A two-microphone noise reduction system for cochlear implant users with nearby microphones. Part II: Performance Evaluation

Users of cochlear implants (auditory aids, which stimulate the auditory nerve electrically at the inner ear) often suffer from poor speech understanding in noise. We evaluate a small (intermicrophone distance 7 mm) and computationally inexpensive adaptive noise reduction system suitable for behind-the-ear cochlear implant speech processors. The system is evaluated in simulated and real, anechoic and reverberant environments. Results from simulations show improvements of 3.4 to 9.3 dB in signal to noise ratio for rooms with realistic reverberation and more than 18 dB under anechoic conditions. Speech understanding in noise is measured in 6 adult cochlear implant users in a reverberant room, showing average improvements of 7.9–9.6 dB, when compared to a single omnidirectional microphone or 1.3–5.6 dB, when compared to a simple directional two-microphone device. Subjective evaluation in a cafeteria at lunchtime shows a preference of the cochlear implant users for the evaluated device in terms of speech understanding and sound quality.

Transalveolar maxillary sinus floor elevation using osteotomes with or without grafting material. Part II: Radiographic tissue remodeling

OBJECTIVES: To evaluate the pattern of tissue remodeling after maxillary sinus floor elevation using the transalveolar osteotome technique with or without utilizing grafting materials. METHODS: During the period of 2000-2005, 252 Straumann dental implants were inserted using the transalveolar sinus floor elevation technique in a group of 181 patients. For 88 or 35% of those implants, deproteinized bovine bone mineral with a particle size of 0.25-1 mm was used as the grafting material, but for the remaining 164 implants, no grafting material was utilized. Periapical radiographs were obtained with a paralleling technique and digitized. Two investigators, who were blinded to whether grafting material was used or not, subsequently evaluated the pattern of tissue remodeling. RESULTS: The mean residual bone height was 7.5 mm (SD 2.2 mm), ranging from 2 to 12.7 mm. The mean residual bone height for implants placed with grafting material (6.4 mm) was significantly less compared with the implants installed without grafting material (8.1 mm). The implants penetrated on average 3.1 mm (SD 1.7 mm) into the sinus cavity. The measured mean radiographic bone gain using the transalveolar technique without grafting material was significantly less, 1.7 mm (SD 2 mm) compared with a mean bone gain of 4.1 mm (SD 2.4 mm), when grafting material was used. Furthermore, the probability of gaining 2 mm or more of new bone was 39.1% when no grafting material was used. The probability increased to 77.9% when the implants were installed with grafting material. CONCLUSION: When the transalveolar sinus floor elevation was performed without utilizing grafting material, only a moderate gain of new bone could be detected mesial and distal to the implants. On the other hand, when grafting material was used, a substantial gain of new bone was usually seen on the radiographs.

The HeartQoL: Part II. Validation of a new core health-related quality of life questionnaire for patients with ischemic heart disease

Background: Evaluation of health-related quality of life (HRQL) is important in improving the quality of patient care. The aim of this study was to determine the psychometric properties of the HeartQoL in patients with ischemic heart disease (IHD), specifically angina, myocardial infarction (MI), or ischemic heart failure. Methods: Data for the interim validation of the HeartQoL questionnaire were collected in (a) a cross-sectional survey and (b) a prospective substudy of patients undergoing either a percutaneous coronary intervention (PCI) or referred to cardiac rehabilitation (CR) and were then analyzed to determine the reliability, validity, and responsiveness of the HeartQoL questionnaire. Results: We enrolled 6384 patients (angina, n = 2111, 33.1%; MI, n = 2351, 36.8%; heart failure, n = 1922, 30.1%) across 22 countries speaking 15 languages in the cross-sectional study and 730 patients with IHD in the prospective substudy. The HeartQoL questionnaire comprises 14-items with physical and emotional subscales and a global score (range 0–3 (poor to better HRQL). Cronbach’s α was consistently ≥0.80; convergent validity correlations between similar HeartQoL and SF-36 subscales were significant (r ≥ 0.60, p < 0.001); discriminative validity was confirmed with predictor variables: health transition, anxiety, depression, and functional status. HeartQoL score changes following either PCI or CR were significant (p < 0.001) with effect sizes ranging from 0.37–0.64. Conclusion: The HeartQoL questionnaire is reliable, valid, and responsive to change allowing clinicians and researchers to (a) assess baseline HRQL, (b) make between-diagnosis comparisons of HRQL, and (c) evaluate change in HRQL in patients with angina, MI, or heart failure with a single IHD-specific HRQL instrument.

State-of-the-art aortic imaging: Part II - applications in transcatheter aortic valve replacement and endovascular aortic aneurysm repair.

