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Ye Y, Mattingly MM, Sunthimer MJ, Gay JD, Rosen MJ. Early-Life Stress Impairs Perception and Neural Encoding of Rapid Signals in the Auditory Pathway. J Neurosci 2023; 43:3232-3244. [PMID: 36973014 PMCID: PMC10162457 DOI: 10.1523/jneurosci.1787-22.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 01/24/2023] [Accepted: 03/03/2023] [Indexed: 03/29/2023] Open
Abstract
During developmental critical periods (CPs), early-life stress (ELS) induces cognitive deficits and alters neural circuitry in regions underlying learning, memory, and attention. Mechanisms underlying critical period plasticity are shared by sensory cortices and these higher neural regions, suggesting that sensory processing may also be vulnerable to ELS. In particular, the perception and auditory cortical (ACx) encoding of temporally-varying sounds both mature gradually, even into adolescence, providing an extended postnatal window of susceptibility. To examine the effects of ELS on temporal processing, we developed a model of ELS in the Mongolian gerbil, a well-established model for auditory processing. In both male and female animals, ELS induction impaired the behavioral detection of short gaps in sound, which are critical for speech perception. This was accompanied by reduced neural responses to gaps in auditory cortex, the auditory periphery, and auditory brainstem. ELS thus degrades the fidelity of sensory representations available to higher regions, and could contribute to well-known ELS-induced problems with cognition.SIGNIFICANCE STATEMENT In children and animal models, early-life stress (ELS) leads to deficits in cognition, including problems with learning, memory, and attention. Such problems could arise in part from a low-fidelity representation of sensory information available to higher-level neural regions. Here, we demonstrate that ELS degrades sensory responses to rapid variations in sound at multiple levels of the auditory pathway, and concurrently impairs perception of these rapidly-varying sounds. As these sound variations are intrinsic to speech, ELS may thus pose a challenge to communication and cognition through impaired sensory encoding.
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Affiliation(s)
- Yi Ye
- Hearing Research Group, Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, Ohio, 44272
- Brain Health Research Institute, Kent State University, Kent, Ohio, 44242
| | - Michelle M Mattingly
- Hearing Research Group, Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, Ohio, 44272
| | - Matthew J Sunthimer
- Hearing Research Group, Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, Ohio, 44272
| | - Jennifer D Gay
- Hearing Research Group, Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, Ohio, 44272
- Department of Otolaryngology, Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, 08901
| | - Merri J Rosen
- Hearing Research Group, Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, Ohio, 44272
- Brain Health Research Institute, Kent State University, Kent, Ohio, 44242
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Fawcett TJ, Longenecker RJ, Brunelle DL, Berger JI, Wallace MN, Galazyuk AV, Rosen MJ, Salvi RJ, Walton JP. Universal automated classification of the acoustic startle reflex using machine learning. Hear Res 2023; 428:108667. [PMID: 36566642 PMCID: PMC10734095 DOI: 10.1016/j.heares.2022.108667] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
The startle reflex (SR), a robust, motor response elicited by an intense auditory, visual, or somatosensory stimulus has been widely used as a tool to assess psychophysiology in humans and animals for almost a century in diverse fields such as schizophrenia, bipolar disorder, hearing loss, and tinnitus. Previously, SR waveforms have been ignored, or assessed with basic statistical techniques and/or simple template matching paradigms. This has led to considerable variability in SR studies from different laboratories, and species. In an effort to standardize SR assessment methods, we developed a machine learning algorithm and workflow to automatically classify SR waveforms in virtually any animal model including mice, rats, guinea pigs, and gerbils obtained with various paradigms and modalities from several laboratories. The universal features common to SR waveforms of various species and paradigms are examined and discussed in the context of each animal model. The procedure describes common results using the SR across species and how to fully implement the open-source R implementation. Since SR is widely used to investigate toxicological or pharmaceutical efficacy, a detailed and universal SR waveform classification protocol should be developed to aid in standardizing SR assessment procedures across different laboratories and species. This machine learning-based method will improve data reliability and translatability between labs that use the startle reflex paradigm.
