Bilingualism alters children’s frontal lobe functioning for attentional control

Bilingualism is a typical linguistic experience, yet relatively little is known about its impact on children’s cognitive and brain development. Theories of bilingualism suggest that early dualâ language acquisition can improve children’s cognitive abilities, specifically those relying on frontal lobe functioning. While behavioral findings present much conflicting evidence, little is known about its effects on children’s frontal lobe development. Using functional nearâ infrared spectroscopy (fNIRS), the findings suggest that Spanishâ English bilingual children (n = 13, ages 7â 13) had greater activation in left prefrontal cortex during a nonâ verbal attentional control task relative to ageâ matched English monolinguals. In contrast, monolinguals (n = 14) showed greater right prefrontal activation than bilinguals. The present findings suggest that early bilingualism yields significant changes to the functional organization of children’s prefrontal cortex for attentional control and carry implications for understanding how early life experiences impact cognition and brain development.This fNIRS study investigated the impact of bilingual exposure on children’s brain organization for attentional control (N = 27, ages 7â 13). During a nonâ verbal attention task, bilinguals showed greater left frontal lobe activation than monolinguals. Monolinguals showed greater right frontal lobe activation than bilinguals. The findings suggest that bilingualism affects the functionality of children’s left prefrontal cortex for attentional control.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136694/1/desc12377-sup-0001-FigS1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136694/2/desc12377.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136694/3/desc12377_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136694/4/desc12377-sup-0003-SupInfo.pd

Glaucomatous Optic Neuropathy Associated with Nocturnal Dip in Blood Pressure: Findings from the Maracaibo Aging Study

Purpose—To determine which nocturnal blood pressure (BP) parameters (low levels or extreme dipper status) are associated with an increased risk of glaucomatous damage in Hispanics. Design—Observational cross-sectional study. Participants—A subset (n=93) of the participants from the Maracaibo Aging Study (MAS) who met the study eligibility criteria were included. These participants — who were at least 40 years of age — had measurements for optical tomography coherence, visual field tests, 24-hour BP, office BP, and intraocular pressureHg. Methods—Univariate and multivariate logistic regression analyses under the generalized estimating equations (GEE) framework were used to examine the relationships between glaucomatous damage and BP parameters, with particular attention to drops in nocturnal BP. Main Outcome Measures—Glaucomatous optic neuropathy (GON) based on the presence of optic nerve damage and visual field defects. Results—The mean age was 61.9 years, and 87.1% were women. Of 185 eyes evaluated, 50 (27.0%) had signs of GON. Individuals with GON had significantly lower 24-hour and nighttime diastolic BP levels than those without. However, results of the multivariate GEE models indicated that the glaucomatous damage was not related to the average systolic or diastolic BP levels measured over 24 hours, daytime, or nighttime. In contrast, extreme drops in nighttime systolic and diastolic BP (\u3e20% compared with daytime BP) were significant risk factors for glaucomatous damage (odds ratio=19.78 and 5.55, respectively). Conclusions—In this population, the link between nocturnal BP and GON is determined by extreme dipping effects rather than low nocturnal BP levels alone. Further studies considering extreme drops in nocturnal BP in individuals at high risk of glaucoma are warranted

