Speech intelligibility and prosody production in children with cochlear implants

Objectives—The purpose of the current study was to examine the relation between speech intelligibility and prosody production in children who use cochlear implants. Methods—The Beginner\u27s Intelligibility Test (BIT) and Prosodic Utterance Production (PUP) task were administered to 15 children who use cochlear implants and 10 children with normal hearing. Adult listeners with normal hearing judged the intelligibility of the words in the BIT sentences, identified the PUP sentences as one of four grammatical or emotional moods (i.e., declarative, interrogative, happy, or sad), and rated the PUP sentences according to how well they thought the child conveyed the designated mood. Results—Percent correct scores were higher for intelligibility than for prosody and higher for children with normal hearing than for children with cochlear implants. Declarative sentences were most readily identified and received the highest ratings by adult listeners; interrogative sentences were least readily identified and received the lowest ratings. Correlations between intelligibility and all mood identification and rating scores except declarative were not significant. Discussion—The findings suggest that the development of speech intelligibility progresses ahead of prosody in both children with cochlear implants and children with normal hearing; however, children with normal hearing still perform better than children with cochlear implants on measures of intelligibility and prosody even after accounting for hearing age. Problems with interrogative intonation may be related to more general restrictions on rising intonation, and th

More Social Needs Endorsed by Caregivers of Young Children Experiencing Everyday Discrimination

Background: Both discrimination and social needs are underlying risk factors for poor health outcomes; however, there are no studies looking at how feelings of discrimination impact reporting of social needs in the pediatric health care setting. Objective: To compare caregiver report of social needs and desire for help addressing social needs in the pediatric primary care setting based on respondents’ experiences with discrimination. Methods: We conducted a cross-sectional study of caregivers of children aged 2-5 in an urban primary care setting. Caregivers completed a tool to screen for 15 social needs and desire for help to address these needs, with in-person assistance available. The tool was adapted based on qualitative data with this same population and included items from the PHQ-2, 2-item food insecurity screener, and WE CARE survey. The short version of the “Everyday Discrimination Scale” was also completed, and caregivers were categorized as experiencing everyday discrimination if they responded “rarely”, “sometimes”, or “often” on any of 5 types of discrimination. If caregivers experienced everyday discrimination, they were also asked about perceived basis for discrimination. T-tests were conducted to compare the number of reported social needs and number of needs for which a caregiver desired help between groups based on experience of everyday discrimination and type of discrimination. Results: One hundred seventy-eight caregivers (94% mothers, mean age 32) of diverse racial and ethnic backgrounds (29% white, 61% black; 10% Hispanic) completed the screening tool. Sixty-seven percent had public insurance, and 35% were from households with an annual income below $20,000. Fifty-three percent of caregivers reported everyday discrimination, especially in regards to being treated with less respect and receiving poorer service in stores and restaurants (Figure 1) and most commonly on the basis of race (48%), gender (38%), and age (31%). Both caregivers who endorsed everyday discrimination in general, and those endorsing discrimination specifically by gender and age, reported a significantly higher number of social needs and number of social needs for which they wanted help (Table 1). Conclusions: In an urban population of mostly young Black mothers, the majority endorsed feeling some degree of everyday discrimination. Despite this, caregivers who endorsed feelings of discrimination, especially because of their gender and age, reported more social needs and a greater desire for help addressing these needs. This suggests that caregivers feel comfortable reporting sensitive social needs in the context of a child’s healthcare setting even though they may experience everyday discrimination. These findings may also suggest an association between experienced discrimination and social needs, with both potentially influenced by similar sociodemographic factors

Välkommen in i butiken

Under de senaste decennierna har det skett en expansion av butikskedjor i Sverige. Mindre butikskedjor har börjat etablera sig på marknaden och expanderat till fler städer, dock har de fått konkurrens från större butikskedjor som har etablerat sig i Sverige på senare tid. Alla butikskedjor erbjuder en uppsjö av utbud med kampanjer och rabatter samt andra erbjudanden för att kunna locka konsumenter till sina butiker. För kunden innebär detta att även utbudet av varor har blivit mycket större än förut eftersom kunden erbjuds fler produktval. Följaktligen har modebranschen blivit mer konkurrenskraftig på grund av framväxten av många alternativ inom detaljhandeln. Detta har skapat stora utmaningar för modebutiker för att locka nya och behålla befintliga kunder. Syftet med arbetet är att undersöka hur en butikschef arbetar i butiken för att skapa konkurrensfördelar gentemot andra butiker. Syftet ska bidra till en förståelse på hur en butikschef ser på sitt arbete och försöker arbeta med det. Vi vill få en ökad förståelse genom att undersöka hur mindre butikskedjor skapar konkurrensfördelar inom modebranschen. För att göra det tar vi reda på hur mindre butikskedjor använder olika strategier i butiken för att differentiera sig från konkurrenterna

Factors Affecting Speech Discrimination in Children with Cochlear Implants: Evidence from Early-Implanted Infants

