The ASL-CDI 2.0: an updated, normed adaptation of the MacArthur Bates Communicative Development Inventory for American Sign Language

Vocabulary is a critical early marker of language development. The MacArthur Bates Communicative Development Inventory has been adapted to dozens of languages, and provides a bird’s-eye view of children’s early vocabularies which can be informative for both research and clinical purposes. We present an update to the American Sign Language Communicative Development Inventory (the ASL-CDI 2.0, https://www.aslcdi.org), a normed assessment of early ASL vocabulary that can be widely administered online by individuals with no formal training in sign language linguistics. The ASL-CDI 2.0 includes receptive and expressive vocabulary, and a Gestures and Phrases section; it also introduces an online interface that presents ASL signs as videos. We validated the ASL-CDI 2.0 with expressive and receptive in-person tasks administered to a subset of participants. The norming sample presented here consists of 120 deaf children (ages 9 to 73 months) with deaf parents. We present an analysis of the measurement properties of the ASL-CDI 2.0. Vocabulary increases with age, as expected. We see an early noun bias that shifts with age, and a lag between receptive and expressive vocabulary. We present these findings with indications for how the ASL-CDI 2.0 may be used in a range of clinical and research settingsAccepted manuscrip

The development and evaluation of a new ASL text comprehension task

Being able to comprehend a language entails not only mastery of its syntax, lexicon, or phonology, but also the ability to use language to construct meaning, draw inferences, and make connections to world knowledge. However, most available assessments of American Sign Language (ASL) focus on mastery of lower level skills, and as a result little is known about development of higher-order ASL comprehension skills. In this paper, we introduce the American Sign Language Text Comprehension Task (ASL-CMP), a new assessment tool to measure ASL text comprehension ability in deaf children. We first administered the task to a group of deaf children with deaf parents (n = 105, ages 8–18 years) in order to evaluate the reliability and validity of the task, and to develop norms. We found that the ASL-CMP has acceptable levels of internal consistency, difficulty, and discriminability. Next, we administered the task to an additional group of deaf children with hearing parents (n = 251, ages 8–18 years), and found that the ASL-CMP is sensitive to expected patterns: older children have better ASL text comprehension skills, literal questions are generally easier to answer than inferential questions, and children with early exposure to ASL generally outperform those with delayed exposure. We conclude that the ASL-CMP task is reliable and valid and can be used to characterize ASL text comprehension skills in deaf children.https://doi.org/10.3389/fcomm.2020.00025Published versio

Toddlers' word learning through overhearing: others' attention matters.

In laboratory settings children are able to learn new words from overheard interactions, yet in naturalistic contexts this is often not the case. We investigated the degree to which joint attention within the overheard interaction facilitates overheard learning. In the study, 20 2-year-olds were tested on novel words they had been exposed to in two different overhearing contexts: one in which both interlocutors were attending to the interaction and one in which one interlocutor was not attending. Participants learned the new words only in the former condition, indicating that they did not learn when joint attention was absent. This finding demonstrates that not all overheard interactions are equally good for word learning; attentive interlocutors are crucial when learning words through overhearing.R01 DC015272 - NIDCD NIH HHS; T32 DC013017 - NIDCD NIH HHSAccepted manuscript2021-06-0

How U.S. Ocean Policy and Market Power Can Reform the Coral Reef Wildlife Trade

As the world’s largest importer of marine ornamental species for the aquaria, curio, home décor, and jewelry industries, the United States has an opportunity to leverage its considerable market power to promote more sustainable trade and reduce the effects of ornamental trade stress on coral reefs worldwide. Evidence indicates that collection of some coral reef animals for these trades has caused virtual elimination of local populations, major changes in age structure, and promotion of collection practices that destroy reef habitats. Management and enforcement of collection activities in major source countries such as Indonesia and the Philippines remain weak. Strengthening US trade laws and enforcement capabilities combined with increasing consumer and industry demand for responsible conservation can create strong incentives for improving management in source countries. This is particularly important in light of the March 2010 failure of the parties to the Convention on International Trade in Endangered Species (CITES) to take action on key groups of corals

Effectiveness and Cost-Effectiveness of Colorectal Cancer Screening With a Blood Test That Meets the Centers for Medicare & Medicaid Services Coverage Decision

Background &amp; Aims: A blood-based colorectal cancer (CRC) screening test may increase screening participation. However, blood tests may be less effective than current guideline-endorsed options. The Centers for Medicare &amp; Medicaid Services (CMS) covers blood tests with sensitivity of at least 74% for detection of CRC and specificity of at least 90%. In this study, we investigate whether a blood test that meets these criteria is cost-effective. Methods: Three microsimulation models for CRC (MISCAN-Colon, CRC-SPIN, and SimCRC) were used to estimate the effectiveness and cost-effectiveness of triennial blood-based screening (from ages 45 to 75 years) compared to no screening, annual fecal immunochemical testing (FIT), triennial stool DNA testing combined with an FIT assay, and colonoscopy screening every 10 years. The CMS coverage criteria were used as performance characteristics of the hypothetical blood test. We varied screening ages, test performance characteristics, and screening uptake in a sensitivity analysis. Results: Without screening, the models predicted 77–88 CRC cases and 32–36 CRC deaths per 1000 individuals, costing $5.3–$5.8 million. Compared to no screening, blood-based screening was cost-effective, with an additional cost of $25,600–$43,700 per quality-adjusted life-year gained (QALYG). However, compared to FIT, triennial stool DNA testing combined with FIT, and colonoscopy, blood-based screening was not cost-effective, with both a decrease in QALYG and an increase in costs. FIT remained more effective (+5–24 QALYG) and less costly (–$3.2 to –$3.5 million) than blood-based screening even when uptake of blood-based screening was 20 percentage points higher than uptake of FIT. Conclusion: Even with higher screening uptake, triennial blood-based screening, with the CMS-specified minimum performance sensitivity of 74% and specificity of 90%, was not projected to be cost-effective compared with established strategies for colorectal cancer screening.</p

