Effects of auditory processing training on speech perception and brainstem plastisity in adolescents with autism spectrum disorders

Objective Autism spectrum disorder (ASD) is a neurodevelopmental disorderA major problem of ASD is speech perception impairment in the presence of background noise. Additionally, researchers have reported temporal auditory processing impairment in these patients. In the present study, we evaluated the effects of a temporal-based rehabilitation program on improvement of speech perception in the presence of noise using the speech auditory brainstem response (sABR). Materials & Methods Twenty-eight adolescents with high functional ASD with the mean age of 14.35±1.86 were randomly selected and divided into the ASD group (11 males and three females), and the control group (13 males and one female). All subjects had a normal hearing and intelligence threshold and had no history of neurological disorder. The speech perception test was performed in signal-to-noise ratios of zero and +10. The intervention group received a temporal processing-based auditory rehabilitation program and the control group received a conventional rehabilitation program (P<0.05 was considered significant). Results speech perception in noise after rehabilitation was significantly higher in intervention group (P <0.001) and the latency of all sABR waves in the rehabilitation group was lower than that of the control group. Conclusion Improvement of speech perception in noisy environments and the reduced latency of sABR waves after a temporal processing-based rehabilitation program and one month later, points to the role of auditory temporal processing training program highlight the role of brainstem neural plasticity in speech processin

The global, regional, and national burden of stomach cancer in 195 countries, 1990-2017 : a systematic analysis for the Global Burden of Disease study 2017

Background: Stomach cancer is a major health problem in many countries. Understanding the current burden of stomach cancer and the differential trends across various locations is essential for formulating effective preventive strategies. We report on the incidence, mortality, and disability-adjusted life-years (DALYs) due to stomach cancer in 195 countries and territories from 21 regions between 1990 and 2017. Methods: Estimates from GBD 2017 were used to analyse the incidence, mortality, and DALYs due to stomach cancer at the global, regional, and national levels. The rates were standardised to the GBD world population and reported per 100 000 population as age-standardised incidence rates, age-standardised death rates, and age-standardised DALY rates. All estimates were generated with 95% uncertainty intervals (UIs). Findings: In 2017, more than 1·22 million (95% UI 1·19–1·25) incident cases of stomach cancer occurred worldwide, and nearly 865 000 people (848 000–885 000) died of stomach cancer, contributing to 19·1 million (18·7–19·6) DALYs. The highest age-standardised incidence rates in 2017 were seen in the high-income Asia Pacific (29·5, 28·2–31·0 per 100 000 population) and east Asia (28·6, 27·3–30·0 per 100 000 population) regions, with nearly half of the global incident cases occurring in China. Compared with 1990, in 2017 more than 356 000 more incident cases of stomach cancer were estimated, leading to nearly 96 000 more deaths. Despite the increase in absolute numbers, the worldwide age-standardised rates of stomach cancer (incidence, deaths, and DALYs) have declined since 1990. The drop in the disease burden was associated with improved Socio-demographic Index. Globally, 38·2% (21·1–57·8) of the age-standardised DALYs were attributable to high-sodium diet in both sexes combined, and 24·5% (20·0–28·9) of the age-standardised DALYs were attributable to smoking in males. Interpretation: Our findings provide insight into the changing burden of stomach cancer, which is useful in planning local strategies and monitoring their progress. To this end, specific local strategies should be tailored to each country's risk factor profile. Beyond the current decline in age-standardised incidence and death rates, a decrease in the absolute number of cases and deaths will be possible if the burden in east Asia, where currently almost half of the incident cases and deaths occur, is further reduced. Funding: Bill & Melinda Gates Foundation

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Musical training enhances neural processing of comodulation masking release in the auditory brainstem

Musical training strengthens segregation the target signal from background noise. Musicians have enhanced stream segregation, which can be considered a process similar to comodulation masking release. In the current study, we surveyed psychoacoustical comodulation masking release in musicians and non-musicians. We then recorded the brainstem responses to complex stimuli in comodulated and unmodulated maskers to investigate the effect of musical training on the neural representation of comodulation masking release for the first time. The musicians showed significantly greater amplitudes and earlier brainstem response timing for stimulus in the presence of comodulated maskers than nonmusicians. In agreement with the results of psychoacoustical experiment, musicians showed greater comodulation masking release than non-musicians. These results reveal a physiological explanation for behavioral enhancement of comodulation masking release and stream segregation in musicians

An introductory overview of bimodal fitting

Background and Aim: In a bimodal fitting, one ear is stimulated acoustically with a hearing aid and the other is stimulated electrically with a cochlear implant. This paper provides a brief summary of the concept of bimodal fitting, binaural hearing and its importance, the hearing benefits of binaural hearing in bimodal fitting, candidacy and hearing aid adjustment in bimodal fitting cases. Recent Findings: Researches have shown that bimodal fitting offers a wide range of hearing benefits over unilateral cochlear implants, such as better speech perception in noise, better musical perception, and a better understanding of pitch and tone perception and naturalness of sound perception. Conclusion: Considering the binaural hearing advantages in bimodal fitting users, it can be concluded that users of unilateral cochlear implants who have measurable residual hearing in their non-implanted ear can use a hearing aid in that ear and enjoy binaural hearing advantages. The hearing aid should be fitted in a way to complement the information obtained through cochlear implantation