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Affiliation(s)
- Timothy J Fawcett
- Global Center for Hearing and Speech Research, University of South Florida, Tampa, FL, USA; Research Computing, University of South Florida, Tampa, FL, USA.
| | - Ryan J Longenecker
- Sound Pharmaceuticals Inc, 4010 Stone Way N., Suite 120, Seattle, WA 98103, USA
| | - Dimitri L Brunelle
- Global Center for Hearing and Speech Research, University of South Florida, Tampa, FL, USA
| | - Joel I Berger
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Mark N Wallace
- Hearing Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Alex V Galazyuk
- Hearing Research Group, Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Merri J Rosen
- Hearing Research Group, Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Richard J Salvi
- Center for Hearing and Deafness, University at Buffalo, University of Buffalo, USA
| | - Joseph P Walton
- Global Center for Hearing and Speech Research, University of South Florida, Tampa, FL, USA; Department of Medical Engineering, University of South Florida, Tampa, FL, USA; Department of Communication Sciences and Disorders, University of South Florida, Tampa, FL, USA.
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Gay JD, Rosen MJ, Huyck JJ. Effects of Gap Position on Perceptual Gap Detection Across Late Childhood and Adolescence. J Assoc Res Otolaryngol 2020; 21:243-258. [PMID: 32488537 DOI: 10.1007/s10162-020-00756-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 04/28/2020] [Indexed: 11/27/2022] Open
Abstract
The ability to detect a silent gap within a sound is critical for accurate speech perception, and gap detection has been shown to have an extended developmental trajectory. In certain conditions, the detectability of the gap decreases as the gap is placed closer to the beginning of the signal. Early in development, the detection of gaps shortly after signal onset may be especially difficult due to immaturities in the encoding and perception of rapidly changing sounds. The present study explored the development of gap detection from age 8 to 19 years, specifically when the temporal placement of the gap varied. Performance improved with age for all temporal placements of the gap, demonstrating a gradual maturation of gap detection abilities throughout adolescence. Younger adolescents did not benefit from increasing gap onset times, while older adolescents' thresholds gradually improved as gap onset time lengthened. Regardless of age, listeners learned between the two testing days but did not improve within days. Younger adolescents had poorer thresholds for the last block of testing on the second day, returning to baseline performance despite learning between days. These data support earlier studies showing that gaps are harder to detect near stimulus onset and confirm that gap detection abilities continue to mature into adolescence. The data also suggest that younger adolescents do not receive the same benefit of increasing gap onset time and respond differently to repeated testing than older adolescents and young adults.
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Affiliation(s)
- Jennifer D Gay
- Department of Anatomy & Neurobiology, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH, 44272, USA.,Biomedical Sciences Program, Kent State University, 800 East Summit St, Kent, OH, 44242, USA
| | - Merri J Rosen
- Department of Anatomy & Neurobiology, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH, 44272, USA.,Kent State Brain Health Research Institute, Kent State University, 251M Integrated Sciences Building, 1175 Lefton Esplanade, Kent, OH, 44242, USA
| | - Julia Jones Huyck
- Kent State Brain Health Research Institute, Kent State University, 251M Integrated Sciences Building, 1175 Lefton Esplanade, Kent, OH, 44242, USA. .,Speech Pathology and Audiology Program, Kent State University, 1325 Theatre Drive, Kent, OH, 44242, USA.
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Fleming G, Wright BA, Wilson DA. The Value of Homework: Exposure to Odors in the Home Cage Enhances Odor-Discrimination Learning in Mice. Chem Senses 2020; 44:135-143. [PMID: 30590399 DOI: 10.1093/chemse/bjy083] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Perceptual learning is an enhancement in discriminability of similar stimuli following experience with those stimuli. Here, we examined the efficacy of adding additional active training following a standard training session, compared with additional stimulus exposure in the absence of associated task performance. Mice were trained daily in an odor-discrimination task, and then, several hours later each day, received 1 of 3 different manipulations: 1) a second active-training session, 2) non-task-related odor exposure in the home cage, or 3) no second session. For home-cage exposure, odorants were presented in small tubes that mice could sniff and investigate for a similar period of time as in the active discrimination task each day. The results demonstrate that daily home-cage exposure was equivalent to active odor training in supporting improved odor discrimination. Daily home-cage exposure to odorants that did not match those used in the active task did not improve learning, yielding outcomes similar to those obtained with no second session. Piriform cortical local field potential recordings revealed that both sampling in the active learning task and investigation in the home cage evoked similar beta band oscillatory activity. Together the results suggest that odor-discrimination learning can be significantly enhanced by addition of odor exposure outside of the active training task, potentially because of the robust activity evoked in the olfactory system by both exposure paradigms. They further suggest that odorant exposure alone could enhance or maintain odor-discrimination abilities in conditions associated with olfactory impairment, such as aging or dementia.
