Benefits of phoneme discrimination training in a randomized controlled trial of 50- to 74-year-olds with mild hearing loss

Objectives: The aims of this study were to (i) evaluate the efficacy of phoneme discrimination training for hearing and cognitive abilities of adults aged 50 to 74 years with mild sensorineural hearing loss who were not users of hearing aids, and to (ii) determine participant compliance with a self-administered, computer-delivered, home- and game-based auditory training program. Design: This study was a randomized controlled trial with repeated measures and crossover design. Participants were trained and tested over an 8- to 12-week period. One group (Immediate Training) trained during weeks 1 and 4. A second waitlist group (Delayed Training) did no training during weeks 1 and 4, but then trained during weeks 5 and 8. On-task (phoneme discrimination) and transferable outcome measures (speech perception, cognition, self-report of hearing disability) for both groups were obtained during weeks 0, 4, and 8, and for the Delayed Training group only at week 12. Results: Robust phoneme discrimination learning was found for both groups, with the largest improvements in threshold shown for those with the poorest initial thresholds. Between weeks 1 and 4, the Immediate Training group showed moderate, significant improvements on self-report of hearing disability, divided attention, and working memory, specifically for conditions or situations that were more complex and therefore more challenging. Training did not result in consistent improvements in speech perception in noise. There was no evidence of any test-retest effects between weeks 1 and 4 for the Delayed Training group. Retention of benefit at 4 weeks post-training was shown for phoneme discrimination, divided attention, working memory, and self-report of hearing disability. Improved divided attention and reduced self-reported hearing difficulties were highly correlated. Conclusions: It was observed that phoneme discrimination training benefits some but not all people with mild hearing loss. Evidence presented here, together with that of other studies that used different training stimuli, suggests that auditory training may facilitate cognitive skills that index executive function and the self-perception of hearing difficulty in challenging situations. The development of cognitive skills may be more important than the development of sensory skills for improving communication and speech perception in everyday life. However, improvements were modest. Outcome measures need to be appropriately challenging to be sensitive to the effects of the relatively small amount of training performed

Exercise-induced mechanical hypoalgesia in musculotendinous tissues of the lateral elbow

The aim of this study was to investigate mechanical sensitivity responses at the lateral elbow to repeated weekly bouts of low load exercise in healthy subjects. Thirteen young men (n = 6) and women participated in 4 weeks of exercise. Arms were randomly allocated to an eccentric-only exercise protocol (ECC: 5 sets of 20 contractions) or to a concentric–eccentric protocol (CON-ECC: 5 sets of 10 eccentric/10 concentric contractions) performed at 30% maximal wrist extension force. Arms were exercised consecutively within each supervised weekly session. Quantitative measures of pressure pain threshold (PPT) recorded at three sites and maximal force for grip and wrist extension were assessed at baseline, and immediately pre/post exercise at each session. Muscle endurance during 100 maximal grip contractions force was assessed at baseline and one week following the final exercise session. Results showed that regardless of protocol, repeated low load exercise resulted in a time-dependent increase in PPT at all sites post exercise Weeks 3 and 4 and persisting at follow up Week 5 (P \u3c 0.02). No significant difference between protocols was evident for any measure. Muscle force and endurance were not significantly augmented compared with baseline. In conclusion mechanical hypoalgesia is induced by repeated low load exercises regardless of exercise mode, and this may prove beneficial if replicated clinically

Young people's experiences of managing Type 1 diabetes at university: a national study of UK university students

Aim: Little is known about the challenges of transitioning from school to university for young people with Type 1 diabetes. In a national survey, we investigated the impact of entering and attending university on diabetes self‐care in students with Type 1 diabetes in all UK universities. Methods: Some 1865 current UK university students aged 18–24 years with Type 1 diabetes, were invited to complete a structured questionnaire. The association between demographic variables and diabetes variables was assessed using logistic regression models. Results: In total, 584 (31%) students from 64 hospitals and 37 university medical practices completed the questionnaire. Some 62% had maintained routine diabetes care with their home team, whereas 32% moved to the university provider. Since starting university, 63% reported harder diabetes management and 44% reported higher HbA1c levels than before university. At university, 52% had frequent hypoglycaemia, 9.6% reported one or more episodes of severe hypoglycaemia and 26% experienced diabetes‐related hospital admissions. Female students and those who changed healthcare provider were approximately twice as likely to report poor glycaemic control, emergency hospital admissions and frequent hypoglycaemia. Females were more likely than males to report stress [odds ratio (OR) 4.78, 95% confidence interval (CI) 3.19–7.16], illness (OR 3.48, 95% CI 2.06–5.87) and weight management issues (OR 3.19, 95% CI 1.99–5.11) as barriers to self‐care. Despite these difficulties, 91% of respondents never or rarely contacted university support services about their diabetes. Conclusion: The study quantifies the high level of risk experienced by students with Type 1 diabetes during the transition to university, in particular, female students and those moving to a new university healthcare provider