Translating and Assessing the Validity and Reliability of Persian Version of the International Outcome Inventory for Hearing Aids (IOI-HA)

Background: The aim of this paper was to prepare the Persian version of the unique International Edition of the self-report Hearing Aids questionnaire and to assess its validity and reliability. This questionnaire was chosen because of its simplicity, comprehensiveness for users, and usefulness, in comparison with other evaluations of outcomes hearing aids. Methods: Permission to translate International Outcome Inventory for Hearing Aids was obtained from its developer. The questionnaire was translated back into Persian, and then the translated version was retranslated to English by qualified individuals to assess its correspondence with the original version. After this stage, the content validity of the questionnaire was checked by nine audiology experts, with the results analyzed by Lawshe statistical method. In order to examine the structural reliability, the questionnaire was completed by 15 hearing impaired people and the necessary corrections were made according to the results. Finally, the final form was answered by 90 hearing-aid users, with the Cronbach’s alpha statistical method utilized to analyze the results. In order to assess the test-retest reliability, the questionnaire was recompleted again by 30 subjects 1-2 weeks later, with the paired t-test correlation employed to evaluate the results. Results: The mean total score was 26.41 (SD=4.86). The test-retest results revealed no significant difference between the two groups. The internal consistency was 0.845 based on Cronbach’s alpha, indicating acceptable test reliability. Conclusion: The present study demonstrated that the Persian version of the International Outcome Inventory for Hearing Aids possesses a good validity and reliability

Development and Validation of the Persian Version of the Acceptable Noise Level (ANL) Test in Normal Children Aged 5-8 Years

Background: The goal of the present study was to develop and validate the Persian version of the Acceptable Noise Level (ANL) test in normal, Persianspeaking children aged 5-8 years. Methods: This tool-making and non-experimental research was conducted in two stages. In the first stage the proper story was selected and recorded after evaluation of its content validity. In the second stage this test material was administered to a total 181 normal children (97 girls and 84 boys) randomly chosen from the population of preschool and primary school children of Tehran (District 5), aged 5-8 years in four age groups to evaluate the reliability of test in order to develop the Persian version of the ANL test and assess its changes during the growth. Lawshe’s method and Cronbach’s alpha coefficient were used to assess the content validity and reliability of the test, respectively. Mann– Whitney U test was used to examine gender differences, and Kruskal-Wallis test was to examine age differences. Results: Test-retest correlation of 0.74 indicated acceptable reliability of the test. Significant differences were found between most of different age groups for the ANL mean scores (P<0.05). There was no significant gender difference for the ANL mean scores (P>0.05). Conclusion: The study results indicated good validity and reliability of the Persian version of the ANL test in children. Therefore this test can be useful in designing classrooms suitable for 5-8 year-old children of both genders

Reliability of Interaural Time Difference-Based Localization Training in Elderly Individuals with Speech-in-Noise Perception Disorder

Background: Previous studies have shown that interaural-time-difference (ITD) training can improve localization ability. Surprisingly little is, however, known about localization training vis-à-vis speech perception in noise based on interaural time difference in the envelope (ITD ENV). We sought to investigate the reliability of an ITD ENV-based training program in speech-in-noise perception among elderly individuals with normal hearing and speech-in-noise disorder. Methods: The present interventional study was performed during 2016. Sixteen elderly men between 55 and 65 years of age with the clinical diagnosis of normal hearing up to 2000 Hz and speech-in-noise perception disorder participated in this study. The training localization program was based on changes in ITD ENV. In order to evaluate the reliability of the training program, we performed speech-in-noise tests before the training program, immediately afterward, and then at 2 months’ follow-up. The reliability of the training program was analyzed using the Friedman test and the SPSS software. Results: Significant statistical differences were shown in the mean scores of speech-in-noise perception between the 3 time points (P=0.001). The results also indicated no difference in the mean scores of speech-in-noise perception between the 2 time points of immediately after the training program and 2 months’ follow-up (P=0.212). Conclusion: The present study showed the reliability of an ITD ENV-based localization training in elderly individuals with speech-in-noise perception disorder

Auditory Working Memory Span of Children with (Central) Auditory Processing Disorders and Normal Children Aged 8 to 10 Year

Background: The aim of the present study was to assess the auditory working memory span of children with (central) auditory processing disorders (C) APDaged 8 to 10 years and to compare the results with normal ones. Methods: Twenty five children with (Central) Auditory Processing Disorders (8-10 years) and 75 normal children (8-10 years) from both genders participated in this comparative study. Participants were chosen by convenient sampling method to assess their auditory working memory (WM) span. Forward digit span, backward digit span and non-word repetition tests were used to evaluate the WM span. Nonparametric statistics (Mann–Whitney U) were used for comparing group differences. Results: Forward digit and backward digit and non-word repetition tests showed significant differences in mean scores between those with (C) APD and normal children (P<0.001). Conclusion: The results suggest that (C) APD children have poorer performance in the WM span than the age matched controls