameters in an NC+DDAE while keeping similar performance rates. This suggests that the proposed NC+DDAE_T model may reduce the implementation costs of this noise reduction system and provide more benefits for cochlear implant users.

Music Is Served: How Acoustic Interventions in Hospital Dining Environments Can Improve Patient Mealtime Wellbeing

Eating-related challenges and discomforts arising from moderately acquired brain injuries (ABI)—including physiological and cognitive difficulties—can interfere with patients’ eating experience and impede the recovery process. At the same time, external environmental factors have been proven to be influential in our mealtime experience. This experimental pilot study investigates whether redesigning the sonic environment in hospital dining areas can positively influence ABI patients’ (n = 17) nutritional state and mealtime experience. Using a three-phase between-subjects interventional design, we investigate the effects of installing sound proofing materials and playing music during the lunch meals at a specialised ABI hospital unit. Comprising both quantitative and qualitative research approaches and data acquisition methods, this project provides multidisciplinary and holistic insights into the importance of attending to sound in hospital surroundings. Our results demonstrate that improved acoustics and music playback during lunch meals might improve the mealtime atmosphere, the patient well-being, and social interaction, which potentially supports patient food intake and nutritional state. The results are discussed in terms of potential future implications for the healthcare sector.

Development and Psychometric Testing of a Self-Rated Scale Based on National Nursing Core Competency Standards

BACKGROUND AND PURPOSE

The objectives of this study were to develop a National Nursing Core Competency Standards (NNCCS)-based instrument and determine its construct validity and internal consistency reliability.

METHODS

A methodologic research design was used to validate the 59-item scale based on the responses of 600 nurses. The scale items were culled from the client care, leadership and management, and research competencies identified in the NNCCS.

RESULTS

The results of the analyses confirmed 53 items and gave rise to a five-factor solution. The five dimensions are leadership, management, research, ethico-legal, and strategic competencies.

CONCLUSIONS

The seminal psychometric testing provided an evidence of acceptable validity and reliability of the proposed instrument. Further testing was recommended to accrue the psychometric soundness of the instrument.

Corrigendum: May I Smell Your Attention: Exploration of Smell and Sound for Visuospatial Attention in Virtual Reality

[This corrects the article DOI: 10.3389/fpsyg.2021.671470.].

Musical Scents: On the Surprising Absence of Scented Musical/Auditory Events, Entertainments, and Experiences

The matching of scents with music is both one of the most natural (or intuitive) of crossmodal correspondences and, at the same time, one of the least frequently explored combinations of senses in an entertainment and multisensory experiential design context. This narrative review highlights the various occasions over the last century or two when scents and sounds have coincided, and the various motivations behind those who have chosen to bring these senses together: This has included everything from the masking of malodour to the matching of the semantic meaning or arousal potential of the two senses, through to the longstanding and recently-reemerging interest in the crossmodal correspondences (now that they have been distinguished from the superficially similar phenomenon of synaesthesia, with which they were previously often confused). As such, there exist a number of ways in which these two senses can be incorporated into meaningful multisensory experiences that can potentially resonate with the public. Having explored the deliberate combination of scent and music (or sound) in everything from "scent-sory" marketing through to fragrant discos and olfactory storytelling, I end by summarizing some of the opportunities around translating such unusual multisensory experiences from the public to the private sphere. This will likely be via the widespread dissemination of sensory apps that promise to convert (or translate) from one sense (likely scent) to another (e.g., music), as has, for example already started to occur in the world of music selections to match the flavour of specific wines.

Promoting Healthier Drinking Habits: Using Sound to Encourage the Choice for Non-Alcoholic Beers in E-Commerce

Important institutions, such as the World Health Organization, recommend reducing alcohol consumption by encouraging healthier drinking habits. This could be achieved, for example, by employing more effective promotion of non-alcoholic beverages. For such purposes, in this study, we assessed the role of experiential beer packaging sounds during the e-commerce experience of a non-alcoholic beer (NAB). Here, we designed two experiments. Experiment 1 evaluated the influence of different experiential beer packaging sounds on consumers' general emotions and sensory expectations. Experiment 2 assessed how the sounds that evoked more positive results in Experiment 1 would influence emotions and sensory expectations related to a NAB digital image. The obtained results revealed that a beer bottle pouring sound helped suppress some of the negativity that is commonly associated with the experience of a NAB. Based on such findings, brands and organizations interested in more effectively promoting NAB may feel encouraged to involve beer packaging sounds as part of their virtual shopping environments.

Silence is Golden: Auditory Preferences in Zoo-housed Gorillas

Enrichment is presented to improve the welfare of captive animals but sound is frequently presented with the assumption that it is enriching without assessing individuals' preferences. Typically, presented sounds are unnatural and animals are unable to choose which sounds they can listen to or escape them. We examined preferences of three zoo-housed gorillas for six categories of sound. The gorillas selected unique icons on a computer touchscreen that initiated brief samples of silence, white noise, nature, animal, percussion, and electronic instrumental sounds. Following training, gorillas selected each sound paired with silence (Phase 2), each sound paired with each other sound (Phase 3), and one sound among all other sound categories (Phase 4). Initially, a single sound was associated with each icon, but additional exemplars of the category were added in phases 5-8. Preferences were generally stable and one gorilla showed a strong preference for silence. Although there were individual differences, a surprising general preference for unnatural over natural sounds was revealed. These results indicate the importance of assessing preferences for individuals before introducing auditory stimulation in captive habitats.

Newborn Incubators Do Not Protect from High Noise Levels in the Neonatal Intensive Care Unit and Are Relevant Noise Sources by Themselves

BACKGROUND

While meaningful sound exposure has been shown to be important for newborn development, an excess of noise can delay the proper development of the auditory cortex.

AIM

The aim of this study was to assess the acoustic environment of a preterm baby in an incubator on a newborn intensive care unit (NICU).

METHODS

An empty but running incubator (Giraffe Omnibed, GE Healthcare) was used to evaluate the incubator frequency response with 60 measurements. In addition, a full day and night period outside and inside the incubator at the NICU of the University Hospital Zurich was acoustically analyzed.

RESULTS

The fan construction inside the incubator generates noise in the frequency range of 1.3-1.5 kHz with a weighted sound pressure level (SPL) of 40.5 dB(A). The construction of the incubator narrows the transmitted frequency spectrum of sound entering the incubator to lower frequencies, but it does not attenuate transient noises such as alarms or opening and closing of cabinet doors substantially. Alarms, as generated by the monitors, the incubator, and additional devices, still pass to the newborn.

CONCLUSIONS

The incubator does protect only insufficiently from noise coming from the NICUThe transmitted frequency spectrum is changed, limiting the impact of NICU noise on the neonate, but also limiting the neonate's perception of voices. The incubator, in particular its fan, as well as alarms from patient monitors are major sources of noise. Further optimizations with regard to the sound exposure in the NICU, as well as studies on the role of the incubator as a source and modulator, are needed to meet the preterm infants' multi-sensory needs.