Factors influencing verbal intelligence and spoken language in children with phenylketonuria

Objectives: To determine verbal intelligence and spoken language of children with phenylketonuria and to study the effect of age at diagnosis and phenylalanine plasma level on these abilities. Design: Cross-sectional. Setting: Children with phenylketonuria were recruited from pediatric hospitals in 2012. Normal control subjects were recruited from kindergartens in Tehran. Participants: 30 phenylketonuria and 42 control subjects aged 4- 6.5 years. Skills were compared between 3 phenylketonuria groups categorized by age at diagnosis/treatment, and between the phenylketonuria and control groups. Main outcome measures: Scores on Wechsler Preschool and Primary Scale of Intelligence for verbal and total intelligence, and Test of Language Development-Primary, third edition for spoken language, listening, speaking, semantics, syntax, and organization. Results: The performance of control subjects was significantly better than that of early-treated subjects for all composite quotients from Test of Language Development and verbal intelligence (P >0.001). Early-treated subjects scored significantly higher than the two groups of late-treated subjects for spoken language (P =0.01), speaking (P =0.04), syntax (P =0.02), and verbal intelligence (P =0.019). There was a negative correlation between phenylalanine level and verbal intelligence (r= �0.79) in early-treated subjects and between phenylalanine level and spoken language (r= �0.71), organization (r= �0.82) and semantics (r= �0.82) for late-treated subjects diagnosed before the age one year. Conclusion: The study confirmed that diagnosis of newborns and control of blood phenylalanine concentration improves verbal intelligence and spoken language scores in phenylketonuria subjects. © 2015, Indian Academy of Pediatrics

A computer-based selective visual attention test for first-grade school children: Design, development and psychometric properties

Background: Visual attention is known as a critical base for learning. The purpose of the present study was to design, develop and evaluate the test-retest and internal consistency reliability as well as face, content and convergent validity of the computer- based selective visual attention test (SeVAT) for healthy first-grade school children. Methods: In the first phase of this study, the computer-based SeVAT was developed in two versions of original and parallel. Ten experts in occupational therapy helped to measure the content validity using the CVR and CVI methods. Face validity was measured through opinions collected from 10 first-grade children. The convergent validity of the test was examined using the Spearman correlation between the SeVAT and Stroop test. In addition, test-retest reliability was determined by measuring the intra-class correlation (ICC) between the original and parallel versions of the SeVAT in a single session. The internal consistency was calculated by Cronbach's alpha coefficients. Sixty first grade children (30 girls/30boys) participated in this study. Results: The developed test was found to have good content and face validity. The SeVAT showed an excellent test-retest reliability (ICC= 0.778, p<0.001) and internal consistency (Cronbach's Alpha of original and parallel tests were 0.857 and 0.831, respectively). SeVAT and Stroop test demonstrated a positive correlation upon the convergent validity testing. Conclusion: Our results suggested an acceptable reliability and validity for the computer-based SeVAT in the assessment of selective attention in children. Further research may warrant the differential validity of such a test in other age groups and neuro-cognitively disordered populations

Outlining a new collaborative business model as a result of the green Building Information Modelling impact in the AEC supply chain

BIM (Building Information Modelling) technological push has enabled to integrate the design/construction outcomes of 3D-CAD along the product/service AEC (Architecture, Engineering and Construction) SC (supply chain) through an intelligent DMS (Data Management System) based on standard and interoperable data formats. The proposed end-to-end approach overcomes a typical AEC gap, enables the operationalisation of the sustainable/green building LCA (Life Cycle Assessment) and puts together new collaborative relationships with the owner, among SC stakeholders and with new forms of BIM procurement. The outlined collaborative business model is based on the Quality Control and Assurance framework and provides conceptual consistency to the reintroduction of the owner concerns/satisfaction in the SC, as well as enables consistent and accountable relationships between (smart)materials procurement and building specification. An expert’s focus group carried out a preliminary check of the model’s interest/applicability, resulting in recommendations for its further detailing and for propositions development into a systematic enquiring process.info:eu-repo/semantics/acceptedVersio

Comparative Study of the ability of selective attention and speech perception in noise between 6 to 9 year old normal and learning disabled children

Object: Selective auditory attention and speech perception in the presence of noise are necessary skills to correctly process speech. Persian version of monaural selective auditory attention test P-mSAAT that simultaneously assesses selective auditory attention and speech in noise perception performance was used in the present study. Design: The P-mSAAT was performed on 89 normal children aged 6 to 9 and 24 children with learning disability sampled from different schools in Tehran in two competitive and non-competitive ways. Results: The average of test scores had a significant difference in a competitive way between normal and children with learning disability (P < 0/001). Furthermore, the test scores improved as a function of age in the both groups. Conclusion: Findings of the current study demonstrated that children presented with learning disability had difficulty in speech perception in the presence of competitive noise accompanied by reduced selective auditory attention ability. It is also suggested that P-mSAAT can be used as a screening test in diagnosing Learning disability in children aged 6 to 9 due to its high sensitivity. © 2019, © 2019 International Association of Physicians in Audiology

Brainstem correlates of comodulation masking release for speech in normal hearing adults