Exploring human-guided strategies for reaction network exploration:Interactive molecular dynamics in virtual reality as a tool for citizen scientists

The emerging fields of citizen science and gamification reformulate scientific problems as games or puzzles to be solved. Through engaging the wider non-scientific community, significant breakthroughs may be made by analyzing citizen-gathered data. In parallel, recent advances in virtual reality (VR) technology are increasingly being used within a scientific context and the burgeoning field of interactive molecular dynamics in VR (iMD-VR) allows users to interact with dynamical chemistry simulations in real time. Here, we demonstrate the utility of iMD-VR as a medium for gamification of chemistry research tasks. An iMD-VR "game" was designed to encourage users to explore the reactivity of a particular chemical system, and a cohort of 18 participants was recruited to playtest this game as part of a user study. The reaction game encouraged users to experiment with making chemical reactions between a propyne molecule and an OH radical, and "molecular snapshots" from each game session were then compiled and used to map out reaction pathways. The reaction network generated by users was compared to existing literature networks demonstrating that users in VR capture almost all the important reaction pathways. Further comparisons between humans and an algorithmic method for guiding molecular dynamics show that through using citizen science to explore these kinds of chemical problems, new approaches and strategies start to emerge.</p

Increasing Feed Conversion Efficiency in Automatic Milking Systems: The Impact of Grain-Based Concentrate Allocation and Kikuyu (\u3cem\u3ePennisetum clandestinum\u3c/em\u3e) Pasture State on Milk Production

Pasture is typically offered to dairy cows in three allocations in pasture-based automatic milking systems (AMS). However, due to voluntary cow movement and distribution of milkings, some dairy cows access fresh pasture and other cows access depleted (stale) pasture. The first cows moving to an allocation of fresh pasture are offered ad-libitum, high quality pasture as opposed to cows arriving to the same allocation during the middle or end of the day accessing poorer quality, high fibre (neutral detergent fibre, NDF) pasture. In addition, grain-based concentrate (GBC) is allocated independently to this pasture state. The ability to increase feed conversion efficiency and AMS herd milk production by targetedGBC supplementation to cows accessing differing pasture states is unknown. Therefore, the aim of the current experiment was to determine the impact of pasture state and GBC allocation on dairy cow milk production

Increasing Feed Conversion Efficiency in Automatic Milking Systems: The Impact of Grain-Based Concentrate Allocation and Kikuyu (\u3cem\u3ePennisetum clandestinum\u3c/em\u3e) Pasture State on Kikuyu Pasture Digestibility

Automatic milking system (AMS) farms, rely upon voluntary cow traffic (the voluntary movement of cattle around a farm) for milk harvesting and feed consumption. Dairy cows on a pasture-based AMS farm typically move from depleted to fresh allocations of pasture in small groups, or individually, at differing times. The first cows moving to an allocation of fresh pasture get access to rapidly fermentable, ad libitum, high quality pasture in contrast to those cows accessing the same allocation towards the end of the access period. At the same time, grain-based concentrate (GBC) is allocated independent of the pasture state that cows access. Inclusion of a high level of GBC in the diet with high or low nutritive value forage, or variable states of forage, may create dramatic variations in rumen fluid pH, which may induce subacute ruminal acidosis (Bramley 2004), reduce feed conversion efficiency and negatively impact animal health. The aim of the current study was to determine the impact of pasture state and GBC allocation on the digestibility of kikuyu pasture

Outcome following multiple subpial transection in Landau-Kleffner syndrome and related regression

OBJECTIVE: To determine whether multiple subpial transection in the posterior temporal lobe has an impact on long-term outcome in children who have drug-resistant Landau-Kleffner syndrome (LKS) or other "electrical status epilepticus during sleep" (ESES)-related regression. Given the wide variability in outcomes reported in the literature, a secondary aim was to explore predictors of outcome. METHODS: The current study includes a surgery group (n = 14) comprising patients who underwent multiple subpial transection of the posterior temporal lobe and a nonsurgery comparison group (n = 21) comprising patients who underwent presurgical investigations for the procedure, but who did not undergo surgery. Outcomes were assessed utilizing clinical note review as well as direct assessment and questionnaires. RESULTS: The distribution of nonclassical cases was comparable between groups. There were some differences between the surgery and nonsurgery groups at presurgical investigation including laterality of discharges, level of language impairment, and age; therefore, follow-up analyses focused on change over time and predictors of outcome. There were no statistically significant differences between the groups in language, nonverbal ability, adaptive behavior, or quality of life at follow-up. There was no difference in the proportion of patients showing improvement or deterioration in language category over time for either group. Continuing seizures and an earlier age of onset were most predictive of poorer quality of life at long-term follow-up (F2,23  = 26.2, p = <0.001, R(2)  = 0.714). SIGNIFICANCE: Both surgery and nonsurgery groups had similar proportions of classic LKS and ESES-related regression. Because no significant differences were found in the changes observed from baseline to follow-up between the two groups, it is argued that there is insufficient evidence to suggest that multiple subpial transection provides additional benefits over and above the mixed recovery often seen in LKS and related regressive epilepsies