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Affiliation(s)
- Gloria Fleming
- Emotional Brain Institute, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Beverly A Wright
- Department of Communication Sciences and Disorders, Knowles Hearing Center, Northwestern University, Evanston, IL, USA.,Center for Neural Science, New York University, New York, NY, USA
| | - Donald A Wilson
- Emotional Brain Institute, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA.,Center for Neural Science, New York University, New York, NY, USA.,Department of Child and Adolescent Psychiatry, New York Langone School of Medicine, New York, NY, USA
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Pienkowski M. Prolonged Exposure of CBA/Ca Mice to Moderately Loud Noise Can Cause Cochlear Synaptopathy but Not Tinnitus or Hyperacusis as Assessed With the Acoustic Startle Reflex. Trends Hear 2019. [PMID: 29532738 PMCID: PMC5858683 DOI: 10.1177/2331216518758109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Hearing loss changes the auditory brain, sometimes maladaptively. When deprived of cochlear input, central auditory neurons become more active spontaneously and begin to respond more strongly and synchronously to better preserved sound frequencies. This spontaneous and sound-evoked central hyperactivity has been postulated to trigger tinnitus and hyperacusis, respectively. Localized hyperactivity has also been observed after long-term exposure to noise levels that do not damage the cochlea. Adult animals exposed to bands of nondamaging noise exhibited suppressed spontaneous and sound-evoked activity in the area of primary auditory cortex (A1) stimulated by the exposure band but had increased spontaneous and evoked activity in neighboring A1 areas. We hypothesized that the cortically suppressed frequencies should for some time after exposure be perceived as less loud than before (hypoacusis), whereas the hyperactivity outside of the exposure band might lead to frequency-specific hyperacusis or tinnitus. To investigate this, adult CBA/Ca mice were exposed for >2 months to 8 to 16 kHz noise at 70 or 75 dB sound pressure level and tested for hypo-/hyperacusis and tinnitus using tone and gap prepulse inhibition of the acoustic startle reflex. Auditory brainstem responses and distortion product otoacoustic emissions showed evidence of cochlear synaptopathy after exposure at 75 but not 70 dB, putting a lower bound on damaging noise levels for CBA/Ca mice. Contrary to hypothesis, neither exposure significantly shifted startle results from baseline. These negative findings nevertheless have implications for startle test methodology and for the putative role of central hyperactivity in hyperacusis and tinnitus.
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Affiliation(s)
- Martin Pienkowski
- 1 Osborne College of Audiology, Salus University, Elkins Park, PA, USA
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Neural Variability Limits Adolescent Skill Learning. J Neurosci 2019; 39:2889-2902. [PMID: 30755494 DOI: 10.1523/jneurosci.2878-18.2019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/24/2019] [Accepted: 01/26/2019] [Indexed: 12/31/2022] Open
Abstract
Skill learning is fundamental to the acquisition of many complex behaviors that emerge during development. For example, years of practice give rise to perceptual improvements that contribute to mature speech and language skills. While fully honed learning skills might be thought to offer an advantage during the juvenile period, the ability to learn actually continues to develop through childhood and adolescence, suggesting that the neural mechanisms that support skill learning are slow to mature. To address this issue, we asked whether the rate and magnitude of perceptual learning varies as a function of age as male and female gerbils trained on an auditory task. Adolescents displayed a slower rate of perceptual learning compared with their young and mature counterparts. We recorded auditory cortical neuron activity from a subset of adolescent and adult gerbils as they underwent perceptual training. While training enhanced the sensitivity of most adult units, the sensitivity of many adolescent units remained unchanged, or even declined across training days. Therefore, the average rate of cortical improvement was significantly slower in adolescents compared with adults. Both smaller differences between sound-evoked response magnitudes and greater trial-to-trial response fluctuations contributed to the poorer sensitivity of individual adolescent neurons. Together, these findings suggest that elevated sensory neural variability limits adolescent skill learning.SIGNIFICANCE STATEMENT The ability to learn new skills emerges gradually as children age. This prolonged development, often lasting well into adolescence, suggests that children, teens, and adults may rely on distinct neural strategies to improve their sensory and motor capabilities. Here, we found that practice-based improvement on a sound detection task is slower in adolescent gerbils than in younger or older animals. Neural recordings made during training revealed that practice enhanced the sound sensitivity of adult cortical neurons, but had a weaker effect in adolescents. This latter finding was partially explained by the fact that adolescent neural responses were more variable than in adults. Our results suggest that one mechanistic basis of adult-like skill learning is a reduction in neural response variability.
