Technology-based rehabilitation to improve communication after acquired brain injury

The utilization of technology has allowed for several advances in aphasia rehabilitation for individuals with acquired brain injury. Thirty-one previous studies that provide technology-based language or language and cognitive rehabilitation are examined in terms of the domains addressed, the types of treatments that were provided, details about the methods and the results, including which types of outcomes are reported. From this, we address questions about how different aspects of the delivery of treatment can influence rehabilitation outcomes, such as whether the treatment was standardized or tailored, whether the participants were prescribed homework or not, and whether intensity was varied. Results differed by these aspects of treatment delivery but ultimately the studies demonstrated consistent improvement on various outcome measures. With these aspects of technology-based treatment in mind, the ultimate goal of personalized rehabilitation is discussed.This project was funded by the Coulter Foundation for Translational Research. (Coulter Foundation for Translational Research

Relationship between self-administered cues and rehabilitation outcomes in individuals with aphasia: understanding individual responsiveness to a technology-based rehabilitation program

An advantage of rehabilitation administered on computers or tablets is that the tasks can be self-administered and the cueing required to complete the tasks can be monitored. Though there are many types of cueing, few studies have examined how participants’ response to rehabilitation is influenced by self-administered cueing, which is cueing that is always available but the individual decides when and which cue to administer. In this study, participants received a tablet-based rehabilitation where the tasks were selfpaced and remotely monitored by a clinician. The results of the effectiveness of this study were published previously (Des Roches et al., 2015). The current study looks at the effect of cues on accuracy and rehabilitation outcomes. Fifty-one individuals with aphasia completed a 10-week program using Constant Therapy on an iPad targeted at improving language and cognitive deficits. Three questions were examined. The first examined the effect of cues on accuracy collapsed across time. Results showed a trend where the greater the cue use, the lower the accuracy, although some participants showed the opposite effect. This analysis divided participants into profiles based on cue use and accuracy. The second question examined how each profile differed in percent cue use and on standardized measures at baseline. Results showed that the four profiles were significantly different in frequency of cues and scores on WAB-R, CLQT, BNT, and ASHA-FACS, indicating that participants with lower scores on the standardized tests used a higher percentage of cues, which were not beneficial, while participants with higher scores on the standardized tests used a lower frequency of cues, which were beneficial. The third question examined how the relationship between cues and accuracy was affected by the course of treatment. Results showed that both more and less severe participants showed a decrease in cue use and an increase in accuracy over time, though more severe participants continued to used a greater number of cues. It is possible that self-administered cues help some individuals to access information that is otherwise inaccessible, even if there is not an immediate effect. Ultimately, the results demonstrate the need for individually modifying the levels of assistance during rehabilitation.This project was funded by the Coulter Foundation for Translational Research. (Coulter Foundation for Translational Research)Published versio

Dairy cows under experimentally-induced <i>Escherichia coli</i> mastitis show negative emotional states assessed through Qualitative Behaviour Assessment

International audienceMastitis and associated pain have been identified as a major health and welfare problem affecting dairy cows, however little is known about how cows emotionally experience this illness. Qualitative behaviour assessment (QBA) is a 'whole animal' methodology for assessing animal emotion, through description and quantification of the expressive qualities of an animal's dynamic style of behaving (eg as relaxed, anxious). The aim of this study was to use QBA to investigate whether emotional expression in dairy cows is affected by an experimental intra" mammary challenge (mastitis) with Escherichia coli, and to investigate the relationship of QBA scores with nine other clinical, physiological and behavioural welfare indicators. Six Holstein-Friesian cows were inoculated with E. coli in one healthy quarter. Evolution of the disease was assessed using bacteriological growth and somatic cell counts (SCC). The cows' response to the challenge was assessed using QBA, clinical observations, data loggers, rumen temperature sensor, and physiological indicators (inflammation, stress) at ten time-points defining the phase of the disease: before inoculation (Phase 0: 0 h), in the pre-clinical Phase (Phase 1: 8 h), in the acute phase (Phase 2: 12 h, 16 h, 24 h) and in the remission phase (Phase 3 : 32 h, 40 h, 56 h, 64 h and 80 h post-inoculation (hpi)). Principal Component Analysis of QBA scores identified two main dimensions of cow expression: PC1, ranging from active/vigorous/happy/bright to suffering/dejected/lethargic, and PC2, ranging from fearful/tense/anxious to confident/calm/relaxed, together explaining 58% of the total variation. QBA PC1 and PC2 scores varied with mastitis phases: QBA PC1 scores decreased by 4.09 in Phase 2, and by 1.98 in Phase 3, reflecting suffering/dejected/lethargic expressivity. QBA PC2 scores decreased by 1.91 in Phase 3, reflecting a confident/calm/relaxed expressivity. Clinical and physiological welfare indicators were associated with QBA. The higher the udder severity score, the body temperature, the concentrations of cortisol, SAA, TNF-alpha, and IL-1 beta, the more the cows were suffering/dejected/lethargic (PC1) (coefficients:-0.51,-0.92,-2.46, 7.52 x 10-5,-0.72,-1.13 respectively). These findings indicate that dairy cows experienced negative emotional state in the acute phase and positive emotional state in the remission phase of mastitis. This suggests that provision of pain-relief treatment during mastitis may improve animal welfare, and potentially lead to faster disease remission. However the sample size of this study was small, and larger controlled studies are needed to further investigate these findings and hypotheses. The sensitivity of QBA in this small study suggests it could potentially be a useful tool for E. coli mastitis detection