Beyond the Bedside: Protocol for a scoping review exploring the experiences of non-practicing healthcare professionals within health professions education

Background: The number of healthcare professionals leaving clinical practice and transitioning to alternative careers in health professions education is increasing. Among these non-practicing healthcare professionals, concerns have been reported regarding tensions in relation to identity, role, and credibility in their new field. There are suggestions that this is a particularly pressing issue for minoritised professionals who make this transition. Support is critical to attract and retain diverse talent within health professions education teaching and research. The purpose of this scoping review is to explore the career experiences of non-practicing healthcare professionals who work in health professions education internationally.Methods: Arksey and O’Malley’s framework has been utilised to guide the design of this scoping review process and will be used throughout the course of the review. A comprehensive search of seven electronic databases and limited search of Google Scholar will be conducted, as well as a hand search of eligible article reference lists. Two reviewers will independently screen all articles based on inclusion criteria, with conflicts resolved by a third reviewer. Data from included articles will be charted, collated, and analysed thematically. Meta-data will be summarised quantitatively.Discussion: This scoping review aims to explore the role and experiences of non-practicing healthcare professionals working within health professions education. The review will follow established scoping review guidelines and will include studies from various regions and languages, provided an English translation is available. The study remit will be broad, including both quantitative and qualitative studies, as well as reviews and opinion papers. Limitations may include the exclusion of non-English articles and potential difficulty of identifying papers which discuss the experiences of non-practicing clinicians. However, the review will provide insight into the current knowledge on what it is like to be a non-practicing clinician working within health professions education and identify gaps for both future research, and future support for those making this career transition

Mineralization and nitrification: Archaea dominate ammonia-oxidising communities in grassland soils

In grasslands, N mineralization and nitrification are important processes and are controlled by several factors, including the in situ microbial community composition. Nitrification involves ammonia oxidising archaea (AOA) and bacteria (AOB) and although AOA and AOB co-exist in soils, they respond differently to environmental characteristics and there is evidence of AOA/AOB niche differentiation. Here, we investigated temporal variation in N mineralization and nitrification rates, together with bacterial, archaeal and ammonia-oxidiser communities in grassland soils, on different geologies: clay, Greensand and Chalk. Across geologies, N mineralization and nitrification rates were slower in the autumn than the rest of the year. Turnover times for soil ammonium pools were <24 h, whilst several days for nitrate. In clay soils, bacterial, archaeal, AOA, and AOB communities were clearly distinct from those in Chalk and Greensand soils. Spatially and temporally, AOA were more abundant than AOB. Notably, Nitrososphaera were predominant, comprising 37.4% of archaeal communities, with the vast majority of AOA found in Chalk and Greensand soils. AOA abundance positively correlated with nitrate concentration, whereas AOB abundance correlated with ammonium and nitrite concentrations, suggesting that these N compounds may be potential drivers for AOA/AOB niche differentiation in these grassland soils

Dual-specificity phosphatase 1 and tristetraprolin cooperate to regulate macrophage responses to lipopolysaccharide

Dual-specificity phosphatase (DUSP) 1 dephosphorylates and inactivates members of the MAPK superfamily, in particular, JNKs, p38a, and p38b MAPKs. It functions as an essential negative regulator of innate immune responses, hence disruption of the Dusp1 gene renders mice extremely sensitive to a wide variety of experimental inflammatory challenges. The principal mechanisms behind the overexpression of inflammatory mediators by Dusp12/2 cells are not known. In this study, we use a genetic approach to identify an important mechanism of action of DUSP1, involving the modulation of the activity of the mRNA-destabilizing protein tristetraprolin. This mechanism is key to the control of essential early mediators of inflammation, TNF, CXCL1, and CXCL2, as well as the anti-inflammatory cytokine IL-10. The same mechanism also contributes to the regulation of a large number of transcripts induced by treatment of macrophages with LPS. These findings demonstrate that modulation of the phosphorylation status of tristetraprolin is an important physiological mechanism by which innate immune responses can be controlled