Changes in children's speech discrimination and spatial release from masking between 2 and 4 years after sequential cochlear implantation

Objective: To document changes in speech reception thresholds (SRTs) and spatial release from masking (SRM) for sequentially implanted children at two and four years after they received their second cochlear implant (CI2). Methods: Participants were 17 children who consistently used two sequentially implanted and optimally programmed cochlear implants. SRTs were measured monaurally in quiet and binaurally in noise using the adaptive McCormick Toy Discrimination Test. Speech signals were presented from 0° azimuth and noise from 0°, +90° or −90° azimuth. SRM was calculated from SRTs in noise. Measurements were made at two and four years post-CI2. Results: There were significant improvements over time in SRTs in quiet, SRTs in noise and SRM. SRTs in quiet improved more for CI2 than for the first implant (CI1). SRTs in noise and SRM improved more when noise was presented closest to CI1 than when closest to CI2. Performance became more symmetrical over time. Discussion: Despite prolonged periods of unilateral auditory deprivation sequentially-implanted children exhibited continued improvement in SRT and SRM. These results are valuable in setting expectations for and counselling families of children considering sequential cochlear implants

Changes in children’s speech reception thresholds and spatial release from masking from 2 to 4 years post sequential cochlear implantation.

Introduction: Knowledge of long-term outcomes in sequential implantation is needed for optimum candidacy selection and patient counselling. Studies to date describe speech outcomes up to two years post 2nd implant only. Up to this point results are asymmetrical across ears, with 1st-implanted ears providing better speech reception thresholds (SRTs), and less spatial release from masking (SRM) experienced if noise is closest to the 1st-implanted ear. Objective: To extend knowledge of clinical outcomes beyond 2 years post 2nd implant we compare results at 2 and 4 years post 2nd implant to test the following hypotheses: Hypothesis 1: Monaural SRTs in quiet will improve in both 1st and 2nd implanted ears. Hypothesis 2: Binaural SRTs in noise will improve. Hypothesis 3: SRM will improve. Hypothesis 4: SRM will become more symmetrical. Methods: This is a longitudinal study where children act as their own controls. From our caseload we identified 17 sequentially implanted children who by two years post 2nd implant were optimally programmed users of both implants, tested at both intervals. They participated in the McCormick Toy Discrimination Test with toy names presented from 0° azimuth, monaurally in quiet and binaurally with pink noise presented from 0°, -90°, and +90°. SRTs were calculated using an adaptive procedure to find the 71% correct level. SRM was calculated from SRTs in noise. Data were analysed via two-level hierarchical regression models with measurement and subject as levels one and two respectively. Results: Hypothesis 1: Both ear and test interval had a significant effect on SRTs in quiet (p<0.05 and p<0.0001 respectively) with 1st-implanted ears performing better. 1st-implanted ears improved by a mean value of 6.4dB and 2nd-implanted ears by 8.1dB over the two year period, however the difference in improvement was not significant. Hypothesis 2: Noise location and test interval both had a significant effect on binaural SRTs in noise (p<0.0001). Noise and speech from 0° was the most challenging condition and noise 90° towards the 2nd-implanted side was the easiest. There was also a significant interaction (p<0.01) showing that the change over time was dependent on the direction of the noise. While SRTs with noise from 0° improved by 2.7dB, larger improvements of 7.2dB and 5.7dB were seen for noise presented 90° towards 1st and 2nd-implanted ears respectively. Hypothesis 3: SRM significantly improved over time (p<0.001). This improvement was not dependent upon noise location. Hypothesis 4: Analysis of the change in absolute differences in SRM with noise at +90° and -90° found a small but non-significant increase in symmetry over time. Conclusion: Our findings support hypotheses 1, 2 and 3, i.e. monaural SRTs in quiet, binaural SRTs in noise and SRM improved from 2 to 4 years post 2nd implant. However our results did not support hypothesis 4. This may be due to a persistent effect of auditory deprivation prior to 2nd implantation

Aerobic fitness is associated with greater white matter integrity in children

Aerobic fitness has been found to play a positive role in brain and cognitive health of children. Yet, many of the neural biomarkers related to aerobic fitness remain unknown. Here, using diffusion tensor imaging, we demonstrated that higher aerobic fitness was related to greater estimates of white matter microstructure in children. Higher fit 9- and 10-year-old children showed greater fractional anisotropy (FA) in sections of the corpus callosum, corona radiata, and superior longitudinal fasciculus, compared to lower fit children. The FA effects were primarily characterized by aerobic fitness differences in radial diffusivity, thereby raising the possibility that estimates of myelination may vary as a function of individual differences in fitness during childhood. White matter structure may be another potential neural mechanism of aerobic fitness that assists in efficient communication between gray matter regions as well as the integration of regions into networks. © 2014 Chaddock-Heyman, Erickson, Holtrop, Voss, Pontifex, Raine, Hillman and Kramer