Transcatheter aortic valve replacement (TAVR) as well as thoracic and abdominal endovascular aortic repair (TEVAR and EVAR) rely on accurate pre- and postprocedural imaging. This review article discusses the application of imaging, including preprocedural assessment and measurements as well as postprocedural imaging of complications. Furthermore, the exciting perspective of computational fluid dynamics (CFD) based on cross-sectional imaging is presented. TAVR is a minimally invasive alternative for treatment of aortic valve stenosis in patients with high age and multiple comorbidities who cannot undergo traditional open surgical repair. Given the lack of direct visualization during the procedure, pre- and peri-procedural imaging forms an essential part of the intervention. Computed tomography angiography (CTA) is the imaging modality of choice for preprocedural planning. Routine postprocedural follow-up is performed by echocardiography to confirm treatment success and detect complications. EVAR and TEVAR are minimally invasive alternatives to open surgical repair of aortic pathologies. CTA constitutes the preferred imaging modality for both preoperative planning and postoperative follow-up including detection of endoleaks. Magnetic resonance imaging is an excellent alternative to CT for postoperative follow-up, and is especially beneficial for younger patients given the lack of radiation. Ultrasound is applied in screening and postoperative follow-up of abdominal aortic aneurysms, but cross-sectional imaging is required once abnormalities are detected. Contrast-enhanced ultrasound may be as sensitive as CTA in detecting endoleaks.

Monte Carlo modeling of polarized light propagation: Stokes vs Jones - Part II

In this second part of our comparative study inspecting the (dis)similarities between “Stokes” and “Jones,” we present simulation results yielded by two independent Monte Carlo programs: (i) one developed in Bern with the Jones formalism and (ii) the other implemented in Ulm with the Stokes notation. The simulated polarimetric experiments involve suspensions of polystyrene spheres with varying size. Reflection and refraction at the sample/air interfaces are also considered. Both programs yield identical results when propagating pure polarization states, yet, with unpolarized illumination, second order statistical differences appear, thereby highlighting the pre-averaged nature of the Stokes parameters. This study serves as a validation for both programs and clarifies the misleading belief according to which “Jones cannot treat depolarizing effects.”

All-ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of the survival and complication rates. Part II: Multiple-unit FDPs.

OBJECTIVE To assess the 5-year survival of metal-ceramic and all-ceramic tooth-supported fixed dental prostheses (FDPs) and to describe the incidence of biological, technical and esthetic complications. METHODS Medline (PubMed), Embase and Cochrane Central Register of Controlled Trials (CENTRAL) searches (2006-2013) were performed for clinical studies focusing on tooth-supported FDPs with a mean follow-up of at least 3 years. This was complemented by an additional hand search and the inclusion of 10 studies from a previous systematic review [1]. Survival and complication rates were analyzed using robust Poisson's regression models to obtain summary estimates of 5-year proportions. RESULTS Forty studies reporting on 1796 metal-ceramic and 1110 all-ceramic FDPs fulfilled the inclusion criteria. Meta-analysis of the included studies indicated an estimated 5-year survival rate of metal-ceramic FDPs of 94.4% (95% CI: 91.2-96.5%). The estimated survival rate of reinforced glass ceramic FDPs was 89.1% (95% CI: 80.4-94.0%), the survival rate of glass-infiltrated alumina FDPs was 86.2% (95% CI: 69.3-94.2%) and the survival rate of densely sintered zirconia FDPs was 90.4% (95% CI: 84.8-94.0%) in 5 years of function. Even though the survival rate of all-ceramic FDPs was lower than for metal-ceramic FDPs, the differences did not reach statistical significance except for the glass-infiltrated alumina FDPs (p=0.05). A significantly higher incidence of caries in abutment teeth was observed for densely sintered zirconia FDPs compared to metal-ceramic FDPs. Significantly more framework fractures were reported for reinforced glass ceramic FDPs (8.0%) and glass-infiltrated alumina FDPs (12.9%) compared to metal-ceramic FDPs (0.6%) and densely sintered zirconia FDPs (1.9%) in 5 years in function. However, the incidence of ceramic fractures and loss of retention was significantly (p=0.018 and 0.028 respectively) higher for densely sintered zirconia FDPs compared to all other types of FDPs. CONCLUSIONS Survival rates of all types of all-ceramic FDPs were lower than those reported for metal-ceramic FDPs. The incidence of framework fractures was significantly higher for reinforced glass ceramic FDPs and infiltrated glass ceramic FDPs, and the incidence for ceramic fractures and loss of retention was significantly higher for densely sintered zirconia FDPs compared to metal-ceramic FDPs.

Shaping EU trade agreements to support human rights

Trade between Europe and developing countries should be shaped such that market shares are just and trade flows foster sustainable development. But this is not always the case. While developing countries have much to gain from trade, they can also suffer serious losses. This is especially apparent with regard to food security, which often depends largely on smallholders and informal markets in poorer countries. This policy brief sketches the link between trade and the right to food, and describes how integration of Human Rights Impact Assessments in EU trade policy can help ensure sustainable trade regimes that do not cause undue harm.