Spondilodiscit caused by Candida parapsilosis: case report and literature review

INTRODUÇÃO: São raras as espondilodiscites fúngicas decorrentes de espécies do gênero Candida, sendo que até 2004 foram descritos menos de 75 casos. RELATO DECASO: Homem, 42 anos, com história de etilismo por 35 anos, foi admitido com quadro de dor em abdome inferior com irradiação para membros inferiores e fraqueza dos mesmos nos últimos 3 meses. Os achados do exame físico foram: atrofia muscular em região glútea, dor à mobilização da articulação coxo-femoral, lombalgia em níveis L4 e L5 e força muscular grau II de parte distal de membros inferiores. O paciente foi internado e introduziu-se empiracamente clindamicina e ciprofloxacina por suspeita de espondilodiscite, confirmada por meio do exame de Ressonância Magnética (RM). Após duas semanas o paciente começou a apresentar quadro de dor à inspiração. A radiografia e a tomografia de tórax mostraram quadro difuso multinodular em pulmão sugestivo de infecção fúngica ou tuberculose de apresentação atípica. A biópsia demonstrou granuloma com necrose central e a cultura Candida albicans. Após 1 mês deantibioticoterapia houve melhora da dor em abdome inferior e membros inferiores porém sem melhora radiológica. Foi então realizada punção aspirativa da massa lombar com cultura positiva para Candida parapsilosis, introduzindo-se Anfoterecina B. Cinco meses após uso contínuo desta droga houve melhora radiológica pulmonar e da coluna lombar, com remissão dos sintomas. DISCUSSÃO: O uso abusivo de álcool constitui um fator de risco para o desenvolvimento de espondilodiscite por espécies do gênero Candida, visto que teoricamente predispõe a ocorrência de infecções sistêmicas por organismos normalmente de baixa virulência. CONCLUSÃO: A espondilodiscite causada por Candida é um evento raro, mas deve ser suspeitada em pacientes com algum tipo de imunosupressão, como o etilismo grave.Introduction: Fungic Spondilodiscit decorrent of Candida generus species are rare, being less than 75 cases described until 2004. Case Report: Man, 42 years old, with 35 years history of alcohol abuse, was admitted with a lower abdomen pain with irradiation to inferior members and weakness of them in the past 3 months. The physical exam were: gluteus muscular atrophy, mobilization pain of the coxo-femoral articulation, L4 and L5 back pain and muscle strength grade II in the inferior member distal part. The patient was admitted and initiated clindamicin and ciprofloxacin with the suspect of spondilodiscit, confirmed by Magnetic Ressonance (RM). Two weeks latter the patient started a breathing pain. Chest radiography and computadorizated tomography shown a difuse multinodule pulmonary presentation suggestive of fungic infection or atypic tubercular presentation. Biopsy shown a granuloma with central necrosis and the culture Candida albicans. One month of antibioticotherapy there was an improvement of inferior abdomen pain and inferior members therefore without radiologic improvement. Aspirative biopsy of the lumbar mass was made with positive culture for parapsilosis candida, introducing Anfotericin B. Five months after the continuous use of these drug there were pulmonary and lumbar spine radiologic improvement with symptoms remission. Discussion: The abusive use of alcohol constitute a risk factor to the development of spondilodiscit of the Candida generus, considered that theorically improve predisposition for systemic infections by regular low virulency organisms. Conclusion: Spondilodisct caused by Cândida is a rare event, therefore must be suspected in patients with some kind of imunossupression, like severe etilism

Research on aging during the Venezuelan humanitarian crisis: the experience of the Maracaibo aging study

Background Venezuela is in the throes of a complex humanitarian crisis that is one of the worst in decades to impact any country outside of wartime. This case analysis describes the challenges faced by the ongoing Maracaibo Aging Study (MAS) during the deteriorating conditions in Venezuela. When the MAS began in 1997, it focused on memory-related disorders. Since then, strategic planning and proactive community participation allowed us to anticipate and address logistical, funding, and ethical challenges, and facilitated the enrollment and retention of more than 2500 subjects over 55 years of age. All participants, who are residents of the city of Maracaibo, Venezuela, underwent various assessments on several occasions. Here, we discuss how our approach to implementing a longitudinal, population-based study of age-related conditions has allowed our research program to continue throughout this period of political, economic, and social upheaval. Discussion As the social context in Venezuela became more complicated, new challenges emerged, and strategies to sustain the study and participation were refined. We identified five main mechanisms through which the evolving humanitarian crisis has affected implementation of the MAS: 1) community dynamics; 2) morale of researchers, staff, and participants; 3) financial feasibility; 4) components of the research process; and 5) impact on the health of staff, participants, and their families. Strategies to compensate for the impact on these components were implemented, based on inputs from community members and staff. Improved communication, greater involvement of stakeholders, broadening the scope of the project, and strengthening international collaboration have been the most useful strategies. Particular demands emerged, related to the increased mortality and comorbidities of participants and staff, and deterioration of basic services and safety. Conclusion Although the MAS has faced numerous obstacles, it has been possible to continue a longitudinal research project throughout the humanitarian crisis, because our research team has engaged the community deeply and developed a sense of mutual commitment, and also because our project has provided funding to help keep researchers employed, somewhat attenuating the brain drain

Contemporary Clinical and Molecular Epidemiology of Vancomycin-Resistant Enterococcal Bacteremia: A Prospective Multicenter Cohort Study (VENOUS I)