IL-22 Production Is Regulated by IL-23 During Listeria monocytogenes Infection but Is Not Required for Bacterial Clearance or Tissue Protection

Listeria monocytogenes (LM) is a gram-positive bacterium that is a common contaminant of processed meats and dairy products. In humans, ingestion of LM can result in intracellular infection of the spleen and liver, which can ultimately lead to septicemia, meningitis, and spontaneous abortion. Interleukin (IL)-23 is a cytokine that regulates innate and adaptive immune responses by inducing the production of IL-17A, IL-17F, and IL-22. We have recently demonstrated that the IL-23/IL-17 axis is required for optimal recruitment of neutrophils to the liver, but not the spleen, during LM infection. Furthermore, these cytokines are required for the clearance of LM during systemic infection. In other infectious models, IL-22 induces the secretion of anti-microbial peptides and protects tissues from damage by preventing apoptosis. However, the role of IL-22 has not been thoroughly investigated during LM infection. In the present study, we show that LM induces the production of IL-22 in vivo. Interestingly, IL-23 is required for the production of IL-22 during primary, but not secondary, LM infection. Our findings suggest that IL-22 is not required for clearance of LM during primary or secondary infection, using both systemic and mucosal models of infection. IL-22 is also not required for the protection of LM infected spleens and livers from organ damage. Collectively, these data indicate that IL-22 produced during LM infection must play a role other than clearance of LM or protection of tissues from pathogen- or immune-mediated damage

EQUIP: Implementing chronic care principles and applying formative evaluation methods to improve care for schizophrenia: QUERI Series

<p>Abstract</p> <p>Background</p> <p>This paper presents a case study that demonstrates the evolution of a project entitled "Enhancing QUality-of-care In Psychosis" (EQUIP) that began approximately when the U.S. Department of Veterans Affairs' Quality Enhancement Research Initiative (QUERI), and implementation science were emerging. EQUIP developed methods and tools to implement chronic illness care principles in the treatment of schizophrenia, and evaluated this implementation using a small-scale controlled trial. The next iteration of the project, EQUIP-2, was further informed by implementation science and the use of QUERI tools.</p> <p>Methods</p> <p>This paper reports the background, development, results and implications of EQUIP, and also describes ongoing work in the second phase of the project (EQUIP-2). The EQUIP intervention uses implementation strategies and tools to increase the adoption and implementation of chronic illness care principles. In EQUIP-2, these strategies and tools are conceptually grounded in a stages-of-change model, and include clinical and delivery system interventions and adoption/implementation tools. Formative evaluation occurs in conjunction with the intervention, and includes developmental, progress-focused, implementation-focused, and interpretive evaluation.</p> <p>Results</p> <p>Evaluation of EQUIP provided an understanding of quality gaps <it>and </it>how to address related problems in schizophrenia. EQUIP showed that solutions to quality problems in schizophrenia differ by treatment domain and are exacerbated by a lack of awareness of evidence-based practices. EQUIP also showed that improving care requires creating resources for physicians to help them easily implement practice changes, plus intensive education as well as product champions who help physicians use these resources. Organizational changes, such as the addition of care managers and informatics systems, were shown to help physicians with identifying problems, making referrals, and monitoring follow-up. In EQUIP-2, which is currently in progress, these initial findings were used to develop a more comprehensive approach to implementing and evaluating the chronic illness care model.</p> <p>Discussion</p> <p>In QUERI, small-scale projects contribute to the development and enhancement of hands-on, action-oriented service-directed projects that are grounded in current implementation science. This project supports the concept that QUERI tools can be useful in implementing complex care models oriented toward evidence-based improvement of clinical care.</p

HLA Alleles Associated with Delayed Progression to AIDS Contribute Strongly to the Initial CD8(+) T Cell Response against HIV-1

BACKGROUND: Very little is known about the immunodominance patterns of HIV-1-specific T cell responses during primary HIV-1 infection and the reasons for human lymphocyte antigen (HLA) modulation of disease progression. METHODS AND FINDINGS: In a cohort of 104 individuals with primary HIV-1 infection, we demonstrate that a subset of CD8(+) T cell epitopes within HIV-1 are consistently targeted early after infection, while other epitopes subsequently targeted through the same HLA class I alleles are rarely recognized. Certain HLA alleles consistently contributed more than others to the total virus-specific CD8(+) T cell response during primary infection, and also reduced the absolute magnitude of responses restricted by other alleles if coexpressed in the same individual, consistent with immunodomination. Furthermore, individual HLA class I alleles that have been associated with slower HIV-1 disease progression contributed strongly to the total HIV-1-specific CD8(+) T cell response during primary infection. CONCLUSIONS: These data demonstrate consistent immunodominance patterns of HIV-1-specific CD8(+) T cell responses during primary infection and provide a mechanistic explanation for the protective effect of specific HLA class I alleles on HIV-1 disease progression