Background To learn words and acquire language, children must be able to discriminate and correctly perceive phonemes. Although there has been much research on the general language outcomes of children with cochlear implants (CIs), little is known about the development of speech perception with regard to specific speech processes, such as speech discrimination. Purpose The purpose of this study was to investigate the development of speech discrimination in infants with CIs and identify factors that might correlate with speech discrimination skills. Research Design Using a Hybrid Visual Habituation procedure, we tested infants with CIs on their ability to discriminate the vowel contrast /i/-/u/. We also gathered demographic and audiological information about each infant. Study Sample Children who had received CIs before 2 yr of age served as participants. We tested the children at two post cochlear implantation intervals: 2–4 weeks post CI stimulation (N = 17) and 6–9 mo post CI stimulation (N = 10). Data Collection and Analysis The infants’ mean looking times during the novel versus old trials of the experiment were measured. A linear regression model was used to evaluate the relationship between the normalized looking time difference and the following variables: chronological age, age at CI stimulation, gender, communication mode, and best unaided pure-tone average. Results We found that the best unaided pure-tone average predicted speech discrimination at the early interval. In contrast to some previous speech perception studies that included children implanted before 3 yr of age, age at CI stimulation did not predict speech discrimination performance. Conclusions The results suggest that residual acoustic hearing before implantation might facilitate speech discrimination during the early period post cochlear implantation; with more hearing experience, communication mode might have a greater influence on the ability to discriminate speech. This and other studies on age at cochlear implantation suggest that earlier implantation might not have as large an effect on speech perception as it does on other language skills

THE INFLUENCE OF TRP53 IN THE DOSE RESPONSE OF RADIATIONINDUCED APOPTOSIS, DNA REPAIR AND GENOMIC STABILITY IN MURINE HAEMATOPOIETIC CELLS

Apoptotic and DNA damage endpoints are frequently used as surrogate markers of cancer risk, and have been well-studied in the Trp53+/- mouse model. We report the effect of differing Trp53 gene status on the dose response of ionizing radiation exposures (0.01- 2 Gy), with the unique perspective of determining if effects of gene status remain at extended time points. Here we report no difference in the dose response for radiationinduced DNA double-strand breaks in bone marrow and genomic instability (MN-RET levels) in peripheral blood, between wild-type (Trp53+/+) and heterozygous (Trp53+/-) mice. The dose response for Trp53+/+ mice showed higher initial levels of radiation-induced lymphocyte apoptosis relative to Trp53+/- between 0 and 1 Gy. Although this trend was observed up to 12 hours post-irradiation, both genotypes ultimately reached the same level of apoptosis at 14 hours, suggesting the importance of late-onset p53-independent apoptotic responses in this mouse model. Expected radiation-induced G1 cell cycle delay was observed in Trp53+/+ but not Trp53+/-. Although p53 has an important role in cancer risk, we have shown its influence on radiation dose response can be temporally variable. This research highlights the importance of caution when using haematopoietic endpoints as surrogates to extrapolate radiation-induced cancer risk estimation

Multifocal demyelinating motor neuropathy and hamartoma syndrome associated with a de novo PTEN mutation.

OBJECTIVE: To describe a patient with a multifocal demyelinating motor neuropathy with onset in childhood and a mutation in phosphatase and tensin homolog (PTEN), a tumor suppressor gene associated with inherited tumor susceptibility conditions, macrocephaly, autism, ataxia, tremor, and epilepsy. Functional implications of this protein have been investigated in Parkinson and Alzheimer diseases. METHODS: We performed whole-exome sequencing in the patient's genomic DNA validated by Sanger sequencing. Immunoblotting, in vitro enzymatic assay, and label-free shotgun proteomic profiling were performed in the patient's fibroblasts. RESULTS: The predominant clinical presentation of the patient was a childhood onset, asymmetric progressive multifocal motor neuropathy. In addition, he presented with macrocephaly, autism spectrum disorder, and skin hamartomas, considered as clinical criteria for PTEN-related hamartoma tumor syndrome. Extensive tumor screening did not detect any malignancies. We detected a novel de novo heterozygous c.269T>C, p.(Phe90Ser) PTEN variant, which was absent in both parents. The pathogenicity of the variant is supported by altered expression of several PTEN-associated proteins involved in tumorigenesis. Moreover, fibroblasts showed a defect in catalytic activity of PTEN against the secondary substrate, phosphatidylinositol 3,4-trisphosphate. In support of our findings, focal hypermyelination leading to peripheral neuropathy has been reported in PTEN-deficient mice. CONCLUSION: We describe a novel phenotype, PTEN-associated multifocal demyelinating motor neuropathy with a skin hamartoma syndrome. A similar mechanism may potentially underlie other forms of Charcot-Marie-Tooth disease with involvement of the phosphatidylinositol pathway

Understanding Social Needs of Families with Young Overweight Children in an Urban Primary Care Setting: A Mixed-Methods Study