Using expert elicitation to abridge the Welfare Quality® protocol for monitoring the most adverse dairy cattle welfare impairments

The Welfare Quality® consortium has developed and proposed standard protocols for monitoring farm animal welfare. The uptake of the dairy cattle protocol has been below expectation, however, and it has been criticized for the variable quality of the welfare measures and for a limited number of measures having a disproportionally large effect on the integrated welfare categorization. Aiming for a wide uptake by the milk industry, we revised and simplified the Welfare Quality® protocol into a user-friendly tool for cost- and time-efficient on-farm monitoring of dairy cattle welfare with a minimal number of key animal-based measures that are aggregated into a continuous (and thus discriminative) welfare index (WI). The inevitable subjective decisions were based upon expert opinion, as considerable expertise about cattle welfare issues and about the interpretation, importance, and validity of the welfare measures was deemed essential. The WI is calculated as the sum of the severity score (i.e., how severely a welfare problem affects cow welfare) multiplied with the herd prevalence for each measure. The selection of measures (lameness, leanness, mortality, hairless patches, lesions/swellings, somatic cell count) and their severity scores were based on expert surveys (14–17 trained users of the Welfare Quality® cattle protocol). The prevalence of these welfare measures was assessed in 491 European herds. Experts allocated a welfare score (from 0 to 100) to 12 focus herds for which the prevalence of each welfare measure was benchmarked against all 491 herds. Quadratic models indicated a high correspondence between these subjective scores and the WI (R(2) = 0.91). The WI allows both numerical (0–100) as a qualitative (“not classified” to “excellent”) evaluation of welfare. Although it is sensitive to those welfare issues that most adversely affect cattle welfare (as identified by EFSA), the WI should be accompanied with a disclaimer that lists adverse or favorable effects that cannot be detected adequately by the current selection of measures

Domestic horses (Equus caballus) discriminate between negative and positive human nonverbal vocalisations

The ability to discriminate between emotion in vocal signals is highly adaptive in social species. It may also be adaptive for domestic species to distinguish such signals in humans. Here we present a playback study investigating whether horses spontaneously respond in a functionally relevant way towards positive and negative emotion in human nonverbal vocalisations. We presented horses with positively- and negatively-valenced human vocalisations (laughter and growling, respectively) in the absence of all other emotional cues. Horses were found to adopt a freeze posture for significantly longer immediately after hearing negative versus positive human vocalisations, suggesting that negative voices promote vigilance behaviours and may therefore be perceived as more threatening. In support of this interpretation, horses held their ears forwards for longer and performed fewer ear movements in response to negative voices, which further suggest increased vigilance. In addition, horses showed a right-ear/left-hemisphere bias when attending to positive compared with negative voices, suggesting that horses perceive laughter as more positive than growling. These findings raise interesting questions about the potential for universal discrimination of vocal affect and the role of lifetime learning versus other factors in interspecific communication

Adult-Young Ratio, a Major Factor Regulating Social Behaviour of Young: A Horse Study

Adults play an important role in regulating the social behaviour of young individuals. However, a few pioneer studies suggest that, more than the mere presence of adults, their proportions in social groups affect the social development of young. Here, we hypothesized that aggression rates and social cohesion were correlated to adult-young ratios. Our biological model was naturally-formed groups of Przewalski horses, Equus f. przewalskii, varying in composition.We investigated the social interactions and spatial relationships of 12 one- and two-year-old Przewalski horses belonging to five families with adult-young ratios (AYR) ranging from 0.67 to 1.33. We found striking variations of aggression rates and spatial relationships related to the adult-young ratio: the lower this ratio, the more the young were aggressive, the more young and adults segregated and the tighter the young bonded to other young.This is the first study demonstrating a correlation between adult-young ratios and aggression rates and social cohesion of young individuals in a naturalistic setting. The increase of aggression and the emergence of social segregation in groups with lower proportions of adults could reflect a related decrease of the influence of adults as regulators of the behaviour of young. This social regulation has both theoretical and practical implications for understanding the modalities of the influence of adults during ontogeny and for recommending optimal settings, as for instance, for schooling or animal group management

Allergen-specific immunotherapy provides immediate, long-term and preventive clinical effects in children and adults: the effects of immunotherapy can be categorised by level of benefit -the centenary of allergen specific subcutaneous immunotherapy