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Huyck JJ, Rosen MJ. Development of perception and perceptual learning for multi-timescale filtered speech. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2018; 144:667. [PMID: 30180675 DOI: 10.1121/1.5049369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 07/18/2018] [Indexed: 06/08/2023]
Abstract
The perception of temporally changing auditory signals has a gradual developmental trajectory. Speech is a time-varying signal, and slow changes in speech (filtered at 0-4 Hz) are preferentially processed by the right hemisphere, while the left extracts faster changes (filtered at 22-40 Hz). This work examined the ability of 8- to 19-year-olds to both perceive and learn to perceive filtered speech presented diotically for each filter type (low vs high) and dichotically for preferred or non-preferred laterality. Across conditions, performance improved with increasing age, indicating that the ability to perceive filtered speech continues to develop into adolescence. Across age, performance was best when both bands were presented dichotically, but with no benefit for presentation to the preferred hemisphere. Listeners thus integrated slow and fast transitions between the two ears, benefitting from more signal information, but not in a hemisphere-specific manner. After accounting for potential ceiling effects, learning was greatest when both bands were presented dichotically. These results do not support the idea that cochlear implants could be improved by providing differentially filtered information to each ear. Listeners who started with poorer performance learned more, a factor which could contribute to the positive cochlear implant outcomes typically seen in younger children.
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Affiliation(s)
- Julia Jones Huyck
- Speech Pathology and Audiology Program, Kent State University, 1325 Theatre Drive, Kent, Ohio 44242, USA
| | - Merri J Rosen
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
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Brown A, Ajufo E, Cone C, Quirk M. LectureKeepr: A novel approach to studying in the adaptive curriculum. MEDICAL TEACHER 2018; 40:834-837. [PMID: 30033790 DOI: 10.1080/0142159x.2018.1484895] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
As medical students search for ways to squeeze more hours of learning into their day, many have turned to technology for quick and efficient ways to study. Most commonly this includes based apps for purchase that involve visual tasks, mental review and repetition. Tasks involve flashcard creation, answering multiple choice questions (MCQs) and schedule planning. They typically require students to visually interact with a computer or smartphone screen. Alternatively, auditory apps may not only offer the benefit of enhanced learning through review and repetition, but also address convenience, portability, and metacognitive development without physical and temporal requirements of visual presentation. Auditory learning is eyes and "hands-free" allowing the learner to contiguously engage in other activities such as physical exercise, traveling, eating, etc. In this randomized, case-comparison study, half of the students were exposed to audio lecture content before class using a mobile application called LectureKeepr (LK) and half were exposed to lecture content before class via written material prepared by the professor. Pre- and post-MCQ quizzes were used to measure differences between groups in knowledge improvement. In addition, student perceptions of the auditory learning experience were assessed by an on-line survey. ANOVA with repeated measures revealed that students in the LK intervention group performed better on the postquiz than the students in the written materials group.