Background Vancomycin-resistant enterococci (VRE) are major therapeutic challenges. Prospective contemporary data characterizing the clinical and molecular epidemiology of VRE bloodstream infections (BSIs) are lacking. Methods The Vancomycin-Resistant Enterococcal BSI Outcomes Study (VENOUS I) is a prospective observational cohort of adult patients with enterococcal BSI in 11 US hospitals. We included patients with Enterococcus faecalis or Enterococcus faecium BSI with >= 1 follow-up blood culture(s) within 7 days and availability of isolate(s) for further characterization. The primary study outcome was in-hospital mortality. Secondary outcomes were mortality at days 4, 7, 10, 12, and 15 after index blood culture. A desirability of outcome ranking was constructed to assess the association of vancomycin resistance with outcomes. All index isolates were subjected to whole genome sequencing. Results Forty-two of 232 (18%) patients died in hospital and 39 (17%) exhibited microbiological failure (lack of clearance in the first 4 days). Neutropenia (hazard ratio [HR], 3.13), microbiological failure (HR, 2.4), VRE BSI (HR, 2.13), use of urinary catheter (HR, 1.85), and Pitt BSI score >= 2 (HR, 1.83) were significant predictors of in-hospital mortality. Microbiological failure was the strongest predictor of in-hospital mortality in patients with E faecium bacteremia (HR, 5.03). The impact of vancomycin resistance on mortality in our cohort changed throughout the course of hospitalization. Enterococcus faecalis sequence type 6 was a predominant multidrug-resistant lineage, whereas a heterogeneous genomic population of E faecium was identified. Conclusions Failure of early eradication of VRE from the bloodstream is a major factor associated with poor outcomes. Failure to eradicate enterococci from the bloodstream in the first 4 days after the index blood culture was the most consistent factor associated with increased risk of mortality. The association of vancomycin resistance with mortality changed throughout the course of the hospitalization

Hemodynamic responses in human multisensory and auditory association cortex to purely visual stimulation

BACKGROUND: Recent findings of a tight coupling between visual and auditory association cortices during multisensory perception in monkeys and humans raise the question whether consistent paired presentation of simple visual and auditory stimuli prompts conditioned responses in unimodal auditory regions or multimodal association cortex once visual stimuli are presented in isolation in a post-conditioning run. To address this issue fifteen healthy participants partook in a "silent" sparse temporal event-related fMRI study. In the first (visual control) habituation phase they were presented with briefly red flashing visual stimuli. In the second (auditory control) habituation phase they heard brief telephone ringing. In the third (conditioning) phase we coincidently presented the visual stimulus (CS) paired with the auditory stimulus (UCS). In the fourth phase participants either viewed flashes paired with the auditory stimulus (maintenance, CS-) or viewed the visual stimulus in isolation (extinction, CS+) according to a 5:10 partial reinforcement schedule. The participants had no other task than attending to the stimuli and indicating the end of each trial by pressing a button. RESULTS: During unpaired visual presentations (preceding and following the paired presentation) we observed significant brain responses beyond primary visual cortex in the bilateral posterior auditory association cortex (planum temporale, planum parietale) and in the right superior temporal sulcus whereas the primary auditory regions were not involved. By contrast, the activity in auditory core regions was markedly larger when participants were presented with auditory stimuli. CONCLUSION: These results demonstrate involvement of multisensory and auditory association areas in perception of unimodal visual stimulation which may reflect the instantaneous forming of multisensory associations and cannot be attributed to sensation of an auditory event. More importantly, we are able to show that brain responses in multisensory cortices do not necessarily emerge from associative learning but even occur spontaneously to simple visual stimulation

How does visual language affect crossmodal plasticity and cochlear implant success?

Cochlear implants (CI) are the most successful intervention for ameliorating hearing loss in severely or profoundly deaf children. Despite this, educational performance in children with CI continues to lag behind their hearing peers. From animal models and human neuroimaging studies it has been proposed the integrative functions of auditory cortex are compromised by crossmodal plasticity. This has been argued to result partly from the use of a visual language. Here we argue that 'cochlear implant sensitive periods' comprise both auditory and language sensitive periods, and thus cannot be fully described with animal models. Despite prevailing assumptions, there is no evidence to link the use of a visual language to poorer CI outcome. Crossmodal reorganisation of auditory cortex occurs regardless of compensatory strategies, such as sign language, used by the deaf person. In contrast, language deprivation during early sensitive periods has been repeatedly linked to poor language outcomes. Language sensitive periods have largely been ignored when considering variation in CI outcome, leading to ill-founded recommendations concerning visual language in CI habilitation