Background and Objectives: Weak signals embedded in fluctuating masker can be perceived more efficiently than similar signals embedded in unmodulated masker. This release from masking is known as comodulation masking release (CMR). In this paper, we investigate, neural correlates of CMR in the human auditory brainstem. Subjects and Methods: A total of 26 normal hearing subjects aged 18-30 years participated in this study. First, the impact of CMR was quantified by a behavioral experiment. After that, the brainstem correlates of CMR was investigated by the auditory brainstem response to complex sounds (cABR) in comodulated (CM) and unmodulated (UM) masking conditions. Results: The auditory brainstem responses are less susceptible to degradation in response to the speech syllable /da/ in the CM noise masker in comparison with the UM noise masker. In the CM noise masker, frequency- following response (FFR) and fundamental frequency (F0) were correlated with better behavioral CMR. Furthermore, the subcortical response timing of subjects with higher CMR was less affected by the CM noise masker, having higher stimulus-to-noise response correlations over the FFR range. Conclusions: The results of the present study revealed a significant link between brainstem auditory processes and CMR. The findings of the present study show that cABR provides objective information about the neural correlates of CMR for speech stimulus. © 2018 The Korean Audiological Society and Korean Otological Society

The effect of repetitive transcranial magnetic stimulation combined with traditional dysphagia therapy on poststroke dysphagia: a pilot double-blinded randomized-controlled trial

Dysphagia following stroke is common and can lead to severe complications such as aspiration pneumonia, but there is inconclusive evidence on how poststroke dysphagia should be treated. This study aimed to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) combined with the traditional dysphagia therapy on the swallowing function in patients with poststroke dysphagia. In this pilot double-blind randomized clinical trial, 18 patients with poststroke dysphagia were allocated randomly to three groups: (i) traditional dysphagia therapy, (ii) rTMS, and (iii) combined intervention. Patients received traditional dysphagia therapy for 18 treatment sessions three times per week. The inhibitory rTMS was applied to the intact cerebral hemisphere at 1 Hz with a train of 1200 for 5 consecutive days. The patients in the combined intervention group received traditional dysphagia therapy and rTMS simultaneously. The Mann Assessment of Swallowing Ability (MASA) and Functional Oral Intake Scale were performed before treatment, after the end of the fifth session, after the end of the 10th session, after the end of the 15th session, and after the end of the 18th session. All groups had improved on MASA and Functional Oral Intake Scale scores over time (P<0.01). The improvements achieved in all outcomes were significantly greater in the combined intervention group than those of the traditional dysphagia therapy and rTMS groups. The large effect sizes were found for the MASA score in all groups: traditional dysphagia therapy group (d = 3.57), rTMS group (d = 2.67), and combined intervention group (d = 3.87). This pilot randomized-controlled trial showed that the combination of rTMS and traditional dysphagia therapy significantly improved swallowing function in patients with poststroke dysphagia

Effects of repetitive transcranial magnetic stimulation on lower extremity spasticity and motor function in stroke patients

Purpose: To investigate the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) on lower extremity (LE) spasticity, motor function and motor neurone excitability in chronic stroke patients. Method: This study was a randomised sham-controlled cross-over trial with 1-week follow-up. A total of 20 post-stroke patients were randomised to receive active (n = 10) or sham (n = 10) rTMS. Fourteen of them (7 in each group) crossed over to the sham or active rTMS after a washout period of 1 month. Interventions consist of five consecutive daily sessions of active or sham rTMS to the unaffected lower extremity motor area (1000 pulses; 1 Hz; 90 of the tibialis anterior motor threshold). Outcome measures were modified modified ashworth scale (MMAS), the H-reflex, lower extremity section of Fugl�Mayer assessment (LE-FMA) and timed UP and GO (TUG) test. All outcomes were measured at three levels in each intervention period: pre- and post-intervention and 1-week follow-up. Results: Friedman�s test revealed significant improvement in MMAS score only after active rTMS. This improvement lasted for one week after the active rTMS. Repeated measure analysis of variance (ANOVA) showed significant time*intervention interaction for LE-FMA. There are no differences between groups for the MMAS and LE-FMA. No significant change in Hmax/Mmax ratio and TUG test was noted. Conclusion: Low-frequency rTMS over the LE motor area can improve clinical measures of muscle spasticity and motor function. More studies are needed to clarify the changes underlying this improvement in spasticity.Implications for Rehabilitation Spasticity is a common disorder and one of the causes of long-term disability after stroke. Physical therapy modalities, oral medications, focal intervention and surgical procedures have been used for spasticity reduction. Beneficial effect of the repetitive transcranial magnetic stimulation (rTMS) for post-stroke upper extremity spasticity reduction and motor function improvement was demonstrated in previous studies. This study shows amelioration of lower extremity spasticity and motor function improvement after five daily sessions of inhibitory rTMS to the unaffected brain hemisphere which lasted for at least 1 week following the intervention. © 2016 Taylor & Francis

Green BIM and CIM: Sustainable Planning Using Building Information Modelling

The design, construction and management of sustainable and intelligent buildings, neighbourhoods and cities require tools that can manage complexity in a completely different manner to the practices adopted to date. This chapter intro-duces the most advanced current approach, Building Information Modelling (BIM), focusing in particular on its use to support green and smart planning of buildings, neighbourhoods and cities. The initial part of the chapter introduces the general con-cepts underlying the BIM. The second part explores its application, the Green BIM, intended as the use of the tool to support the sustainable design of buildings. The chapter concludes with the introduction of a more recent concept, the City Informa-tion Modelling (CIM), intended as a common platform to design, build and manage the buildings, infrastructures and services of neighbourhoods and cities that evolve towards sustainable and smart schemes