The role of aerobic fitness in cortical thickness and mathematics achievement in preadolescent children

Growing evidence suggests that aerobic fitness benefits the brain and cognition during childhood. The present study is the first to explore cortical brain structure of higher fit and lower fit 9-and 10-year-old children, and how aerobic fitness and cortical thickness relate to academic achievement. We demonstrate that higher fit children (>70th percentile VO2max) showed decreased gray matter thickness in superior frontal cortex, superior temporal areas, and lateral occipital cortex, coupled with better mathematics achievement, compared to lower fit children (<30th percentile VO2max). Furthermore, cortical gray matter thinning in anterior and superior frontal areas was associated with superior arithmetic performance. Together, these data add to our knowledge of the biological markers of school achievement, particularly mathematics achievement, and raise the possibility that individual differences in aerobic fitness play an important role in cortical gray matter thinning during brain maturation. The establishment of predictors of academic performance is key to helping educators focus on interventions to maximize learning and success across the lifespan

The rare presentations of a large polyp and an esophageal carcinoma in heterotropic gastric mucosa: a case series

<p>Abstract</p> <p>Background</p> <p>Heterotopic gastric mucosa (HGM) is commonly seen in the upper esophagus during endoscopyand is generally considered a benign disease. A hyperplastic polyp and an adenocarcinoma arising in heterotopic gastric mucosa are quite rare occurences.</p> <p>Case presentations</p> <p>We present two cases: The first is a patient who suffered from dysphagia because of a large hyperplastic polyp that arose from HGM; the polyp was excised endoscopically. Secondly, we report a rare case of adenocarcinoma arising in HGM of the cervical esophagus.</p> <p>Conclusion</p> <p>Morphologic changes or malignant transformation can develop in the inlet patch. Therefore, gastroenterologists should be aware of the possibility of HGM just distal to the upper esophageal sphincter.</p

Transcriptomic profiling reveals a pronociceptive role for angiotensin II in inflammatory bowel disease.

Visceral pain is a leading cause of morbidity in inflammatory bowel disease (IBD), contributing significantly to reduced quality of life. Currently available analgesics often lack efficacy or have intolerable side effects, driving the need for a more complete understanding of the mechanisms causing pain. Whole transcriptome gene expression analysis was performed by bulk RNA sequencing of colonic biopsies from patients with ulcerative colitis (UC) and Crohn's disease (CD) reporting abdominal pain and compared with noninflamed control biopsies. Potential pronociceptive mediators were identified based on gene upregulation in IBD biopsy tissue and cognate receptor expression in murine colonic sensory neurons. Pronociceptive activity of identified mediators was assessed in assays of sensory neuron and colonic afferent activity. RNA sequencing analysis highlighted a 7.6-fold increase in the expression of angiotensinogen transcripts, Agt , which encode the precursor to angiotensin II (Ang II), in samples from UC patients ( P = 3.2 × 10 -8 ). Consistent with the marked expression of the angiotensin AT 1 receptor in colonic sensory neurons, Ang II elicited an increase in intracellular Ca 2+ in capsaicin-sensitive, voltage-gated sodium channel subtype Na V 1.8-positive sensory neurons. Ang II also evoked action potential discharge in high-threshold colonic nociceptors. These effects were inhibited by the AT 1 receptor antagonist valsartan. Findings from our study identify AT 1 receptor-mediated colonic nociceptor activation as a novel pathway of visceral nociception in patients with UC. This work highlights the potential utility of angiotensin receptor blockers, such as valsartan, as treatments for pain in IBD

Timing of Intervention Affects Brain Electrical Activity in Children Exposed to Severe Psychosocial Neglect

Background: Early psychosocial deprivation has profound effects on brain activity in the young child. Previous reports have shown increased power in slow frequencies of the electroencephalogram (EEG), primarily in the theta band, and decreased power in higher alpha and beta band frequencies in infants and children who have experienced institutional care. Methodology/Principal Findings: We assessed the consequences of removing infants from institutions and placing them into a foster care intervention on brain electrical activity when children were 8 years of age. We found the intervention was successful for increasing high frequency EEG alpha power, with effects being most pronounced for children placed into foster care before 24 months of age. Conclusions/Significance: The dependence on age of placement for the effects observed on high frequency EEG alpha power suggests a sensitive period after which brain activity in the face of severe psychosocial deprivation is less amenabl