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Affiliation(s)
- Aaron Brown
- a American University of the Caribbean School of Medicine , Cupecoy , Sint Maarten
| | - Emeka Ajufo
- a American University of the Caribbean School of Medicine , Cupecoy , Sint Maarten
| | - Cecil Cone
- a American University of the Caribbean School of Medicine , Cupecoy , Sint Maarten
| | - Mark Quirk
- a American University of the Caribbean School of Medicine , Cupecoy , Sint Maarten
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Longenecker RJ, Kristaponyte I, Nelson GL, Young JW, Galazyuk AV. Addressing variability in the acoustic startle reflex for accurate gap detection assessment. Hear Res 2018; 363:119-135. [PMID: 29602592 DOI: 10.1016/j.heares.2018.03.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 03/06/2018] [Accepted: 03/09/2018] [Indexed: 11/18/2022]
Abstract
The acoustic startle reflex (ASR) is subject to substantial variability. This inherent variability consequently shapes the conclusions drawn from gap-induced prepulse inhibition of the acoustic startle reflex (GPIAS) assessments. Recent studies have cast doubt as to the efficacy of this methodology as it pertains to tinnitus assessment, partially, due to variability in and between data sets. The goal of this study was to examine the variance associated with several common data collection variables and data analyses with the aim to improve GPIAS reliability. To study this the GPIAS tests were conducted in adult male and female CBA/CaJ mice. Factors such as inter-trial interval, circadian rhythm, sex differences, and sensory adaptation were each evaluated. We then examined various data analysis factors which influence GPIAS assessment. Gap-induced facilitation, data processing options, and assessments of tinnitus were studied. We found that the startle reflex is highly variable in CBA/CaJ mice, but this can be minimized by certain data collection factors. We also found that careful consideration of temporal fluctuations of the ASR and controlling for facilitation can lead to more accurate GPIAS results. This study provides a guide for reducing variance in the GPIAS methodology - thereby improving the diagnostic power of the test.
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Affiliation(s)
- Ryan J Longenecker
- Northeast Ohio Medical University, Department of Anatomy and Neurobiology, Rootstown, OH, USA
| | - Inga Kristaponyte
- Northeast Ohio Medical University, Department of Anatomy and Neurobiology, Rootstown, OH, USA; Biomedical Sciences Program, Kent State University, Kent, OH, USA
| | - Gregg L Nelson
- Northeast Ohio Medical University, Department of Anatomy and Neurobiology, Rootstown, OH, USA
| | - Jesse W Young
- Northeast Ohio Medical University, Department of Anatomy and Neurobiology, Rootstown, OH, USA
| | - Alexander V Galazyuk
- Northeast Ohio Medical University, Department of Anatomy and Neurobiology, Rootstown, OH, USA.
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Brief Stimulus Exposure Fully Remediates Temporal Processing Deficits Induced by Early Hearing Loss. J Neurosci 2017; 37:7759-7771. [PMID: 28706081 DOI: 10.1523/jneurosci.0916-17.2017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 06/24/2017] [Accepted: 07/08/2017] [Indexed: 12/30/2022] Open
Abstract
In childhood, partial hearing loss can produce prolonged deficits in speech perception and temporal processing. However, early therapeutic interventions targeting temporal processing may improve later speech-related outcomes. Gap detection is a measure of auditory temporal resolution that relies on the auditory cortex (ACx), and early auditory deprivation alters intrinsic and synaptic properties in the ACx. Thus, early deprivation should induce deficits in gap detection, which should be reflected in ACx gap sensitivity. We tested whether earplugging-induced, early transient auditory deprivation in male and female Mongolian gerbils caused correlated deficits in behavioral and cortical gap detection, and whether these could be rescued by a novel therapeutic approach: brief exposure to gaps in background noise. Two weeks after earplug removal, animals that had been earplugged from hearing onset throughout auditory critical periods displayed impaired behavioral gap detection thresholds (GDTs), but this deficit was fully reversed by three 1 h sessions of exposure to gaps in noise. In parallel, after earplugging, cortical GDTs increased because fewer cells were sensitive to short gaps, and gap exposure normalized this pattern. Furthermore, in deprived animals, both first-spike latency and first-spike latency jitter increased, while spontaneous and evoked firing rates decreased, suggesting that deprivation causes a wider range of perceptual problems than measured here. These cortical changes all returned to control levels after gap exposure. Thus, brief stimulus exposure, perhaps in a salient context such as the unfamiliar placement into a testing apparatus, rescued impaired gap detection and may have potential as a remediation tool for general auditory processing deficits.SIGNIFICANCE STATEMENT Hearing loss in early childhood leads to impairments in auditory perception and language processing that can last well beyond the restoration of hearing sensitivity. Perceptual deficits can be improved by training, or by acoustic enrichment in animal models, but both approaches involve extended time and effort. Here, we used a novel remediation technique, brief periods of auditory stimulus exposure, to fully remediate cortical and perceptual deficits in gap detection induced by early transient hearing loss. This technique also improved multiple cortical response properties. Rescue by this efficient exposure regime may have potential as a therapeutic tool to remediate general auditory processing deficits in children with perceptual challenges arising from early hearing loss.
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