Unmet social needs, such as stable housing, reliable access to food and treatment of parental depression are associated with childhood overweight. Little information exists on parental perception of addressing these needs. We sought to understand the perspective of parents of young overweight children on how to best address social needs in the primary care setting. We conducted a mixed-methods study. The 11-item WE CARE survey, PHQ-2, and 2-item food insecurity screener were used to screen for social needs. Semi-structured interviews were conducted with English-speaking parents of overweight (BMI ≥ 85%) children 2-5 years of age with Medicaid. Interviews assessed parental perception about addressing social needs in the primary care setting. Twenty-two parents participated. Parents responded positively to having a social need 46 times on the WE CARE survey, with the majority being in the areas of smoking cessation and employment. However, parents reported that they did not want to address the majority of these needs at the visit. Only 2 of 11 parents who screened positive for depression on the PHQ-2 endorsed wanting help to address mood, and only 1 in 10 who screened positive for food insecurity endorsed wanting help accessing food. Two salient themes arose during the interviews that influence asking for support: 1) level of comfort disclosing needs and 2) family resourcefulness and resiliency. Discomfort was associated with parental fear of being considered neglectful and involvement of child protective services. Though a majority of parents found the screener to be useful, they suggested reframing to highlight support available, emphasizing how resources may benefit the child. Screening tools may benefit from adaptation for families are uncomfortable asking for support or who are resourceful at meeting their needs. Emphasizing the non-punitive nature and providing information on resources upfront may promote resource utilization among this patient population

Assessing the virulence of Cryptococcus neoformans causing meningitis in HIV infected and uninfected patients in Vietnam.

We previously observed a substantial burden of cryptococcal meningitis in Vietnam atypically arising in individuals who are uninfected with human immunodeficiency virus (HIV). This disease was associated with a single genotype of Cryptococcus neoformans (sequence type [ST]5), which was significantly less common in HIV-infected individuals. Aiming to compare the phenotypic characteristics of ST5 and non-ST5 C. neoformans, we selected 30 representative Vietnamese isolates and compared their in vitro pathogenic potential and in vivo virulence. ST5 and non-ST5 organisms exhibited comparable characteristics with respect to in vitro virulence markers including melanin production, replication at 37°C, and growth in cerebrospinal fluid. However, the ST5 isolates had significantly increased variability in cellular and capsular sizing compared with non-ST5 organisms (P < .001). Counterintuitively, mice infected with ST5 isolates had significantly longer survival with lower fungal burdens at day 7 than non-ST5 isolates. Notably, ST5 isolates induced significantly greater initial inflammatory responses than non-ST5 strains, measured by TNF-α concentrations (P < .001). Despite being generally less virulent in the mouse model, we hypothesize that the significant within strain variation seen in ST5 isolates in the tested phenotypes may represent an evolutionary advantage enabling adaptation to novel niches including apparently immunocompetent human hosts

The Solar Neighborhood XXIII CCD Photometric Distance Estimates of SCR Targets -- 77 M Dwarf Systems within 25 Parsecs

We present CCD photometric distance estimates of 100 SCR (SuperCOSMOS RECONS) systems with $\mu$ $\geq$ 0\farcs18/yr, 28 of which are new discoveries previously unpublished in this series of papers. These distances are estimated using a combination of new $VRI$ photometry acquired at CTIO and $JHK$ magnitudes extracted from 2MASS. The estimates are improvements over those determined using photographic plate $BRI$ magnitudes from SuperCOSMOS plus $JHK$, as presented in the original discovery papers. In total, 77 of the 100 systems investigated are predicted to be within 25 pc. If all 77 systems are confirmed to have $\pi$$_{trig}$ $\ge$ 40 milliarcseconds, this sample would represent a 23% increase in M dwarf systems nearer than 25 pc in the southern sky.Comment: 34 pages, 8 figure

Principal role of adenylyl cyclase 6 in K+ channel regulation and vasodilator signalling in vascular smooth muscle cells

AIMS: Membrane potential is a key determinant of vascular tone and many vasodilators act through the modulation of ion channel currents [e.g. the ATP-sensitive potassium channel (K(ATP))] involved in setting the membrane potential. Adenylyl cyclase (AC) isoenzymes are potentially important intermediaries in such vasodilator signalling pathways. Vascular smooth muscle cells (VSMCs) express multiple AC isoenzymes, but the reason for such redundancy is unknown. We investigated which of these isoenzymes are involved in vasodilator signalling and regulation of vascular ion channels important in modulating membrane potential. METHODS AND RESULTS: AC isoenzymes were selectively depleted (by >75%) by transfection of cultured VSMCs with selective short interfering RNA sequences. AC6 was the predominant isoenzyme involved in vasodilator-mediated cAMP accumulation in VSMCs, accounting for ∼60% of the total response to β-adrenoceptor (β-AR) stimulation. AC3 played a minor role in β-AR signalling, whereas AC5 made no significant contribution. AC6 was also the principal isoenzyme involved in β-AR-mediated protein kinase A (PKA) signalling (determined using the fluorescent biosensor for PKA activity, AKAR3) and the substantial β-AR/PKA-dependent enhancement of K(ATP) current. K(ATP) current was shown to play a vital role in setting the resting membrane potential and in mediating the hyperpolarization observed upon β-AR stimulation. CONCLUSION: AC6, but not the closely related AC5, plays a principal role in vasodilator signalling and regulation of the membrane potential in VSMCs. These findings identify AC6 as a vital component in the vasodilatory apparatus central to the control of blood pressure