Neonicotinoid pesticide limits improvement in buzz pollination by bumblebees

Neonicotinoid pesticides have been linked to global declines of beneficial insects such as bumblebees. Exposure to trace levels of these chemicals causes sub-lethal effects, such as reduced learning and foraging efficiency. Complex behaviours may be particularly vulnerable to the neurotoxic effects of neonicotinoids. Such behaviours may include buzz pollination (sonication), in which pollinators, usually bees, use innate and learned behaviours to generate high-frequency vibrations to release pollen from flowers with specialised anther morphologies. This study assesses the effect of field-realistic, chronic exposure to the widely-used neonicotinoid thiamethoxam on the development of sonication buzz characteristics over time, as well as the collection of pollen from buzz-pollinated flowers. We found that the pollen collection of exposed bees improved less with increasing experience than that of unexposed bees, with exposed bees collecting between 47% and 56% less pollen by the end of 10 trials. We also found evidence of two distinct strategies for maximising pollen collection: (1) extensions to the duration of individual buzzes and (2) extensions of the overall time spent buzzing. We find new complexities in buzz pollination, and conclude that the impacts of field-realistic exposure to a neonicotinoid pesticide may seriously compromise this important ecosystem service

Building social capital through breastfeeding peer support: Insights from an evaluation of a voluntary breastfeeding peer support service in North-West England

Background: Peer support is reported to be a key method to help build social capital in communities. To date there are no studies that describe how this can be achieved through a breastfeeding peer support service. In this paper we present findings from an evaluation of a voluntary model of breastfeeding peer support in North-West England to describe how the service was operationalized and embedded into the community. This study was undertaken from May, 2012 to May, 2013. Methods: Interviews (group or individual) were held with 87 participants: 24 breastfeeding women, 13 peer supporters and 50 health and community professionals. The data contained within 23 monthly monitoring reports (January, 2011 to February 2013) compiled by the voluntary peer support service were also extracted and analysed. Results: Thematic analysis was undertaken using social capital concepts as a theoretical lens. Key findings were identified to resonate with ’bonding’, ‘bridging’ and ‘linking’ forms of social capital. These insights illuminate how the peer support service facilitates ‘bonds’ with its members, and within and between women who access the service; how the service ‘bridges’ with individuals from different interests and backgrounds, and how ‘links’ were forged with those in authority to gain access and reach to women and to promote a breastfeeding culture. Some of the tensions highlighted within the social capital literature were also identified. Conclusions: Horizontal and vertical relationships forged between the peer support service and community members enabled peer support to be embedded into care pathways, helped to promote positive attitudes to breastfeeding and to disseminate knowledge and maximise reach for breastfeeding support across the community. Further effort to engage with those of different ethnic backgrounds and to resolve tensions between peer supporters and health professionals is warranted

Combined pesticide exposure severely affects individual- and colony-level traits in bees

Reported widespread declines of wild and managed insect pollinators have serious consequences for global ecosystem services and agricultural production [1–3]. Bees contribute approximately 80% of insect pollination, so it is important to understand and mitigate the causes of current declines in bee populations [4–6]. Recent studies have implicated the role of pesticides in these declines, as exposure to these chemicals has been associated with changes in bee behaviour [7–11] and reductions in colony queen production [12]. However, the key link between changes in individual behaviour and the consequent impact at the colony level has not been shown. Social bee colonies depend on the collective performance of many individual workers. Thus, although field-level pesticide concentrations can have subtle or sublethal effects at the individual level [8], it is not known whether bee societies can buffer such effects or whether it results in a severe cumulative effect at the colony level. Furthermore, widespread agricultural intensification means that bees are exposed to numerous pesticides when foraging [13–15], yet the possible combinatorial effects of pesticide exposure have rarely been investigated [16,17]. Here we show that chronic exposure of bumblebees to two pesticides (neonicotinoid and pyrethroid) at concentrations that could approximate field-level exposure impairs natural foraging behaviour and increases worker mortality leading to significant reductions in brood development and colony success. We found that worker foraging performance, particularly pollen collecting efficiency, was significantly reduced with observed knock-on effects for forager recruitment, worker losses and overall worker productivity. Moreover, we provide evidence that combinatorial exposure to pesticides increases the propensity of colonies to fail