Allergen Specific Immunotherapy (SIT) for respiratory allergic diseases is able to significantly improve symptoms as well as reduce the need for symptomatic medication, but SIT also has the capacity for long-term clinical effects and plays a protective role against the development of further allergies and symptoms. The treatment acts on basic immunological mechanisms, and has the potential to change the pathological allergic immune response. In this paper we discuss some of the most important achievements in the documentation of the benefits of immunotherapy, over the last 2 decades, which have marked a period of extensive research on the clinical effects and immunological background of the mechanisms involved. The outcome of immunotherapy is described as different levels of benefit from early reduction in symptoms over progressive clinical effects during treatment to long-term effects after discontinuation of the treatment and prevention of asthma. The efficacy of SIT increases the longer it is continued and immunological changes lead to potential long-term benefits. SIT alone and not the symptomatic treatment nor other avoidance measures has so far been documented as the therapy with long-term or preventive potential. The allergic condition is driven by a subset of T-helper lymphocytes (Th2), which are characterised by the production of cytokines like IL-4, and IL-5. Immunological changes following SIT lead to potential curative effects. One mechanism whereby immunotherapy suppresses the allergic response is through increased production of IgG4 antibodies. Induction of specific IgG4 is able to influence the allergic response in different ways and is related to immunological effector mechanisms, also responsible for the reduced late phase hyperreactivity and ongoing allergic inflammation. SIT is the only treatment which interferes with the basic pathophysiological mechanisms of the allergic disease, thereby creating the potential for changes in the long-term prognosis of respiratory allergy. SIT should not only be recognised as first-line therapeutic treatment for allergic rhinoconjunctivitis but also as secondary preventive treatment for respiratory allergic diseases

Visual laterality in dolphins: importance of the familiarity of stimuli

<p>Abstract</p> <p>Background</p> <p>Many studies of cerebral asymmetries in different species lead, on the one hand, to a better understanding of the functions of each cerebral hemisphere and, on the other hand, to develop an evolutionary history of hemispheric laterality. Our animal model is particularly interesting because of its original evolutionary path, i.e. return to aquatic life after a terrestrial phase. The rare reports concerning visual laterality of marine mammals investigated mainly discrimination processes. As dolphins are migrant species they are confronted to a changing environment. Being able to categorize new versus familiar objects would allow dolphins a rapid adaptation to novel environments. Visual laterality could be a prerequisite to this adaptability. To date, no study, to our knowledge, has analyzed the environmental factors that could influence their visual laterality.</p> <p>Results</p> <p>We investigated visual laterality expressed spontaneously at the water surface by a group of five common bottlenose dolphins (<it>Tursiops truncatus</it>) in response to various stimuli. The stimuli presented ranged from very familiar objects (known and manipulated previously) to familiar objects (known but never manipulated) to unfamiliar objects (unknown, never seen previously). At the group level, dolphins used their left eye to observe very familiar objects and their right eye to observe unfamiliar objects. However, eyes are used indifferently to observe familiar objects with intermediate valence.</p> <p>Conclusion</p> <p>Our results suggest different visual cerebral processes based either on the global shape of well-known objects or on local details of unknown objects. Moreover, the manipulation of an object appears necessary for these dolphins to construct a global representation of an object enabling its immediate categorization for subsequent use. Our experimental results pointed out some cognitive capacities of dolphins which might be crucial for their wild life given their fission-fusion social system and migratory behaviour.</p

Sensitivity of the integrated Welfare Quality® scores to changing values of individual dairy cattle welfare measures

The Welfare Quality((R)) (WQ) protocol for on-farm dairy cattle welfare assessment describes 33 measures and a step-wise method to integrate the outcomes into 12 criteria scores, grouped into four principle scores and into an overall welfare categorisation with four possible levels. The relative contribution of various welfare measures to the integrated scores has been contested. Using a European dataset (491 herds), we investigated: i) variation in sensitivity of integrated outcomes to extremely low and high values of measures, criteria and principles by replacing each actual value with minimum and maximum observed and theoretically possible values; and ii) the reasons for this variation in sensitivity. As intended by the WQ consortium, the sensitivity of integrated scores depends on: i) the observed value of the specific measures/criteria; ii) whether the change was positive/negative; and iii) the relative weight attributed to the measures. Additionally, two unintended factors of considerable influence appear to be side-effects of the complexity of the integration method. Namely: i) the number of measures integrated into criteria and principle scores; and ii) the aggregation method of the measures. Therefore, resource-based measures related to drinkers (which have been criticised with respect to their validity to assess absence of prolonged thirst), have a much larger influence on integrated scores than health-related measures such as 'mortality rate' and 'lameness score'. Hence, the integration method of the WQ protocol for dairy cattle should be revised to ensure that the relative contribution of the various welfare measures to the integrated scores more accurately reflect their relevance for dairy cattle welfare

Randomized double-blind placebo-controlled trial of sublingual immunotherapy in children with house dust mite allergy in primary care: study design and recruitment

Background. For respiratory allergic disorders in children, sublingual immunotherapy has been developed as an alternative to subcutaneous immunotherapy. Sublingual immunotherapy is more convenient, has a good safety profile and might be an attractive option for use in primary care. A randomized double-blind placebo-controlled study was designed to establish the ef