Integration of temporal and semantic components into the Geographic Information. Part II: Methodology

The overall objective of this research project is to enrich geographic data with temporal and semantic components in order to significantly improve spatio-temporal analysis of geographic phenomena. To achieve this goal, we intend to establish and incorporate three new layers (structures) into the core of the Geographic Information by using mark-up languages as well as defining a set of methods and tools for enriching the system to make it able to retrieve and exploit such layers (semantic-temporal, geosemantic, and incremental spatio-temporal). Besides these layers, we also propose a set of models (temporal and spatial) and two semantic engines that make the most of the enriched geographic data. The roots of the project and its definition have been previously presented in Siabato & Manso-Callejo 2011. In this new position paper, we extend such work by delineating clearly the methodology and the foundations on which we will base to define the main components of this research: the spatial model, the temporal model, the semantic layers, and the semantic engines. By putting together the former paper and this new work we try to present a comprehensive description of the whole process, from pinpointing the basic problem to describing and assessing the solution. In this new article we just mention the methods and the background to describe how we intend to define the components and integrate them into the GI.

Prediction of wake effects on wind farm power production using a RANS approach. Part II. Offshore: Case studies from the UPWIND project

The estimation of power losses due to wind turbine wakes is crucial to understanding overall wind farm economics. This is especially true for large offshore wind farms, as it represents the primary source of losses in available power, given the regular arrangement of rotors, their generally largerdiameter and the lower ambient turbulence level, all of which conspire to dramatically affect wake expansion and, consequently, the power deficit. Simulation of wake effects in offshore wind farms (in reasonable computational time) is currently feasible using CFD tools. An elliptic CFD model basedon the actuator disk method and various RANS turbulence closure schemes is tested and validated using power ratios extracted from Horns Rev and Nysted wind farms, collected as part of the EU-funded UPWIND project. The primary focus of the present work is on turbulence modeling, as turbulent mixing is the main mechanism for flow recovery inside wind farms. A higher-order approach, based on the anisotropic RSM model, is tested to better take into account the imbalance in the length scales inside and outside of the wake, not well reproduced by current two-equation closure schemes.

Code assessment and modelling for Design Basis Accident analysis of the European Sodium Fast Reactor design. Part II: Optimised core and representative transients analysis

The new reactor concepts proposed in the Generation IV International Forum require the development and validation of computational tools able to assess their safety performance. In the first part of this paper the models of the ESFR design developed by several organisations in the framework of the CP-ESFR project were presented and their reliability validated via a benchmarking exercise. This second part of the paper includes the application of those tools for the analysis of design basis accident (DBC) scenarios of the reference design. Further, this paper also introduces the main features of the core optimisation process carried out within the project with the objective to enhance the core safety performance through the reduction of the positive coolant density reactivity effect. The influence of this optimised core design on the reactor safety performance during the previously analysed transients is also discussed. The conclusion provides an overview of the work performed by the partners involved in the project towards the development and enhancement of computational tools specifically tailored to the evaluation of the safety performance of the Generation IV innovative nuclear reactor designs.

The laws of Harvard College, Part II, 1767

Handwritten soft-cover copy of the 1767 College laws labeled as "Part II" and consisting of chapters VI to X.

The Strasbourg View on the Charter of Fundamental Rights. Research Paper in Law (Cooperative Research Paper) 03/2013

From the Introduction. May I say how delighted I am at this opportunity of talking to you today about the perspective of a Strasbourg judge on the Charter of Fundamental Rights of the European Union. It goes without saying that the views I here express are not to be attributed to the Court itself; yet they may be taken as reflecting, in a general sense, what I regard to be the Strasbourg approach.

The Triangular Relationship between Fundamental Rights, Democracy and the Rule of Law in the EU: Towards an EU Copenhagen Mechanism. CEPS Paperbacks. November 2013

This study examines the protection of fundamental rights, democracy and rule of law in the European Union, and the challenges that arise in reflecting on ways to strengthen EU competences in these contested terrains. It provides a ‘state of play’ and critical account of EU-level policy and legal mechanisms assessing the relationship between rule of law, democracy and fundamental rights in the member states of the Union. The cross-cutting challenges affecting their uses, effective implementation and practical operability constitute a central point of the analysis. The study argues that the relationship between rule of law, democracy and fundamental rights is co-constitutive. Any future rule of law-related policy discussion in the EU should start from an understanding of the triangular relationship between these dimensions from the perspective of ‘democratic rule of law with fundamental rights’, i.e. the legally based rule of a democratic state that delivers fundamental rights. The three criteria are inherently and indivisibly interconnected, and interdependent on each of the others, and they cannot be separated without inflicting profound damage to the whole and changing its essential shape and configuration.